Topolewski Paweł, Szplit Dariusz, Kobiela Jarek, Łaski Dariusz, Stepaniak Pieter, Stefaniak Tomasz J
Division Of Quality in Healthcare, Medical University of Gdańsk, Gdańsk, POL.
Department of Innovation and Clinical Processes Analysis, University Clinical Center of Medical University of Gdańsk, Gdańsk, POL.
Cureus. 2024 Nov 22;16(11):e74205. doi: 10.7759/cureus.74205. eCollection 2024 Nov.
With the emergence of the global pandemic caused by SARS-CoV-2, health service providers were put to the test. The utilization of operating theatres is one of the prime indicators of the logistic and organizational efficacy of a hospital. We performed an analysis evaluating the impact of the COVID-19 pandemic on the fluidity of providing surgical care to a patient with severe comorbidities and the organizational efficacy of the operating theater in a university hospital in northern Poland.
Casemix between the periods was tested and Fisher's test was used to examine the significance of the association between (i) patient, (ii) workup, (iii) resource/facility, and (iv) bed-related causes of day-of-surgery cancellations in pre- and post-COVID-19 pandemic periods and early- and medium-COVID-19 pandemic periods.
In the study period, a total of 1,935 elective surgeries were booked, 2,219 elective and emergency surgeries were performed, and there were 203 (10.5%) cancellations. Patient-related cancellations increased significantly during the COVID-19 pandemic, accounting for 18.8% of cancellations, compared to 5.1% in pre- and post-pandemic periods ( = 0.0115). Resource/facility-related reasons remained the most frequent cause, contributing to 57.3% of cancellations during the pandemic.
Patient-related causes were the most frequent reasons in the COVID-19 pandemic period. Furthermore, patient-related reasons may have contributed to a drop in demand for surgical care and a nonsignificant change in the correlation between demand and supply for surgical care. The further effects of the COVID-19 pandemic on surgical department work are yet to be observed and should be reported to find a solution for growing societies' need for surgical care and find tools to minimize the "damage" caused by the next crisis in global healthcare.
随着严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引发的全球大流行的出现，医疗服务提供者面临考验。手术室的利用率是医院后勤和组织效率的主要指标之一。我们进行了一项分析，评估2019冠状病毒病大流行对为患有严重合并症的患者提供手术护理的流畅性以及波兰北部一家大学医院手术室的组织效率的影响。
对不同时期的病例组合进行测试，并使用费舍尔检验来检验在2019冠状病毒病大流行前和大流行后时期以及2019冠状病毒病大流行早期和中期，（i）患者、（ii）检查、（iii）资源/设施和（iv）与床位相关的手术日取消原因之间关联的显著性。
在研究期间，共预约了1935例择期手术，进行了2219例择期和急诊手术，有203例（10.5%）取消。在2019冠状病毒病大流行期间，与患者相关的取消显著增加，占取消病例的18.8%，而在大流行前和大流行后时期为5.1%（P = 0.0115）。与资源/设施相关的原因仍然是最常见的原因，在大流行期间占取消病例的57.3%。
在2019冠状病毒病大流行期间，与患者相关的原因是最常见的原因。此外，与患者相关的原因可能导致了手术护理需求的下降以及手术护理供需之间相关性的无显著变化。2019冠状病毒病大流行对外科工作的进一步影响还有待观察，应予以报告，以便找到解决社会对手术护理日益增长需求的办法，并找到工具来尽量减少全球医疗保健下一次危机造成的“损害”。
