Financial cost of elective day of surgery cancellations

Abstract

Operative care is one of the major areas of healthcare services as over 310 million surgeries are conducted yearly. Surgery cancellations is a widely used indicator when evaluating the quality of preoperative care. Cancellations cause financial lost for organizations, however there is only limited research about the costs. The aim of this study was to evaluate the cost of elective day of surgery (DOS) cancellations in 13 operative specialties at a university hospital in Finland between September 1, 2015 and May 31, 2016 after a structured preoperative protocol was implemented to practice and a cancellation rate of 4.7% was recognized. Procedure prices conducted the data for the research and were collected from the hospital’s invoicing system. Financial loss and savings of cancellations were calculated from the total cost of procedures. As a result the total cost of DOS cancellations during the nine-month time period was 953,374.27 euros and mean loss of a single cancelled operation was 2,459.91 euros. The total of material savings for the hospital were 106,917.33 euros. As a conclusion, DOS cancellations cause unnecessary wastage, and financial aspects should be followed and evaluated systematically by setting goals and providing continuing developments.

Predicting Elective Orthopaedic Sports Medicine Surgical Cancellations Based on Patient Demographics

“…Cancellation of elective orthopaedic surgical procedures is a significant problem that can lead to decreased operating room efficiency and revenue for a hospital. 10 Turunen et al 11 recently analyzed the average cost to a hospital in Finland for elective dayof-surgery cancellations across multiple surgical subspecialties. Orthopaedic surgery cancellation was associated with one of the highest costs to the hospital compared with other surgical subspecialties.…”

“…This number is estimated to be half the cost of cancellation in the United States. 11 Several improvements in quality of care and systemsbased practice focusing on limiting elective surgical cancellations have been found to be successful. Sebach et al 18 described an evidence-based nurse practitionereled preoperative evaluation clinic within a large orthopaedic practice.…”

“…3,8,9 Cancellation of elective surgical cases negatively impacts patient experience; surgeon scheduling; and overall operating room function, efficiency, and revenue. [10][11][12][13] Even with advancements in hospital quality measures directed toward decreasing patient cancellation rates, these "avoidable" cancellations continue to occur. 8,14,15 Despite the increased interest in surgical cancellations, knowledge regarding the factors that influence patient cancellations is incomplete.…”

Health specialists’ views on the needs for developing a digital gaming solution for paediatric day surgery: A qualitative study

“…Enrolment at the day surgery and surgeon continuity can be difficult for hospital members to organise and this poses challenges for families: children and families must be well-prepared for their upcoming surgery (Al-Sagarat, Al-Oran, Obeidat, Hamlan, & Moxham, 2017;Criss et al, 2018;Fortier & Kain, 2015), but at the same time, children should not fast for longer than necessary (Heikal, Bowen, & Thomas, 2019). In Finland, 4.7% of all elective surgeries are cancelled causing unnecessary wastage (Turunen, Miettinen, Setälä, & Vehviläinen-Julkunen, 2018). For instance, in 2013 the cancellation rate for paediatric patients was 4.5% (Laisi, Tohmo, & Keränen, 2013).…”

“…For instance, in 2013 the cancellation rate for paediatric patients was 4.5% (Laisi, Tohmo, & Keränen, 2013). The main reason for the cancellations was that the patients were inappropriately prepared for the upcoming operation (Turunen et al, 2018). In the USA, it was shown in a 5-years data set that last-minute cancellations were mostly "no shows" or NPO violations (failures to comply with eating/drinking instructions).…”