The economic and psychological impact of cancellations of elective spinal surgeries in the COVID-19 era

Abstract

Background: The adoption of health care restrictions due to the COVID-19 pandemic led to the cancellation of elective surgical care. However, the impact on patients is unknown. Objective: To evaluate the psychological and economic impact of the cancellation of scheduled spinal operations. Methods: We identified 50 patients with cancelled surgeries between 16 March 2020 and 24 April 2020. Forty-nine (98%) participants were contacted, with whom the modified WES-Pi questionnaire was filled in during a telephone interview. Results: Of the 49 respondents, 28 (57.2%) were aged <65 years. The most often reported problem (85.7%) was an ongoing limitation in basic daily activities. At least moderate sadness was experienced by 65.3% and disappointment by 73.5% of the patients. More than 80% reported concerns about the continuation and 73.5% about the progression of their symptoms. Out of 27 employees (55.1%), 63% could not work due to severe pain or movement limitation (p < .001). The inability to work was associated with anger (p ¼ .037). The work-related impact of the cancellation was associated with stress (p < .0001) and concerns about continuing the symptoms (p ¼ .004). Two-third of patients would undergo immediate surgery despite the current epidemic situation. Conclusions: The cancellations of elective spinal surgeries have a serious psychological impact on patients. This together with potential economic consequences is especially evident in employees unable to work due to pain or movement disability. The information is beneficial for health management. Every effort should be made to resume planned surgical treatment if the epidemiological situation allows it.

Patients awaiting surgery for neurosurgical diseases during the first wave of the COVID-19 pandemic in Spain: a multicentre cohort study

“…Although these conditions are not life-threatening, delayed treatment can influence definite loss of functionality23 and increase indirect costs related to work absenteeism. Consequently, psychological symptoms, such as anger and sadness, and the economic impact due to surgical cancellation of elective surgeries have also been documented 24…”

“…Consequently, psychological symptoms, such as anger and sadness, and the economic impact due to surgical cancellation of elective surgeries have also been documented. 24 On the other hand, clinical deterioration was even more frequently observed in patients with functional (39.5%) or CSF disorders (40%). These subgroups of patients can be considered more vulnerable to becoming critically ill if they become infected, but treatment on time can reduce mortality and the need for residential nursing care.…”

Impact on patients of the coronovirus disease 2019 pandemic and postponement of cochlear implant surgery: a qualitative study

“…who also found disappointment to be the most common emotional reaction by patients who had their elective spinal surgical procedures cancelled because of the Covid-19 pandemic. 14…”

“…Although the anxiety induced by this pandemic on healthcare workers is well documented, the true effect upon patients is poorly understood, with only three studies published in the literature so far that have directly explored the impact on patients of delayed elective surgical procedures. 11–14…”

COVID-19 and the forgone health benefits of elective operations

“…The majority of studies published over the years appear to suggest either a stasis or a significant deterioration in the quality of life, even for waiting periods of less than 3 months [ 5 , 6 ]. A number of observational studies conducted during the pandemic confirmed a loss of health or quality of life due to a postponement of elective surgery procedures (e.g., [ 7 – 9 ]). Cancellations were reported to have negative consequences in terms of pain, work productivity, or psychological status.…”