From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Koh); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Phelan, Engen); and the Kingston General Health Research Institute, and Department of Public Health Sciences, Queen's University, Kingston, Ont. (Hopman).
Can J Surg. 2021 Mar 5;64(2):E155-E161. doi: 10.1503/cjs.008119.
The cancellation of elective surgeries is a major problem that increases wait times, exacerbates costs and can negatively affect patients, both psychologically and physically. Our objectives were to investigate the reasons for cancellations across specialties at a single centre, to compare these reasons with previous data from the same centre between 2005 and 2009 and to examine how cancellations affected patients' lives and views of the medical system in cases when the cancellations were potentially preventable.
Cancellation records of all elective surgeries scheduled between June 1, 2012, and Jan. 31, 2016, at a medium-sized, tertiary care, academic centre were retrospectively reviewed. We evaluated the rates and reasons for cancellation and interviewed a subset of patients whose surgery was cancelled for a potentially preventable reason (i.e., operating room running late, bed shortage, emergency case took place of scheduled surgery).
Across 11 surgical specialties, 2933 of 20 881 surgeries (14.0%) were cancelled and of these, 2448 (83.5%) were for administrative or structural reasons. Compared with the data collected previously for general, gynecological and urological procedures, cancellation rates increased from 8.1% to 11.8%. Although patients reported inconvenience, they were generally satisfied with the availability and the quality of the health care they received.
Consistent with the previous study, our data suggest that most cancellations occur because of administrative or structural processes that are potentially preventable. Targeting these processes may help to reduce cancellations for elective surgeries and thereby improve economic efficiency and patient outcomes.
取消择期手术是一个主要问题，会增加等待时间、加剧成本，并对患者的身心产生负面影响。我们的目标是调查一个中心各专业取消手术的原因，将这些原因与同一中心 2005 年至 2009 年期间的先前数据进行比较，并在取消手术可能是可以预防的情况下，研究取消手术如何影响患者的生活和对医疗系统的看法。
回顾性分析了 2012 年 6 月 1 日至 2016 年 1 月 31 日期间在一家中等规模的三级保健学术中心计划进行的所有择期手术的取消记录。我们评估了取消的比率和原因，并对因潜在可预防原因（即手术室延误、床位短缺、急诊手术取代了计划手术）而取消手术的患者进行了亚组访谈。
在 11 个外科专业中，20881 例手术中有 2933 例（14.0%）被取消，其中 2448 例（83.5%）是由于行政或结构原因。与之前为一般、妇科和泌尿科手术收集的数据相比，取消率从 8.1%上升到 11.8%。尽管患者报告有不便，但他们对所接受的医疗保健的可用性和质量普遍感到满意。
与之前的研究一致，我们的数据表明，大多数取消手术是由于行政或结构过程造成的，这些过程是潜在可预防的。针对这些流程可能有助于减少择期手术的取消，从而提高经济效率和患者结果。
