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埃塞俄比亚南部沃莱塔地区医院手术当天的病例取消情况及相关因素

Case cancellations and associated factors on the day of surgery in hospitals of Wolaita Zone, South Ethiopia.

作者信息

Ayalew Tadele Lankrew

机构信息

Department of Nursing, College of medicine and health science, Wolaita Sodo University, Wolaita, Ethiopia.

出版信息

BMC Surg. 2024 Feb 4;24(1):45. doi: 10.1186/s12893-024-02330-5.

Abstract

BACKGROUND

Cancellations of elective surgery cases are frequent and have significant negative consequences. It causes wasting of valuable resources, patient unhappiness, and psychological stress of patients. Despite this, little is known about the case cancellation and associated factors on the day of surgery in Ethiopia, particularly in the study area.

OBJECTIVE

This study aimed to assess the magnitude of case cancellation and associated factors on the day of surgery in hospitals in Wolaita zone, South Ethiopia, from May 17 to June 17, 2023.

METHODS

A hospital-based cross-sectional study involving 322 patients was conducted at Wolaita Sodo Zone, South Ethiopia. All elective surgical cases scheduled during the study period were included. The entire number of participants was selected using a systematic random sampling process. Epidata V.3 was used to enter data, and SPSS V.25 was used to analyze it. Binary logistic regression was used to check for a possible association. P-values < 0.05 and 95% CI were used on multi-variable analysis as the threshold for the significant statistical association.

RESULT

A total of 313 study participants were scheduled for elective surgical procedures during the study period and gave a response rate of 97.2%. The mean (± SD) age of the study participants was 39.18 (± 10.64) years. The two-third of patients, 53(64%) were rural residents, and more than half (178, or 55.3%) of the participants were female. This finding showed that the case cancellation was 22.4% (95% CI: 19.3 -25.9%). Among the total canceled cases, 49(58.3%) were males. Variables like rural residence (AOR = 3.48 95% CI: 1.22-9.95), Lack of lab result (AOR = 2.33, 95%CI:1.20-4.51), ophthalmology dept. (AOR = 2.53 95% CI:1.52-4.49), HTN (AOR = 2.53, 95% CI:1.52-4.49), patient refusal (AOR = 3.01 95% CI:1.22-5.05), and age b/n 31 and 43 (AOR = 1.50, 95% CI:1.02-2.01) were significantly associated factors with cancellation of elective surgical cases.

CONCLUSION

In this study schedule of case cancellation was high. The contributing factors of case cancellation were rural residence, Lack of lab results, ophthalmology dept, HTN, patient refusal, and age. To decrease unnecessary cancellations and increase cost efficiency, hospital administration and medical staff must plan ahead carefully, communicate effectively, and make efficient use of hospital resources.

摘要

背景

择期手术病例的取消情况频繁发生,且会产生重大负面影响。这会造成宝贵资源的浪费、患者的不满以及患者的心理压力。尽管如此,在埃塞俄比亚,尤其是在研究区域,对于手术当天病例取消情况及其相关因素却知之甚少。

目的

本研究旨在评估2023年5月17日至6月17日埃塞俄比亚南部沃莱塔地区医院手术当天病例取消的规模及其相关因素。

方法

在埃塞俄比亚南部沃莱塔索多地区开展了一项基于医院的横断面研究,涉及322名患者。纳入了研究期间安排的所有择期手术病例。通过系统随机抽样过程选取了全部参与者。使用Epidata V.3录入数据,并使用SPSS V.25进行分析。采用二元逻辑回归来检验可能的关联。多变量分析中以P值<0.05和95%置信区间作为显著统计关联的阈值。

结果

在研究期间,共有313名研究参与者被安排进行择期手术,应答率为97.2%。研究参与者的平均(±标准差)年龄为39.18(±10.64)岁。三分之二的患者,即53名(64%)为农村居民,超过一半(178名,即55.3%)的参与者为女性。这一结果表明病例取消率为22.4%(95%置信区间:19.3 - 25.9%)。在所有取消的病例中,49名(58.3%)为男性。农村居民(比值比=3.48,95%置信区间:1.22 - 9.95)、缺乏实验室检查结果(比值比=2.33,95%置信区间:1.20 - 4.51)、眼科科室(比值比=2.53,95%置信区间:1.52 - 4.49)、高血压(比值比=2.53,95%置信区间:1.52 - 4.49)、患者拒绝(比值比=3.01,95%置信区间:1.22 - 5.05)以及年龄在31岁至43岁之间(比值比=1.50,95%置信区间:1.02 - 2.01)等变量是与择期手术病例取消显著相关的因素。

结论

在本研究中,病例取消的比例较高。病例取消的影响因素包括农村居民身份、缺乏实验室检查结果、眼科科室、高血压、患者拒绝以及年龄。为减少不必要的取消并提高成本效益,医院管理部门和医务人员必须提前仔细规划、有效沟通并高效利用医院资源。

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