Lege bedden in ziekenhuisgang

The COVID-19 pandemic caused over 305,000 operations to be postponed in 2020 and 2021 in the Netherlands. The National Institute for Public Health and the Environment (RIVM) has calculated that this led to the loss of 320,000 life years in good health. The chances of making up for this loss of health are slim. When it comes to scheduling operations, RIVM advises factoring in the health benefits that can be achieved by expediting medical intervention.

Number of postponed elective operations 

Each year, hospitals in the Netherlands perform approximately 900,000 elective operations. These are operations for which waiting more than one month would be acceptable from a medical perspective. Until the end of 2021, the COVID-19 pandemic led to 305,000 of these operations being cancelled or postponed. Total cancellations or postponements are higher, since some of the postponed operations were performed prior to 31 December 2021. The scope of the present study did not extend to emergency surgery, for example urgent operations performed on cancer patients or traffic accident casualties.

Loss of health 

Surgical interventions improve people’s health. The postponement or cancellation of operations led to the loss of 320,000 life years in good health. The vast majority involved postponed cataract, hip and knee operations. The total health loss is likely to have been higher, since not all forms of healthcare were factored in. Diagnostic delays and postponed outpatient healthcare, for example, were not included in the study.

Difficult to clear the backlog

RIVM also calculated the potential effect of managing to clear the backlog (wholly or partially). Increasing the number of operations by 5% for a couple of weeks each year until the end of 2026 would bring about a reduction in loss of healthy life years of 19,000. Whether or not this target would be met would not only depend on healthcare staffing levels. Another significant factor would be whether people are still eligible for surgery, or still willing to have an operation. In any case, it will not be possible to clear the backlog fully.

Structural improvements in elective healthcare

RIVM has offered recommendations on how to handle elective healthcare in hospitals in the event of another crisis. For instance, it would be good to agree on the circumstances under which private clinics or hospitals in other countries would step in. Another option would be to make the most efficient use of surgical capacity for operations that produce high health benefits. This study could help identify those types of operations.