Costanza Vicentini , Elettra Ugliono , Heba Safwat Mhmoued Abdo Elhadidy , Giovanni Paladini , Alessandro Roberto Cornio , Federico Cussotto , Mario Morino , Carla Maria Zotti
{"title":"COVID-19 大流行期间的外科重组及其对病例组合和手术部位感染的影响：意大利多中心队列研究","authors":"Costanza Vicentini , Elettra Ugliono , Heba Safwat Mhmoued Abdo Elhadidy , Giovanni Paladini , Alessandro Roberto Cornio , Federico Cussotto , Mario Morino , Carla Maria Zotti","doi":"10.1016/j.healthpol.2024.105113","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The coronavirus 2019 (COVID-19) pandemic led to major disruptions in surgical activity, particularly in the first year (2020). The objective of this study was to assess the impact of surgical reorganization on surgical outcomes in Northern Italy in 2020 and 2021.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was conducted among 30 hospitals participating in the surveillance system for surgical site infections (SSIs). Abdominal surgery procedures performed between 2018 and 2021 were considered. Predicted SSI rates for 2020 and 2021 were estimated based on 2018–2019 data and compared with observed rates. Independent predictors for SSI were investigated using logistic regression, including procedure year.</p></div><div><h3>Results</h3><p>7605 procedures were included. Significant differences in case-mix were found comparing the three time periods. Observed SSI rates among all patients in 2020 were significantly lower than expected based on 2018–2019 SSI rates (p 0.0465). Patients undergoing procedures other than cancer surgery in 2020 had significantly lower odds for SSI (odds ratio, OR 0.52, 95 % confidence interval, CI 0.3–0.89, p 0.018) and patients undergoing surgery in 2021 had significantly higher odds for SSI (OR 1.49, 95 % CI 1.07–2.09, p 0.019) compared to 2018–2019.</p></div><div><h3>Conclusions</h3><p>Enhanced infection prevention and control (IPC) measures could explain the reduced SSI risk during the first pandemic year. IPC practices should continue to be reinforced beyond the pandemic context.</p></div>","PeriodicalId":55067,"journal":{"name":"Health Policy","volume":"146 ","pages":"Article 105113"},"PeriodicalIF":3.6000,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0168851024001234/pdfft?md5=69d6543eb71083dc860a73df250bde25&pid=1-s2.0-S0168851024001234-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Surgical reorganization during the COVID-19 pandemic and impact on case-mix and surgical site infections: A multicenter cohort study in Italy\",\"authors\":\"Costanza Vicentini , Elettra Ugliono , Heba Safwat Mhmoued Abdo Elhadidy , Giovanni Paladini , Alessandro Roberto Cornio , Federico Cussotto , Mario Morino , Carla Maria Zotti\",\"doi\":\"10.1016/j.healthpol.2024.105113\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The coronavirus 2019 (COVID-19) pandemic led to major disruptions in surgical activity, particularly in the first year (2020). The objective of this study was to assess the impact of surgical reorganization on surgical outcomes in Northern Italy in 2020 and 2021.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was conducted among 30 hospitals participating in the surveillance system for surgical site infections (SSIs). Abdominal surgery procedures performed between 2018 and 2021 were considered. Predicted SSI rates for 2020 and 2021 were estimated based on 2018–2019 data and compared with observed rates. Independent predictors for SSI were investigated using logistic regression, including procedure year.</p></div><div><h3>Results</h3><p>7605 procedures were included. Significant differences in case-mix were found comparing the three time periods. Observed SSI rates among all patients in 2020 were significantly lower than expected based on 2018–2019 SSI rates (p 0.0465). Patients undergoing procedures other than cancer surgery in 2020 had significantly lower odds for SSI (odds ratio, OR 0.52, 95 % confidence interval, CI 0.3–0.89, p 0.018) and patients undergoing surgery in 2021 had significantly higher odds for SSI (OR 1.49, 95 % CI 1.07–2.09, p 0.019) compared to 2018–2019.</p></div><div><h3>Conclusions</h3><p>Enhanced infection prevention and control (IPC) measures could explain the reduced SSI risk during the first pandemic year. IPC practices should continue to be reinforced beyond the pandemic context.</p></div>\",\"PeriodicalId\":55067,\"journal\":{\"name\":\"Health Policy\",\"volume\":\"146 \",\"pages\":\"Article 105113\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-06-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0168851024001234/pdfft?md5=69d6543eb71083dc860a73df250bde25&pid=1-s2.0-S0168851024001234-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0168851024001234\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Policy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0168851024001234","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Surgical reorganization during the COVID-19 pandemic and impact on case-mix and surgical site infections: A multicenter cohort study in Italy
Background
The coronavirus 2019 (COVID-19) pandemic led to major disruptions in surgical activity, particularly in the first year (2020). The objective of this study was to assess the impact of surgical reorganization on surgical outcomes in Northern Italy in 2020 and 2021.
Methods
A retrospective cohort study was conducted among 30 hospitals participating in the surveillance system for surgical site infections (SSIs). Abdominal surgery procedures performed between 2018 and 2021 were considered. Predicted SSI rates for 2020 and 2021 were estimated based on 2018–2019 data and compared with observed rates. Independent predictors for SSI were investigated using logistic regression, including procedure year.
Results
7605 procedures were included. Significant differences in case-mix were found comparing the three time periods. Observed SSI rates among all patients in 2020 were significantly lower than expected based on 2018–2019 SSI rates (p 0.0465). Patients undergoing procedures other than cancer surgery in 2020 had significantly lower odds for SSI (odds ratio, OR 0.52, 95 % confidence interval, CI 0.3–0.89, p 0.018) and patients undergoing surgery in 2021 had significantly higher odds for SSI (OR 1.49, 95 % CI 1.07–2.09, p 0.019) compared to 2018–2019.
Conclusions
Enhanced infection prevention and control (IPC) measures could explain the reduced SSI risk during the first pandemic year. IPC practices should continue to be reinforced beyond the pandemic context.
期刊介绍：
Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.
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