Recent reports from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) Cardiac Surgery Database show high standards were maintained for cardiac surgery patients throughout the first year of the COVID-19 pandemic, despite major changes to models of care.
The VAHI-supported Database was one of many clinical registries that expanded their data capture to include COVID-19 diagnoses and redirection of patients from early 2020. This simple step enabled a better understanding of service provision as health services adjusted resources to manage patients presenting with COVID-19.
Some of the key changes for patients included the interruption of elective surgery procedures in public hospitals, and a shift of public patients to private hospitals to receive surgical treatment.
The latest ANZSCTS Database Annual Report, released at the end of 2021, shows the collaboration between public and private hospitals was largely successful for cardiac surgery patients, with equivalent service to previous years being maintained through 2020 across a range of key outcomes.
However, compared to the average of the previous three years, there was an overall 13.8% reduction in cardiac surgical throughput in the public sector and 9.5% reduction in the private sector in 2020.
Anecdotal evidence also pointed to issues in early detection and treatment. Dr Andrew Newcomb, Director of Cardiothoracic Surgery at St Vincent’s Public Hospital Melbourne, said the switch to telehealth and fear of infection led to patients avoiding in-person screening.
“Patients were reluctant to come into hospital to have cardiac assessments,” Dr Newcomb said. “This led to many more patients having to be admitted via emergency departments and having inpatient surgery.”
Combined with further elective surgery restrictions to limit the spread of COVID-19 in later waves of the pandemic, this reluctance to seek care may have contributed to worse outcomes for some cardiac patients in 2021.
“The ability for patients to receive healthcare has improved, but in 2021 it [felt] like we were still seeing the tail of those that were neglected [in 2020], with an increase in acuity and severity of disease overall,” Dr Newcomb said.
More definitive information related to those assumptions will be available as the ANZSCTS Database continues to analyse its COVID-directed data for 2021.
The Victorian Agency for Health Information (VAHI) continues to work with key clinical quality registries to improve the information available to Health Service executives and government about the care provide in Victorian hospitals.
For more information about VAHI’s clinical quality registries program, please contact Louise Kelly, Clinical Quality Registries and Patient Reported Outcomes via [email protected]
For more information about the ANZSCTS registry please contact Jenni Williams-Spence, [email protected]