Abstract

BackgroundOperation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their elective surgery rescheduled for non-medical reasons.MethodsIn this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test.ResultsSignificantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer.ConclusionsElderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery.Trial registration DRKS00015836. Retrospectively registered.

Highlights

  • Operation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures

  • N = 2521 patients gave informed consent to participate in this study. 313 patients were excluded from further analysis due to several reasons

  • It is hardly possible to specify if this effect is due to procedural problems, to medical reasons or if this is an indicator for any kind of preventable undertreatment

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Summary

Introduction

Operation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency opera‐ tions is inevitable at times. We hypothesized that specific patient groups could be at higher risk for having their elective surgery rescheduled for non-medical reasons. Operating room (OR) scheduling is a complex process that is influenced by multiple variables. Optimizing OR scheduling has been subject to numerous studies to improve on-site processes using methods of operations research [1]. This is not to be discussed further here, even if such considerations touch on aspects of a potential undersupply of patients

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