Cancellation of elective surgery and its associated factors among scheduled patients at Debre Markos Comprehensive Specialized Hospital, Amhara Region, North West Ethiopia: a cross-sectional explanatory mixed-methods approach.

Abstract

To assess the magnitude of elective surgery cancellation and associated factors among scheduled patients at Debre Markos Comprehensive Specialized Hospital, Amhara region, North West Ethiopia, 2023. A cross-sectional explanatory mixed-methods approach was used. The study was carried out at Debre Markos Comprehensive Specialized Hospital between 1 March and 30 April 2023. A total of 340 participants were included in the study, comprising 194 males and 146 females from various ethnic backgrounds. All participants scheduled for elective surgical procedures were selected using a simple random sampling method. Those with missing key information, such as operation or cancellation dates, were excluded from the study. The primary outcome was the status of elective surgery, whether it was cancelled or conducted. The secondary outcomes focused on identifying the factors associated with elective surgery cancellations. Elective surgery cancellations accounted for 24.40% of the scheduled procedures. Significant factors associated with cancellation included residing in a rural area (rural area (AOR)=2.47; 95% CI: 1.19 to 5.11), overscheduling (AOR=6.85; 95% CI: 2.27 to 20.63), lack of health insurance (AOR=8.68; 95% CI: 2.18 to 34.61), unstable medical conditions (AOR=9.99; 95% CI: 2.57 to 38.92), absence of a recovery bed (AOR=14.91; 95% CI: 5.10 to 43.59) and missing preoperative laboratory orders (AOR=18.16; 95% CI: 5.22 to 63.11). A substantial number of elective surgeries were cancelled on the day they were scheduled. Key contributing factors included patients' medical conditions, health insurance status, place of residence, availability of preoperative laboratory tests, overscheduling and lack of recovery beds. To reduce cancellations, healthcare stakeholders should enhance preoperative assessments, schedule procedures based on estimated surgical duration and ensure the availability of essential operating room resources.