{"id":1719,"date":"2022-12-20T00:00:00","date_gmt":"2022-12-20T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/characterizing-the-impact-of-procedure-funding-on-the-covid-19-generated-procedure-gap-in-ontario-a-population-based-analysis\/"},"modified":"2023-11-22T15:44:50","modified_gmt":"2023-11-22T20:44:50","slug":"characterizing-the-impact-of-procedure-funding-on-the-covid-19-generated-procedure-gap-in-ontario-a-population-based-analysis","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/characterizing-the-impact-of-procedure-funding-on-the-covid-19-generated-procedure-gap-in-ontario-a-population-based-analysis\/","title":{"rendered":"Characterizing the impact of procedure funding on the Covid-19 generated procedure gap in Ontario: a population-based analysis"},"content":{"rendered":"

Background<\/strong> \u2014 Surgical procedures in Canada were historically funded through global hospital budgets. Activity-based funding models were developed to improve access, equity, timeliness and value of care for priority areas. COVID-19 upended health priorities and resulted in unprecedented disruptions to surgical care which created a significant procedure gap. We hypothesized that activity-based funding models influenced the magnitude and trajectory of this procedure gap.<\/p>\n

Methods<\/strong> \u2014 Population-based analysis of procedure rates comparing pandemic (March 1, 2020 to December 31, 2021) to a pre-pandemic baseline (January 1, 2017 to February 29, 2020) in Ontario, Canada. Poisson generalized estimating equation models were used to predict expected rates in the pandemic based on the pre-pandemic baseline. Analyses were stratified by procedure type (out-patient, in-patient), body region, and funding category (activity-based funding programs vs. global budget).<\/p>\n

Results<\/strong> \u2014 281,328 fewer scheduled procedures were performed during the COVID-19 period compared to the pre-pandemic baseline (Rate Ratio 0.78; 95%CI 0.77\u20130.80). In-patient procedures saw a larger reduction (24.8%) in volume compared to out-patient procedures (20.5%). An increase in the proportion of procedures funded through activity-based programs was seen during the pandemic (52%) relative to the pre-pandemic baseline (50%). Body systems funded predominantly through global hospital budgets (e.g. gynecology, otologic surgery) saw the least months at or above baseline volumes whereas those with multiple activity-based funding options (e.g. musculoskeletal, abdominal) saw the most months at or above baseline volumes.<\/p>\n

Conclusions<\/strong> \u2014 Those needing procedures funded though global hospital budgets may have been disproportionately disadvantaged by pandemic-related healthcare disruptions.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background \u2014 Surgical procedures in Canada were historically funded through global hospital budgets. Activity-based funding models were developed to improve access, equity, timeliness and value of care for priority areas. COVID-19 upended health priorities and resulted in unprecedented disruptions to surgical care which created a significant procedure gap. We hypothesized that activity-based funding models influenced […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[61,39],"migration-helper-qa-sample-set":[],"class_list":["post-1719","journal_article","type-journal_article","status-publish","hentry","topic-health-economics","topic-infectious-diseases"],"acf":{"citation":"Gomez D, de Mestral C, Stukel TA, Irish J, Simpson AN, Wilton AS, Rotstein OD, Campbell RJ, Eskander A, Urbach DR, Baxter NN. Ann Surg<\/em>. 2023; 278(4):e719-25. Epub 2022 Dec 20.","source_url":"https:\/\/doi.org\/10.1097\/SLA.0000000000005781","ices_scientist":[1227,1241,1219,1372,1358,1203,1177,1343],"site":[6733],"research_program":[6745],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"7BF722CB-596E-48D1-A219-86BF70872209","sitecore_item_name":"Characterizing-the-impact-of-procedure-funding-on-the-Covid-19-generated-procedure-gap-in-Ontario","sitecore_field_values":"{\r\n \"Title\": \"Characterizing the impact of procedure funding on the Covid-19 generated procedure gap in Ontario: a population-based analysis\",\r\n \"Short title\": \"Characterizing the impact of procedure\",\r\n \"Summary\": \"This study found that those needing procedures funded though global hospital budgets may have been disproportionately disadvantaged by pandemic-related healthcare disruptions.\",\r\n \"Citation\": \"

Gomez D, de Mestral C, Stukel TA, Irish J, Simpson AN, Wilton AS, Rotstein OD, Campbell RJ, Eskander A, Urbach DR, Baxter NN. Ann Surg<\/em>. 2022; Dec 20 [Epub ahead of print]. DOI: https:\/\/doi.org\/10.1097\/SLA.0000000000005781<\/a><\/p>\",\r\n \"Abstract\": \"

Background<\/strong> — Surgical procedures in Canada were historically funded through global hospital budgets. Activity-based funding models were developed to improve access, equity, timeliness and value of care for priority areas. COVID-19 upended health priorities and resulted in unprecedented disruptions to surgical care which created a significant procedure gap. We hypothesized that activity-based funding models influenced the magnitude and trajectory of this procedure gap.<\/p>n

Methods<\/strong> — Population-based analysis of procedure rates comparing pandemic (March 1, 2020 to December 31, 2021) to a pre-pandemic baseline (January 1, 2017 to February 29, 2020) in Ontario, Canada. Poisson generalized estimating equation models were used to predict expected rates in the pandemic based on the pre-pandemic baseline. Analyses were stratified by procedure type (out-patient, in-patient), body region, and funding category (activity-based funding programs vs. global budget).<\/p>n

Results<\/strong> — 281,328 fewer scheduled procedures were performed during the COVID-19 period compared to the pre-pandemic baseline (Rate Ratio 0.78; 95%CI 0.77–0.80). In-patient procedures saw a larger reduction (24.8%) in volume compared to out-patient procedures (20.5%). An increase in the proportion of procedures funded through activity-based programs was seen during the pandemic (52%) relative to the pre-pandemic baseline (50%). Body systems funded predominantly through global hospital budgets (e.g. gynecology, otologic surgery) saw the least months at or above baseline volumes whereas those with multiple activity-based funding options (e.g. musculoskeletal, abdominal) saw the most months at or above baseline volumes.<\/p>n

Conclusions<\/strong> — Those needing procedures funded though global hospital budgets may have been disproportionately disadvantaged by pandemic-related healthcare disruptions.<\/p>\",\r\n \"ICES Scientists\": \"{D7B53E18-8D1F-4D4F-8ADC-9FAB15D9E5EC}|{598E7316-D670-4CCF-A8EC-4D6DFE432E49}|{E0BAC4D7-85D0-472A-A045-7BFEC4CAD15D}|{A0978F87-1C10-4E62-A833-89616146CA59}|{5F26526F-8E1A-43EF-A3BD-4DD394329190}|{F8C8C01B-CFDC-4601-804E-F7C502970FCC}|{73B9FD95-5453-4FBA-B02E-CD2911B86ACD}|{44155080-6CB5-428D-9E38-9693CAD11DD3}\",\r\n \"Posted Date\": \"20221220T000000\",\r\n \"Show on Publications Landing Page\": \"1\"\r\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/December\/Characterizing-the-impact-of-procedure-funding-on-the-Covid-19-generated-procedure-gap-in-Ontario"},"yoast_head":"\nICES | Characterizing the impact of procedure funding on the Covid-19 generated procedure gap in Ontario: a population-based analysis<\/title>\n<meta name=\"description\" content=\"Background \u2014 Surgical procedures in Canada were historically funded through global hospital budgets. 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