Abstract
Background This study examines the impact of COVID-19 infection waves on the healthcare utilization of elective procedures versus non-elective procedures. Methods Eligible encounters were classified into simple/elective (elective) and cancer/complex (non-elective) groups based on the ICD-10-CM diagnosis codes. Procedure-specific volumes were used to evaluate healthcare utilization. Results Compared with the non-elective cohort, the elective cohort showed a greater dip (93% and 58% of the baseline volumes in March and April 2020 vs. 70% and 18% respectively, p-value = 0.0001). Similar patterns were identified for each successive wave of the pandemic. Conclusions During each of the first four waves of the pandemic, elective procedure volumes both fell and recovered at higher relative rates when compared with non-elective procedure volumes. Throughout the pandemic, there was a trend toward less cancelation of both elective and non-elective procedures with each successive wave. Our findings characterize the pandemic as a cyclic disease that surgical specialties are learning to cope with over time.