Last-minute surgery cancellations and patient no-shows cost hospitals millions of dollars each year, according to a study presented at the American Society of Anesthesiologists' annual conference.

For the study, Tulane University Medical Center researchers examined records for 4,876 elective outpatient surgeries scheduled at the New Orleans medical center in 2009. They found that 6.7% of the scheduled surgeries in 2009—or 327 surgeries overall—were cancelled, costing the medical center nearly $1 million.

According to the study:

• More than 30% of the procedures were cancelled because patients did not arrive at the hospital at the correct time; and
• Nearly 33% of the procedures were cancelled because of a mistake or issue related to the hospital, such as scheduling errors resulting in a lack of equipment or beds.

Study author Sabrina Bent, director of research at Tulane University's Department of Anesthesia, says most of the costs incurred from cancelled procedures stem from "opportunity costs" as hospitals often are unable to move other procedures into the cancelled time slot.

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Variation in the cost of cancellations
In addition, the study found that some surgeries cost more to cancel than others. Specifically, they found that:

• Neurosurgeries cost $5,962 to cancel;
• Urology procedures cost $4,758 to cancel;
• Otolaryngology procedures cost $4,623 to cancel;
• Thoracic surgeries cost $4,208 to cancel;
• Ophthalmology procedures cost $2,927 to cancel;
• Radiology procedures cost $2,787 to cancel;
• Orthopedic procedures cost $2,779 to cancel;
• Plastic surgeries cost $2,260 to cancel;
• General surgery procedures cost $1,965 to cancel; and
• Pediatrics procedures cost $1,325 to cancel.

How to prevent cancellations
To avoid cancellations, researchers recommend performing preoperative visits with all patients. In the study, only 4% of surgeries where patients had a preoperative clinic visit with an anesthesiologist were cancelled. In comparison, 11% of surgeries where patients did not have a preoperative visit were cancelled.

Researchers also suggest that hospitals focus on surgeries that result in the highest losses, such as neurosurgery and urology. While hospitals may be unable to solve all cancellations, "maybe there is something you can do to improve the efficiency and lack of cancellations in specialized groups," Bent said (McCook, Anesthesiology News, 5/2012).