title: Cancellation of pediatric outpatient surgery: economic and emotional implications for patients and their families.
abstract: OBJECTIVE
  To determine the cause and timing of case cancellation in a pediatric outpatient surgical population, and to examine the economic and emotional impact of such cancellations on patients and their families.
  
  
  METHODS
  Questionnaire survey.
  
  
  METHODS
  Outpatient surgery unit of a large university children's hospital.
  
  
  METHODS
  127 parents of children whose elective outpatient surgery had been cancelled.
  
  
  METHODS
  A total of 200 questionnaires were mailed to the parents of children who had their outpatient surgery cancelled.
  
  
  RESULTS
  Of those children whose surgery had been cancelled, 34.6% were due to upper respiratory infections (URIs), 30.7% for other medical reasons, and the balance for scheduling errors, because the child had not fasted, or for difficulties with transportation. The majority of surgeries (58.3%) were cancelled prior to their scheduled surgery date. However, 18.9% were cancelled on the day of surgery prior to leaving for the hospital and 22.8% were cancelled on arrival at the outpatient surgery clinic. Of those patients whose surgeries were not cancelled until they arrived at the hospital, 38.5% of mothers and 50.0% of fathers missed a day of work and, of these, 53.3% and 42.1%, respectively, went unpaid for the work day missed. The mean number of miles driven (round trip) to the hospital for a cancelled operation was 158.8 miles (range 8 to 1,350 miles). Additional testing and new appointments were ordered in 25.2% of the cancelled cases. 45% of parents and 16% of children were disappointed by the cancellation; 16% of parents were frustrated by the cancellation and 3.3% were angry.
  
  
  CONCLUSIONS
  This study suggests that last-minute cancellation of surgery has an important impact on patients and their families and suggests a need to review present protocols for screening patients prior to surgery.
authors.affiliation: Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor 48109, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Tait
authors.forename: T
authors.initials: T
authors.lastname: Voepel-Lewis
authors.forename: H M
authors.initials: HM
authors.lastname: Munro
authors.forename: H B
authors.initials: HB
authors.lastname: Gutstein
authors.forename: P I
authors.initials: PI
authors.lastname: Reynolds
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000523:psychology*; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D005190:Family; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012141:Respiratory Tract Infections / Q000150:complications; D011795:Surveys and Questionnaires