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坦桑尼亚湖区一所大学教学医院择期外科手术取消的发生率、原因及模式。

Incidence, causes and pattern of cancellation of elective surgical operations in a university teaching hospital in the Lake Zone, Tanzania.

作者信息

Chalya P L, Gilyoma J M, Mabula J B, Simbila S, Ngayomela I H, Chandika A B, Mahalu W

机构信息

Department of Surgery, Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.

出版信息

Afr Health Sci. 2011 Sep;11(3):438-43.

Abstract

BACKGROUND

Cancellation of elective surgical operations is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence, causes and pattern of cancellation of elective surgical operations in our setting and to find the appropriate solutions for better patient management.

METHODS

This was a prospective hospital-based study which was conducted in a teaching hospital at Bugando medical Centre from March 2009 to February 2010.

RESULTS

A total of 3,064 patients were scheduled for elective surgical operations. Of these, 644 (21.0%) patients' operations were cancelled. General surgery had the highest rate of cancellations (31.5%) followed by orthopaedic surgery in 25.5%. Lack of theatre space and theatre facilities were the most common causes of cancellations in 53.0% and 28.4% of cases respectively. The majority of these cancellations were attributable to hospital administration in 82.0 % and most of them were preventable in 93.8% of cases. The mean hospital stay was 28.46 days and it was significantly related to the number of cancellations (p < 0.001).

CONCLUSION

Cancellation of elective surgical operations is a significant problem in our hospital. To prevent unnecessary cancellations, efforts should be made to enhance cost effectiveness through careful planning and efficient utilization of the few available hospital resources.

摘要

背景

择期外科手术取消被认为是给患者及其家属带来精神创伤的主要原因。开展本研究以评估我院择期外科手术取消的发生率、原因及模式,并找出改善患者管理的合适解决方案。

方法

这是一项基于医院的前瞻性研究,于2009年3月至2010年2月在布甘多医疗中心的一家教学医院进行。

结果

共有3064例患者计划进行择期外科手术。其中,644例(21.0%)患者的手术被取消。普通外科的取消率最高(31.5%),其次是骨科手术,取消率为25.5%。手术室空间不足和手术室设施问题分别是53.0%和28.4%的取消病例的最常见原因。这些取消病例中的大多数(82.0%)可归因于医院管理,且其中93.8%的病例是可预防的。平均住院时间为28.46天,且与取消手术的次数显著相关(p < 0.001)。

结论

择期外科手术取消在我院是一个重大问题。为防止不必要的取消,应通过精心规划和有效利用现有的少量医院资源来提高成本效益。

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