Financial implications of cancellation of elective surgery to patients in Mulago Hospital

Abstract

Background: Cancellation of elective surgical procedures in Mulago hospital stands at a rate of about 28.8% with most of the reasons for these cancellations being system-related. These cancellations come with consequences to the patient that can be clinical, psychological and financial. The financial consequences in specific can affect both the patient, their family, and the institution and this negatively affect the quality as well as health outcomes. The financial burden to the patients comes in form of direct and indirect costs. The main objective of this study was to determine the financial implications of cancellation of an elective surgical procedure on to the patients. Methods: This was a cross-sectional study done in the surgical wards of Mulago National Referral and Teaching Hospital. A total of 113 participants were recruited into study. A structured questionnaire was used to assess the financial implications on patients resulting from cancellation of their elective surgical procedure. Data was analyzed quantitatively using descriptive analysis and appropriately reported in the findings. Results: A total of 113 patients from Mulago hospital surgical department participated in this study. These were patients who had been cancelled off elective surgical procedure lists and rescheduled for operation, during the study period. This study found that the cancellation of an elective surgery resulted into a total cost of $14,804.0 for all patients considered in the study, with an average cost per patient of $131. The largest proportion of the total costs to patients were in form of direct costs (76%). Costs on investigations dominated all direct costs, amounting to $4,331 (38.3%). Patients enrolled in the cardiothoracic ward incurred more costs, 31.1% ($4,598) than their counterparts in other wards. Most patients reported using their own savings to meet their costs. Conclusion: Cost of cancelling an elective surgery in Mulago Hospital was high in relation to the GDP per capita income of Uganda and this may contribute to health care access constraints and household impoverishment. Strategies for mitigating these costs need to be identified and implemented to reduce these costs and protect patients from catastrophic expenditures.