1. Patient Perceptions on Barriers and Facilitators to Accessing Low-acuity Surgery During COVID-19 Pandemic
- Author
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Sophia Hernandez, Tasce Bongiovanni, Sandhya B. Kumar, Ogonna N. Nnamani Silva, Elizabeth C. Wick, Christopher Johnson, Laura E. Wong, Hope Schwartz, Jeanette M. Broering, Deborah B. Martins, Sanziana A. Roman, and Anya L. Greenberg
- Subjects
Patient experience ,Male ,Infectious Disease Transmission ,8.1 Organisation and delivery of services ,Surgery Department ,Health Services Accessibility ,Infectious Disease Transmission, Professional-to-Patient ,ZSFG, Zuckerberg San Francisco General ,Delayed Procedures ,0302 clinical medicine ,Surveys and Questionnaires ,Pandemic ,Medicine ,COVID-19, Coronavirus disease 2019 ,Uncertainty ,Fear ,Middle Aged ,Elective Surgical Procedures ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Medical emergency ,Patient Safety ,PPE, personal protective equipment ,Health and social care services research ,Patient Perceptions ,Adult ,Coronavirus disease 2019 (COVID-19) ,Professional-to-Patient ,Clinical Sciences ,Patient perceptions ,Article ,Patient Experience ,03 medical and health sciences ,Patient safety ,Hospital ,Appointments and Schedules ,Patient Education as Topic ,Plastic Surgical Procedures ,Clinical Research ,Humans ,UCSF, University of California, San Francisco ,Pandemics ,Infection Control ,Delayed procedures ,business.industry ,Postponement ,Stressor ,COVID-19 ,Timeline ,medicine.disease ,Good Health and Well Being ,Cross-Sectional Studies ,Surgery ,Generic health relevance ,business ,Surgery Department, Hospital - Abstract
Background The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. Methods We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted. Results One hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns. Conclusions Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients’ perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
- Published
- 2020