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DOI: 10.1055/a-1546-8302
Impact of the SARS-CoV-2 pandemic on turnover time and revenue in the endoscopy unit: single-center experience[*]
Abstract
Background and study aims The SARS-CoV-2 pandemic heavily impacted the New York metro area causing most institutions to either reduce case volume or fully close remaining open units incorporated specific guidelines for procedures lockdown potentially leading to a greater turn-over time. We analyzed the quantitative and financial impact of this lost time on our tertiary care center’s endoscopy unit.
Patients and methods This single-center, retrospective study included demographics, procedure details and turn-over times (TOT) from all endoscopic procedures between December 1, 2019 to June 30, 2020. Cases were categorized as pre-COVID-19 group from December 1, 2019 to March 15, 2020 and during COVID-19 (lockdown) group from March 16, 2020 to June 30, 2020. The financial impact was assessed using national averages for reimbursement of outpatient endoscopic procedures provided by Center for Medicare and Medicaid Services.
Results A total of 3622 procedures were performed during the study period: 2297 in the pre-COVID-19 period, 1325 in the COVID-19 period, representing a 42.32 % decrease. In the COVID-19 lockdown group, there was a significant increase in TOT in both the general endoscopy cases (18.11 minutes, P = 0.000) and advanced endoscopy cases (17.7 minutes, P = 0.000). The 42.3 % decrease in volume equated to at least $1.6 million USD in lost revenue during the lockdown.
Conclusions COVID-19 pandemic led to an increase in TOT with overall reduced procedure volume and a negative effect on revenue. Providing continued endoscopic management during a pandemic avoids delays in reopening the endoscopy unit and hampers the post-pandemic surge of delayed cases and its financial impact.
* Meeting presentations: Digestive Disease Week, 2021
Publication History
Received: 12 March 2021
Accepted: 17 June 2021
Article published online:
12 November 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
-
1
Allen J,
Almukhtar S,
Aufrichtig A.
et al.
New Jersey Coronavirus Map and Case Count. The New York Times. 19.05.2021 Available at: https://www.nytimes.com
- 2 Cheung K, Hung I, Chan P. et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from the Hong Kong cohort and systematic review and meta-analysis. Gastroenterology 2020; 159: 81-95
- 3 Guidance for resuming GI endoscopy and practice operations after the COVID-19 Pandemic [PDF file]. American Society for Gastrointestinal Endoscopy; 2020 Available at: https://www.asge.org/docs/default-source/default-document-library/asge-guidance-for-reopeningl_4-28-2020.pdf
- 4 Gastroenterology professional society guidance on endoscopic procedures during the COVID-19 pandemic [PDF file]. American Society for Gastrointestinal Endoscopy; 2020 Available at: https://webfiles.gi.org/links/media/Joint_GI_Society_Guidance_on_Endoscopic_Procedure_During_COVID19_FINAL_impending_3312020.pdf
-
5
Pochapin M,
Greenwald D.
COVID-19 update & recommendations for gastroenterologists. American College of Gastroenterology. Available at: https://mailchi.mp/gi/acgrecommendations-re-covid-19-for-gastroenterologists?e=dbeba47cbc
- 6 Rational use of personal protective equipment for coronavirus disease (COVID-19): interim guidance [PDF file]. World Health Organization; 2020 Available at: https://www.who.int/publications/i/item/rational-use-of-personal-protective-equipment-for-coronavirus-disease-(covid-19)-and-considerations-during-severe-shortages
- 7 Berg B, Denton B, Nelson H. et al. A discrete event simulation model to evaluate operational performance of a colonoscopy suite. Med Decision Making 2010; 30: 380-387
- 8 2020 MPFS proposed rule GI endoscopy RVU [PDF file]. The Centers for Medicare and Medicaid Services; 2019 Available at: https://webfiles.gi.org/links/policy/2020%20MPFS%20Proposed%20Rule%20GI%20endoscopy%20RVUs_for%20members.pdf
- 9 Procedural and reimbursement guide gastroenterology [PDF file]. Boston Scientific. American Medical Association; 2019 Available at: https://www.bostonscientific.com/content/dam/bostonscientific/Reimbursement/Gastroenterology/2019/2019-GI-Procedural-Reimbursement-Guide.pdf
- 10 Medtronic reimbursement support program [PDF file]. Medtronic and Center for Medicare and Medicaid Services; 2020 Available at: https://www.medtronic.com/content/dam/covidien/library/us/en/services-support/reimbursement-guide-gih-solutions.pdf
-
11 CMS releases payment information for endoscopic fundoplication for GERD. 03.11.2015 Available at: https://www.healio.com/news/gastroenterology/20151103/cms-releases-payment-information-for-endoscopic-fundoplication-for-gerd
- 12 2020 Medicare reimbursement rules: impact to GI practice. American Gastroenterological Association. American Gastroenterological Association and Center for Medicare and Medicaid Services; 2020 Available at: https://gastro.org/news/2020-medicare-reimbursement-rules-impact-to-gi-practice/
- 13 Belle A, Barret M, Bernardini D. et al. Impact of the COVID-19 pandemic on the gastrointestinal endoscopic activity in France. Endoscopy 2020; 52: 1111-1115
- 14 Capurso G, Archibugi L, Vanella G. et al. Infection control practices and outcomes of endoscopy units in the lombardy region of Italy: a survey from the Italian Society of Digestive Endoscopy during COVID-19 spread. J Clin Gastroenterol 2020;