Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in Germany

Background: In Germany, over 16 million pre-anesthesia consultations (PAC) are conducted annually, which is associated with a significant investment of time and high costs. However, some PACs do not lead to surgery, which is inefficient and results in wasted resources. This study evaluates the costs...

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Main Authors: Julia Alexandra Simons, Steffen B. Wiegand, Lisa Thiehoff, Patrick Winnersbach, Gereon Schälte, Anna Fischbach
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Anesthesia Research
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Online Access:https://www.mdpi.com/2813-5806/2/1/2
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author Julia Alexandra Simons
Steffen B. Wiegand
Lisa Thiehoff
Patrick Winnersbach
Gereon Schälte
Anna Fischbach
author_facet Julia Alexandra Simons
Steffen B. Wiegand
Lisa Thiehoff
Patrick Winnersbach
Gereon Schälte
Anna Fischbach
author_sort Julia Alexandra Simons
collection DOAJ
description Background: In Germany, over 16 million pre-anesthesia consultations (PAC) are conducted annually, which is associated with a significant investment of time and high costs. However, some PACs do not lead to surgery, which is inefficient and results in wasted resources. This study evaluates the costs and time loss associated with PACs that did not result in anesthesia-required surgery or diagnostic procedures and identifies the predictors of these cancellations. Methods: A total of 1357 PACs conducted in September 2023 at the University Hospital Aachen were retrospectively analyzed. The study groups included patients whose PACs resulted in anesthesia-required surgery or diagnostic procedures (SURG group) and those whose PACs did not (NoSURG group). The primary outcomes were costs in EUR and the hours lost due to PACs not resulting in anesthesia for patients in the NoSURG group, and the secondary outcomes included the predictors of surgery cancellations, the frequency of missing test results, necessary pre-anesthesia re-consultations due to missing tests, and hospital length of stay for NoSURG patients. Results: In September 2023, 7.3% (99/1357) of PACs did not result in anesthesia-required procedures. ASA scores were higher in the NoSURG group, with almost two-thirds classified as ASA III or higher (<i>p</i> = 0.001). The NoSURG group had more planned postoperative IMC stays (16.2% vs. 9.3%; <i>p</i> = 0.027) and fewer medical report letters available (50.5% vs. 97.1%; <i>p</i> < 0.001). The reasons for surgery cancellation were often undetermined (47.5%). Other reasons included surgeons opting for a conservative approach (19.2%), patient decisions (9.1%), surgery no longer indicated (8.1%), hospital capacity constraints (5.1%), patient transfers (3.0%), and high surgical risk (8.1%). The annual projected cost for the NoSURG group was EUR 29,182, with 888 h of time loss. The median hospital length of stay for the NoSURG group was 5 (2; 15) days. Conclusions: PACs that were carried out but were not followed by anesthesiology services led to substantial costs and time loss. Improving medical report availability and assessing procedure necessity beforehand might help to reduce these expenses and time losses.
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spelling doaj-art-7fa400fa4ba1437ca66a19fbf3d6e2342025-08-20T01:49:24ZengMDPI AGAnesthesia Research2813-58062025-01-0121210.3390/anesthres2010002Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in GermanyJulia Alexandra Simons0Steffen B. Wiegand1Lisa Thiehoff2Patrick Winnersbach3Gereon Schälte4Anna Fischbach5Department of Anesthesiology, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyDepartment of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, GermanyDepartment of Anesthesiology, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyDepartment of Anesthesiology, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyDepartment of Anesthesiology, Intensive Care and Emergency Medicine, Hermann-Josef Krankenhaus Erkelenz, Tenholter Str. 43, 41812 Erkelenz, GermanyDepartment of Anesthesiology, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyBackground: In Germany, over 16 million pre-anesthesia consultations (PAC) are conducted annually, which is associated with a significant investment of time and high costs. However, some PACs do not lead to surgery, which is inefficient and results in wasted resources. This study evaluates the costs and time loss associated with PACs that did not result in anesthesia-required surgery or diagnostic procedures and identifies the predictors of these cancellations. Methods: A total of 1357 PACs conducted in September 2023 at the University Hospital Aachen were retrospectively analyzed. The study groups included patients whose PACs resulted in anesthesia-required surgery or diagnostic procedures (SURG group) and those whose PACs did not (NoSURG group). The primary outcomes were costs in EUR and the hours lost due to PACs not resulting in anesthesia for patients in the NoSURG group, and the secondary outcomes included the predictors of surgery cancellations, the frequency of missing test results, necessary pre-anesthesia re-consultations due to missing tests, and hospital length of stay for NoSURG patients. Results: In September 2023, 7.3% (99/1357) of PACs did not result in anesthesia-required procedures. ASA scores were higher in the NoSURG group, with almost two-thirds classified as ASA III or higher (<i>p</i> = 0.001). The NoSURG group had more planned postoperative IMC stays (16.2% vs. 9.3%; <i>p</i> = 0.027) and fewer medical report letters available (50.5% vs. 97.1%; <i>p</i> < 0.001). The reasons for surgery cancellation were often undetermined (47.5%). Other reasons included surgeons opting for a conservative approach (19.2%), patient decisions (9.1%), surgery no longer indicated (8.1%), hospital capacity constraints (5.1%), patient transfers (3.0%), and high surgical risk (8.1%). The annual projected cost for the NoSURG group was EUR 29,182, with 888 h of time loss. The median hospital length of stay for the NoSURG group was 5 (2; 15) days. Conclusions: PACs that were carried out but were not followed by anesthesiology services led to substantial costs and time loss. Improving medical report availability and assessing procedure necessity beforehand might help to reduce these expenses and time losses.https://www.mdpi.com/2813-5806/2/1/2pre-anesthesia clinicpre-anesthesia consultationPACpreoperative caresurgery cancellation
spellingShingle Julia Alexandra Simons
Steffen B. Wiegand
Lisa Thiehoff
Patrick Winnersbach
Gereon Schälte
Anna Fischbach
Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in Germany
Anesthesia Research
pre-anesthesia clinic
pre-anesthesia consultation
PAC
preoperative care
surgery cancellation
title Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in Germany
title_full Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in Germany
title_fullStr Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in Germany
title_full_unstemmed Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in Germany
title_short Costs and Time Loss from Pre-Anesthesia Consultations for Canceled Surgeries: A Retrospective Study at Aachen University Hospital in Germany
title_sort costs and time loss from pre anesthesia consultations for canceled surgeries a retrospective study at aachen university hospital in germany
topic pre-anesthesia clinic
pre-anesthesia consultation
PAC
preoperative care
surgery cancellation
url https://www.mdpi.com/2813-5806/2/1/2
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