PI (Performance Improvement) Team, Dongguk University Ilsan Hospital, Gyeongi-Do 10326, Korea.
Department of Hospital Administration, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea.
Int J Environ Res Public Health. 2018 Dec 20;16(1):7. doi: 10.3390/ijerph16010007.
: This study researched related causes that make scheduled surgeries canceled not to be conducted and based on the research it is to derive issues in order to reduce surgery cancellation. : We analyzed the association of surgery cancellation with patient characteristics, surgical characteristics and surgery schedule related characteristics, using electronic medical record (EMR) data on surgeries conducted at a university hospital in Korea over 10 years. Additionally, we examined the reasons for surgery cancellation based on patient and hospital characteristics. We used chi-square tests to analyze the distribution of various characteristics according to reasons for surgery cancellation. Multivariate logistic regression analyses were conducted to evaluate the factors associated with surgery cancellation. : Among 60,333 cases, surgery cancellation rate was 8.0%. The results of the logistic regression indicated a high probability of surgery cancellation when the patient was too old (odds ratio [OR]: 1.35, 95% confidence interval [CI]: 1.14⁻1.59), when it was a neurosurgery case (OR: 1.39, 95% CI: 1.21⁻1.59), when local anesthesia was used (OR: 1.15, 95% CI: 1.07⁻1.24) or when it was a planned surgery (OR: 2.45, 95% CI: 2.21⁻2.73). The surgery cancellation rate was lower when the patient was female (OR: 0.87, 95% CI: 0.82⁻0.93) or when the surgery was related to Obstetrics & Gynecology (OR: 0.53, 95% CI: 0.46⁻0.60) or Ophthalmology (OR: 0.66, 95% CI: 0.56⁻0.79). Among the canceled 4834 cases, the surgery cancellation rate for the reasons of patients was 93.2% and the surgery cancellation rate for the reasons of a hospital was 6.8%. : This study found that there are related various causes to cancel operations, including patient characteristics, surgery related characteristics and surgery schedule related characteristics and it means that it would be possible for some reasons to be prevented. Every medical institution should consider the operation cancellation as an important issue and systematic monitoring should be needed.
这项研究调查了导致计划手术取消的相关原因,并基于研究结果提出了一些问题,以减少手术取消的情况。
我们使用韩国一家大学医院 10 年来的电子病历 (EMR) 数据,分析了手术取消与患者特征、手术特征和手术时间相关特征的关联。此外,我们根据患者和医院特征检查了手术取消的原因。我们使用卡方检验分析了根据手术取消原因的各种特征的分布。我们还进行了多变量逻辑回归分析,以评估与手术取消相关的因素。
在 60333 例病例中,手术取消率为 8.0%。逻辑回归的结果表明,当患者年龄较大(优势比 [OR]:1.35,95%置信区间 [CI]:1.14-1.59)、进行神经外科手术(OR:1.39,95% CI:1.21-1.59)、使用局部麻醉(OR:1.15,95% CI:1.07-1.24)或进行计划手术(OR:2.45,95% CI:2.21-2.73)时,手术取消的可能性较高。当患者为女性(OR:0.87,95% CI:0.82-0.93)或手术与妇产科(OR:0.53,95% CI:0.46-0.60)或眼科(OR:0.66,95% CI:0.56-0.79)相关时,手术取消率较低。在取消的 4834 例手术中,因患者原因导致的手术取消率为 93.2%,因医院原因导致的手术取消率为 6.8%。
这项研究发现,导致手术取消的原因有很多,包括患者特征、手术相关特征和手术时间相关特征,这意味着有些原因是可以预防的。每个医疗机构都应该将手术取消视为一个重要问题,并进行系统监测。