Assessing cancellation of elective surgery and its impact on patient and facility at Komfo Anokye Teaching Hospital (KATH), Kumasi.

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Date
JUNE, 2019
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Abstract
Background: Surgical operations constitute a significant aspect of treatment administered in hospitals. The situations where patients’ surgical appointments are cancelled are an unfortunate occurrence within medical practice. Objective: The main objective of the study was to assess cancellation of elective surgeries on the day of operation and its effect on patients and the hospital in KATH, Kumasi. Methods: A descriptive cross-sectional study involving a self-administered questionnaire and face-to-face interview were conducted at the surgery department of KATH over a period of three months from May, 2018 to July, 2018. Total population (purposive sampling) was combined with convenient sampling technique in the selection of patients and health professionals for the study. Data analysiswas done with the aid Nvivo software. A sample size of 278 patients was used for the study with response rate of 97.12%. Results: During the study, 1078 elective surgical operations were booked and 74.2% elective operations were performed over the study period. 278 cases were cancelled representing 25.78%. The study found the lowest rate of 3.0% for cardio-thoracic and the highest (28.1%) for trauma orthopaedics. Medical/work-up, patient-related, administrative-related and others accounted for 16.3%, 54.1%, 30.7% and 18.9% of the cancelled surgeries respectively. The most common patient-related reason for cancellation was patients not turning up (40.7%). Majority of the patients (47.8%) expressed the feeling of disappointment while 23.7% indicated prolongs their staying thereby increasing their bill. Regarding, hospital related effects, 25.2% indicated lost confidence in the hospital. Conclusions: The study demonstrates a low cancellation rate compared to reported rates in Africa with trauma experienced the highest cancellation rate. However, the vast majority of cancellations could be avoided by improving the hospital administrative procedures and protocols.
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A thesis submitted to the Department of Health Policy, Management and Economics, College of Health Sciences, School of Public Health, in partial fulfilment of the requirements for the degree of Master of Public Health in Health Service Planning and Management.
Keywords
Cancellation rate, Elective surgeries, Patient impact, Patient
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