Magnitude and associated factors of elective surgical case cancellation in Woldia Comprehensive Specialized Hospital hybrid retrospective and prospective cross-sectional study, Amhara, Ethiopia, 2025

Abstract

Background: Elective surgical case cancellation is a pervasive global challenge, with rates ranging from 0.37 to 40% in developed nations and reaching up to 73% in low- and middle-income countries. In Ethiopia, while descriptive studies indicate high cancellation rates, there is a lack of analytical studies identifying the associated factors. This study aimed to determine the magnitude and associated factors of elective surgical case cancellations in the study area. Methods: This hybrid retrospective and prospective cross-sectional study was conducted from September 2024 to April 2025 among 378 systematically sampled elective surgical cases. Data were collected using pretested, structured questionnaires and medical record reviews. Data analysis was performed using SPSS version 25. Bivariable and multivariable logistic regression analyses were employed to identify associated factors, with an adjusted odds ratio (AOR) at a 95% confidence interval and a P -value < 0.05 considered statistically significant. Results: The magnitude of elective surgical case cancellation was 25.6% (95% CI: 20.94, 30.26). The leading reasons for cancellation were time-related factors (28.7%, n = 27), including prolonged previous cases (17.0%, n = 16) and emergency case priority (11.7%, n = 11), as well as facility/management-related issues (23.4%, n = 22). Factors significantly associated with cancellation included age 61–70 years [AOR = 2.83; 95% CI (1.29, 6.24)], age 71 years and above [AOR = 3.68; 95% CI (1.37, 9.85)], and a monthly income less than 2000 Birr [AOR = 2.67; 95% CI (1.44, 4.98)]. Conclusion: The cancellation rate exceeded the recommended benchmark. Advanced age and low income were significant risk factors. We recommend implementing thorough preoperative assessments, creating realistic surgical schedules, optimizing resource management, and establishing effective policies to mitigate this issue.