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Research Article
Sharif Kikomeko
Habib Medical School, Islamic University in Uganda (Kampala Campus)
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Surgical conditions account for 11% of the total worlds’ disability-adjusted life years (DALYs). Despite having about 25% of the global surgical burden, the worlds’ poor expenditure countries only undertake 3.5% of the total worlds’ surgical procedures. In the face of meager healthcare financing in these areas, interventions that enable efficient utilization of the available surgical infrastructure -for instance efficient management of pre-surgery waiting times- offer a first step to mitigating this enormous unmet surgical need. This study therefore set out to determine the waiting times to elective surgery, and factors contributing to surgical delays amongst patients attending Mulago National referral hospital.
Methods: This was a cross-sectional study conducted between June and August 2014 on 412 patients scheduled for elective surgery. Mean and median waiting times (WT) to surgery, and reasons for postponement of surgery were determined by retrospective chart reviews and face-to-face interviews, using standardized pre-tested questionnaires.
Results: Of the 412 surgeries that had been scheduled, 119 (28.9%) were postponed. Health care system factors which included: lack of theatre space, lack of adequate equipment or sundries, absence of blood for intra and/post-operative blood transfusion, and lack of utilities (water and/electricity), were responsible for most of the rescheduled surgeries. Of all study participants, subjects with Oral and maxillo-facial surgery (OMF), Ear, nose and throat (E.N.T), and Neurosurgery surgical conditions had significantly shorter median waiting-times to surgery (median WT; 3.5 days, 6.5 days & 6.0 days respectively, p<0.0001). Patients whose surgical procedures were curative in nature also had significantly shorter waiting-times (median WT; 8.0 days) compared to patients with diagnostic (median WT; 12.0 days), reconstructive (median WT; 12.0 days) or palliative surgical procedures (median WT; 11.5 days) (p=0.005).
Conclusions: Generally, the median waiting-time to surgery amongst participants scheduled for elective surgery in the current study was low, compared to that observed elsewhere. However, the proportion of rescheduled surgeries is still high, with factors intrinsic to operational processes in the surgical health care setting mostly to blame. Additionally, surgical conditions involving the head and neck region, and curative surgical procedures were significantly associated with shorter waiting-tines to surgery.
Keywords
Waiting times, waiting list, elective surgery, cancellation, surgery delay
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This is a preprint. It has not completed peer review.
Research Article
Sharif Kikomeko
Habib Medical School, Islamic University in Uganda (Kampala Campus)
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 11 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Surgical conditions account for 11% of the total worlds’ disability-adjusted life years (DALYs). Despite having about 25% of the global surgical burden, the worlds’ poor expenditure countries only undertake 3.5% of the total worlds’ surgical procedures. In the face of meager healthcare financing in these areas, interventions that enable efficient utilization of the available surgical infrastructure -for instance efficient management of pre-surgery waiting times- offer a first step to mitigating this enormous unmet surgical need. This study therefore set out to determine the waiting times to elective surgery, and factors contributing to surgical delays amongst patients attending Mulago National referral hospital.
Methods: This was a cross-sectional study conducted between June and August 2014 on 412 patients scheduled for elective surgery. Mean and median waiting times (WT) to surgery, and reasons for postponement of surgery were determined by retrospective chart reviews and face-to-face interviews, using standardized pre-tested questionnaires.
Results: Of the 412 surgeries that had been scheduled, 119 (28.9%) were postponed. Health care system factors which included: lack of theatre space, lack of adequate equipment or sundries, absence of blood for intra and/post-operative blood transfusion, and lack of utilities (water and/electricity), were responsible for most of the rescheduled surgeries. Of all study participants, subjects with Oral and maxillo-facial surgery (OMF), Ear, nose and throat (E.N.T), and Neurosurgery surgical conditions had significantly shorter median waiting-times to surgery (median WT; 3.5 days, 6.5 days & 6.0 days respectively, p<0.0001). Patients whose surgical procedures were curative in nature also had significantly shorter waiting-times (median WT; 8.0 days) compared to patients with diagnostic (median WT; 12.0 days), reconstructive (median WT; 12.0 days) or palliative surgical procedures (median WT; 11.5 days) (p=0.005).
Conclusions: Generally, the median waiting-time to surgery amongst participants scheduled for elective surgery in the current study was low, compared to that observed elsewhere. However, the proportion of rescheduled surgeries is still high, with factors intrinsic to operational processes in the surgical health care setting mostly to blame. Additionally, surgical conditions involving the head and neck region, and curative surgical procedures were significantly associated with shorter waiting-tines to surgery.
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