Cleaning up procedural backlogs for the elderly in a post-COVID era: a comparative review

ABSTRACT

The COVID-19 pandemic has produced massive procedural backlogs in many parts of the developed world, with a disproportionate impact on the elderly. Whereas it is well-known that such a backlog would cause undue morbidity and mortality in thousands of patients, it is still unclear how jurisdictions plan on catching up on their missed surgeries and screening tests. In this comparative review therefore, we examine existing literature to quantify the backlog and thereafter summarize the solutions that have been proposed to clear it. Searches were performed on Google, Google Scholar, PubMed, Ovid MEDLINE®, and Ovid Embase® to identify literature from Canada, the United Kingdom, and the United States of America. We report our findings with a focus on three representative types of procedures including cataract surgery, colorectal screening, and hip and knee replacement surgery. Common themes of potential solutions included leveraging more advanced technology, ensuring preventative care, training an appropriate allied health workforce, and innovating in the operating room to improve efficiency and surgical capacity. Although no single solution emerges to be universally applicable, a combination of proposed solutions can be considered after an individualized assessment of the hospital or clinic context, the type of surgery required, and the availability of equipment, facility, and staff. © 2022, University of Toronto. All rights reserved.