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

Abstract

Background: Cancellation of scheduled surgery creates a financial burden for hospitals, caregivers and patients. Cancellation causes emotional stress, which impacts on outcomes. In poor countries where the adequacy of healthcare is limited, the ethical dilemma created by scheduled surgery cancellation is particularly important. Objective: To identify the incidence, cost and emotional impact of elective surgical cancellation in a teaching hospital in Burkino Faso. Methods: A four month, prospective, observational study was undertaken in a teaching hospital (Yalgado Ouedraogo). All surgical patients were eligible. The causes of cancellation, financial cost and patients' emotional response were assessed. The cost was estimated using a tool adapted for the economic cost of African job types. Results: During the study period, 1 088 cases were scheduled to undergo inpatient surgery. Of these, 239 cases (21.9%) were cancelled. Among the cancelled cases, 237 were cancelled during preparation in the surgical ward and two cases were cancelled in the operation room. A large number of the patients were housewives (n = 87). The highest cancellation rate (35.9%) was found in general surgery. Cancellation was judged avoidable in 214 cases (89.5%). The total cost of surgery cancellation to the hospital was US$ 19 147 (mean value US$ 80 per patient). Patients lost a mean of US$ 62.70, which represented 117.6% of the official average monthly income in Burkina Faso. ENT surgery was the costliest to the hospital (US$ 4 989 ). Cancellation caused a negative emotional reaction in 205 patients (85.7%) and 'sadness' was the most frequent (54.8%; n = 131). Cancellation resulted in 163 days of work lost. Conclusion: Based on income, the cost of day of surgery cancellation was high in Burkina Faso.

An audit of operating theatre utilisation and day-of-surgery cancellations at a regional hospital in the Durban metropole

“…Avoidable' was defined as a cancellation or delay that occurred as a result of situations that existed prior to the day of surgery and could have been avoided by careful review and communication between patients and/or staff. [9] 'Unavoidable' was defined as a delay or cancellation that could not have been avoided even with adequate review or communication between patients and/or staff. [9]…”

“…[9] 'Unavoidable' was defined as a delay or cancellation that could not have been avoided even with adequate review or communication between patients and/or staff. [9]…”

Global prevalence and reasons for case cancellation on the intended day of surgery: A systematic review and meta-analysis

“…Operation Room (OR) is the financial centre of the Hospital [ [3] , [4] , [5] , [6] , [7] ] which can generate 40–50% of hospital and 60–70% of hospital revenue [ 8 ] with an average cost of 15–50 US Dollars per minute[ 3 , [9] , [10] , [11] , [12] , [13] , [14] ].…”

“…Cancellation of operation on the intended day of surgery affects the efficiency of OR, reduces utilization of OR time and waste resources which incur a significant financial loss for the patient hospital and health care cost of a country at large [ [2] , [3] , [4] , [5] , [6] , [7] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] ].…”

Winter cancellations of elective surgical procedures in the UK: a questionnaire survey of patients on the economic and psychological impact

“…Any rescheduled operation date may also result in patients and carers incurring the same costs again with no recourse to reimbursement. This may lead to a considerable economic burden on the patient and their family5 and cause additional loss of working days for the economy. Postponement or cancellation of elective surgery may also have a profound psychological impact on patients and their families, who may have mentally prepared themselves for the event.…”