Departments of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Cornea and Refractive Surgery, Katzen, Eye Group, Baltimore, MD, USA.
Indian J Ophthalmol. 2021 Dec;69(12):3648-3650. doi: 10.4103/ijo.IJO_1069_21.
To analyze the impact of the pandemic on trends in cataract surgical volume in 2020 in a high-volume tertiary care academic center in North India.
The monthly cataract surgical volume for a large, high-volume, tertiary care academic center in North India was obtained from January 2018 through December 2020. Based on historical trends, we used time-series forecasting, probability sensitivity analysis, and linear regression models to estimate what the expected monthly cataract volume should have been from March 2020 onward.
In 2020, we expected to perform 7500 cases (assuming historical trends) but performed only 2500 cases (33% of the expected volume). The remaining 5000 cases (67% cases) constituted the "fixed" backlog. Assuming the ramp-up in cataract surgical volume starts in January 2021, results of the Monte Carlo simulation revealed that for our system, it would take on average 5 months (May 2021) under the optimistic scenario and 10 months (October 2021) under the ambivalent scenario to reach pre-pandemic expected surgical volume. There would be a collective backlog of 5500 cases under the optimistic scenario (8.8 months' worth of cases) and a collective backlog of 6900 cases under the ambivalent scenario (11 months' worth of cases).
An intuitive approach and out-of-the-box solutions are required by the government and private institutes' collaborative efforts to help mitigate the disruptions caused by the pandemic and lessen the backlog without causing provider burnout.
分析 2020 年印度北部一家高容量三级保健学术中心大流行对白内障手术量趋势的影响。
从 2018 年 1 月至 2020 年 12 月，获取印度北部一家大型、大容量三级保健学术中心的每月白内障手术量。根据历史趋势，我们使用时间序列预测、概率敏感性分析和线性回归模型来估计从 2020 年 3 月起每月白内障手术量应该是多少。
2020 年，我们预计要进行 7500 例手术（假设历史趋势），但只进行了 2500 例（预期量的 33%）。剩下的 5000 例（67%的病例）构成了“固定”积压。假设白内障手术量的增加从 2021 年 1 月开始，蒙特卡罗模拟的结果表明，对于我们的系统，在乐观情况下平均需要 5 个月（2021 年 5 月），在矛盾情况下需要 10 个月（2021 年 10 月）才能达到大流行前的预期手术量。在乐观情况下，将会有 5500 例的累计积压（8.8 个月的病例），在矛盾情况下，将会有 6900 例的累计积压（11 个月的病例）。
政府和私立机构需要合作，采取直观的方法和非常规的解决方案，以帮助减轻大流行造成的干扰，并减少积压，而不会导致提供者疲惫不堪。
