Characterizing the Impact of Procedure Funding on the Covid-19 Generated Procedure Gap in Ontario: A Population-Based Analysis.
Ann Surg
; 2022 Dec 20.
Article
in English
| MEDLINE | ID: covidwho-2191223
ABSTRACT
BACKGROUND:
Surgical procedures in Canada were historically funded through global hospital budgets. Activity-based funding models were developed to improve access, equity, timeliness and value of care for priority areas. COVID-19 upended health priorities and resulted in unprecedented disruptions to surgical care which created a significant procedure gap. We hypothesized that activity-based funding models influenced the magnitude and trajectory of this procedure gap.METHODS:
Population-based analysis of procedure rates comparing pandemic (March 1, 2020 to December 31, 2021) to a pre-pandemic baseline (January 1, 2017 to February 29, 2020) in Ontario, Canada. Poisson generalized estimating equation models were used to predict expected rates in the pandemic based on the pre-pandemic baseline. Analyses were stratified by procedure type (out-patient, in-patient), body region, and funding category (activity-based funding programs vs. global budget).RESULTS:
281,328 fewer scheduled procedures were performed during the COVID-19 period compared to the pre-pandemic baseline (Rate Ratio 0.78; 95%CI 0.77-0.80). In-patient procedures saw a larger reduction (24.8%) in volume compared to out-patient procedures (20.5%). An increase in the proportion of procedures funded through activity-based programs was seen during the pandemic (52%) relative to the pre-pandemic baseline (50%). Body systems funded predominantly through global hospital budgets (e.g. gynecology, otologic surgery) saw the least months at or above baseline volumes whereas those with multiple activity-based funding options (e.g. musculoskeletal, abdominal) saw the most months at or above baseline volumes.CONCLUSIONS:
Those needing procedures funded though global hospital budgets may have been disproportionately disadvantaged by pandemic-related health care disruptions.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Prognostic study
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
SLA.0000000000005781
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