COVID-19 疫情对日本骨科手术数量的影响。
The influence of COVID-19 epidemic on the number of orthopaedic surgeries in Japan.
机构信息
Department of Orthopaedic Surgery, Nakanoshima Orthopaedics, Kanagawa, Japan.
Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan.
出版信息
J Orthop Sci. 2024 Sep;29(5):1319-1328. doi: 10.1016/j.jos.2023.08.016. Epub 2023 Oct 19.
BACKGROUND
There is limited data on the impact of COVID-19 epidemic on the number of orthopaedic surgeries in Japan.
METHODS
We conducted a nationwide hospital survey asking for the monthly number of orthopaedic surgeries performed at each facility from January 2019 to June 2021. Those facilities that had performed at least 100 surgeries in 2019 were included for analyses. The facilities were further grouped by prefecture and by hospital characteristics. A brief health economic evaluation was also performed. Risk ratios were compared using univariate analyses with P < 0.05 considered statistically significant.
RESULTS
Questionnaire was sent to 1988 hospitals with 1671 hospitals (84%) responding. The survey data indicated a total number of orthopaedic surgeries decreased in 2020 compared to 2019 (1,061,541 vs 1,119,955 P < 0.01), and also for the first six months of 2021 compared to the same period in 2019 (530,388 vs 550,378 P < 0.01). In 2020, over 50% of all facilities in nearly all of the prefectures saw a decline in surgical procedures. The risk of incurring more than a 25% decease in the number of surgeries was significantly higher in 2020 for class I designated medical institutions compared to those that were not designated for any types of infectious diseases among the institutions with a tertiary emergency medical center in 2020 (crude risk ratio 2.9: 95% CI 1.2-7.4, p = 0.02) and in 2021 (crude risk ratio 4.7: 95% CI 1 0.9-12.1, p < 0.01). The estimated total nationwide decrease of revenue were in the range of approximately ¥29.2 to ¥116.8 billion per year for orthopaedic surgeries alone.
CONCLUSION
There was a statistically significant decrease in the number of orthopaedic surgeries in Japan. The magnitude of the decline varied by prefectures and hospital characteristics, with the greater impact imposed on medical institutions with higher classification functions. The estimated immediate health economic impact was sizable.
背景
关于 COVID-19 疫情对日本骨科手术数量的影响，数据有限。
方法
我们进行了一项全国范围的医院调查，要求每家医院提供 2019 年 1 月至 2021 年 6 月期间每月进行的骨科手术数量。对 2019 年至少进行了 100 例手术的医院进行了分析。根据所在地区和医院特点对医院进行了分组。还进行了简要的健康经济评估。使用单变量分析比较风险比，P 值<0.05 被认为具有统计学意义。
结果
向 1988 家医院发出了问卷，其中 1671 家（84%）做出了回应。调查数据显示，与 2019 年相比，2020 年骨科手术总数减少（1061541 例比 1119955 例，P<0.01），与 2019 年同期相比，2021 年前六个月也有所减少（530388 例比 550378 例，P<0.01）。2020 年，几乎所有地区的 50%以上的医院手术量都有所下降。与 2020 年未指定任何传染病类型的医疗机构相比，2020 年被指定为 I 类传染病指定医疗机构的机构中，手术数量减少超过 25%的风险显著更高（未调整风险比 2.9：95%置信区间 1.2-7.4，p=0.02），2021 年也更高（未调整风险比 4.7：95%置信区间 1.0-12.1，p<0.01）。仅骨科手术一项，全国范围内的收入估计减少额在每年约 2920 亿至 11680 亿日元之间。
结论
日本骨科手术数量呈显著下降趋势。下降幅度因地区和医院特点而异，对分类功能较高的医疗机构影响更大。估计的直接健康经济影响相当大。
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