Differential Impact of COVID-19 on Urological Surgeries in Public and Private Institutions at a Nationwide Level: Towards the Day of Reckoning

Brument, Mathilde; Pfister, Christian; Cornu, Jean‐Nicolas

doi:10.1016/j.eururo.2021.12.018

Cited by 7 publications

(4 citation statements)

References 2 publications

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“…Since the pandemic is an unprecedented and challenging situation for all countries in the world, health systems and urologic cancer services have had to deal with extra burdens, such as restricted theater availability for elective oncology. In a recent study, a 2-7% decrease in urological cancer surgeries in both public and private centers was observed respectively [ 8 ]. In another local study comparing the first year of the pandemic with the pre-pandemic in a high-volume center in Milan, Italy, a significant decrease was found in the number of urological oncological surgeries, similar to our study, and also they demonstrated that this reduction was largely due to radical prostatectomy surgery [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

How Does the COVID-19 Pandemic Influence Histopathological Outcomes for Urologic Cancers?

KALEMCI¹,

Ergun²,

Akyol³

et al. 2022

Cureus

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Objective: The coronavirus disease 2019 pandemic disrupted all routine health care services and resulted in a significant reconfiguration of urologic cancer services and care pathways across the globe. This study aimed to retrospectively determine the pandemic's impact on the urologic oncological surgery outcomes at a high-volume referral center.Materials and methods: We compared the number and histopathological outcomes of urologic oncological procedures in a referral center coded during the pandemic and data of the period before the pandemic as control. Data were extracted from patient files and hospital records. The pathological examination included a complete histopathological staging according to TNM stage.Results: A total of 683 patients were included in the study, 424 (62%) of which were operated in the prepandemic period. There was a 39% decline in urologic oncological surgical activity in the pandemic, mostly in renal and prostate cancer. The mean tumor size was larger in renal cancer patients who underwent surgery during the pandemic (5.6 cm vs 4.5 cm, p=0.002). During the pandemic, more lymph node involvement was seen after radical cystectomy and prostatectomy (50% vs 27.8%, p=0.024 and 12.5% vs 4.5%, p=0.026, respectively). No differences in terms of main pathologic features were observed in patients undergoing radical orchiectomy.Conclusion: COVID-19 appeared to adversely effect oncologic outcomes in patiens undergone surgery for prostate and bladder cancer. Tumor development induced by a delay in diagnosis may cause severe consequences for patients. Reprioritizion of non-deferrable urologic oncological seems crucial.

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Section: Discussionmentioning

confidence: 99%

How Does the COVID-19 Pandemic Influence Histopathological Outcomes for Urologic Cancers?

KALEMCI¹,

Ergun²,

Akyol³

et al. 2022

Cureus

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“…The majority of extant studies have primarily explored disparities in service provision between public and private hospitals [ 20 – 23 ].Some studies have shown that the response to policy interventions differs between public and private hospitals [ 24 – 27 ]. In addition, the current research on MAs mainly focused on the qualitative analysis of the policy content [ 5 ] and the implementation effect of medical reform [ 28 ], as well as the analysis of the impact of MAs on the service quality of medical institutions [ 29 ] and patient service utilization [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the market share of public and private hospitals under different Medical Alliances: an interrupted time-series analysis in rural China

