Patients' Perceptions of Receiving Orthopaedic Care During a Pandemic

A Patient Survey

Shea Comadoll, MD; Megan Reams, MA; Arthur J. Only, MD; Brian P. Cunningham, MD

Disclosures

Curr Orthop Pract. 2021;32(3):284-289. 

In This Article

Abstract and Introduction

Abstract

Background: Coronavirus 2019 (COVID-19) has had a great effect on the health care landscape, including altering the availability and methods of orthopaedic care. There is little information regarding patients' perceptions of orthopaedic care during the pandemic. This study was designed to assess patient concerns surrounding orthopaedic care and determine what areas can be addressed to optimize orthopaedic care during this pandemic.

Methods: In the spring of 2020, during this study that was exempt from institutional review board (IRB) approval, a survey designed to evaluate the attitudes and beliefs from healthcare consumers about receiving care during the COVID-19 pandemic was sent to a group of panelists via email.

Results: Three hundred sixty-six (31%) out of 1,200 individuals completed the survey. The majority of participants expressed they would feel comfortable receiving care in orthopaedic clinics (48% immediately, 36% in 1 to 3 mo) in the immediate or near future. Participants reported they were more comfortable seeking orthopaedic care at an orthopedic urgent care facility (8% not comfortable) versus an emergency room (41% not comfortable). When thinking about receiving care at orthopaedic clinics, participants were most concerned about the risks of getting sick from other patients (18% extremely, 26% very). Seventeen percent of respondents reported that despite having orthopaedic concerns, they delayed seeking care due to COVID-19. One-third of respondents expressed a desire to know what precautions were in place to ensure safety.

Conclusions: Patients remained interested in receiving orthopaedic care in the midst of a pandemic. As a result, physicians need to ensure that they effectively communicate what safety precautions are in place and what additional infection prevention measures are available.

Level of Evidence: Level IV.

Introduction

Coronavirus disease 2019 (COVID-19) is a widespread viral pandemic with large implications for healthcare. The rise in COVID-19 cases in the United States led to a shortage of personal protective equipment and hospital resources. This brought elective surgeries, including orthopaedic surgeries, to a halt.[1] Because emphasis was placed on conservative management of nonemergent orthopaedic conditions, there was a delay in treatment for patients who had semiurgent orthopaedic needs or chronic musculoskeletal disabilities.[1,2] With the relaxation of current restrictions and the restart of elective and semielective procedures, various protocols have been put into practice to stratify orthopaedic procedures in order of importance and urgency.[2,3] Strategies have also been implemented to prevent the spread of COVID-19 and avoid inadvertent exposure. These include systemic changes such as hand hygiene, social distancing, and mandatory mask wearing as well as clinical changes that include increased availability of video appointments, more regular surface cleaning, control of patient flow, preoperative COVID-19 testing, and symptom screening.[1–4]

With the return of elective cases, it is important to ensure patients who are undergoing elective surgery are educated on the protocols that have been put in place.[5] It is also important to assess patients' perceptions of the virus and determine their desire to receive orthopaedic care. Prior to the pandemic, patients had questions about the surgery itself and the postoperative course.[6,7] Chief among these questions were surgical timing, surgical complications, and ability to ambulate after surgery. Additional questions surrounding the postoperative course often included the need for postoperative care and if patients would be able to meet rehabilitation demands.[6,7] In the setting of a global pandemic, it is likely that the perceptions of patients have shifted from questions that are focused on surgery to concerns regarding the new associated risk of surgery in the midst of a pandemic.

With this in mind, the authors designed a study to further assess patients' perception of receiving orthopaedic care during the COVID-19 pandemic. Currently, there is little information regarding patients' perceptions of receiving orthopaedic care during the pandemic. The aims of this study were to use a survey to determine if patients were comfortable receiving orthopaedic care, assess patient concerns surrounding care, determine what areas could be addressed in order to better inform patients, and provide safe access to orthopaedic care. Our hypothesis was that despite the concern of the COVID-19 pandemic, patients would continue to have a desire to undergo orthopaedic interventions as long as proper precautionary measures were implemented to minimize risk of COVID-19 infection.

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