The effect of hospital size and surgical service on case cancellation in elective surgery
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The effect of hospital size and surgical service on case cancellation in elective surgery : results from a prospective multicenter study. / Schuster, Martin; Neumann, Christian; Neumann, Konrad; Braun, Jan; Geldner, Goetz; Martin, Joerg; Spies, Claudia; Bauer, Martin; CASCAES Study Group ; Salzwedel, Cornelie.
In: ANESTH ANALG, Vol. 113, No. 3, 01.09.2011, p. 578-85.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The effect of hospital size and surgical service on case cancellation in elective surgery
T2 - results from a prospective multicenter study
AU - Schuster, Martin
AU - Neumann, Christian
AU - Neumann, Konrad
AU - Braun, Jan
AU - Geldner, Goetz
AU - Martin, Joerg
AU - Spies, Claudia
AU - Bauer, Martin
AU - CASCAES Study Group
AU - Salzwedel, Cornelie
PY - 2011/9/1
Y1 - 2011/9/1
N2 - BACKGROUND: Short-term case cancellation causes frustration for anesthesiologists, surgeons, and patients and leads to suboptimal use of operating room (OR) resources. In many facilities, >10% of all cases are cancelled on the day of surgery, thereby causing major problems for OR management and anesthesia departments. The effect of hospital type and service type on case cancellation rate is unclear.METHODS: In 25 hospitals of different types (university hospitals, large community hospitals, and mid- to small-size community hospitals) we studied all elective surgical cases of the following subspecialties over a period of 2 weeks: general surgery, trauma/orthopedics, urology, and gynecology. Case cancellation was defined as any patient who had been scheduled to be operated on the next day, but cancelled after the finalization of the OR plan on the day before surgery. A list of possible cancellation reasons was provided for standardized documentation.RESULTS: A total of 6009 anesthesia cases of 82 different anesthesia services were recorded during the study period. Services in university hospitals had cancellation rates 2.23 (95% confidence interval [CI] = 1.49 to 3.34) times higher than mid- to small-size community hospitals 12.4% (95% CI = 11.0% to 13.8%) versus 5.0% (95% CI = 4.0% to 6.2%). Of the surgical services, general surgical services had a significantly (1.78, 95% CI = 1.25 to 2.53) higher cancellation rate than did gynecology services-11.0% (95% CI = 9.7% to 12.5%) versus 6.6% (95% CI = 5.1% to 8.4%).CONCLUSIONS: When benchmarking cancellation rates among hospitals, comparisons should control for academic institutions having higher incidences of case cancellation than nonacademic hospitals and general surgery services having higher incidences than other services.
AB - BACKGROUND: Short-term case cancellation causes frustration for anesthesiologists, surgeons, and patients and leads to suboptimal use of operating room (OR) resources. In many facilities, >10% of all cases are cancelled on the day of surgery, thereby causing major problems for OR management and anesthesia departments. The effect of hospital type and service type on case cancellation rate is unclear.METHODS: In 25 hospitals of different types (university hospitals, large community hospitals, and mid- to small-size community hospitals) we studied all elective surgical cases of the following subspecialties over a period of 2 weeks: general surgery, trauma/orthopedics, urology, and gynecology. Case cancellation was defined as any patient who had been scheduled to be operated on the next day, but cancelled after the finalization of the OR plan on the day before surgery. A list of possible cancellation reasons was provided for standardized documentation.RESULTS: A total of 6009 anesthesia cases of 82 different anesthesia services were recorded during the study period. Services in university hospitals had cancellation rates 2.23 (95% confidence interval [CI] = 1.49 to 3.34) times higher than mid- to small-size community hospitals 12.4% (95% CI = 11.0% to 13.8%) versus 5.0% (95% CI = 4.0% to 6.2%). Of the surgical services, general surgical services had a significantly (1.78, 95% CI = 1.25 to 2.53) higher cancellation rate than did gynecology services-11.0% (95% CI = 9.7% to 12.5%) versus 6.6% (95% CI = 5.1% to 8.4%).CONCLUSIONS: When benchmarking cancellation rates among hospitals, comparisons should control for academic institutions having higher incidences of case cancellation than nonacademic hospitals and general surgery services having higher incidences than other services.
KW - Adult
KW - Aged
KW - Appointments and Schedules
KW - Female
KW - Germany
KW - Hospital Bed Capacity
KW - Hospitals, Community
KW - Hospitals, University
KW - Humans
KW - Male
KW - Middle Aged
KW - Monte Carlo Method
KW - Operating Room Information Systems
KW - Prospective Studies
KW - Regression Analysis
KW - Specialties, Surgical
KW - Surgical Procedures, Elective
KW - Surgical Procedures, Operative
KW - Time Factors
U2 - 10.1213/ANE.0b013e318222be4d
DO - 10.1213/ANE.0b013e318222be4d
M3 - SCORING: Journal article
C2 - 21680860
VL - 113
SP - 578
EP - 585
JO - ANESTH ANALG
JF - ANESTH ANALG
SN - 0003-2999
IS - 3
ER -