Impact of the COVID-19 Pandemic on Inpatient and Outpatient Utilization of Bariatric Surgery,Surgical Endoscopy

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Impact of the COVID-19 Pandemic on Inpatient and Outpatient Utilization of Bariatric Surgery
Surgical Endoscopy ( IF 2.4 ) Pub Date : 2022-09-27 , DOI: 10.1007/s00464-022-09655-3
Jillian Angelo ₁ , Mark Soto ₂ , Dannie Dai ₂ , David Spector ₁ , E John Orav ₃ , Ali Tavakkoli ₁ , Thomas C Tsai _{1,

2,

4}

Affiliation

Background

During the COVID-19 pandemic, deferral of inpatient elective surgical procedures served as a primary mechanism to increase surge inpatient capacity. Given the benefit of bariatric surgery on treating obesity and associated comorbidities, decreased access to bariatric surgery may have long-term public health consequences. Understanding the extent of the disruption of the COVID-19 pandemic to bariatric surgery will help health systems plan for appropriate access.

Materials and methods

This is an observational cohort study using the PINC AI Healthcare Database from 1/1/2019–6/31/2021. A Poisson regression model with patient characteristics and hospital-fixed effects was used to assess the relative monthly within-hospital reduction in surgical encounters, variations by race and ethnicity, and shift from inpatient to outpatient procedures. A multivariate linear probability model was used to assess the change in 30-day readmissions from 2020 and 2021 compared to 2019.

Results

Among 309 hospitals, there were 46,539 bariatric procedures conducted in 2019 with a 14.8% reduction in volume to 39,641 procedures in 2020. There were 22,642 bariatric procedures observed from January to June of 2021. The most pronounced decrease in volume occurred in April with an 89.7% relative reduction from 2019. Black and Hispanic patients were more likely to receive bariatric surgery after the height of the pandemic compared to white patients. A clinically significant shift from inpatient to outpatient bariatric surgical procedures was not observed. Relative to 2019, there were no significant differences in bariatric surgical readmission rates.

Conclusion

During the pandemic there was a sizable decrease in bariatric surgical volume. There did not appear to be disparities in access to bariatric surgery for minority patients. We did not observe a meaningful shift toward outpatient bariatric surgical procedures. Post-pandemic, monitoring is needed to assess if hospitals have been able to meet the demand for bariatric surgical procedures.

Graphical abstract

中文翻译：

COVID-19 大流行对住院和门诊患者使用减肥手术的影响

背景

在 COVID-19 大流行期间，推迟住院择期外科手术是增加激增住院容量的主要机制。鉴于减肥手术对治疗肥胖和相关合并症的益处，减少接受减肥手术可能会对公共健康产生长期影响。了解 COVID-19 大流行对减肥手术的破坏程度将有助于卫生系统规划适当的准入。

材料和方法

这是一项使用 PINC AI 医疗保健数据库的观察性队列研究，时间为 1/1/2019 至 6/31/2021。使用具有患者特征和医院固定效应的泊松回归模型来评估每月院内手术次数的相对减少、种族和民族的差异以及从住院到门诊手术的转变。使用多元线性概率模型评估 2020 年和 2021 年与 2019 年相比 30 天再入院率的变化。

结果

在 309 家医院中，2019 年进行了 46,539 例减肥手术，数量减少 14.8% 至 2020 年的 39,641 例。从 2021 年 1 月到 6 月，观察到 22,642 例减肥手术。数量下降最明显的是 4 月份，为 89.7自 2019 年以来的相对减少百分比。与白人患者相比，黑人和西班牙裔患者在大流行高峰期后更有可能接受减肥手术。没有观察到从住院患者到门诊患者减肥手术的临床显着转变。与 2019 年相比，减肥手术再入院率没有显着差异。