Evidence map›Paper›PMID 37308762›Full record

ArticleSurgical endoscopy2023

The financial impact of the COVID-19 pandemic on sleeve gastrectomy at a major academic institution.

Danny Mou, Mathu Kumarasamy, Zachary Grunewald, Kristin Cooper, Katherine Fay, Carrie E Hall, Jennifer Bibler, Edward Lin, Scott Davis, John F Sweeney and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Danny MouDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA. moudanny@gmail.com.ORCID http://orcid.org/0000-0003-3529-3563
Mathu KumarasamyDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Zachary GrunewaldDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Kristin CooperFinance Department, Emory Healthcare Hospital, Atlanta, GA, USA.
Katherine FayDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Carrie E HallDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Jennifer BiblerFinance Department, Emory Healthcare Hospital, Atlanta, GA, USA.
Edward LinDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Scott DavisDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
John F SweeneyDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Gregory EsperDepartment of Neurology, Emory University, Atlanta, GA, USA.
Jyotirmay SharmaDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
Elizabeth HechenbleiknerDepartment of Surgery, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe 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.

methodsHospital 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.

resultsA 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).

conclusionsThe 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.

Indexed as

COVID-19Obesity, MorbidAgedGastrectomyHumansLength of StayMedicarePandemicsRetrospective StudiesUnited StatesCostCOVID-19 pandemicFinancial impactProfitRevenuesSleeve gastrectomy

Identifiers

PMID37308762

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.