A predictive model for the post-pandemic delay in elective treatment

Nehme, Romy; Puchkova, Alena; Parlikad, Ajith Kumar

doi:10.1016/j.orhc.2022.100357

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…Reductions in emergency care are likely to require different approaches to workforce and resource planning, compared with elective care, and for admissions versus procedures (27,28). Therefore, the greater effect on procedural activity and the relatively slower recovery of elective procedural activity, especially in England and Wales, requires further investigation, explanation and mitigation…”

Section: Discussionmentioning

confidence: 99%

“…Reductions in emergency care are likely to require different approaches to workforce and resource planning, compared with elective care, and for admissions vs. procedures. 27 , 28 Therefore, the greater effect on procedural activity and the relatively slower recovery of elective procedural activity, especially in England and Wales, requires further investigation, explanation, and mitigation strategies. The widespread strain on health systems due to COVID-19 is unprecedented and staff and resource shortages over successive waves may provide part of the explanation.…”

Section: Discussionmentioning

confidence: 99%

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Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

Wright

Cheema

Goldacre

et al. 2022

European Heart Journal - Quality of Care and Clinical Outcomes

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Background Although morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described. Methods Analyses used national administrative electronic hospital records in England, Scotland and Wales for 2016–2021. Admissions and procedures during the pandemic (2020–2021) related to six major cardiovascular conditions (acute coronary syndrome, heart failure, stroke/transient ischaemic attack, peripheral arterial disease, aortic aneurysm, and venous thromboembolism) were compared to the annual average in the pre-pandemic period (2016–2019). Differences were assessed by time period and urgency of care. Results In 2020, there were 31 064 (-6%) fewer hospital admissions (14 506 [-4%] fewer emergencies, 16 560 [-23%] fewer elective admissions) compared to 2016–2019 for the six major cardiovascular diseases combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries (-10 996 [-15%] fewer admissions). However, these reductions were offset by higher than expected total emergency admissions (+25 878 [+6%] higher admissions), notably for heart failure and stroke in England, and for venous thromboembolism in all three countries. Analyses for procedures showed similar temporal variations to admissions. Conclusion This study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

Wright

Cheema

Goldacre

et al. 2022

European Heart Journal - Quality of Care and Clinical Outcomes

View full text Add to dashboard Cite

show abstract

“…Reductions in emergency care are likely to require different approaches to workforce and resource planning, compared with elective care, and for admissions versus procedures(27, 28). Therefore, the greater effect on procedural activity and the relatively slower recovery of elective procedural activity, especially in England and Wales, requires further investigation, explanation and mitigation strategies.…”

Section: Discussionmentioning

confidence: 99%

Indirect effects of the first two years of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

Wright

Cheema

Goldacre

et al. 2022

Preprint

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Background: Although morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described. Methods: Analyses used national administrative electronic hospital records in England, Scotland and Wales for 2016-2021. Admissions and procedures during the pandemic (2020-2021) related to six major cardiovascular conditions (acute coronary syndrome, heart failure, stroke/transient ischaemic attack, peripheral arterial disease, aortic aneurysm, and venous thromboembolism) were compared to the annual average in the pre-pandemic period (2016-2019). Differences were assessed by time period and urgency of care. Results: In 2020, there were 31,064 (-6%) fewer hospital admissions (14,506 [-4%] fewer emergencies, 16,560 [-23%] fewer elective admissions) compared to 2016-2019 for the six major cardiovascular diseases combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries (-10,996 [-15%] fewer admissions). However, these reductions were offset by higher than expected total emergency admissions (+25,878 [+6%] higher admissions), notably for heart failure and stroke in England, and for venous thromboembolism in all three countries. Analyses for procedures showed similar temporal variations to admissions. Conclusion: This study highlights increasing emergency cardiovascular admissions as a result of the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.

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“…Per that model, capacity would need to increase by 55% to meet that wait time performance standard by 2026. 12 …”

mentioning

confidence: 99%

“…Per that model, capacity would need to increase by 55% to meet that wait time performance standard by 2026. 12 While a variety of approaches have been proposed to increase endoscopic capacity, supranormal capacity, or even a return to pre-pandemic capacity, may not be achievable at many centers. Endoscopic capacity is still limited by a variety of factors, including staff shortages and hospital and outpatient capacity.…”

mentioning

confidence: 99%

The impact of COVID-19 on endoscopy and cancer screening: a focus on access and equity

Gardner

Feld

2023

Therap Adv Gastroenterol

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The SARS-CoV2 pandemic has had a profound and lasting impact on healthcare delivery. Gastrointestinal endoscopy services were limited during the early phases of the pandemic, which has resulted in ongoing procedural backlog. Procedural delays have had continuing effects including delayed colorectal cancer (CRC) diagnoses and exacerbation of existing disparities in the CRC-screening and treatment pathways. In this review, we outline these effects as well as the variety of strategies that have been proposed to eliminate this backlog, including increased endoscopy hours, re-triaging of referrals, and alternative CRC-screening strategies.

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A predictive model for the post-pandemic delay in elective treatment

Cited by 7 publications

References 33 publications

Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

Indirect effects of the first two years of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

The impact of COVID-19 on endoscopy and cancer screening: a focus on access and equity

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