Format

Send to

Choose Destination
Plast Reconstr Surg. 2019 Feb;143(2):340e-349e. doi: 10.1097/PRS.0000000000005260.

Impact of Economic Downturn on the Surgical Volumes of Common Hand Procedures.

Author information

1
Ann Arbor, Mich.; Nagoya, Japan; and Taoyuan, Taiwan From the Department of Surgery, Section of Plastic Surgery, University of Michigan, the University of Michigan Medical School; the Department of Hand Surgery, Nagoya University; and the Division of Rheumatology, Allergy and Immunology and the Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital.

Abstract

BACKGROUND:

Economic conditions affect surgical volumes, particularly for elective procedures. In this study, the authors aimed to identify the effects of the 2008 U.S. economic downturn on hand surgery volumes to guide surgeons and managers when facing future economic crises.

METHODS:

The authors used the California State Ambulatory Surgery and Services Database from January of 2005 to December of 2011, which includes the entire period of the Great Recession (December of 2007 to June of 2009). The authors abstracted the monthly volume of five common hand procedures using International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes. Pearson statistics were used to identify the correlation between unemployment rate and surgical volume for each procedure.

RESULTS:

The total number of operative cases was 345,583 during the 7-year study period. Most common elective hand procedures, such as carpal tunnel release and trigger finger release, had a negative correlation with unemployment rate, but the volume of distal radius fracture surgery did not show any correlation. Compared with carpal tunnel release (r = -0.88) or trigger finger release volumes (r = -0.85), thumb arthroplasty/arthrodesis volumes (r = -0.45) showed only a moderate correlation.

CONCLUSIONS:

The economic downturn decreased elective hand procedure surgical volumes. This may be detrimental to small surgical practices that rely on revenue from elective procedures. Taking advantage of the principle that increased volume reduces unit cost may mitigate the lost revenue from these elective procedures. In addition, consolidating hand surgery services at larger, regional centers may reduce the effect of the economic environment on individual hand surgeons.

PMID:
30531621
PMCID:
PMC6349518
[Available on 2020-02-01]
DOI:
10.1097/PRS.0000000000005260
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center