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The financial impact of the COVID-19 pandemic on sleeve gastrectomy at a major academic institution.
Mou, Danny; Kumarasamy, Mathu; Grunewald, Zachary; Cooper, Kristin; Fay, Katherine; Hall, Carrie E; Bibler, Jennifer; Lin, Edward; Davis, Scott; Sweeney, John F; Esper, Gregory; Sharma, Jyotirmay; Hechenbleikner, Elizabeth.
Afiliación
  • Mou D; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA. moudanny@gmail.com.
  • Kumarasamy M; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
  • Grunewald Z; Office of Quality, Emory Healthcare, Atlanta, GA, USA.
  • Cooper K; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
  • Fay K; Finance Department, Emory Healthcare Hospital, Atlanta, GA, USA.
  • Hall CE; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
  • Bibler J; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
  • Lin E; Finance Department, Emory Healthcare Hospital, Atlanta, GA, USA.
  • Davis S; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
  • Sweeney JF; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
  • Esper G; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
  • Sharma J; Department of Neurology, Emory University, Atlanta, GA, USA.
  • Hechenbleikner E; Department of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Surg Endosc ; 37(8): 6558-6564, 2023 08.
Article en En | MEDLINE | ID: mdl-37308762
INTRODUCTION: The COVID-19- pandemic significantly impacted metabolic and bariatric surgery (MBS) practices due to large-scale surgery cancellations along with staff and supply shortages. We analyzed sleeve gastrectomy (SG) hospital-level financial metrics before and after the COVID-19 pandemic. METHODS: Hospital cost-accounting software (MicroStrategy, Tysons, VA) was reviewed for revenues, costs, and profits per SG at an academic hospital (2017-2022). Actual figures were obtained, not insurance charge estimates or hospital projections. Fixed costs were obtained through surgery-specific allocation of inpatient hospital and operating-room costs. Direct variable costs were analyzed with sub-components including: (1) labor and benefits, (2) implants, (3) drug costs, and 4) medical/surgical supplies. The pre-COVID-19 period (10/2017-2/2020) and post-COVID-19 period (5/2020-9/2022) financial metrics were compared with student's t-test. Data from 3/2020 to 4/2020 were excluded due to COVID-19-related changes. RESULTS: A total of 739 SG patients were included. Average length of stay (LOS), Center for Medicaid and Medicare Case Mix Index (CMI), and percentage of patients with commercial insurance were similar pre vs. post-COVID-19 (p > 0.05). There were more SG performed per quarter pre-COVID-19 than post-COVID-19 (36 vs. 22; p = 0.0056). Pre-COVID-19 and post-COVID-19 financial metrics per SG differed significantly for, respectively, revenues ($19,134 vs. $20,983) total variable cost ($9457 vs. $11,235), total fixed cost ($2036 vs. $4018), total profit ($7571 vs. $5442), and labor and benefits cost ($2535 vs. $3734; p < 0.05). CONCLUSIONS: The post-COVID-19 period was characterized by significantly increased SG fixed cost (i.e., building maintenance, equipment, overhead) and labor costs (increased contract labor), resulting in precipitous profit decline that crosses the break-even in calendar year quarter (CQ) 3, 2022. Potential solutions include minimizing contract labor cost and decreasing LOS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 4_TD Problema de salud: 4_pneumonia Asunto principal: Obesidad Mórbida / COVID-19 Tipo de estudio: Health_economic_evaluation / Observational_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Surg Endosc Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 4_TD Problema de salud: 4_pneumonia Asunto principal: Obesidad Mórbida / COVID-19 Tipo de estudio: Health_economic_evaluation / Observational_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Surg Endosc Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos
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