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Can We Identify Patients in Danger of Delayed Treatment? Management of COVID-19 Pandemic Backlog in Urology Care in Poland

Author

Listed:
  • Jakub Marek Ratajczak

    (Department of Management and Logistics in Health Care, Medical University of Lodz, 90-647 Lodz, Poland)

  • Anna Gawrońska

    (Łukasiewicz Research Network, Poznań Institute of Technology, 61-755 Poznań, Poland)

  • Margaret Fischer

    (Faculty of Pharmacy, Medical University of Gdansk, 80-210 Gdansk, Poland)

  • Taras Hladun

    (Urology Department, Regional Specialized Hospital in Nowa Sól, 67-100 Nowa Sól, Poland)

  • Michał Marczak

    (Department of Management and Logistics in Health Care, Medical University of Lodz, 90-647 Lodz, Poland)

Abstract

The COVID-19 pandemic had a tremendous impact on healthcare systems around the world. This study aims to research the course of surgical treatment in urology during the pandemic in 2020, evaluate the volume of deferred treatment in urology in Poland, and indicate groups of patients that are especially vulnerable to a delay in the delivery of healthcare services. The National Health Found statistics (NHF) database was searched for information on procedures completed in urology departments from 2015 to 2020. Changes in hospital discharges of adults from 2019 to 2021 were investigated using monthly reports of NHF on patient billing groups. Statistics of PSA, testosterone, and creatinine testing were extracted from NHF reports. Annual changes in the number of surgeries were calculated. Then, the estimation of the expected quantity of procedures without the occurrence of the pandemic was performed using linear regression based on data from 2015 to 2020. The estimation was assumed reliable at R 2 > 0.8. The difference between collected and estimated data was analysed. In 2020, the volume of radical prostatectomies, cystectomies, and kidney surgeries noted downturns following lockdowns in March and November. All analysed procedures, except radical cystectomy, noted a reduction in the entire year. The declines reached −34% in shockwave lithotripsy, −13% in ureterorenoscopic lithotripsy, −22% in cystolithotripsy, −28% in percutaneous lithotripsy, −12% in transurethral resection of a bladder tumour (TURBT), −31% in transurethral resection of the prostate, −15% in nephrectomy and kidney tumorectomy, and −10% in radical prostatectomy. Among the analysed procedures, only radical cystectomy rates increased 5%. Prostate-specific antigen and creatinine tests fell −17%, and testosterone testing was down −18%. In conclusion, the patients most vulnerable to delayed treatment due to the post-pandemic backlog are those requiring TURBT, kidney cancer operations, and radical prostatectomies. Solving backlogs in urology should prioritise cancer patients and thus requires improved access to cystoscopy, TURBT, diagnoses and surgery of prostate and kidney tumours. Addressing the needs of patients suffering from benign diseases demands appropriate measures to increase the surgical productivity of urology departments.

Suggested Citation

  • Jakub Marek Ratajczak & Anna Gawrońska & Margaret Fischer & Taras Hladun & Michał Marczak, 2022. "Can We Identify Patients in Danger of Delayed Treatment? Management of COVID-19 Pandemic Backlog in Urology Care in Poland," IJERPH, MDPI, vol. 19(24), pages 1-15, December.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:24:p:16547-:d:998457
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    References listed on IDEAS

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    1. Giulio Nittari & Demetris Savva & Daniele Tomassoni & Seyed Khosrow Tayebati & Francesco Amenta, 2022. "Telemedicine in the COVID-19 Era: A Narrative Review Based on Current Evidence," IJERPH, MDPI, vol. 19(9), pages 1-15, April.
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    Cited by:

    1. Krystian Kaczmarek & Jakub Kalembkiewicz & Marta Jankowska & Karolina Kalembkiewicz & Jakub Narożnicki & Artur Lemiński & Marcin Słojewski, 2023. "Did the COVID-19 Pandemic Restrict Access to Emergency Urological Services: Assessment of Reorganisation Effectiveness for Hospital Treatment," IJERPH, MDPI, vol. 20(4), pages 1-8, February.

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