Lee Mu Ha, Park Hye Ran, Chang Jae Chil, Park Hyung Ki, Lee Gwang Soo
Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
Department of Neurosurgery, Soonchunhyang University Gumi Hospital, Gumi, Korea.
J Korean Neurosurg Soc. 2022 Sep;65(5):741-750. doi: 10.3340/jkns.2022.0087. Epub 2022 Jul 1.
In March 2020, World Health Organization declared a global pandemic caused by a novel coronavirus (SARS-CoV-2). The disease caused by this virus is called COVID-19. Due to its high contagiousness, many changes have occurred in overall areas of our daily life including hospital use by patients. The aim of this study was to investigate the impact of COVID-19 on volume of spine surgery in South Korea using the National Health Insurance database and compare it with the volume of a homologous period before the pandemic.
Data of related to spine surgery from January 2019 to April 2021 were obtained from the National Health Insurance and Health Insurance Review and Assessment Service database. Primary outcomes were total number of patients, rate of patients per 100000 population, and total number of procedures. The number of patients by hospital size was also analyzed.
COVID-19 outbreaks occurred in South Korea in March, August, and December of 2020. Compared to the previous year, the total number of patients who underwent spinal surgery showed a decrease for 2-3 months after the first and second outbreaks. However, it showed an increasing trend after the third outbreak. The same pattern was observed in terms of the ratio of the number of patients per 100000 population. Between 2019 and 2021, the mean number of spine surgeries per month tended to increase. Mean annual medical expenses increased over the years (p=0.001). When the number of spine surgeries was analyzed by hospital size, proportion of tertiary general hospital in 2021 increased compared to those in 2019 and 2020 (vs. 2019, p=0.012; vs. 2020, p=0.016). The proportion of general hospital was significantly decreased in 2020 compared to that in 2019 (p=0.037).
After the COVID-19 outbreak, patients tended to postpone spinal surgery temporarily. The number of spinal surgeries decreased for 2-3 months after the first and second outbreaks. However, as the ability to respond to the COVID-19 pandemic at the hospital and society-wide level gradually increased, the number of spine surgeries did not decrease after the third outbreak in December 2020. In addition, the annual number of spine surgeries continued to increase. However, it should be noted that patients tend to be increasingly concentrated in tertiary hospitals for spinal surgery.
2020年3月，世界卫生组织宣布由新型冠状病毒（SARS-CoV-2）引发全球大流行。该病毒所致疾病名为COVID-19。因其高传染性，我们日常生活的各个方面都发生了诸多变化，包括患者对医院的使用情况。本研究旨在利用国家健康保险数据库调查COVID-19对韩国脊柱手术量的影响，并将其与疫情前同期的手术量进行比较。
从国家健康保险及健康保险审查与评估服务数据库获取2019年1月至2021年4月与脊柱手术相关的数据。主要结果指标为患者总数、每10万人口的患者率以及手术总数。还分析了不同规模医院的患者数量。
韩国在2020年3月、8月和12月出现了COVID-19疫情。与上一年相比，首次和第二次疫情爆发后的2至3个月内，接受脊柱手术的患者总数有所下降。然而，第三次疫情爆发后呈上升趋势。每10万人口的患者数量比例也呈现相同模式。2019年至2021年，每月脊柱手术的平均数量呈上升趋势。多年来平均年度医疗费用有所增加（p = 0.001）。按医院规模分析脊柱手术数量时，2021年三级综合医院的比例相较于2019年和2020年有所增加（与2019年相比，p = 0.012；与2020年相比，p = 0.016）。2020年综合医院的比例相较于2019年显著下降（p = 0.037）。
COVID-19疫情爆发后，患者倾向于暂时推迟脊柱手术。首次和第二次疫情爆发后的2至3个月内，脊柱手术数量减少。然而，随着医院和全社会应对COVID-19大流行的能力逐渐增强，2020年12月第三次疫情爆发后脊柱手术数量并未减少。此外，脊柱手术的年度数量持续增加。然而，应注意到脊柱手术患者越来越倾向于集中在三级医院。
