Cancellation of pediatric outpatient surgery: Economic and emotional implications for patients and their families

Tait, Alan R.; Voepel‐Lewis, Terri; Munro, Hamish M.; Gutstein, Howard B.; Reynolds, Paul I.

doi:10.1016/s0952-8180(97)00032-9

Cited by 171 publications

(136 citation statements)

References 18 publications

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“…Cancellation of elective surgery because of a recent URI is troublesome for patients, families, 11 and operating room staff. Cancellation is often advocated based on the association between URI and adverse events, but such events were not predictable from preoperative data in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…6,9 Elective surgery may be cancelled because of recent URI, although individual practice varies widely. 10 The circumvention of complications that cancellation achieves may not justify the inconvenience of postponing a procedure, 11 especially since another URI may develop while awaiting rescheduled surgery -children have an average of six URI per year. 12 While the association between recent URI and respiratory-related adverse events is well documented, the implication for a given child with a recent URI is not clear.…”

mentioning

confidence: 99%

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Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

Elwood

Morris

Martin

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Upper respiratory infections (URI) presage perioperative respiratory complications, but thresholds to cancel surgery vary widely. We hypothesized that autonomically-mediated complications seen during emergence from anesthesia would be predicted by capnometry and reduced with preoperative bronchodilator administration.M Me et th ho od ds s: : Afebrile outpatient tertiary-care children (age two months to 18 yr, n = 109) without lung disease or findings, having non-cavitary, non-airway surgery for under three hours, were randomized to bronchodilator premedication vs placebo and had preoperative capnometry. After halothane via mask, laryngeal mask airway, or endotracheal tube, and regional anesthesia as appropriate, patients recovered breathing room air while cough, wheeze, stridor, laryngospasm, and cumulative desaturations were recorded for 15 min.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

Elwood

Morris

Martin

et al. 2003

Can J Anesth/J Can Anesth

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“…It results in emotional trauma and inconvenience for patients and their families, as well as the medical team. [2] The people who suffer most are those of low income, who depend entirely on the public health services for their healthcare needs. In addition, cancellation of an operation results in wasted investigations and blood cross-matching.…”

Section: Researchmentioning

confidence: 99%

Provision of an emergency theatre in tertiary hospitals is cost-effective: Audit and cost of cancelled planned elective general surgical operations at Pietersburg Hospital, Limpopo Province, South Africa

2017

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Background. Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital. Objectives. To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions. Methods. We did a prospective descriptive study of cancellations of elective general surgical operations over the 1-year period JanuaryDecember 2014 in the main theatre at Pietersburg (PTB) Hospital, Limpopo Province, South Africa. All patients listed on the theatre booking slate for elective general surgical operations before the cut-off time of 13h00 on the day before the anticipated operation were included. Epi Info version 7 was used to analyse the data and derive the descriptive statistics.Results. There were 537 booked patients (median age 47 years, range 1 -94); a total of 298 operations were performed, and 239 were cancelled (cancellation rate 44.5%). Reasons for cancellation were as follows: theatre needed for an emergency n=154 (64.4%), theatre equipment failure and lack of consumables n=17 (7.1%), non-theatre equipment failure n=10 (4.2%), prolonged time of operations n=13 (5.4%), abnormal blood results n=8 (3.3%), patient comorbidity and poor general condition n=9 (3.8%), patients absent from the ward n=8 (3.3%), patients not starved n=2 (0.8%), patients' condition improved significantly n=3 (1.3%), nurses' strike n=5 (2.1%), rebooking of cases for senior surgeons or other specialty n=2 (0.8%), and other reasons n=8 (3.3%). The cost per inpatient per day was estimated at ZAR4 890 at PTB Hospital and ZAR2 100 at district hospitals, and the total cost per cancelled operation was ZAR25 860. Conclusions. Over the 1-year period 44.5% of elective operations at PTB Hospital were cancelled, 64.4% because the theatre was needed for an emergency operation. We recommend that a theatre dedicated to emergencies be opened at PTB Hospital. The cost incurred due to cancellations was about ZAR6 million for the hospital, with additional cost and emotional trauma for the patients.

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“…Therefore, the benefit of properly treating such a chronic condition at the expense of delaying the procedure, which most likely poses a more urgent threat to the patient's overall health, is usually not practical. In fact, the consequences of postponing a case may include the depressing effect of cancellation on patients and their families because of the high levels of emotional stress and anxiety that are associated with surgery, 78,79 working days lost, and disruption of daily life. There is also the potential for revenue losses incurred by the hospital.…”

Section: Optimizing Dental Health Before Surgery: Risks and Benefitsmentioning

confidence: 99%

Perioperative Dental Evaluation

Yasny

Herlich

2012

Mount Sinai J Medicine

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show abstract

Cancellation of pediatric outpatient surgery: Economic and emotional implications for patients and their families

Cited by 171 publications

References 18 publications

Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

Provision of an emergency theatre in tertiary hospitals is cost-effective: Audit and cost of cancelled planned elective general surgical operations at Pietersburg Hospital, Limpopo Province, South Africa

Perioperative Dental Evaluation

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