Main Session
Sep
28
PQA 03 - Digital Health Innovation and Informatics, Patient Safety & Quality, and Radiation and Cancer Biology
2568 - Unsolicited Patient Complaints about Oncologists before and during the SARS-CoV-2 Pandemic: A Multicenter Retrospective Cohort Study
Presenter(s)
Evan Osmundson, MD, PhD - Vanderbilt-Ingram Cancer Center, Nashville, TN
E. C. Osmundson1, W. Cooper2, G. B. Hickson2, H. Domenico2, D. K. Gaines1, A. Raldow3, M. Warso4, S. Anand5, V. Subbiah6, C. Wright7, C. Crusto8, and E. T. Shinohara1; 1Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, 2Vanderbilt University Medical Center, Nashville, TN, 3Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, 4University of Illinois Health, Chicago, IL, 5University of California, Los Angeles Heath, Los Angeles, CA, 6The University of Texas MD Anderson Cancer Center, Houston, TX, 7MD Anderson Cancer Center, Houston, TX, 8Keck School of Medicine of USC, Los Angeles, CA
Purpose/Objective(s):
The COVID-19 pandemic placed unprecedented challenges on healthcare systems and patients. The care of oncology patients was particularly challenging as patients with cancer represent an inherently vulnerable population and they require complex, highly coordinated care. Understanding how COVID-19-related healthcare disruptions influenced cancer patients’ perceptions of care may provide unique insight into systematic deficiencies during crises. Our objective was to assess quantitative and qualitative changes in unsolicited patient complaints (UPCs) about radiation, medical, and surgical oncologists before and during the SARS-CoV-2 pandemic. We hypothesized that COVID-19-related disruptions would be reflected in the rate and content of UPCs.Materials/Methods:
This is a retrospective multicenter cohort study using deidentified complaint data from January 1, 2018, to December 31, 2021, from >40 health systems, including 300 hospitals, participating in the Vanderbilt Center for Patient and Professional Advocacy’s national Patient Advocacy Reporting System (PARS). All UPCs for attending radiation, medical, and surgical oncologists practicing continuously at PARS sites during the study period were categorized using a validated, standardized coding system. Main Outcomes and Measures: The rate of UPCs per physician per month before and during the pandemic was compared using Poisson and segmented regression analyses. Pre- and during-pandemic complaint types were compared by specialty. COVID-related UPC narratives were qualitatively analyzed to identify the frequency of recurring and co-occurring themes.Results:
Among 6726 UPCs analyzed, the overall complaint rate decreased from 2.73 to 2.55 per 1,000 physician days (rate ratio [RR], 0.94; 95% CI, 0.89–0.98; p=0.01). Surgical oncologists demonstrated a significant decline in UPCs (RR, 0.89; p=0.03); reductions among medical oncologists and radiation oncologists were not statistically significant. Complaints concerning “Care and Treatment” declined significantly (RR, 0.89; 95% CI 0.83-0.96, p=0.003). Among 3,162 pandemic-period UPCs, 89 (2.8%) specifically referenced COVID-19, revealing five dominant themes: COVID policy concerns (50.6%), communication and care coordination (48.3%), patient care delays (24.7%), patient anxieties about COVID-19 (15.7%), and stressed physician/professionalism (13.5%).Conclusion:
UPCs can offer actionable insights into oncology patients' trust, perception of care received, team communication, and care coordination during healthcare crises. Systematic evaluation of UPCs may inform adaptive strategies that optimize health outcomes and strengthen clinician–patient relationships during crises.