Factors Influencing Cancellation of Scheduled Elective Paediatric Operations in Benin City

Abstract

Background: Cancellation of scheduled elective paediatric cases can be distressing to both parents/caregivers and surgeons. The negative impacts on  utilization of operating theatre space and the additional cost of hospitalization have been stressed in many reports.

Aim: The aim of this study is to determine factors influencing the cancellation of schedule elective paediatric cases at the University of Benin Teaching  Hospital.

Methods: A one-year (October 2012-September 2013) prospective study was undertaken. Records of all children on scheduled elective list, those  cancelled and reasons for the cancellation were documented using a structured pro-forma. Data were entered into Microsoft Office Excel Spreadsheet  2007 and analyzed.

Results: Of a total 469 children booked for elective surgery during the period, 89 (18.9%) comprising 78 males and 11 females with a male/female ratio  7:1 had their operation cancelled. Groin hernias/hydrocele 38 (42.6%), hypospadias/post circumcision urethrocutaneous fistula 21 (23.5%), undescended  testis 18 (20.2%) and colostomy closure 3 (3.4%) were the major indications for elective surgeries that were cancelled. Inability of parents/caregivers to  pay operation fees in 62 (70%) cases was the major reason for cancellation. This was followed by sudden onset of intercurrent pathologies such as URTI in  8 (8.9%), malaria fever 6 (6.7%) and anaemia/non availability of blood 5 (5.6%) in children who were earlier certified fit. Ten (11.2%) children had their  surgery at a later date; one was discharged against medical advice while four were lost to follow-up.

Conclusion: Financial constraint was the major factor influencing cancellation of elective operations. We advocate that NHIS should cover all citizens and  government should provide free surgical treatment for indigent children.