Surgical case cancellation in a tertiary hospital in Yenagoa, Nigeria

Background: The efficiency of patient care in an operating theatre and by extension the hospital can be assessed by examining the rate of cancellation of surgical procedures. Case cancellation may significantly decrease the quality of healthcare delivery and reduce the income generated while increasing hospital running costs. There is also a significant impact on the patient and family. Aim: This study was carried out in our centre to identify the case cancellation rate, factors responsible for and associated with such cancellations and suggest mitigating measures. Methods: A hospital-based cross-sectional study of surgical case cancellations carried out over a 6-month period at a tertiary hospital in Nigeria. Case notes and theatre records of patients booked for elective and emergency procedures over the study period were utilized. A standardized data form was used, with retrieved data entered into Microsoft Excel and exported to IBM Statistical Package for Social Sciences (SPSS) version 21 for analysis. Results: Three hundred and thirty-four cases were recorded in this 6-month period. Two hundred and fifty two (75.4%) were elective procedures while eighty two (24.6%) were emergencies. The average case cancellation rate was 26.2%. Fifty percent of case cancellation reasons were patient-related. The most common patient-related cause was unfitness for surgery (46.1%). Hospital-related factors accounted for 28.01% of cancellations. Conclusion: Cancellation of surgical cases remains one of the most important challenges facing a hospital surgical service. Financial constraints encountered by patients can be relieved by the expansion and modification of government health insurance schemes. Hospitals are encouraged to periodically identify factors causing cancellations and solve them.