What older adults are concerned about when it comes to surgery

When it comes to deciding on whether or not to have surgery, most older adults cite one top concern: pain.

The University of Michigan National Poll on Healthy Aging surveyed adults 50-80 about their top considerations in elective surgery and released the findings March 9. Roughly two out of three (64%) said they were worried about pain and discomfort, the top consideration, according to the poll.

Nearly three out of five (57%) said they were worried about the difficulty of recovery, the second highest concern cited.

As with so much in healthcare, many patients expressed concerns about costs. Nearly half (46%) said they were worried about their out-of-pocket costs. Among those adults who were working, about half (46%) of the respondents said they were worried about taking time off of work, the poll found.

The survey also included perspective on those who considered surgery within the past year, and nearly half of those respondents (46%) said they were concerned about the possible exposure to COVID-19.

Some hospitals have paused non-urgent surgeries during surges of COVID-19, while healthcare leaders said some patients have deferred care or procedures during the pandemic. In January, operating room minutes dropped nearly 16%, according to a Kaufman Hall analysis.

Roughly one in three participants (34%) said they were worried about having someone take care of them after surgery, the poll found. A recent study suggested healthcare providers need to consider more carefully the recovery of seniors, particularly when they choose to recover at home after a hospital stay.

About one in five respondents (17%) said they were concerned their surgery would hinder their ability to take care of others.

Even with the concerns, most of those who were considering an elective surgery opted to go ahead with the procedure.

The poll surveyed those who considered an elective surgery within the past five years and found 65% underwent the procedure, while 24% said they planned to have the surgery in the future. Only one in 10 (11%) said they weren’t having the surgery.

About three out of four (73%) adults between the ages of 65 and 80 surveyed had elective surgery, compared to 57% of those aged 50-64. Those who had retired were also more likely to have had surgery than those adults still working (71% of retirees, compared to 55% of those who are working).

The poll also gathered responses from those who hadn’t considered elective surgery in the last five years, and the vast majority said the costs would weigh heavily on their decision. For this group, 90% said their out-of-pocket costs were their top concern, followed by their health insurance coverage (89%).

Roughly four out of five (82%) said the reviews and recommendations of the surgeon were a top concern, followed by the recommendations of their primary care physician (74%) and the reviews of the hospital (68%). About two out of three (64%) said they would want a second opinion before surgery.

For those who had surgery in the past five years, most (67%) said they were pleased with the outcome, although the responses varied based on the health of the patients. Nearly four in five (79%) of those in very good or excellent physical health were very satisfied, compared to 53% of respondents who said they were in fair or poor health.

These were the most common elective surgeries considered by older adults: joint surgery (18%), eye surgery (12%), abdominal surgery (10%), cosmetic surgery (9%), and foot or leg surgery (7%), according to the poll.

The National Poll on Healthy Aging surveyed adults online and via phone in August 2021. The poll has a margin of error of 1 to 3 percentage points for the full survey, with a higher margin of error for responses involving subgroups.