Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned
Background: Elective surgeries were suspended during the national lockdown in March 2020 to curb the spread of the COVID-19 pandemic in Malaysia. We sought to evaluate the impact of the lockdown on cataract surgeries and suggest lessons for future outbreaks. Study design: We conducted an interrupted...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Public Health in Practice |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666535224000065 |
| _version_ | 1797338240614662144 |
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| author | Amanda Wei-Yin Lim Chin Tho Leong Mohamad Aziz Salowi Yvonne Mei Fong Lim Wen Jun Wong Wen Yea Hwong |
| author_facet | Amanda Wei-Yin Lim Chin Tho Leong Mohamad Aziz Salowi Yvonne Mei Fong Lim Wen Jun Wong Wen Yea Hwong |
| author_sort | Amanda Wei-Yin Lim |
| collection | DOAJ |
| description | Background: Elective surgeries were suspended during the national lockdown in March 2020 to curb the spread of the COVID-19 pandemic in Malaysia. We sought to evaluate the impact of the lockdown on cataract surgeries and suggest lessons for future outbreaks. Study design: We conducted an interrupted time series analysis to examine rates of cataract surgery before and during the lockdown. Methods: We used national cataract surgical data between 2015 and 2021 from the Malaysian Cataract Surgery Registry. Segmented regression with a seasonally adjusted Poisson model was used for the analysis. Stratified analyses were performed to establish whether the effect of the lockdown on cataract surgeries varied by hospital designation, type of cataract service, sex, and age groups. Results: Cataract surgeries began falling in March 2020 at the onset of the lockdown, reached a trough in April 2020, and subsequently increased but never recovered to pre-lockdown levels. Cataract surgical rates in December 2021 were still 43 % below the expected surgical volume, equivalent to 2513 lost cataract surgeries. There was no evidence of a differential effect of the lockdown between COVID-19 designated and non-COVID-19 designated hospitals. The relative decrease in cataract surgical rates appears to have been greatest in outreach services and in people 40 years and older. Conclusions: The lockdown caused an immediate reduction in cataract surgical rates to nearly half of its baseline rate. Despite its gradual recovery, further delays remain to be expected should there be no redistribution or increase in resources to support backlogs and incoming new cases. |
| first_indexed | 2024-03-08T09:28:10Z |
| format | Article |
| id | doaj.art-bc8dd2b955d24320a34aed9d1a318585 |
| institution | Directory Open Access Journal |
| issn | 2666-5352 |
| language | English |
| last_indexed | 2024-03-08T09:28:10Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Public Health in Practice |
| spelling | doaj.art-bc8dd2b955d24320a34aed9d1a3185852024-01-31T05:45:40ZengElsevierPublic Health in Practice2666-53522024-06-017100469Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learnedAmanda Wei-Yin Lim0Chin Tho Leong1Mohamad Aziz Salowi2Yvonne Mei Fong Lim3Wen Jun Wong4Wen Yea Hwong5Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia; Corresponding author. Block B4, National Institutes of Health, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia.Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, MalaysiaDepartment of Ophthalmology, Selayang Hospital, Ministry of Health Malaysia, Batu Caves, Selangor, Malaysia; Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, MalaysiaCentre for Clinical Care and Outcomes Research, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia; Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the NetherlandsCentre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, MalaysiaCentre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia; Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the NetherlandsBackground: Elective surgeries were suspended during the national lockdown in March 2020 to curb the spread of the COVID-19 pandemic in Malaysia. We sought to evaluate the impact of the lockdown on cataract surgeries and suggest lessons for future outbreaks. Study design: We conducted an interrupted time series analysis to examine rates of cataract surgery before and during the lockdown. Methods: We used national cataract surgical data between 2015 and 2021 from the Malaysian Cataract Surgery Registry. Segmented regression with a seasonally adjusted Poisson model was used for the analysis. Stratified analyses were performed to establish whether the effect of the lockdown on cataract surgeries varied by hospital designation, type of cataract service, sex, and age groups. Results: Cataract surgeries began falling in March 2020 at the onset of the lockdown, reached a trough in April 2020, and subsequently increased but never recovered to pre-lockdown levels. Cataract surgical rates in December 2021 were still 43 % below the expected surgical volume, equivalent to 2513 lost cataract surgeries. There was no evidence of a differential effect of the lockdown between COVID-19 designated and non-COVID-19 designated hospitals. The relative decrease in cataract surgical rates appears to have been greatest in outreach services and in people 40 years and older. Conclusions: The lockdown caused an immediate reduction in cataract surgical rates to nearly half of its baseline rate. Despite its gradual recovery, further delays remain to be expected should there be no redistribution or increase in resources to support backlogs and incoming new cases.http://www.sciencedirect.com/science/article/pii/S2666535224000065COVID-19LockdownCataract surgeryInterrupted time seriesSegmented regressionHealthcare system |
| spellingShingle | Amanda Wei-Yin Lim Chin Tho Leong Mohamad Aziz Salowi Yvonne Mei Fong Lim Wen Jun Wong Wen Yea Hwong Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned Public Health in Practice COVID-19 Lockdown Cataract surgery Interrupted time series Segmented regression Healthcare system |
| title | Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned |
| title_full | Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned |
| title_fullStr | Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned |
| title_full_unstemmed | Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned |
| title_short | Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned |
| title_sort | trends in cataract surgery and healthcare system response during the covid 19 lockdown in malaysia lessons to be learned |
| topic | COVID-19 Lockdown Cataract surgery Interrupted time series Segmented regression Healthcare system |
| url | http://www.sciencedirect.com/science/article/pii/S2666535224000065 |
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