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Defining Essential Surgery in the US During the COVID-19 Pandemic Response

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The World Bank Disease Control Priorities1 defined 44 essential surgical procedures (ESPs) as a starting point for health care systems in low- and middle-income countries (LMICs) to avert substantial death and/or disability. This list has never been expanded for nations with more advanced health care systems. The initial US COVID-19 pandemic response to curtail elective surgery offered an opportunity to evaluate and modify the list of essential procedures applicable to the US health care system. We aimed to compare ESPs with other surgical procedures performed during the COVID-19 shutdown in April 2020.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: July 7, 2022.

Published Online: October 19, 2022. doi:10.1001/jamasurg.2022.3944

Corresponding Author: Sherry M. Wren, MD, Department of Surgery, Stanford University School of Medicine, G112, 3801 Miranda Ave, Palo Alto, CA 94304 (swren@stanford.edu).

Author Contributions: Dr Rose had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Mattingly, Wren.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Eddington, Rose, Trickey.

Obtained funding: Wren.

Administrative, technical, or material support: Mattingly, Wren.

Supervision: Cullen, Wren.

Conflict of Interest Disclosures: Dr Rose reported receiving grants from the Department of Veterans Affairs during the conduct of the study. Dr Cullen reported receiving personal fees from Datavant, Inc, Pfizer, Manatt, and the Bill & Melinda Gates Foundation outside the submitted work. No other disclosures were reported.

Funding/Support: This study was funded by a seed grant from the Stanford University School of Medicine Department of Surgery (Dr Wren).

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The opinions expressed in this article are those of the authors and do not necessarily represent the views of Change Healthcare.

References
1.
Debas  HT , Donkor  P , Gawande  A , Jamison  DT , Kruk  ME , Mock  CN , eds. Disease Control Priorities, Third Edition (Volume 1): Essential Surgery. World Bank; 2015.
2.
Mattingly  AS , Rose  L , Eddington  HS ,  et al.  Trends in US surgical procedures and health care system response to policies curtailing elective surgical operations during the COVID-19 pandemic.   JAMA Netw Open. 2021;4(12):e2138038. doi:10.1001/jamanetworkopen.2021.38038 PubMedGoogle ScholarCrossref
3.
Centers for Medicare & Medicaid Services. Non-emergent, elective medical services, and treatment recommendations. April 7, 2020. Accessed March 20, 2021. https://www.cms.gov/files/document/cms-non-emergent-elective-medical-recommendations.pdf
4.
Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project: Clinical Classifications Software for Services and Procedures, Version 2020.1. Accessed May 14, 2021. https://www.hcup-us.ahrq.gov/toolssoftware/ccs_svcsproc/ccssvcproc.jsp
5.
NSW Government. Elective surgery access. January 12, 2022. Accessed January 20, 2022. https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2022_001.pdf
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