Covid-19 pandemic: Economic burden on patients with musculoskeletal injuries in a tertiary care hospital of LMIC; retrospective cross sectional study

Abstract

Covid-19 has adversely impacted the health care organizations by over burdening with Covid patients and suspending the elective surgeries and clinics. Hospitalization during pandemic may increase health cost of patients for elective and emergency procedure due to extra cost of covid testing and isolation. A single center retrospective study was conducted to quantify losses due to postponement of elective surgeries and extra cost for procurement of PPEs. The secondary objective was to see the effect of Covid −19 on the total costs of inpatient care during Covid era. Patient and method We included all the patients admitted in orthopedic section for operative intervention of fractures and elective procedures from January 1, 2020 to May 31, 2020. We divided this period into two halves; the first half was from January first to March 15 named as PreCovid Era and second half was from March 16, to May 31, 2020, termed as Covid Era. The total number of trauma procedures and elective procedures were compared in both eras. We compared six procedures each from upper and lower limit for cost analysis and length of stay. We also analyzed the extra cost for procurement of PPEs. Results A total 625 patients were admitted during study period; 417 in precovid and 208 in covid era. There was 50% reduction in patients admissions during Covid era. There was no statistically significant difference in age and gender of both groups. A total of 840 (591in preCovid era and 251 in Covid era) procedures were performed on these 625 patients. Elective and emergency procedures were significantly reduced in Covid era. There was 55.7% drop in the collective revenue generated in covid era as compared to that of Precovid era. The average length of stay was decreased in Covid era. No statistically significance difference was found in inpatient hospital charges of both groups except for two procedures ankle and proximal humeral fractures; that was significantly reduced in Covid era. There was significantly increase in use of PPE in covid era Conclusion The financial income of our service decreased more than 55% due to postponement of elective work. The number of elective and procedures related to musculoskeletal trauma also decreased. The cost for inpatient care did not increase during covid era. There was significant reduction in inpatient hospital stay during covid era. The hospital management had to spent additional expenses on procurement of PPEs.

Epidemiology of Distal Radius Fractures in Children and Adults During the COVID-19 Pandemic – A Two-Center Study

“…In one of Turkish hospitals, the total number of fractures recorded during the COVID-19 pandemic was by 61.6% lower than the number of fractures recorded in 2019 [20].Our retrospective study showed reduced numbers of pediatric (by 3.8%) and adult patients (by 22%) referred to emergency departments due to DRFs during the COVID-19 pandemic. Similar, or even more pronounced decreases over the COVID-19 pandemic period (compared to period prior to the COVID-19 pandemic ) have been reported in other countries (19-69%) [13,[15][16][17][18][19][20][21][22]24].…”

“…Distal radius fractures constitute a social problem [1][2][3][4][5][6][7][8][9][10][11][12][13]. The COVID-19 pandemic has had a considerable impact on the lives of both adults and children around the world [13][14][15][16][17][18][19][20][21][22][23][24]. Some schools have been closed, causing children to stay at home, and some adults work from home.…”

“…Bram et al noted a decreased incidence of injuries due to sports and other outdoor activities, with an increased incidence of high-energy injuries due to falls from trampolines and bicycles [15]. Hashmi reported a 50% decrease in both elective and emergency admissions to orthopedic wards, with no changes in either the mean age or male-to-female ratio in patients in the COVID-19 pandemic period in comparison with the relevant pre-pandemic gures [16]. Yu et al observed a 42% decrease in the number of patients with fractures seen at one of the orthopedic wards in China during the COVID-19 epidemic [17].…”

“…The COVID-19 pandemic altered the healthcare in the whole world in the year 2020 [13][14][15][16][17][18][19][20][21][22][23][24]. Although the causative coronavirus (SARS-CoV-2) can infect both adults and children, the majority of children have mild or asymptomatic course of the disease [13].…”

“…Some physicians contracted COVID-19, some shortened their o ce hours to limit the risk of infection. Some trauma and orthopedic units and some emergency wards have also altered their admission criteria [16,17,22]. Despite having suffered an injury, some patients, particularly the elderly and those with comorbidities, have avoided seeking medical help at emergency or trauma and orthopedic wards due to the fear of contracting COVID-19 [13,22].…”