Assessing the Rates and Reasons of Elective Surgical Cancellations on the Day of Surgery: A Multicentre Study from Urban Indian Hospitals

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Assessing the Rates and Reasons of Elective Surgical Cancellations on the Day of Surgery: A Multicentre Study from Urban Indian Hospitals


JournalWorld Journal of Surgery
Article typeJournal research article – Clinical research
Publication date – Nov – 2021
Authors – Bhakti Sarang, Geetu Bhandoria, Priti Patil, Anita Gadgil, Lovenish Bains, Monty Khajanchi, Deepa Kizhakke Veetil, Rohini Dutta, Priyansh Shah, Prashant Bhandarkar, Lileswar Kaman, Dhruva Ghosh, Kavita Mandrelle, Ashwani Kumar, Akshay Bahadur, Sunil Krishna, Kamal Kishore Gautam, Ya Dev, Manisha Aggarwal, Neil Thivalapill & Nobhojit Roy On Behalf of the IndSurg Collaboration
Keywordsanaesthetic assessment, elective surgeries, India, Low-and Middle-Income Countries (LMIC)
Open access – Yes
SpecialityHealth policy
World region Southern Asia
Country: India
Language – English
Submitted to the One Surgery Index on November 29, 2021 at 7:47 am
Abstract:

Background
Cancellations of elective surgeries on the day of surgery (DOS) can lead to added financial burden and wastage of resources for healthcare facilities; as well as social and emotional problems to patients. These cancellations act as barriers to delivering efficient surgical services. Optimal utilisation of the available resources is necessary for resource-constrained low-and-middle-income countries (LMIC). This study investigates the rate and causes of cancellations of elective surgeries on the DOS in various surgical departments across ten hospitals in India.

Methods
A research consortium ‘IndSurg’ led by World Health Organisation Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in LMICs, India conducted this multicentre retrospective cross-sectional study to analyse the cancellations of elective/planned surgical operations on DOS across urban secondary and tertiary level hospitals. We audited surgical records of a pre-decided period of six weeks for cancellations, documented relevant demographic information and reasons for cancellations.

Results
We analysed records from the participating hospitals, with an overall cancellation rate of 9.7% (508/5231) on the DOS for elective surgical operations. Of these, 74% were avoidable cancellations. A majority (30%) of these 508 cancellations were attributed to insufficient resources, 28% due to patient’s refusal or failure to show-up, and 22% due to change in patient’s medical status.

Conclusion
We saw a preponderance of avoidable reasons for elective surgery cancellations. A multidisciplinary approach with adequate preoperative patient counselling, timely communication between the patients and caregivers, adequate preoperative anaesthetic assessment, and planning by the surgical team may help reduce the cancellation rate.

OSI Number – 21372

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