영남대학교 의과대학 부속병원 수술실에서 1990년 7월 1일부터 동년 12월 31일까지 6개월간 마취과에 예약된 계획수술예약환자를 대상으로 계획수술이 취소되는 환자를 조사하여 분석한 결과, 계획수술이 시행된 123일중 전신 또는 부위마취가 필요한 계획수술예약례는 3,108예였고 이들중 수술이 취소된 예는 502예로 평균 계획수술취소율은 16.2%였다. 후반기 6개월간 월별 계획수술예약이 가장 많았던 달은 8월(671예)이었고 계획수술취소율이 가장 높았던 달은 10월(21.2%)이었으며, 과별 계획수술취소율이 가장 높았던과는 치과(37.5%)였고 가장 낮았던 과는 안과(8.6%)였다. 계획수술이 취소되는 원인은 동반된 질환이나 검사소견이상(42.4%)이 가장 많았고, 입원안됨(14.5%), 과다한 수술스케줄이나 수술방부족(10.3%), 수술거부(8.6%), 수술준비부족(7.8%), 집도의 및 시술과사정(7.4%)등이 많았으며 그 외에 수술설비 및 기구고장, 계획수술전 응급으로 수술시행, 응급수술발생 및 질환의 증상완화나 치유등이 원인이었다. 따라서 계획수술의 취소 및 연기로 인한 환자입원일수를 줄이고 병상이용율을 증가시키기 위해서는, 수술전 외래에서 충분한 검사를 시행하고 그 결과를 판정한후 입원을 시켜야 하겠으며, 가급적 통원수술예를 증가시키고, 적절한 수술스케줄작성, 수술실운영의 합리화 및 각 과간의 긴밀한 협조등이 이루어져야 할것으로 사료된다.

Because operating room time is one of the most expensive hospital resources, cancellation of a planned surgery is a wasteful expenditure of specialized buman manpower and other medical resources. To decrease the rate of cancellation, we performed this prospective study about patients who planned elective surgery under general or regional anesthesia from September 1, 1990 to December 31, 1990 in the operating room of Yeungnam University Hospital. Daily, the total number of planned surgeries and cancelled patients were recorded, and the most important reasons for cancelling by an individual patient were also recorded. The results were as follows: 1) The total number of planned elective surgeries was 3,102 patients and total number of cancelled patients was 502 patients. Thus the mean rate of cancellation was 16.2%. 2) The highest rate of cancellation was in October(21.2%), and the departmental variation was the highest rate in dental(37.5%) and the lowest rate in the ophthalmic department(8.6%). 3) The reasons of cancellation were as follows: combined systemic diseases or or abnormal laboratory findings(42.4%) were most common, and the next was no admission(14.5%), heavy schedule or deficiency of operating room(10.3%), refusal of operation(8.6%), insufficient patient preparation(7.8%), and affairs of operator or department(7.4%), and others. As a result of this study, there are several ways to decrease the cancellation rate in operating room of Yeungnam University Hospital. The first is a careful preoperative evaluation of patient`s physical status and results of labaratory examination before hospitalization, and then the common practice of outpatient surgery, appropriate plan of overall elective operation, reasonable management of an operation room, and good relationships between the individual department, especially surgeons and consultants. If we follow the above mentioned ways, disruptions of the surgical schedules may be avoided and a more economical management of the operating room is possible.