Economic Impact of Childs Surgery Cancellation on Family

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Economic Impact of Childs Surgery Cancellation
on Family

• Siavash Jafari
• MD, MHSc,
• Community Medicine Resident (PGY-4)
• Research team
• Dr. Kourosh Afshar Damian J. Duffy Anky Lai
  Bindy Sahota Angie Kennedy
• November 2, 2009

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Back ground

• Cancellation of elective surgeries
• Health impact
• Economical impacts
• Psychosocial impacts
• To our knowledge there is no previous study to
  assess financial impact on patients

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Objectives of study

• To identify and collect details of expenses
  incurred related to the cancellation of a childs
  surgery on their family.
• To identify factors related to the degree of
  financial loss.
• To provide health care providers and decision
  makers with knowledge and insight into the
  financial burden of cancelled surgeries.

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Methods

• Study site (BCCH)
• Study period May 22- October 5, 2009
• Inclusion
• Surgery cancelled on surgery day
• after travel to hospital
• Ethics approval
• Consent
• Interviews
• Reimbursement Toys and gift cards

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?
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Variables of interest

• Age
• Gender
• Number of household
• Family income
• Number of cancellations
• Total wait time
• Reasons for cancellation
• Cost related info
• Hotel
• Gas
• Transportation
• Food
• Income lost
• Others

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Results
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Demographics

• 2806 surgery scheduled
• 454 cancelation (total)
• 29 surgery-day cancellation
• 9 did not consented/very upset
• Of those 20
• Male 8
• Female 11
• Unknown 1
• Age
• Min7 months
• Max17.8 years
• Mean 6.8 years
• Median 5.4 years

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What does it mean?

• Average per family 1282.53
• Most significant category
• Lost income
• Transportation
• Annual loss from surgeries in BCCH
• 7530 cancellation per year
• 78 surgery-day cancelation
• 68,641.62

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What it Means Provincially?

• 430,000 total surgeries (CIHI)
• 300,000 elective surgery (CIHI)
• 48,539 total cancellations
• 7,853 (surgery-day cancellation)
• 10,072,250 (Total family loss in BC)
• 8,000,000 productivity loss
• 2,000,000 Family Cash Loss

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Limitations

• Volunteered time
• Travel time
• Psycho-social effects on child
• Psycho-social effects on family members
• Educational loss, school days
• QoL effects
• Lost opportunity
• Reimbursed costs
• Some medications cost

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Conclusion

• Impact of Surgical Cancellation
• On child (QoL, education, growth and development,
  physical, mental, )
• On family (financial, psychological, )
• On system (increased wait time, )
• Reasons
• Identify the causes
• Resource related (bed, staff, OR, )
• Patient related (status change, disease
  progression/ remission,)
• System related (planning, scheduling, )

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Recommendations

• More resources required
• Families Reimbursement
• ICU bed and staff
• Dedicated Emergency OR
• Ability to run late rooms

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Acknowledgements

• Source of funding CYHRNet
• Research team
• Dr. Kourosh Afshar, MD, MHSc, FRCPC
• Damian J. Duffy (Executive Director Office of
  Pediatric Surgical Evaluation and Innovation)
• Anky Lai
• Bindy Sahota
• Angie Kennedy

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Thank you!Questions?
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