COVİD-19 PANDEMİSİNİN GENEL CERRAHİ KLİNİĞİNDE ACİL VE ELEKTİF CERRAHİ GİRİŞİMLERE OLAN ETKİSİNİN DEĞERLENDİRLİMESİ: KESİTSEL ÇALIŞMA
Abstract
Amaç: Covid-19 pandemisi cerrahi kliniklerinde ameliyat programlarının oluşturulmasında aksamalara neden olmuştur. Bu nedenle hasta profilinde değişimler ve gelirlerde azalmaya neden olmuştur. Bu çalışmada 2020 yılının 3 aylık Covid pandemisi dönemi 2019 yılının aynı periyodu ile karşılaştırılarak gelecek dönemler için çıkarımlar sağlanması amaçlanmıştır.
Gereç ve Yöntem: Eğitim ve Araştırma Hastanemizde 2019 ve 2020 yılları Mart, Nisan ve Mayıs aylarında Genel Cerrahi Kliniği’nde tedavi edilen hastalar veri kayıt sisteminden çıkarılarak, demografik özellikleri, cerrahi girişimlerin tipleri, malign/benign olgular, yatış süresi, mortalite ve geri ödeme miktarları ile değerlendirildi. Çalışmanın sonuçlarında istatistik olarak nicel ve nitel değişkenin grupları arasında istatistiksel olarak anlamlı farklılık olup olmadığına bakıldı.
Bulgular: 2019 yılında 947 olgu, 2020 yılında 165 olgu ameliyat edildi. Kadın/erkek oranı 2019 ve 2020 yıllarında sırası ile 1/1.04 ve 1/1.08 bulundu. Yaş ortalaması 2019 yılı için 50.57, 2020 için 47.59 bulundu (p=0.041). 2019 yılında % 80 olan elektif ameliyat sayısı 2020 yılında %34.5bulundu (p=0.000) Aynı dönemlerde malign/benign oranı 1/10.9 ve 1/3.1 bulundu. Hastanede kalış süreleri ise sırasıyla 3.01 ve 5.92 gün olarak bulundu. Tedavisi şifa ile sonuçlanan hastalarda anlamlı azalma olmuştur.
Sonuç: Pandemiler programli yatışların gecikmesine neden olmakta ve hasta profilini değiştirmektedir. Bu nedenle, pandemi sürecinde elektif hastaların tedavisinin ertelenmemesi ve dolayısı ile ekonomik kaybında önüne geçilmesi için pandemi dışı hizmet verecek hastanelerin belirlenmesinin yaralı olacağını düşünmekteyiz.
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References
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- 8. Ellis R, Hay-David AGS, Brennan PA. Operating during the COVID-19 pandemic: How to reduce medical error. British J Oral Maxillofacial Surg. 2020; 58: 577-80.
- 9. Alfano V, ErcolanoS. The efficacy of lockdown against covıd-19: a cross-country panel analysis. Appl Health Econ Health Policy. 2020; 18: 509-17.
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- 11. Al-Shamsi HO, Alhazzani W, Alhuraiji A, et al. A Practical approach to the management of cancer patients during the novel corona virus disease 2019 (COVID-19) Pandemic: An International Collaborative Group .The Oncologist 2020; 25:b936-45.
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- 13.Whithford E. Pandemic hits academic hospitals hard. Inside Higher RAMA on Healthcare ED May 4, 2020.https://ramaonhealthcare.com/pandemic-hits-academic-hospitals-hard/
- 14. Mouton C , Hirschmann MT, Ollivier M, et al. COVID-19 - ESSKA Guidelines and recommendations for resuming elective surgery.J Exp Orthop 2020; 7: 28.
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Abstract
Project Number
-
References
- 1.Squitieri LMS, Chung KC. Survivingthe COVID-19 Pandemic.Plast Reconstr Surg. 2020; 146: 437-46.
- 2.Stewart A. Hospitals forfeit major revenue stream by delaying electives urgeries -5 things to know. Becker’s ASC Review 2020; 1.800.417.2035.
- 3. Spolverato G, Capelli G, Restivo A, et al.The management of surgical patients during the corona virus dieases 2019 (COVID-19) pandemic. Surgery 2020; 168: 4-10.
- 4. Health Management Associates (2020). COVID-19 Impact on medicaid, marketplace, and the uninsured, by State. Available at: https://www.healthmanagement.com/wp-content/uploads/HMA-Estimates-of-COVID-Impact-on-Coverage-public-version-for-April-3-830-CT.pdf.
- 5. Rubino F, Cohen RV, Mingrone G, et al.Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of Access to surgery. Lancet Diabetes Endocrinol. 2020; 8: 640-8.
- 6. Gok AFK, Eryılmaz M, Ozmen MM, et al. Recommendations for trauma and emergency general surgery practice during COVID-19 Pandemic. Ulus Travma Acil Cerrahi Derg 2020; 26: 335-42.
- 7. Gilat R, Haunschild ED, Tauro T, et al. Recommendation to optimize safety of elective surgical care while limiting the spread of COVID-19: Primum Non Nocere. Arthrosc Sports Med Rehabil. 2020;2:177-83
- 8. Ellis R, Hay-David AGS, Brennan PA. Operating during the COVID-19 pandemic: How to reduce medical error. British J Oral Maxillofacial Surg. 2020; 58: 577-80.
- 9. Alfano V, ErcolanoS. The efficacy of lockdown against covıd-19: a cross-country panel analysis. Appl Health Econ Health Policy. 2020; 18: 509-17.
- 10. Nepogodiev D, Bhangu A. Elective surgery cancellations due to the covıd-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg 2020 May 12. doi: 10.1002/bjs.11746.
- 11. Al-Shamsi HO, Alhazzani W, Alhuraiji A, et al. A Practical approach to the management of cancer patients during the novel corona virus disease 2019 (COVID-19) Pandemic: An International Collaborative Group .The Oncologist 2020; 25:b936-45.
- 12. COVID Surg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An International Cohort Study. Lancet 2020; 396: 27-38.
- 13.Whithford E. Pandemic hits academic hospitals hard. Inside Higher RAMA on Healthcare ED May 4, 2020.https://ramaonhealthcare.com/pandemic-hits-academic-hospitals-hard/
- 14. Mouton C , Hirschmann MT, Ollivier M, et al. COVID-19 - ESSKA Guidelines and recommendations for resuming elective surgery.J Exp Orthop 2020; 7: 28.
- 15. Wiseman SM, Crump RT, Sutherland JM.Surgical wait list management in Canada during a pandemic: many challenges ahead. Can J Surg 2020; 63(3): 226-8.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original research article |
| Authors | |
| Project Number | - |
| Publication Date | December 31, 2020 |
| Submission Date | October 29, 2020 |
| Published in Issue | Year 2020 |