Preliminary Evaluation of a New Initiative to Centralize Colorectal Cancer Care During the COVID-19 Epidemic in Shanghai, China: A Retrospective Study (preprint)

ABSTRACT

Background: A novel colorectal cancer center (CCC) was developed in the Tenth Hospital of Shanghai during the coronavirus disease 2019 (COVID-19) epidemic. We aimed to evaluate the CCC for the centralized management of colorectal cancer (CRC) on three dimensions during this distinctive period. Methods: This retrospective study used data from the Tenth Hospital’s patient databases. The research hypothesis was that the CCC reduces preoperative waiting time (PWT), length of stay (LOS) during hospitalization, and costs of hospitalization, without reducing the quality of surgery. Thus, we analyzed three dimensions time, cost, and quality. We compared the expected outcomes between March 1–December 31, 2019, and March 1–December 31, 2020. Descriptive and inferential analyses of patient demographic characteristics, time, postoperative outcomes, and inpatient costs were conducted. Findings: A total of 965 hospitalizations for CRC were identified. In the CCC, PWT declined by 26.2 hours (p<0.01). Patients who entered the CCC express group only needed to wait for 24.5 hours before undergoing surgery, with shorter LOS during hospitalization than the normal group (p<0.01). No patients had any symptoms of COVID-19 or high-risk COVID-19 contacts, and the immediate postoperative complication incidence was low. The mean total inpatient cost (TIC) for all patients with CRC was 78309.824 Chinese yuan in 2020, which was slightly lower than this cost in 2019. Interpretation: This study examined the efficiency of the centralized management model for CRC care during the COVID-19 epidemic in terms of time, cost, and quality. Funding Information This study was sponsored by the Clinical Research Plan of SHDC (No. SHDC2020CR5006-002), the National Natural Science Foundation of China (No.71804128, 71904145), the Special Funds for Fundamental Research Expenses of Central Universities (No. 22120200407) and the Personnel Development Plan of Shanghai Tenth People's Hospital of Tongji University (No. 2021SYPDRC014).Declaration of Interests None declared.Ethics Approval Statement This study has been approved by the Ethics Committee of the Shanghai Tenth People's Hospital of Tongji University (SHSY-IEC-4.1/20-272/01).