Which Patients Get in the Door First After Reopening?
MedPage Today features an article co-authored by HSS hip and knee surgeon Michael L. Parks, MD, discussing how healthcare systems are preparing to resume non-emergent surgeries following the COVID-19 crisis, and systemic issues that can lead to inequitable access to care for medically complex patients.
The authors explain while non-emergent outpatient or short-stay surgeries will lower the risk of exposure to the virus, some patients may lack a strong social support system required for successful recovery at home and medically complex patients with co-existing conditions (e.g., obesity, diabetes, hypertension, and heart disease, etc.), often require a longer inpatient stay following surgery. Patients of African American descent are disproportionately affected by such co-existing medical conditions and social barriers. Research has demonstrated African Americans and Latinos have a higher likelihood of being too medically complex for joint replacement surgery. Reopening for only same-day and short-stay medical procedures means many people of color and patients who are socially vulnerable will face continued delays in care.
The authors underscore the importance of carefully monitoring the types of patients are receiving care as healthcare systems reopen; to be aware if providers and hospitals are avoiding medically and socially complex patients or limiting access for Medicaid patients; and suggest funding research to survey patients and audit claims data to understand if vulnerable patients continue to lack access to care. The authors advise providers to use shared decision-making tools to help their patients understand all available treatment options and the consequences of postponing care, and conclude that long-term actions (e.g., improving reimbursement parity among the various types of health insurers and risk adjusting value-based payment models to better account for medical complexities and social determinants of health), must be taken to address the systemic issues that lead to inequitable access to care.
Read the full article at Medpagetoday.com.