Xiong,

Lin,

Yao

et al. 2024

BMC Health Serv Res

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Background China initiated the Medical Alliances (MAs) reform to enhance resource allocation efficiency and ensure equitable healthcare. In response to challenges posed by the predominance of public hospitals, the reform explores public-private partnerships within the MAs. Notably, private hospitals can now participate as either leading or member institutions. This study aims to evaluate the dynamic shifts in market share between public and private hospitals across diverse MAs models. Methods Data spanning April 2017 to March 2019 for Dangyang County’s MA and January 2018 to December 2019 for Qianjiang County’s MA were analyzed. Interrupted periods occurred in April 2018 and January 2019. Using independent sample t-tests, chi-square tests, and interrupted time series analysis (ITSA), we compared the proportion of hospital revenue, the proportion of visits for treatment, and the average hospitalization days of discharged patients between leading public hospitals and leading private hospitals, as well as between member public hospitals and member private hospitals before and after the reform. Results After the MAs reform, the revenue proportion decreased for leading public and private hospitals, while member hospitals saw an increase. However, ITSA revealed a notable rise trend in revenue proportion for leading private hospitals (p < 0.001), with a slope of 0.279% per month. Member public and private hospitals experienced decreasing revenue proportions, with outpatient visits proportions declining in member public hospitals by 0.089% per month (p < 0.05) and inpatient admissions proportions dropping in member private hospitals by 0.752% per month (p < 0.001). The average length of stay in member private hospitals increased by 0.321 days per month after the reform (p < 0.01). Conclusions This study underscores the imperative to reinforce oversight and constraints on leading hospitals, especially private leading hospitals, to curb the trend of diverting patients from member hospitals. At the same time, for private hospitals that are at a disadvantage in competition and may lead to unreasonable prolongation of hospital stay, this kind of behavior can be avoided by strengthening supervision or granting leadership.

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“…The majority of extant studies have primarily explored disparities in service provision between public and private hospitals [20][21][22][23] .Some studies have shown that the response to policy interventions differs between public and private hospitals [24][25][26][27] . In addition, the current research on MAs mainly focused on the performance evaluation of MAs system construction [5] and the implementation effect of medical reform [28] , as well as the analysis of the impact of MAs on the service quality of medical institutions [29] and patient service utilization [30] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the market share of public and private hospitals under different Medical Alliances: an interrupted time-series analysis in rural China

Xiong,

Lin,

Yao

et al. 2024

Preprint

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Background China initiated the Medical Alliances (MAs) reform to enhance resource allocation efficiency and ensure equitable healthcare. In response to challenges posed by the predominance of public hospitals, the reform explores public-private partnerships within the MAs. Notably, private hospitals can now participate as either leading or member institutions. This study aims to evaluate the dynamic shifts in market share between public and private hospitals across diverse MAs models. Methods Data spanning April 2017 to March 2019 for Dangyang County's MA and January 2018 to December 2019 for Qianjiang County's MA were analyzed. Interrupted periods occurred in April 2018 and January 2019. Using independent sample t-tests, chi-square tests, and interrupted time series analysis (ITSA), we compared the proportion of hospital revenue, the proportion of visits for treatment, and the average hospitalization days of discharged patients between leading public hospitals and leading private hospitals, as well as between member public hospitals and member private hospitals before and after the reform. Results After the MAs reform, the revenue proportion decreased for leading public and private hospitals, while member hospitals saw an increase. However, ITSA revealed a notable rise trend in revenue proportion for leading private hospitals (p < 0.001). Member public and private hospitals experienced decreasing revenue proportions, with outpatient visits declining in member public hospitals (p < 0.05) and inpatient admissions dropping in member private hospitals (p < 0.001). The average length of stay in member private hospitals increased from 15.29 to 16.16 days post-reform, maintaining a monthly growth of 0.321 days (p < 0.01). Conclusions This study underscores the imperative to reinforce oversight and constraints on leading hospitals, especially private leading hospitals, to curb the trend of diverting patients from member hospitals. At the same time, for private hospitals that are at a disadvantage in competition and may lead to unreasonable prolongation of hospital stay, this kind of behavior can be avoided by strengthening supervision or granting leadership.

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Differential Impact of COVID-19 on Urological Surgeries in Public and Private Institutions at a Nationwide Level: Towards the Day of Reckoning

Cited by 7 publications

References 2 publications

How Does the COVID-19 Pandemic Influence Histopathological Outcomes for Urologic Cancers?

How Does the COVID-19 Pandemic Influence Histopathological Outcomes for Urologic Cancers?

Comparison of the market share of public and private hospitals under different Medical Alliances: an interrupted time-series analysis in rural China

Comparison of the market share of public and private hospitals under different Medical Alliances: an interrupted time-series analysis in rural China

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