Análise das causas de cancelamentos em cirurgia ambulatorial: um estudo transversal

Abstract

The objective of the study was to analyze the causes of cancellation in a university outpatient surgery unit of the SUS. Cross-sectional, descriptive and analytical study, presented with the support of the STROBE® tool, based on document analysis of the institution's internal record. The setting was the outpatient hospital center of a university polyclinic that is part of the Unified Health System in the city of Rio de Janeiro. An archived data collection instrument was used to organize the data, constructed by the author based on the literature review. Study participants were the records of 2,147 surgeries scheduled, 1,813 performed, and 334 canceled between August 2021 and July 2022. The collected data were entered into an electronic spreadsheet (Microsoft Excel®) and underwent inferential statistical analysis using the statistical package R, version 4.2.1. The numerous causes of cancellation were refined and grouped into ten reasons: patient absence, non-compliance with preoperative preparation, patient with incomplete doses/no vaccine against COVID-19, patient withdrawal, absence of RT-PCR test for COVID-19 , unfavorable clinical conditions, lack of professional, scheduling error, lack of preoperative examination and lack of equipment/supplies/bed. These causes were categorized, according to the literature, into: patient, clinical and institutional. Surgical cancellations were more frequently related to patient absence 117 (35.05%), followed by unfavorable clinical conditions 92 (27.54%).Among the categories listed, causes related to patients were 182 (54%), followed by clinical causes 92 (27%). There was an annual rate of surgical cancellation of 15.55%, the highest rate was recorded in the month of December/2021 27 (22.5%) and in the specialty of vascular surgery 66 (20.89%). There was a statistically significant difference between surgical cancellations according to month (p= 0.010), gender (p≤ 0.001), surgical specialty (p= 0.001) and age (p= 0.007). It is concluded that the predominant cause of cancellation in outpatient surgery was patient absence and an annual cancellation rate considered high, denoting the need for greater intervention through the adoption of tools that enable management strategies, especially for the most critical aspects.