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Association between...
Association between government policy and delays in emergent and elective surgical care during the COVID-19 pandemic in Brazil : a modeling study
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- Truche, Paul (författare)
- Harvard Medical School, USA
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- Campos, Letícia Nunes (författare)
- Universidade de Pernambuco, Recife, PE, Brazil
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- Marrazzo, Enzzo Barrozo (författare)
- Pontifícia Universidade Católica de Minas Gerais Poços de Caldas, Brazil
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- Rangel, Ayla Gerk (författare)
- Universidad Católica Argentina, Argentina
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- Bernardino, Ramon (författare)
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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- Bowder, Alexis N (författare)
- Harvard Medical School, USA
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- Buda, Alexandra M (författare)
- Harvard Medical School, USA
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- Faria, Isabella (författare)
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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- Pompermaier, Laura (författare)
- Harvard Medical School, USA
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- Rice, Henry E. (författare)
- Duke University Medical Center and Duke Global Health Institute, Durham, USA
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- Watters, David (författare)
- Deakin University and Barwon Health, Melbourne, Australia
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- Dantas, Fernanda Lage Lima (författare)
- Federal University of Acre, Public Health System State of Acre, Brazil
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- Mooney, David P. (författare)
- Boston Children’s Hospital, Boston, MA, USA
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- Botelho, Fabio (författare)
- Montreal Children’s Hospital, Montreal, Canada
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- Ferreira, Rodrigo Vaz (författare)
- Disciplina de Cirurgia, Universidade do Estado do Amazonas, Brazil
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- Alonso, Nivaldo (författare)
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
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(creator_code:org_t)
- Elsevier, 2021
- 2021
- Engelska.
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Ingår i: The Lancet Regional Health - Americas. - : Elsevier. - 2667-193X.
- Relaterad länk:
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https://liu.diva-por... (primary) (Raw object)
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background:The impact of public health policy to reduce the spread of COVID-19 on access to surgical care is poorly defined. We aim to quantify the surgical backlog during the COVID-19 pandemic in the Brazilian public health system and determine the relationship between state-level policy response and the degree of state-level delays in public surgical care.Methods:Monthly estimates of surgical procedures performed per state from January 2016 to December 2020 were obtained from Brazil's Unified Health System Informatics Department. Forecasting models using historical surgical volume data before March 2020 (first reported COVID-19 case) were constructed to predict expected monthly operations from March through December 2020. Total, emergency, and elective surgical monthly backlogs were calculated by comparing reported volume to forecasted volume. Linear mixed effects models were used to model the relationship between public surgical delivery and two measures of health policy response: the COVID-19 Stringency Index (SI) and the Containment & Health Index (CHI) by state.Findings:Between March and December 2020, the total surgical backlog included 1,119,433 (95% Confidence Interval 762,663–1,523,995) total operations, 161,321 (95%CI 37,468–395,478) emergent operations, and 928,758 (95%CI 675,202–1,208,769) elective operations. Increased SI and CHI scores were associated with reductions in emergent surgical delays but increases in elective surgical backlogs. The maximum government stringency (score = 100) reduced emergency delays to nearly zero but tripled the elective surgical backlog.Interpretation:Strong health policy efforts to contain COVID-19 ensure minimal reductions in delivery of emergent surgery, but dramatically increase elective backlogs. Additional coordinated government efforts will be necessary to specifically address the increased elective backlogs that accompany stringent responses.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Nyckelord
- COVID-19; Global health; Health policy; Surgery; Elective surgery; Emergency surgery; Pandemics
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Truche, Paul
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Campos, Letícia ...
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Marrazzo, Enzzo ...
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Rangel, Ayla Ger ...
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Bernardino, Ramo ...
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Bowder, Alexis N
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Buda, Alexandra ...
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Faria, Isabella
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Pompermaier, Lau ...
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Rice, Henry E.
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Watters, David
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Dantas, Fernanda ...
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Mooney, David P.
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Botelho, Fabio
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Ferreira, Rodrig ...
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Alonso, Nivaldo
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