TY - JOUR
T1 - Minimising population health loss in times of scarce surgical capacity
T2 - a modelling study for surgical procedures performed in nonacademic hospitals
AU - van Alphen, Anouk M.I.A.
AU - van Hof, Kira S.
AU - Value Based Operation Room Triage team collaborators
AU - Gravesteijn, Benjamin Y.
AU - Krijkamp, Eline M.
AU - Bakx, Pieter A.G.M.
AU - Langenbach, Peter
AU - Busschbach, Jan J.
AU - Lingsma, Hester F.
AU - Baatenburg de Jong, Robert J.
AU - Arends, Arend
AU - van Rossem, Charles
AU - Sleeboom, Harm
AU - Postema, Jonne
AU - van Scheltinga, Josien Terwisscha
AU - Valk-Kleibreuker, Linda
AU - Hoedt, Marco
AU - Nieboer, Mike
AU - Faes, Miriam
AU - Pouwels, Sjaak
AU - Raaff, Suze
AU - Nieboer, Taco
AU - van Dorp, Tietse
AU - Bosman, Willem Maarten
N1 - Funding Information:
Eline Krijkamp was supported by the Society for Medical Decision Making fellowship through a grant (GBMF7853) by the Gordon and Betty Moore Foundation, Palo Alto, CA, United States. Support for this study was solely from institutional and/or departmental sources.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/11/30
Y1 - 2022/11/30
N2 - Background: The burden of the COVID-19 pandemic resulted in a reduction of available health care capacity for regular care. To guide prioritisation of semielective surgery in times of scarcity, we previously developed a decision model to quantify the expected health loss due to delay of surgery, in an academic hospital setting. The aim of this study is to validate our decision model in a nonacademic setting and include additional elective surgical procedures. Methods: In this study, we used the previously published three-state cohort state-transition model, to evaluate the health effects of surgery postponement for 28 surgical procedures commonly performed in nonacademic hospitals. Scientific literature and national registries yielded nearly all input parameters, except for the quality of life (QoL) estimates which were obtained from experts using the Delphi method. Two expert panels, one from a single nonacademic hospital and one from different nonacademic hospitals in the Netherlands, were invited to estimate QoL weights. We compared estimated model results (disability adjusted life years (DALY)/month of surgical delay) based on the QoL estimates from the two panels by calculating the mean difference and the correlation between the ranks of the different surgical procedures. The eventual model was based on the combined QoL estimates from both panels. Results: Pacemaker implantation was associated with the most DALY/month of surgical delay (0.054 DALY/month, 95% CI: 0.025–0.103) and hemithyreoidectomy with the least DALY/month (0.006 DALY/month, 95% CI: 0.002–0.009). The overall mean difference of QoL estimates between the two panels was 0.005 (95% CI -0.014–0.004). The correlation between ranks was 0.983 (p < 0.001). Conclusions: Our study provides an overview of incurred health loss due to surgical delay for surgeries frequently performed in nonacademic hospitals. The quality of life estimates currently used in our model are robust and validate towards a different group of experts. These results enrich our earlier published results on academic surgeries and contribute to prioritising a more complete set of surgeries.
AB - Background: The burden of the COVID-19 pandemic resulted in a reduction of available health care capacity for regular care. To guide prioritisation of semielective surgery in times of scarcity, we previously developed a decision model to quantify the expected health loss due to delay of surgery, in an academic hospital setting. The aim of this study is to validate our decision model in a nonacademic setting and include additional elective surgical procedures. Methods: In this study, we used the previously published three-state cohort state-transition model, to evaluate the health effects of surgery postponement for 28 surgical procedures commonly performed in nonacademic hospitals. Scientific literature and national registries yielded nearly all input parameters, except for the quality of life (QoL) estimates which were obtained from experts using the Delphi method. Two expert panels, one from a single nonacademic hospital and one from different nonacademic hospitals in the Netherlands, were invited to estimate QoL weights. We compared estimated model results (disability adjusted life years (DALY)/month of surgical delay) based on the QoL estimates from the two panels by calculating the mean difference and the correlation between the ranks of the different surgical procedures. The eventual model was based on the combined QoL estimates from both panels. Results: Pacemaker implantation was associated with the most DALY/month of surgical delay (0.054 DALY/month, 95% CI: 0.025–0.103) and hemithyreoidectomy with the least DALY/month (0.006 DALY/month, 95% CI: 0.002–0.009). The overall mean difference of QoL estimates between the two panels was 0.005 (95% CI -0.014–0.004). The correlation between ranks was 0.983 (p < 0.001). Conclusions: Our study provides an overview of incurred health loss due to surgical delay for surgeries frequently performed in nonacademic hospitals. The quality of life estimates currently used in our model are robust and validate towards a different group of experts. These results enrich our earlier published results on academic surgeries and contribute to prioritising a more complete set of surgeries.
UR - http://www.scopus.com/inward/record.url?scp=85143100455&partnerID=8YFLogxK
U2 - 10.1186/s12913-022-08854-x
DO - 10.1186/s12913-022-08854-x
M3 - Article
C2 - 36451147
AN - SCOPUS:85143100455
SN - 1472-6963
VL - 22
JO - Bmc Health Services Research
JF - Bmc Health Services Research
IS - 1
M1 - 1456
ER -
