在 COVID-19 大流行期间重新引入择期手术的资源需求：建模研究。
Resource requirements for reintroducing elective surgery during the COVID-19 pandemic: modelling study.
机构信息
William Harvey Research Institute, Queen Mary University of London, London, UK.
Reconstructive Surgery and Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Swansea, UK.
出版信息
Br J Surg. 2021 Jan 27;108(1):97-103. doi: 10.1093/bjs/znaa012.
BACKGROUND
The COVID-19 response required the cancellation of all but the most urgent surgical procedures. The number of cancelled surgical procedures owing to Covid-19, and the reintroduction of surgical acivirt, was modelled.
METHODS
This was a modelling study using Hospital Episode Statistics data (2014-2019). Surgical procedures were grouped into four urgency classes. Expected numbers of surgical procedures performed between 1 March 2020 and 28 February 2021 were modelled. Procedure deficit was estimated using conservative assumptions and the gradual reintroduction of elective surgery from the 1 June 2020. Costs were calculated using NHS reference costs and are reported as millions or billions of euros. Estimates are reported with 95 per cent confidence intervals.
RESULTS
A total of 4 547 534 (95 per cent c.i. 3 318 195 to 6 250 771) patients with a pooled mean age of 53.5 years were expected to undergo surgery between 1 March 2020 and 28 February 2021. By 31 May 2020, 749 247 (513 564 to 1 077 448) surgical procedures had been cancelled. Assuming that elective surgery is reintroduced gradually, 2 328 193 (1 483 834 - 3 450 043) patients will be awaiting surgery by 28 February 2021. The cost of delayed procedures is €5.3 (3.1 to 8.0) billion. Safe delivery of surgery during the pandemic will require substantial extra resources costing €526.8 (449.3 to 633.9) million.
CONCLUSION
As a consequence of the Covid-19 pandemic, provision of elective surgery will be delayed and associated with increased healthcare costs.
背景
COVID-19 疫情期间，除最紧急的手术外，所有手术均被取消。本研究旨在建立模型，以评估因 COVID-19 而取消的手术数量以及重新开展手术活动的情况。
方法
本研究采用医院病例统计数据（2014-2019 年）进行建模。将手术分为四个紧急程度类别。模拟 2020 年 3 月 1 日至 2021 年 2 月 28 日期间实施的手术数量。根据保守假设，使用逐步重新开展择期手术（自 2020 年 6 月 1 日开始）来估算手术例数的不足。使用国民保健服务参考成本计算成本，并以百万或十亿为单位报告。估计值以 95%置信区间报告。
结果
共有 4547534 名（95%置信区间 3318195 至 6250771 名）年龄中位数为 53.5 岁的患者预计在 2020 年 3 月 1 日至 2021 年 2 月 28 日期间接受手术。截至 2020 年 5 月 31 日，已有 749247 例（513564 至 1077448 例）手术被取消。假设择期手术逐渐恢复，到 2021 年 2 月 28 日，将有 2328193 名（1483834 至 3450043 名）患者需要手术。延迟手术的费用为 53 亿欧元（31 至 80 亿欧元）。在大流行期间安全开展手术将需要额外的大量资源，费用为 5268 亿欧元（4493 至 6339 百万欧元）。
结论
由于 COVID-19 疫情，择期手术的开展将被延迟，并导致医疗保健成本增加。
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