ABSTRACT
Introduction: The COVID-19 pandemic has a significant impact on the primary, secondary and tertiary levels of the health system. In a low-middle income countries such as Bosnia and Herzegovina, ensuring optimal oncology care was challenging even before the COVID-19 pandemic. Since the beginning of the COVID-19 pandemic, there was a warning of the possible impact of worsening mortality and/ or morbidity due to delayed diagnosis and suboptimal treatment.1 The COVID 19 pandemic has impact on reducing the number of patients treated with radiotherapy.2 The aim of our study was to analyze the impact of the COVID-19 pandemic on radiotherapy in a patient with head and neck cancer who were treated with radiotherapy in a tertiary health care facility. Methods: We analyzed data from the institutional databases for radiotherapy of the Oncology Department at University Clinical Hospital Mostar, Bosnia and Herzegovina. We performed data extraction for patients with head and neck cancer who were treated with primary or adjuvant radiotherapy with or without chemotherapy from January 2018 to December 2021. Results: A total of 114 patients were treated with radiotherapy for head and neck cancer in the pre- COVID-19 period (2018-2019) and COVID-19 period (2020-2021). There were more patients treated with radiotherapy in the preCOVID19 period, 64 (56%) compared to the COVID19 period, 50 (44%). In the COVID 19 period, the number of patients treated with radiotherapy was reduced by 22% compared to the preCOVID19 period. Conclusion: A decline innumber of patients treated with radiotherapy in the COVID 19 period was detected. Health system optimization and education of the general population about the negative indirect impact of COVID 19 on the health system, diagnosis and treatment of cancer is needed.
ABSTRACT
Introduction: Last two pandemic years significantly changed our lives in many ways and also oncology care. Medical centers adapted to the situation and reorganized the service, including service on oncology departments. Inpatient Oncology Department, University Clinical Hospital Mostar, had a reduced number of hospital beds for oncology patients, patients had to own a negative RT-PCR COVID-19 test before admission, visits to patients were prohibited and patients were restricted from moving outside the department. We were interested in how these measures impacted our inpatient care in terms of the number of visits. Methods: We retrospectively analysed data from the Hospital Information System (BIS) for the University Clinical Hospital Mostar, Inpatient Oncology Department. We looked for the number of inpatient visits at our department within the 'pre-pandemic period', between 9 March 2018 to 31 January 2020, compared with the 'pandemic period', between 9 March 2020 to 31 January 2022. Furthermore, we made additional analyses by subunits: radiotherapy subunit and chemotherapy subunit. We calculated the percentage difference between the 'pre-pandemic period' and the 'pandemic period'. Results: Within the 'pre-pandemic period', the total number of inpatient visits was 1818, of which 1601 were at the chemotherapy subunit, and 217 were at the radiotherapy subunit. In the 'pandemic period' we had the total number of inpatient visits 1591, 1443 at the chemotherapy subunit, and 148 at the radiotherapy subunit. In the 'pandemic period' we had 87.5% of the total number of inpatient visits from the 'pre-pandemic period', 90.1% of the chemotherapy inpatient visits, and 68.2% of the radiotherapy visits. This was a 12.5% decrease in the total number of inpatient visits in the 'pandemic period' as compared with the 'pre-pandemic period'. The decrease in the number of chemotherapy visits was 9.9% and 31.8% for radiotherapy visits in the 'pandemic period' compared with the 'pre-pandemic period'. Conclusion: Measures that were taken to control the COVID-19 pandemic had a noticeable impact on inpatient oncology care in terms of patient visits, especially in terms of radiotherapy admissions. The extent to which these measures affect patient outcomes will be shown in the future and should be the subject of research.