The impact of a preanesthesia assessment clinic on scheduled elective case cancelations at a Thai university hospital
Issued Date
2023-08-25
Resource Type
eISSN
15365964
Scopus ID
2-s2.0-85169387601
Pubmed ID
37653830
Journal Title
Medicine
Volume
102
Issue
34
Rights Holder(s)
SCOPUS
Bibliographic Citation
Medicine Vol.102 No.34 (2023) , e34823
Suggested Citation
Vongchaiudomchoke W., Wongcharoen P., Wongyingsinn M. The impact of a preanesthesia assessment clinic on scheduled elective case cancelations at a Thai university hospital. Medicine Vol.102 No.34 (2023) , e34823. doi:10.1097/MD.0000000000034823 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/89614
Title
The impact of a preanesthesia assessment clinic on scheduled elective case cancelations at a Thai university hospital
Author's Affiliation
Other Contributor(s)
Abstract
Elective surgical case cancelations negatively impact healthcare systems and patient dissatisfaction. Preanesthesia assessment clinics (PACs) have been established in many countries to facilitate preoperative medical optimization. However, their benefits for elective procedure cancelations in Thailand have not been formally assessed. This study evaluated the impact of a PAC on scheduled elective surgical case cancelations at a Thai university hospital. A retrospective cross-sectional study was conducted for the period covering from May 2016 to April 2017. We included all scheduled elective surgical cases at Siriraj Hospital, Thailand, canceled on the day of surgery. The cancelation incidences of patients attending and not attending the PAC were compared. Cancellation reasons were categorized as "patient issue," "hospital-facility issue," "surgeon issue," "anesthesiologist issue," "medical condition," and "miscellaneous." The PAC patients' reasons were rigorously explored to determine their preventability. There were 30,351 scheduled elective procedures during the study period. The case-cancelation incidences were 0.9% (95% confidence interval [CI], 0.7-1.2%) for patients visiting the PAC and 5.9% (95% CI, 5.6-6.3%) for those who did not. Medical conditions were the most common reason for cancelation for non-PAC patients (27.3%), whereas hospital-facility issues were the most frequent for PAC patients (43.8%). The cancelation rate for patient issues was significantly lower in the PAC group (4.2% vs 20.7%; P < .05). Thirty-one (64.6%) of the PAC patients' cancelations were potentially preventable. Of the 15 PAC patient cancelations related to medical conditions, 12 were for patients with a history of acute illness and were determined to be nonpreventable. Visiting the PAC was significantly associated with a decreased elective-case cancelation rate. Cancellations were most frequently related to hospital-facility issues for patients visiting the PAC and medical conditions for those who did not. Some PAC patient cancelations for medical conditions involved unpreventable acute patient illnesses. Clinical Trials.gov (NCT02816281).