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埃塞俄比亚西北部阿姆哈拉州德布雷马科斯综合专科医院择期手术取消情况及其相关因素:一项横断面解释性混合方法研究

Cancellation of elective surgery and its associated factors among scheduled patients at Debre Markos Comprehensive Specialized Hospital, Amhara Region, North West Ethiopia: a cross-sectional explanatory mixed-methods approach.

作者信息

Getie Addisu, Ayele Bizuayehu, Getie Girma Alem

机构信息

Department of Nursing, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia

Department of Nursing, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia.

出版信息

BMJ Open. 2025 Aug 6;15(8):e085156. doi: 10.1136/bmjopen-2024-085156.

Abstract

OBJECTIVE

To assess the magnitude of elective surgery cancellation and associated factors among scheduled patients at Debre Markos Comprehensive Specialized Hospital, Amhara region, North West Ethiopia, 2023.

DESIGN

A cross-sectional explanatory mixed-methods approach was used.

SETTING

The study was carried out at Debre Markos Comprehensive Specialized Hospital between 1 March and 30 April 2023.

PARTICIPANTS

A total of 340 participants were included in the study, comprising 194 males and 146 females from various ethnic backgrounds. All participants scheduled for elective surgical procedures were selected using a simple random sampling method. Those with missing key information, such as operation or cancellation dates, were excluded from the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the status of elective surgery, whether it was cancelled or conducted. The secondary outcomes focused on identifying the factors associated with elective surgery cancellations.

RESULT

Elective surgery cancellations accounted for 24.40% of the scheduled procedures. Significant factors associated with cancellation included residing in a rural area (rural area (AOR)=2.47; 95% CI: 1.19 to 5.11), overscheduling (AOR=6.85; 95% CI: 2.27 to 20.63), lack of health insurance (AOR=8.68; 95% CI: 2.18 to 34.61), unstable medical conditions (AOR=9.99; 95% CI: 2.57 to 38.92), absence of a recovery bed (AOR=14.91; 95% CI: 5.10 to 43.59) and missing preoperative laboratory orders (AOR=18.16; 95% CI: 5.22 to 63.11).

CONCLUSION

A substantial number of elective surgeries were cancelled on the day they were scheduled. Key contributing factors included patients' medical conditions, health insurance status, place of residence, availability of preoperative laboratory tests, overscheduling and lack of recovery beds. To reduce cancellations, healthcare stakeholders should enhance preoperative assessments, schedule procedures based on estimated surgical duration and ensure the availability of essential operating room resources.

摘要

目的

评估2023年埃塞俄比亚西北部阿姆哈拉地区德布雷马科斯综合专科医院计划接受手术的患者中择期手术取消的比例及相关因素。

设计

采用横断面解释性混合方法。

地点

研究于2023年3月1日至4月30日在德布雷马科斯综合专科医院进行。

参与者

共有340名参与者纳入研究,包括194名男性和146名女性,来自不同种族背景。所有计划接受择期手术的参与者均采用简单随机抽样方法选取。缺少关键信息(如手术或取消日期)的参与者被排除在研究之外。

主要和次要结局指标

主要结局是择期手术的状态,即是否取消或进行。次要结局侧重于确定与择期手术取消相关的因素。

结果

择期手术取消占计划手术的24.40%。与取消相关的显著因素包括居住在农村地区(农村地区(比值比)=2.47;95%置信区间:1.19至5.11)、安排过度(比值比=6.85;95%置信区间:2.27至20.63)、缺乏医疗保险(比值比=8.68;95%置信区间:2.18至34.61)、病情不稳定(比值比=9.99;95%置信区间:2.57至38.92)、没有恢复床位(比值比=14.91;95%置信区间:5.10至43.59)以及术前实验室检查医嘱缺失(比值比=18.16;95%置信区间:5.22至63.11)。

结论

大量择期手术在预定当天被取消。主要促成因素包括患者的病情、医疗保险状况、居住地点、术前实验室检查的可获得性、安排过度以及缺乏恢复床位。为减少取消情况,医疗利益相关者应加强术前评估,根据估计的手术时长安排手术,并确保手术室基本资源的可获得性。

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