Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia.
MHA, King Fahad Medical City, Riyadh, Saudi Arabia.
PLoS One. 2023 May 11;18(5):e0285616. doi: 10.1371/journal.pone.0285616. eCollection 2023.
The coronavirus disease (COVID-19) disrupted healthcare systems and medical care worldwide. This study attempts to assess the performance of three Saudi hospitals during COVID-19 by comparing waiting times for outpatient appointments and the volume of elective surgeries before and after COVID-19.
We used ADA'A data collected from three Saudi hospitals for this retrospective cohort study. The outcome variables were "Waiting Time for Appointment" and "Elective OR Utilization". The hospitals included in this study were: a 300-bed maternity and children's hospital; a 643-bed general hospital; and a 1230-bed tertiary hospital. We included all patients who visited the OPD and OR in the time period from September 2019 to December 2021. A two-way ANOVA test was used to examine the differences in the outcome variables by hospital and by the phase of COVID-19.
For the elective OR utilization rate, the results showed that both the hospital and the phase of COVID-19 were significantly different (p-value < 0.05). On average, the elective OR utilization rate dipped considerably in the early phase of COVID-19 (33.2% vs 44.9%) and jumped sharply in the later phase (50.3%). The results showed that the waiting time for OPD appointment was significantly different across hospitals and before and after COVID-19 in each hospital (p-value < 0.05). the waiting time dropped during the early phase of COVID-19 for both the general hospital (GEN) (24.6 days vs 34.8 days) and the tertiary hospital (MDC) (40.3 days vs 48.6 days), while the maternity and children's hospital (MCH)'s score deteriorated sharply (24.6 days vs 9.5 days).
This study indicates that COVID-19 led to a significant impact on elective surgery rates and waiting time for OPD appointments in the early stage of the pandemic when the lockdown strategy was implemented in the country. Although the elective surgery rate had decreased at the designated COVID-hospital, the waiting time for OPD appointment had improved. This is a clear indication that the careful planning and management of resources for essential services during pandemic was effective.
冠状病毒病（COVID-19）扰乱了全球的医疗保健系统和医疗服务。本研究试图通过比较 COVID-19 前后门诊预约的等待时间和择期手术量，来评估沙特的三家医院的表现。
我们使用 ADA'A 数据进行了这项回顾性队列研究，该数据来自沙特的三家医院。结果变量是“预约等待时间”和“择期手术室利用率”。纳入本研究的医院有：一家拥有 300 张床位的妇产儿童医院；一家拥有 643 张床位的综合医院；以及一家拥有 1230 张床位的三级医院。我们纳入了 2019 年 9 月至 2021 年 12 月期间在 OPD 和 OR 就诊的所有患者。采用双向方差分析检验医院和 COVID-19 阶段对结果变量的差异。
择期手术室利用率方面，结果表明医院和 COVID-19 阶段均有显著差异（p 值<0.05）。平均而言，COVID-19 早期择期手术室利用率明显下降（33.2%比 44.9%），后期急剧上升（50.3%）。结果表明，门诊预约的等待时间在医院之间以及每家医院在 COVID-19 前后均有显著差异（p 值<0.05）。COVID-19 早期，综合医院（GEN）（24.6 天比 34.8 天）和三级医院（MDC）（40.3 天比 48.6 天）的等待时间下降，而妇产儿童医院（MCH）的分数则急剧恶化（24.6 天比 9.5 天）。
本研究表明，COVID-19 在该国实施封锁策略的大流行早期阶段，对择期手术率和门诊预约的等待时间产生了重大影响。尽管指定的 COVID-19 医院的择期手术率有所下降，但门诊预约的等待时间有所改善。这清楚地表明，在大流行期间对基本服务资源进行精心规划和管理是有效的。
