The Compounding Access Problem for Surgical Care

Billig, Jessica I.; Sears, Erika D.

doi:10.1097/sla.0000000000004085

Cited by 13 publications

(14 citation statements)

References 5 publications

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“…Many authors advocated for the active use of telemedicine clinics in general surgery during the first six months of the pandemic [ 12 ], which was believed to play a key role in the perioperative management of surgical patients during COVID-19 pandemic, allowing monitoring progression of the underlying disease and determining urgency [ 13 ]. In a cross-sectional survey, 88.5% of surgeons and 91% of patients reported positive perceptions on the use of telemedicine [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

The Role of Telemedicine in Surgical Specialties During the COVID‐19 Pandemic: A Scoping Review

et al. 2021

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Background The objective of this study was to evaluate the current body of evidence on the use of telemedicine in surgical subspecialties during the COVID‐19 pandemic. Methods This was a scoping review conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews (PRISMA‐ScR). MEDLINE via Ovid, PubMed, and EMBASE were systematically searched for any reports discussing telemedicine use in surgery and surgical specialties during the first period (February 2020–August 8, 2020) and second 6‐month period (August 9–March 4, 2021) of the COVID‐19 pandemic. Results Of 466 articles screened through full text, 277 articles were included for possible qualitative and/or quantitative data synthesis. The majority of publications in the first 6 months were in orthopedic surgery, followed by general surgery and neurosurgery, whereas in the second 6 months of COVID‐19 pandemic, urology and neurosurgery were the most productive, followed by transplant and plastic surgery. Most publications in the first 6 months were opinion papers (80%), which decreased to 33% in the second 6 months. The role of telemedicine in different aspects of surgical care and surgical education was summarized stratifying by specialty. Conclusion Telemedicine has increased access to care of surgical patients during the COVID‐19 pandemic, but whether this practice will continue post‐pandemic remains unknown.

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Section: Resultsmentioning

confidence: 99%

The Role of Telemedicine in Surgical Specialties During the COVID‐19 Pandemic: A Scoping Review

et al. 2021

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“…During the pandemic, reimbursement for telehealth has improved to match that of in-person services, and our institution has permitted us to perform video visits that are billable at the same level as in-person visits for the foreseeable future. 8 , 9 …”

Section: Future Considerations For Craniofacial Carementioning

confidence: 99%

Transitioning Multidisciplinary Craniofacial Care to Telehealth during the COVID-19 Pandemic: A Single Center Experience

Badiee

Willsher

Rorison

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Summary: Craniofacial clinics are composed of multidisciplinary teams of providers to deliver coordinated and comprehensive patient care. The coronavirus disease of 2019 (COVID-19) pandemic has disrupted this model, as social distancing guidelines have precluded in-person patient appointments and forced clinics to reconsider their method of care delivery. The University of California, San Francisco, Craniofacial Center has continued to serve patients during this acute period, adopting a hybrid model in which the vast majority of patients are seen through telehealth and a limited number of patients are evaluated in-person. Surveyed patients and families reported high rates of satisfaction, with time savings cited as a particular benefit. Furthermore, most felt comfortable using the video technology required for their appointment. This experience has demonstrated to us that multidisciplinary craniofacial evaluations can be effectively delivered in a telehealth format and has informed our conception of idealized clinic structure. Moving forward, we intend to utilize telehealth visits for selected components of craniofacial evaluations in an effort to maximize efficiency and minimize burden, including addressing barriers to accessing care. Benefits of a hybrid model will include decongestion of clinics and waiting areas, allowing social distancing, addressing clinic space limits, and increased efficiency by eliminating the need for patient and family movement. Demonstration of the safety and efficacy of telehealth visits, combined with regulatory reform that improves reimbursement and allows for appointments across state lines, will be critical for this model to persist beyond the pandemic.

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“…The general effect of the cancellation of elective surgeries has been described as having multiple levels of impact. 5 , 6 At the patient family level, deferred surgery for cleft lip and palate prolonged the psychological, nutritional, and speech challenges experienced by those affected. In a recent publication, a consensus of providers suggested that cleft lip surgery could be postponed for up to 3 months without adverse effects on the patient.…”

Section: Literature Reviewmentioning

confidence: 99%

Impact of COVID-19 on Elective Cleft Surgery in Low- and Middle-income Countries

Burg

Agrawal

Desai

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: The COVID-19 pandemic disrupted health systems worldwide, including in low- and middle-income countries (LMICs). Many countries limited the delivery of elective surgery. To date, COVID-19’s impact on elective surgery in LMICs has been unquantified. We use operative data from a large international non-government cleft organization to compare case volume for 2019 and 2020 to quantify the impact of COVID-19. Methods: Smile Train supports a partner network of over 1100 partners globally to deliver treatment to children with cleft lip and cleft palate (CLP). Treatment data is documented into a proprietary digital platform, Smile Train Express. We compared monthly treatment data for 2019 to 2020, by country, and by World Bank Income group to describe the effect that the COVID-19 pandemic has had on CLP surgery in LMICs. Results: Our analysis shows 25,444 (31.4%) fewer primary operations performed between January and December 2020 than in the same period in 2019 with the most significant decline in procedures observed in April 2020. Many countries resumed elective surgery for CLP procedures from May onward and volume approximated that of pre-pandemic baseline by November of 2020. Conclusions: The emergence of the COVID-19 pandemic had a large impact on health systems and service delivery across the world. We find that this is evident in the delivery of CLP surgery in LMICs. The impact is characterized by a dramatic decrease in surgery rates in April of 2020 with a recovery of surgical volume from July 2020 onwards. The rate of surgical rate recovery is consistent across World Bank Income groups.

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The Compounding Access Problem for Surgical Care

Cited by 13 publications

References 5 publications

The Role of Telemedicine in Surgical Specialties During the COVID‐19 Pandemic: A Scoping Review

The Role of Telemedicine in Surgical Specialties During the COVID‐19 Pandemic: A Scoping Review

Transitioning Multidisciplinary Craniofacial Care to Telehealth during the COVID-19 Pandemic: A Single Center Experience

Impact of COVID-19 on Elective Cleft Surgery in Low- and Middle-income Countries

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