Elective Surgical Delays Due to COVID-19: The Patient Lived Experience

Med Care. 2021 Apr 1;59(4):288-294. doi: 10.1097/MLR.0000000000001503.


Background: This qualitative research explored the lived experiences of patients who experienced postponement of elective cardiac and vascular surgery due to coronavirus disease 2019 (COVID-19). We know very little about patients during the novel coronavirus pandemic. Understanding the patient voice may play an important role in prioritization of postponed cases and triage moving forward.

Methods: Utilizing a hermeneutical phenomenological qualitative design, we interviewed 47 individuals who experienced a postponement of cardiac or vascular surgery due to the COVID-19 pandemic. Data were analyzed and informed by phenomenological research methods.

Results: Patients in our study described 3 key issues around their postponement of elective surgery. Patients described robust narratives about the meanings of their elective surgeries as the chance to "return to normal" and alleviate symptoms that impacted everyday life. Second, because of the meanings most of our patients ascribed to their surgeries, postponement often took a toll on how patients managed physical health and emotional well-being. Finally, paradoxically, many patients in our study were demonstrative that they would "rather die from a heart attack" than be exposed to the coronavirus.

Conclusions: We identified several components of the patient experience, encompassing quality of life and other desired benefits of surgery, the risks of COVID, and difficulty reconciling the 2. Our study provides significant qualitative evidence to inform providers of important considerations when rescheduling the backlog of patients. The emotional and psychological distress that patients experienced due to postponement may also require additional considerations in postoperative recovery.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control*
  • COVID-19 / psychology
  • COVID-19 / transmission
  • Cardiovascular Surgical Procedures / psychology
  • Cardiovascular Surgical Procedures / standards*
  • Elective Surgical Procedures / psychology
  • Elective Surgical Procedures / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics / prevention & control
  • Patient Preference
  • Psychological Distress*
  • Qualitative Research
  • Time Factors
  • Time-to-Treatment*
  • Triage / standards