Surgery cancelling at a teaching hospital: implications for cost management

Abstract

This study discusses the problem of surgery cancellation on the economic-financial perspective. It was carried out in the Surgical Center Unit of a school hospital with the objective to identify and analyze the direct costs (human resources, medications and materials) and the opportunity costs that result from the cancellation of elective surgeries. Data were collected during three consecutive months through institutional documents and a form elaborated by the researchers. Only 58 (23.3%) of the 249 cancelled scheduled surgeries represented costs for the institution. The cancellations direct total cost was R$ 1.713.66 (average cost per patient R$ 29.54); distributed as follows: expenses with consumption materials R$ 333.05; sterilization process R$201.22; medications R$149.77 and human resources R$1,029.62. The human resources costs represented the greatest percentile in relation to the total cost (60.40%). It was observed that most of the cancellations could be partially avoided. Planning on management; redesigning work processes, training the staff and making early clinical evaluation can be strategies to minimize this occurrence.

Economic and psychological burden of scheduled surgery cancellation in a sub-Saharan country (Burkina Faso)

“…In the literature some authors 29 estimated cost by using financial prediction. In Brasil, Perroca et al 2 used bills, factory prices, salaries, vacation salary and taxes to estimate cost. Due to the limited technology in Burkina Faso, we used the tool created by Guiguemdé et al 16 Cost containment through effective and efficient utilisation of resources has become a necessary part of healthcare delivery worldwide.…”

“…Maimaiti et al 11 found a total cost for all surgery cancellations to be around US$ 92 049 with an average cost of US$ 336 per cancelled surgery. In Brasil Perroca et al 2 found a total cost of US$ 3 466.70 with an average cost of US$ 9.50 per patient. Our results showed that the most expensive cancellation to the hospital was ENT procedures (US$ 4 830) for all cancelled cases followed by T&OS (US$ 3 039).…”

“…1 DOSC causes an inefficient use of the operating theatre, and is a waste of time and resources for patients and their families. 2 It increases healthcare costs, and results in theatre inefficiency and financial loss, lost personal income 3 and emotional distress for patients. The DOSC rate ranges from 1.96% to 36.4% for numerous reasons.…”

“…In Brasil, DOSC costs US$ 3 466.70 over three months, at an average of US$ 9.5 per patient. 2 In Iran, Maimaiti et al 11 found that the total cost of surgery cancellation was US$ 92 049.0. Cost was frequently evaluated using different tools according to the hospital concerned and the level of the country's development.…”

Measuring quality indicators in the operating room: cleaning and turnover time

“…This same author concluded, the maximum use of surgical capacity favors better management of resources (24) .…”