Reasons for cancellation of elective surgery in Ilorin

Background: The rising cost of health care and dwindling economic resources necessitate the need to encourage cost-effectiveness in patient care. Cancellation of cases on the scheduled day of surgery leads to inefficient utilization of theatre space, waste of valuable manpower and scarce resources for patients and hospital. Avoidance of unnecessary cancellations of cases may therefore be an important way of ensuring efficient utilization of resources. Methods: This is a prospective study. Record was taken of all patients whose names appeared on the routine elective surgical operation lists. The names of all those who could not have their surgery done were compiled. The age, sex, diagnosis, specialty of surgery, proposed surgery and reasons for cancellation were collated and analysed. Results: Out of the 1,175 patients scheduled for surgery during the study period, 272(23.15%) were cancelled for various reasons. The highest incidence of cancellation 130(11.06%) was recorded in orthopaedic specialty, even though it ranked second to General Surgery in the total number of cases booked. Cardiothoracic unit recorded the lowest incidence of cancellations (1.84%), but it also had the lowest number of cases scheduled for surgery. The commonest cause of cancellations was time constraints (22.59%). Patients absconded from surgery for personal reasons not communicated to the Surgeons in 13.60% of cases, while unanticipated logistic problems accounted for another 9.93%. Other causes of cancellations included industrial action embarked upon by members of the hospital community staff auditing exercise, uncontrolled medical illness and unresolved laboratory abnormalities. Conclusion: The incidence of cancellation of cases on the scheduled day of surgery is still high in our hospital. Most of the causes of the cancellations are preventable. In order to enhance cost-effectiveness, efforts should be made to prevent unnecessary cancellations through careful planning and closer interactions between surgeons and patients, and amongst members of the surgical team. Keywords: Elective surgery, Cancellation, Causes, Cost-effectiveness. Nig. J. of Surgical Research 4(1-2) 2002: 28-3