Impact of reduced elective ophthalmic surgical volume on U.S. hospitals during the early coronavirus disease 2019 pandemic

Fliotsos, Michael J.; Field, Matthew G.; Srikumaran, Uma; Repka, Michael X.; Woreta, Fasika A.; Srikumaran, Divya

doi:10.1097/j.jcrs.0000000000000410

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…Appointment cancellations and restrictions on the number of patient visits during COVID-19 pandemic resulted in enormous income loss for healthcare facilities around the world. 25 For our Department, collections dropped from $1.38M in February 2020 to $456,172 in May 2020. In total, the Department received $4.26M less in clinical and surgical collections in 2020 compared to 2019.…”

Section: Resultsmentioning

confidence: 95%

Approach of an Academic Ophthalmology Department to Recovery During the Coronavirus Pandemic

Brodin¹,

Tamhankar²,

Whitehead³

et al. 2022

OPTH

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Introduction A methodology for safe recovery of an ophthalmology department during a pandemic does not currently exist. This study describes successful recovery strategies for an urban, multi-specialty ophthalmology department serving a high-risk patient population. Methods The study took place at a large multi-specialty tertiary care academic ophthalmology department in a metropolitan city during a seven-month period (March–October 2020). Five recovery ad hoc committees were charged with formulating metrics and initiatives to manage clinical volumes while maintaining safe practices, providing patient access, and minimizing financial damage. A six-tier system was created to resume non-urgent appointments in May 2020. Educational and research activities were maintained through the development of virtual curricula and research platforms. Results The number of clinical and surgical visits per month in 2020 compared to 2019 and the time to reach ≥95% of pre-COVID patient volumes were monitored. In October 2020, ≥95% of pre-COVID volumes were attained (11,975 vs 12,337 patient visits in October 2019; 266 vs 272 surgical cases in October 2019). Despite significant financial losses, the department surpassed December 2019 collections in December 2020. No faculty, staff, or trainees received furloughs or pay cuts. There was no COVID-19 transmission between faculty, staff, and patients. Discussion With strategic implementation of recovery strategies following CDC safety measures, it was possible to safely deliver care to patients with urgent and non-urgent eye conditions. Patient volumes were fully recovered in an ambulatory urban healthcare setting within a high-risk COVID-19 population within seven months while educational and research missions were successfully sustained.

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Section: Resultsmentioning

confidence: 95%

Approach of an Academic Ophthalmology Department to Recovery During the Coronavirus Pandemic

Brodin¹,

Tamhankar²,

Whitehead³

et al. 2022

OPTH

View full text Add to dashboard Cite

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“…Considering the resources needed to mitigate the spread of COVID-19 (ie, masks for all parties, sanitation supplies, time to clean rooms) and the significant decrease in procedures seen during the pandemic, this represents another added cost to the healthcare system. 15 – 17 …”

Section: Discussionmentioning

confidence: 99%

Perioperative COVID-19 Screening at a Tertiary Ophthalmic Institution

Gendi

Akotoye

Kalur

et al. 2023

Journal of VitreoRetinal Diseases

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Purpose: To characterize the rate of COVID-19 positivity during presurgical screening and the surgical outcomes of ophthalmic patients who were positive for COVID-19 and to report the overall cost. Methods: This retrospective study included patients 18 years or older who had ophthalmic surgical procedures at a tertiary institution between May 11, 2020, and December 31, 2020. Patients without a valid presurgical COVID-19 test within 3 days before their scheduled procedure, who had incomplete or mislabeled visits, or who had incomplete or missing data in their file were excluded. COVID-19 screening was completed using a polymerase chain reaction (PCR) kit. Results: Of the 3585 patients who met the inclusion criteria, 2044 (57.02%) were women; the mean age was 68.2 years ± 12.8 (SD). Thirteen asymptomatic patients (0.36%) tested positive for COVID-19 via PCR screening. Three patients had a known positive COVID-19 infection within the 90 days before surgery; thus, 10 patients (0.28%) were found to have asymptomatic naïve COVID-19 infection via PCR testing. Testing was associated with a total charge of US $800 000. Five of the 13 patients (38.46%) who tested positive for COVID-19 experienced a delay in their surgery; the mean delay was 17.23 ± 22.97 days. Conclusions: Asymptomatic ophthalmic surgical patients had a low positivity rate with a limited impact on surgery scheduling at a significant cost. Further studies would be valuable in evaluating a targeted presurgical screening population as opposed to universal testing.

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“…The current pandemic has had a heavy impact on the psychological, social, and economic impact on eye care professionals and hospitals. [ 19 20 ] In providing care for elective surgeries and clearing the backlog of surgeries that arouse due to lockdown, eye care facilities have been modified both structurally and functionally to provide safe service. [ 4 17 18 21 22 23 24 25 26 27 ] Apart from several general modifications in the clinical and surgical setting, a few major impactful modifications have been the use of teleconsultation services and immediate sequential bilateral cataract surgery that minimizes post-operative visits.…”

Section: Discussionmentioning

confidence: 99%

Year one of COVID-19 pandemic: Effect of lockdown and unlock phases on cataract surgery at a multi-tier ophthalmology network

Das

Reddy

2021

Indian Journal of Ophthalmology

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Purpose: To describe the impact of lockdown and unlock phases of the COVID-19 pandemic on cataract surgery at a multitier ophthalmology network. Methods: This cross-sectional hospital-based study included 106,279 eyes operated between March 23, 2019 and March 31, 2021. The data of patients who underwent cataract surgery presenting during the lockdown and unlock phases were compared with the respective periods in the previous year before COVID-19. Results: The cataract surgeries performed decreased to 5.6% (839/14,994) of pre-COVID-19 volumes during the lockdown phase. There was a gradual recovery of the cataract surgeries performed to 86.7% of pre-COVID-19 volumes by May 2020 and exceeded by 17.9% by September 2020. There was a decrease in the number of women who underwent cataract surgery during the lockdown phase (49.11%) compared to the pre-COVID-19 (52.59%) or unlock phase (52.29%, P < 0.001). Patients operated during the lockdown phase were younger when compared to other groups ( P < 0.001). The mean LogMAR presenting visual acuity at the time of surgery was worse in patients operated during the lockdown phase (1.84 ± 1.16) as compared to pre-COVID-19 (1.39 ± 1.05) and unlock phases (1.51 ± 1.08, P =<0.001). The proportion of patients with total cataracts were higher during the lockdown and unlock phases compared to the pre-COVID-19 phase ( P < 0.001). Conclusion: The first year of the COVID-19 pandemic saw a drastic reduction in the surgical volume in the lockdown phase, which recovered quickly during the unlock period. Patients of younger age, male gender, poor presenting visual acuity, denser cataracts, and living close to the surgical center were able to access surgical care due to lockdown restrictions.

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Impact of reduced elective ophthalmic surgical volume on U.S. hospitals during the early coronavirus disease 2019 pandemic

Abstract: Hospitals sustained an estimated 107 to 120 million U.S. dollars loss per month of COVID-19–related shutdowns due to reduced volume of cataract surgery, keratoplasty, and strabismus surgery.

Cited by 9 publications

References 13 publications

Approach of an Academic Ophthalmology Department to Recovery During the Coronavirus Pandemic

Approach of an Academic Ophthalmology Department to Recovery During the Coronavirus Pandemic

Perioperative COVID-19 Screening at a Tertiary Ophthalmic Institution

Year one of COVID-19 pandemic: Effect of lockdown and unlock phases on cataract surgery at a multi-tier ophthalmology network

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