Efficiency estimation on the use of elective surgical theaters in the Chilean public health system from 2018 to 2021

Abstract

Objective The efficient use of wards intended for elective surgeries is essential to resolve cases on the surgical waiting list. This study aims to estimate the efficiency of ward use in the Chilean public health system between 2018 and 2021. Methods The design was an ecological study. Section A.21 of the database constructed by the monthly statistical summaries that each public health network facility reported to the Ministry of Health between 2018 and 2021 was analyzed. Data from subsections A, E and F were extracted: ward staffing, total elective surgeries by specialty, number and causes of suspension of elective surgeries. Then, the surgical performance during working hours and the percentage of hourly occupancy for a working day was estimated. Additionally, an analysis was made by region with data from 2021. Results The percentage of elective wards in use ranged from 81.1% to 94.1%, while those enabled for those staffing ranged from 70.5% to 90.4% during 2018 and 2021. The total number of surgeries was highest in 2019 (n = 416 339), but for 2018, 2020, and 2021 it ranged from 259 000 to 297 000. Suspensions varied between 10.8% (2019) and 6.9% (2021), with the leading cause being patient-related. When analyzing the number of cases canceled monthly by facility, we saw that the leading cause was trade union-related. The maximum throughput of a ward intended for elective surgery was reached in 2019 and was 2.5 surgeries; in 2018, 2020 and 2021, the throughput borders on two surgeries per ward enabled for elective surgery. The percentage of ward time occupied during working hours by contract day varies between 80.7% (2018) and 56.8% (2020). Conclusions All the parameters found and estimated in this study show that there is an inefficient utilization of operating rooms in Chilean public healthcare facilities.