Clearing the surgical backlog caused by COVID-19 in Ontario: a time series modelling study
Clearing the surgical backlog caused by COVID-19 in Ontario: a time series modelling study
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DOI：
10.1503/cmaj.201521
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发表时间：
2020-11-02
影响因子：
14.6
通讯作者：
Irish, Jonathan
中科院分区：
文献类型：
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作者：
Wang, Jonathan;Vahid, Saba;Irish, Jonathan
背景：为了减轻2019冠状病毒病（COVID-19）的影响，全球各地的司法管辖区减少了非紧急手术，造成全球手术积压。我们试图估计加拿大安大略COVID-19期间非紧急手术积压的规模，以及清除积压所需的时间和资源。方法：我们使用6个安大略或加拿大人口管理来源，获得2017年1月1日至2020年6月13日期间部分或全部时间的数据，按手术类型和地区划分的历史手术量和手术室吞吐量分布，以及病房和重症监护室（ICU）床位的住院时间。我们使用时间序列预测、排队模型和概率敏感性分析来估计+10%（每周+1天，50%容量）激增情景下的积压量和清除时间。结果：在2020年3月15日至6月13日期间，安大略的积压量估计为148 364例手术（95%预测区间为124 508-174 589），平均每周增加11 413例手术。估计积压清理时间为84周（95%置信区间[CI] 46-145），估计每周吞吐量为717例患者（95% CI 326-1367）需要719个手术室小时（95%CI 431-1038）、265张病房床位（95%CI 87-678）和9张ICU床位（95%CI 4-20）。解释：COVID-19造成的手术积压的规模对安大略的恢复阶段产生了严重影响。我们的手术积压恢复建模框架可以适用于其他司法管辖区，使用本地数据来协助规划。
BACKGROUND:To mitigate the effects of coronavirus disease 2019 (COVID-19), jurisdictions worldwide ramped down nonemergent surgeries, creating a global surgical backlog. We sought to estimate the size of the nonemergent surgical backlog during COVID-19 in Ontario, Canada, and the time and resources required to clear the backlog.METHODS:We used 6 Ontario or Canadian population administrative sources to obtain data covering part or all of the period between Jan. 1, 2017, and June 13, 2020, on historical volumes and operating room throughput distributions by surgery type and region, and lengths of stay in ward and intensive care unit (ICU) beds. We used time series forecasting, queuing models and probabilistic sensitivity analysis to estimate the size of the backlog and clearance time for a +10% (+1 day per week at 50% capacity) surge scenario.RESULTS:Between Mar. 15 and June 13, 2020, the estimated backlog in Ontario was 148 364 surgeries (95% prediction interval 124 508-174 589), an average weekly increase of 11 413 surgeries. Estimated backlog clearance time is 84 weeks (95% confidence interval [CI] 46-145), with an estimated weekly throughput of 717 patients (95% CI 326-1367) requiring 719 operating room hours (95% CI 431-1038), 265 ward beds (95% CI 87-678) and 9 ICU beds (95% CI 4-20) per week.INTERPRETATION:The magnitude of the surgical backlog from COVID-19 raises serious implications for the recovery phase in Ontario. Our framework for modelling surgical backlog recovery can be adapted to other jurisdictions, using local data to assist with planning.