Title : Scheduled surgery cancellations: A socioeconomic analysis
Abstract:
Background: Scheduled surgeries are essential for improving quality of life and preventing disease progression. While the clinical benefits are well established, their delivery is frequently challenged by significant operational pressures, including bed shortages, workforce constraints, seasonal demand fluctuations and organisational disruptions. In shared-care centres, elective services are particularly vulnerable to acute care pressures, with surges in emergency admissions often necessitating short-notice cancellations. Although the clinical and psychological consequences of cancellations are increasingly recognised, comparatively little attention has been paid to their broader socioeconomic impacts. This scoping review aims to evaluate the extent, nature and characteristics of the existing literature examining these impacts on patients and healthcare systems within publicly funded healthcare settings.
Methods: Following the Population, Concept, Context (PCC) framework, consistent with PRISMA-ScR guidelines, a comprehensive search was conducted across PubMed, Embase, Cochrane Library, APA PsycInfo and CINAHL. Two independent reviewers applied inclusion and exclusion criteria to identify eligible studies. Studies were included if they reported on adult patients affected by scheduled surgery cancellations within publicly funded healthcare systems in high-income countries. Outcomes of interest included patient-level socioeconomic impacts (employment disruption, financial stress, social role changes, caregiver burden) and healthcare system-level consequences (economic and operational costs). Data were synthesised using descriptive and thematic analysis.
Results: Orthopaedic procedures were the most frequently examined speciality. Patient-level impacts included employment disruption, income loss, additional travel and childcare costs, social role impairment and increased reliance on informal caregivers. System-level impacts included lost revenue, underutilised operating capacity, administrative inefficiencies and excess costs related to recurrent admissions and repeated investigations. Seasonal pressures and covid-19 further amplified these effects.
Conclusion: Scheduled surgery cancellations generate multidimensional socioeconomic consequences affecting patients, caregivers and healthcare systems. Systematic measurement and economic evaluation of these impacts are needed to inform policy, optimise resource allocation and strengthen scheduled care resilience.
