Healthcare Delivery, Quality, and Safety| Volume 288, P51-63, August 2023

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Seasonality in General Surgery Hospitalizations and Procedures in the US: Workflow Implications

Published:March 20, 2023DOI:


      • Many surgical pathologies display seasonal patterns relevant for surgeon workflow.
      • Emergent admissions demonstrate more prominent seasonality than elective ones.
      • The volume of inpatient surgical procedures decreases at the end of the calendar year.
      • Acute intra-abdominal conditions and traumas peak in summer months.
      • Peaks in elective cases may be related to insurance deductibles.



      Seasonality has been studied in select conditions treated by surgeons and internists, but is not well understood regarding overall procedural volume in general surgery. Furthermore, much of the literature is limited due to lack of use of seasonal-trend–decomposition analyses.


      All admissions with general surgery procedures were pooled from NIS 2002-2014, monthly hospitalization rates calculated, and seasonal-trend decomposition performed.


      Emergent admissions, accounting for 9% of the average annual incidence, had more prominent seasonality than elective admissions. Inpatient surgical-procedural volume remained relatively stable throughout the year and decreased only in the third quarter. Procedures for acute intra-abdominal conditions and traumas peaked in summer months, while endoscopies, tracheostomies and gastrostomies peaked in winter months.


      Many surgical pathologies and corresponding general-surgery procedures obey circannual patterns. Surgical workforce remains in high demand throughout the year except for fall and winter holidays. Understanding seasonal variation in such demand may be important for staffing and resource planning.


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