COVID-19 and the duration of operating room procedures in Ontario: a population-based retrospective study

• Published in: Canadian journal of surgery Vol. 65; no. 5; pp. E675 - E682
• Main Authors: Kantarevic, Jasmin, Chami, Nadine, Vinden, Chris, Nadolski, Joanna, Adamson, Michael, Li, Yin, Weir, Sharada, Wright, James G, McClure, Andrew, Hill, Samantha
• Format: Journal Article
• Language: English
• Published: CMA Impact Inc 01.10.2022
• Subjects: Health care industry; Operating rooms; Safety and security measures; Ontario
• ISSN: 0008-428X; 1488-2310
• DOI: 10.1503/cjs.011521

Background: Studies have estimated that a large backlog of procedures was generated by emergency measures implemented in Ontario, Canada, at the onset of the COVID-19 pandemic, when nonessential and scheduled procedures were postponed. Understanding the impact of the COVID-19 pandemic on the time needed to perform a procedure may help to determine the resources needed to tackle the substantial backlog caused by the deferral of cases. The purpose of this study was to examine the duration of operating room (OR) procedures before and after the onset of the COVID-19 pandemic to inform planning around changes in required resources. Methods: A population-based, retrospective cohort study was conducted using Ontario Health Insurance Plan claims data and other administrative health care data from Apr. 1, 2019, to Sept. 30, 2020. Statistical analysis was conducted using multivariate regression, with procedure duration as the outcome variable. Results: Results showed that the average duration of nonelective procedures increased by 34 minutes during the COVID-19 period and by 19 minutes after the resumption of scheduled procedures. Controlling for physician, patient and hospital characteristics, and the procedure code submitted, procedure duration increased by 12 minutes in the nonelective COVID-19 period and by 5 minutes when scheduled procedures resumed, compared with the pre-COVID-19 period. Conclusion: Procedures may take longer in the COVID-19 period. This will affect wait times, which had already increased because of the deferral of procedures at the beginning of the pandemic, and will have an impact on Ontario's ability to provide patients with timely care. Contexte : Selon des etudes, on estime que la mise en place des mesures d'urgence en Ontario (Canada) au debut de la pandemie de COVID-19, qui ont entraine le report de toutes les interventions planifiees et non essentielles, a mene a l'accumulation d'un retard important des interventions chirurgicales. Comprendre l'incidence de la pandemie de COVID-19 sur le temps necessaire pour realiser une intervention pourrait aider a determiner les ressources requises pour s'attaquer a cet arriere considerable. Le but de cette etude etait d'observer la duree des interventions en salle d'operation avant et apres le debut de la pandemie de COVID-19 pour mieux planifer les changements aux ressources necessaires. Methodes : Une etude de cohorte retrospective populationnelle a ete menee a l'aide des donnees sur les reclamations medicales soumises au Regime d'assurance-sante de l'Ontario et d'autres donnees administratives sur les soins de sante du 1 (er) avril 2019 au 30 septembre 2020. L'analyse statistique a ete realisee au moyen d'une regression multivariable, ou la duree de l'intervention constituait la variable dependante. Resultats : Les resultats ont montre que la duree moyenne des interventions non urgentes a augmente de 34 minutes durant la periode de restrictions associees a la COVID-19, et de 19 minutes apres la reprise des interventions planifees. En tenant compte de variables comme les caracteristiques du medecin, du patient et de l'hopital ainsi que des codes d'acte soumis, le temps moyen des interventions a augmente de 12 minutes pendant la periode de restrictions associees a la COVID-19 pour les interventions non urgentes et de 5 minutes apres la reprise des interventions planifees comparativement a la periode precedant la COVID-19. Conclusion : Les interventions peuvent prendre plus de temps en contexte de COVID-19. Cela influencera les temps d'attente, qui ont deja augmente en raison du report des interventions au debut de la pandemie, et aura des repercussions sur la capacite de l'Ontario a fournir aux patients des soins dans des delais raisonnables.