Economic Impact of COVID-19 on a High Volume Academic Neurosurgical Practice

Sivakanthan, Sananthan; Pan, James; Kim, Louis; Ellenbogen, Richard; Saigal, Rajiv

Abstract: Introduction Coronavirus-19 (COVID-19) is a novel disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that rapidly spread around the globe. The dramatic increase in the number of cases and deaths have placed tremendous strain on healthcare systems worldwide. As healthcare workers and society adjust to focus treatment and prevention of COVID-19, other facets of the healthcare enterprise are affected, particularly surgical volume and revenue. Objective The purpose of this study is to describe the financial impact of COVID-19 on an academic neurosurgery department. Methods A retrospective review of weekly average daily work relative value units (wRVU) was compared before and after COVID-19 in the fiscal year 2020. A comparative time period of the same months in the year prior was also included for review. We also review strategies for triaging neurosurgical disease as needing emergent, urgent, or routine operative treatment. Results Daily average wRVU after COVID-19 dropped significantly with losses in all weeks examined. Of the 7 weeks in the current post-COVID period the weekly daily average wRVU was 173 (range 128-363). The mean decline was 51.4% compared to the pre-COVID era. Both inpatient and outpatient revenue was affected. Conclusion COVID-19 had a profound detrimental effect on surgical productivity and revenue generation.