Cost of Canceled Outpatient Surgeries Can Climb Into Millions

Ever stop and figure how much canceled surgeries are costing your facility? They can add up to millions in lost revenue each year, according to new research findings.

Tulane University Medical Center researchers found that 327 (6.7%) of the facility's 4,876 scheduled elective outpatient surgeries were canceled in 2009, which cost the hospital nearly $1 million in revenue over that 12-month span, according to Sabrina Bent, MD, MS, clinical associate professor of anesthesiology and director of research at the Tulane University department of anesthesia and the study's lead author.

The Tulane study found that patient no-shows were a common cause of cancellations, with 30% of patients failing to show up on the day of surgery due to transportation issues, uncertainty regarding the date of the procedure or simply forgetting about the appointment, Dr. Bent told Anesthesiology News. Patients' confusion and forgetfulness weren't the only contributing factors, however. For example, the study found that nearly one-third of Tulane's cancellations in 2009 stemmed from issues at the hospital, like a lack of available beds or equipment.

The study found that the cost of cancellations varies by specialty. For example, the hospital only saw 7 cancellations in neurosurgery in 2009, but lost a total of $41,735 in revenue, with an average loss of $5,962 per case, as a result. Fourteen procedures in urology were canceled in that timeframe, which cost the facility $66,614 in lost revenue.

Ensuring that all patients have a pre-operative clinic visit with an anesthesiologist, to verify that patients are prepared for surgery and receive proper pre-op instructions, can help curb cancellations, said Dr. Bent. "That is a major factor that should be achievable," she said, adding that improving allocations of equipment and resources and increasing efficiency in order to move patients through the facility faster also help reduce the likelihood of having to cancel surgeries.

Focus your efforts on high-revenue subspecialties that consequently stand to see the biggest losses from canceling procedures, says Dr. Bent. "Maybe you cannot fix everything right away," she says, "but maybe there is something you can do to improve the efficiency and lack of cancellations in specialized groups."

Mark McGraw