Abstract
Introductionthe cancellation of elective surgery is still a worldwide challenge and this is associated with emotional and economical trauma for the patients and their families as well as a decrease in the efficiency of the operating theatre. This study aimed at determining the prevalence and factors associated with cancellation and deferment of elective surgery in a rural private tertiary teaching hospital in Western Uganda.Methodsa cross-sectional study design was conducted. Data was collected from 1st July 2019 to 31st December 2019. Patients scheduled for elective surgery and either cancelled or deferred on the actual day of surgery were included in the study. Statistical analysis was done using STATA version 15.Resultsfour hundred patients were scheduled for elective surgery during the study period, among which 90 (22.5%) were cancelled and 310 (78.5%) had their surgeries as scheduled. The highest cancellation of elective surgical operations was observed in general surgery department with 81% elective cases cancelled or deferred, followed by orthopedic department 10% and gynecology department 9%. The most common reasons for cancellation were patient-related (39%) and health worker-related (35%) factors. Other factors included administrative (17%) and anesthesia related factors (9%). Cancellation was mainly due to lack of finances which accounted for 23.3% of the patients, inadequate patient preparation (16.6%) and unavailability of surgeons (15.5%). Major elective surgeries were cancelled 1.7 times more than minor electives surgeries [adjusted prevalence ratio 1.7 (95%CI: 1.07-2.73) and p-value: 0.024].Conclusioncancellation and deferment of elective surgeries is still of a major concern in this private rural tertiary hospital with most of the reasons easily preventable through proper scheduling of patients, improved communication between surgical teams and with patients; and effective utilization of available resources and man power.
Highlights
The cancellation of a scheduled list for elective surgery is still a worldwide challenge [1]
This study focused on cancellation of elective surgeries in a rural tertiary hospital in Western Uganda with the aim of determining the prevalence and contributory factors to cancellation in order to generate strategies to reduce the rate of cancellation of elective surgeries
Setting: the study was done in operating theatres of Kampala International University Teaching Hospital (KIU-TH), a private nonprofit teaching hospital located in Bushenyi district in Western Uganda
Summary
The cancellation of a scheduled list for elective surgery is still a worldwide challenge [1]. Cancellation of surgery refers to failure to realize a scheduled surgical procedure [2]. Cancellation can be avoidable and non-avoidable and the latter is seen as the commonest in developing countries with a range of 10-45% and 0.37-28% in developed countries [3]. Abrupt cancellation of elective surgery leads to emotional trauma and financial loss for such patients and their families [4]. The reasons for cancellation of elective surgery are not exhaustive and vary from one hospital to another [5]. Inadequate preoperative evaluation, scheduling errors, unavailability of human resources and lack of equipment are the avoidable reasons for late cancellation of patients from the operation list [5]
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