Cancellation of Elective Surgery and Its Associated Factors in Public Teaching Hospitals of Addis Ababa, Ethiopia, 2021

Elective surgical case cancellation is common and can have significant adverse effects by causing prolonged waiting times, harm to patients, and wasting of scarce resources in countries like Ethiopia. Cancellation of scheduled surgeries may lead to reduced occupation of operation theatres and may be recognized as a major cause of trauma to patients and their families. Reasons for elective surgery cancellation are complex and different from hospital to hospital. Many literatures agree with patient related, facility related, medical related and staff related others divide reason in to two avoidable and non-avoidable causes. The aim of this study was to assess prevalence of cancelation of elective surgery and associated factors in public teaching hospitals of Addis Ababa, Ethiopia, 2021. This was institutional-based cross-sectional study conducted in all operation theater specialties from February 1 to March 30, 2021 at Tikur Anbessa Specialized Hospital (TASH) and Yekatit 12 hospital. The study participants consisted of patients across all ages, included both genders and who were scheduled for elective surgery. Data was collected by using pretested structured questionnaires and an assigned operational theater staff was recording the cancelled cases in real time. Data was entered in to SPSS version 25 for analysis. Logistic regression models were used to identify predictors of cancellation of elective surgery. Statistical significance was determined using odds ratio with 95% confidence interval and the narratives were used to describe the quantitative findings. During data collection period, 924 elective surgeries were scheduled to be performed in all surgery departments at Tikur Anbessa Specialized Hospital and Yekatit 12 hospital, of which 225 (24.35%) were cancelled on the day of surgery. The average age of participants was 35.2 +/- 19.17 (Standard Deviation) years the main reason for cancellation were shortage of time (26%) followed by facility related (23%), medical related (18%) and Covid-19 related problems (15%). This study found that the cancelation of elective surgical operations on the scheduled day of surgery was significant. Most of the reasons were due to avoidable causes. A team approach was employed to ensure the presence of policies and procedures for improving efficiency and scheduling realistic operation lists.