Caesar Ulla, Karlsson Jon, Olsson Lars-Eric, Samuelsson Kristian, Hansson-Olofsson Elisabeth
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, SE- 413 45 Gothenburg, Sweden.
Institute of Health and Care Sciences Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Patient Saf Surg. 2014 Jun 2;8:24. doi: 10.1186/1754-9493-8-24. eCollection 2014.
The purpose of the Swedish public health-care system is to provide care on equal terms for all citizens. In this, as in most other systems where taxes and/or insurances pay for most of the care, normal market forces are set aside at least in part. At times, this has, for example, resulted in long waiting lists, particularly in terms of elective orthopaedic surgery, with several negative consequences, such as cancellations of planned surgery.
The main purpose of this retrospective observational single center study was to evaluate and describe the number and reasons for cancellations in elective orthopaedic surgery. Studied were all the elective patients scheduled for joint replacement, arthroscopy and foot & ankle surgery, January 1, 2007 to December 31, 2011, whose procedure was cancelled at least once.
Of all 17,625 patients scheduled for elective surgery 6,911 (39%) received at least one, some several cancellations. The most common reason for cancelling a planned surgery was different patient-related factors 3,293 (33%). Cancellations due to treatment guarantee legislation reached 2,885 (29%) and 1,181 (12%) of the cancellations were related to incomplete pre-operative preparation of the patients. Organisational reasons were the cause of approximately 869 (9%) of the cancellations.
In this study of patients waiting for elective orthopaedic surgery 6,911(39%) had their surgical procedure cancelled at least once, some several times. It appears that it should be possible to eliminate many of these cancellations, while others are unavoidable or caused by factors outside the responsibility of the individual clinic or even hospital. One possible way of influencing the high rate of cancellations might be to change the view of the patients and involve them in the overall planning of the care process.
瑞典公共医疗体系的目的是为所有公民提供平等的医疗服务。在这方面，如同大多数其他由税收和/或保险支付大部分医疗费用的体系一样，正常的市场力量至少在一定程度上被搁置。例如，这种情况有时会导致长长的等候名单，尤其是在择期骨科手术方面，还会产生一些负面后果，比如计划好的手术被取消。
这项回顾性观察性单中心研究的主要目的是评估和描述择期骨科手术取消的数量及原因。研究对象为2007年1月1日至2011年12月31日期间所有计划进行关节置换、关节镜检查以及足踝手术的择期患者，其手术至少被取消过一次。
在所有17625名计划进行择期手术的患者中，6911名（39%）至少经历过一次手术取消，有些患者甚至经历过多次取消。取消计划手术最常见的原因是与患者相关的不同因素，共3293例（33%）。因治疗保障立法导致的取消达2885例（29%），1181例（12%）的取消与患者术前准备不充分有关。组织方面的原因导致了约869例（9%）的手术取消。
在这项针对等待择期骨科手术患者的研究中，6911名（39%）患者的手术至少被取消过一次，有些甚至被取消过多次。看来应该有可能消除许多此类取消情况，而其他一些取消则不可避免或由个别诊所甚至医院无法负责的因素导致。影响高取消率的一种可能方法或许是改变患者的观念，并让他们参与到护理过程的整体规划中。
