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COVID-19 疫情对智利膝关节置换手术的影响:基于全国注册登记的横断面研究分析。

Impact of COVID-19 outbreak in knee arthroplasty in Chile: a cross-sectional, national registry-based analysis.

机构信息

Departamento de Ortopedia y Traumatología, Universidad de Chile, Santiago, Chile. Address: Carlos Lorca Tobar 999, Santiago, Chile. Email:

Departamento de Ortopedia y Traumatología, Universidad de Chile, Santiago, Chile. ORCID: 0000-0002-8541-0839.

出版信息

Medwave. 2022 May 12;22(4):e8731. doi: 10.5867/medwave.2022.04.002511.

Abstract

INTRODUCTION

The need for beds and health personnel to treat coronavirus (COVID- 19) patients has led to the suspension of many elective sur-geries in Chile, including knee arthroplasties. This study aims to determine the incidence of knee arthroplasty in 2020, reflecting the effect of the COVID- 19 pandemic, and estimate the cost and time it would take to recover the waiting list prior to March 2020.

METHODS

A cross- sectional study was designed. We analyzed databases from The Department of Statistics and Health Information databases from Chile for 2019 and 2020, identifying patients with surgical discharges associated with knee arthroplasty codes. We estimated the time it would take to recover the surgeries unperformed in 2020 by simulating a monthly workload increase from the 2019 baseline. The costs of knee arthroplasty paid by the National Health Fund to institutions were estimated by diagnosis-related groups.

RESULTS

We found that the incidence rate of knee arthroplasty in 2020 decreased by 64% compared with 2019. The impact was higher in the public system (68%) and the National Health Found (63%). A simulated increase in knee arthroplasty productivity by 30% would allow recovering the postponed knee arthroplasty surgeries in 27 months, at a monthly cost to the public system of 318 million Chilean pesos (378 thousand US dollars).

CONCLUSIONS

The incidence rate of knee arthroplasty during 2020 decreased by 64%, revealing the extensive waiting line for people with knee osteoarthritis. An increase between 20- 40% in productivity compared with 2019 would allow recovering the unperformed surgeries in 20 to 41 months, at a monthly cost to the public network between 210 and 425 million Chilean pesos (250 to 506 thousand US dollars).

摘要

引言

为了治疗冠状病毒(COVID-19)患者,需要病床和医务人员,这导致智利暂停了许多择期手术,包括膝关节置换术。本研究旨在确定 2020 年膝关节置换术的发病率,反映 COVID-19 大流行的影响,并估计在 2020 年 3 月之前恢复术前等待名单所需的成本和时间。

方法

设计了一项横断面研究。我们分析了智利统计和卫生信息部门 2019 年和 2020 年的数据库,确定了与膝关节置换术代码相关的手术出院患者。我们通过模拟 2019 年基线每月工作量的增加来估计 2020 年未完成手术所需的时间。通过诊断相关组来估计国家卫生基金向机构支付的膝关节置换术费用。

结果

我们发现,与 2019 年相比,2020 年膝关节置换术的发病率下降了 64%。公共系统(68%)和国家卫生基金(63%)的影响更大。膝关节置换术生产率提高 30%的模拟增加将允许在 27 个月内恢复推迟的膝关节置换术,公共系统每月的成本为 3.18 亿智利比索(37.8 万美元)。

结论

2020 年膝关节置换术的发病率下降了 64%,这表明膝关节骨关节炎患者的等待名单很长。与 2019 年相比,生产率提高 20-40%将允许在 20-41 个月内恢复未完成的手术,公共网络每月的成本在 2.10-4.25 亿智利比索(250-506 万美元)之间。

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