Clinical trial NCT03812133: Risk Factors and Reasons for Cancellation Within 24 Hours of Scheduled Elective Surgery in an Academic Medical Centre
Official title: Risk Factors and Reasons for Cancellation Within 24 Hours of Scheduled Elective Surgery in an Academic Medical Centre
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Operating Theatre Cancellations
Lead sponsor: Singapore General Hospital
Sponsor class: OTHER
First posted: 2019-01-22
Enrollment: 4060
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The median patient age was 68 years (IQR 63 - 75 years), with 44% being male patients and 80% Chinese. Majority were Singapore citizens or permanent residents (98%). Two-thirds of the surgical patients were in a subsidized ward class (2665, 66%). Only 2% required Medifund assistance.

Brief summary: The Operating Theatre (OT) is the largest cost centre as well as the main revenue generator in most hospitals. One of the common problems affecting optimal OT utilization is the cancellation of scheduled surgeries. The goal of this study was to identify factors associated with cancellation within 24 hours of scheduled surgeries in a tertiary hospital

Detailed description: The Operating Theatre (OT) is the largest cost centre as well as the main revenue generator in most hospitals. The operating theatre involves significant resources - materials, medications and manpower. One of the common problems affecting optimal OT utilization is the cancellation of scheduled surgeries. This results in a significant waste of resources, especially when cancellation occurs within 24 hours of the scheduled surgery, when it is too late to arrange replacement surgery. Cancellation also impacts the patient and their families.

Reported cancellation rates range between 5% to 40%. Reasons for cancellations vary, including patient factors, surgeon factors, and system issues relating to the preoperative anaesthesia assessment clinic attendance, the surgery itself, and the availability of post-surgical care facilities. Between 60% to 90% of cancellations have been reported to be potentially avoidable.

The goal of this study was to identify factors associated with cancellation within 24 hours of scheduled surgery in a tertiary academic hospital, and the reasons for cancellation, with the goal of identifying areas for intervention to reduce avoidable surgery cancellations and reduce unnecessary waste.

Eligibility criteria: Adult patients (age 18 years and older) who were scheduled for elective surgery at the Singapore General Hospital main operating theatre or ambulatory surgical centre, regardless of surgical discipline, or residency, were included in the study. Only the first surgery in the study period was included if a patient had multiple surgeries over this period. Minor surgeries under local anaesthesia were also excluded. We excluded those without previous admissions in the past 3 years prior to the surgery, as data for chronic disease history and healthcare utilization patterns were not available for these patients

Primary outcomes:
measure: Cancellation
timeFrame: 24 hours of surgery
Secondary outcomes:
Other outcomes:
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Study officials:
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