Surgery During the Pandemic in a Public Hospital in South West Victoria, Australia: A Regional/Rural Perspective

Objective

In Victoria, the onset of COVID-19 resulted in restricted entry to metropolitan areas, and lockdowns were a common occurrence. Our health services adapted and changed procedures. Surgical services were limited to urgent cases, while staff were redirected to support COVID-19 health care. This study documents the experience of surgical services in a public hospital serving a rural and regional population in south-west Victoria.

Design

Cohort study.

Methods

All patients who had operations at University Hospital Geelong, the major regional hospital in south-west Victoria, were included in this study. Operations pre-pandemic (2019), during the pandemic (2020–2022) and late pandemic (2023) were recorded. The flow of procedures within each subspecialty, cancellations and the waiting list are reported.

Results

From July 2019 until June 2023, there were 76 098 operations performed with the largest number of operations by general surgery (17 610), plastics and reconstruction (10 560), obstetrics and gynaecology (10 848) and orthopaedics (8376). Emergency procedures peaked at 41% in 2020. Urology experienced the highest percentage increase for operations in 2023 (by 40%), followed by obstetrics and gynaecology (15%), general surgery (14%), otolaryngology (14%), orthopaedics (12%), ophthalmology (11%) and vascular surgery (9%). Staff not available was a reason for cancellation of surgery and the wait list increased by 121% in 2022.

Conclusion

The wait list late pandemic far exceeds that of pre pandemic, increasing the potential to exacerbate regional/rural Victoria's limited access to care. The significant impact on various surgical specialties in regional hospitals requires refocus to ensure that the elective surgery waitlist is addressed.