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. 2023 Nov 8;18(11):e0294026.
doi: 10.1371/journal.pone.0294026. eCollection 2023.

Prioritization of surgical patients during the COVID-19 pandemic and beyond: A qualitative exploration of patients' perspectives

Anouk M I A van Alphen  1 , Sandra Sülz  2 , Hester F Lingsma  3 , Robert J Baatenburg de Jong  1
Affiliations

Prioritization of surgical patients during the COVID-19 pandemic and beyond: A qualitative exploration of patients' perspectives

Anouk M I A van Alphen et al. PLoS One. .

Abstract

Introduction: During the COVID-19 pandemic, prioritizing certain surgical patients became inevitable due to limited surgical capacity. This study aims to identify which factors patients value in priority setting, and to evaluate their perspective on a decision model for surgical prioritization.

Methods: We enacted a qualitative exploratory study and conducted semi-structured interviews with N = 15 patients. Vignettes were used as guidance. The interviews were transcribed and iteratively analyzed using thematic analysis.

Results: We unraveled three themes: 1) general attitude towards surgical prioritization: patients showed understanding for the difficult decisions to be made, but demanded greater transparency and objectivity; 2) patient-related factors that some participants considered should, or should not, influence the prioritization: age, physical functioning, cognitive functioning, behavior, waiting time, impact on survival and quality of life, emotional consequences, and resource usage; and 3) patients' perspective on a decision model: usage of such a model for prioritization decisions is favorable if the model is simple, uses trustworthy data, and its output is supervised by physicians. The model could also be used as a communication tool to explain prioritization dilemmas to patients.

Conclusion: Support for the various factors and use of a decision model varied among patients. Therefore, it seems unrealistic to immediately incorporate these factors in decision models. Instead, this study calls for more research to identify feasible avenues and seek consensus.

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Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet (London, England). 2020;395(10223):470–3. Epub 2020/01/24. doi: 10.1016/S0140-6736(20)30185-9 . - DOI - PMC - PubMed
    1. World Health Organization. Third round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic: November–December 2021. Geneva: WHO: 2022.
    1. NZa. NZa-analyse van de gevolgen van de coronacrisis voor de reguliere zorg—20 april 2020. 2020. Accessed on January 19 2022. [Accessed on January 19 2022]. Available from: https://puc.overheid.nl/nza/doc/PUC_306627_22/1/.
    1. Iacobucci G. Covid-19: all non-urgent elective surgery is suspended for at least three months in England. Bmj. 2020;368:m1106. doi: 10.1136/bmj.m1106 - DOI - PubMed
    1. Fowler S, Zahir SF, Manning W, Kearney A, Sturgess D. Effect of the COVID-19 pandemic first wave and public policy on elective and emergency surgery provision in Southern Queensland. ANZ J Surg. 2021;91(3):249–54. doi: 10.1111/ans.16568 . - DOI - PMC - PubMed

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