Appropriateness of Preoperative Screenings in Patients Undergoing Elective Gynecologic Surgery at Srinagarind Hospital, Khon Kaen University, Thailand: An Observational Study

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Published: Dec 29, 2017
DOI: https://doi.org/10.14456/tjog.2017.30

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Pol Likitdee
Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Pisake Lumbiganon
Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Cattleya Thongrong
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Chumnan Kietpeerakool
Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Kiattisak Kongwattanakul
Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

Abstract

Objectives: To evaluate the appropriateness of routine preoperative screening for patients who undergoing elective major gynecologic surgery at a tertiary care university hospital, Khon Kaen Province based on the hospital guideline.
Materials and Methods: This retrospective descriptive study reviewed 808 medical records of gynecologic patients undergoing elective surgery in 2014.
Results: The mean age of the patients was 44.2 years. Approximately 36% of patients had associated co-morbidity. Almost 90% of the patients had inappropriate screening tests. Complete blood count and chest x-ray were the two most appropriate screening test. The most inappropriate tests were urinalysis and fasting blood sugar. Patients were classified into 4 groups: 1) patients < 45 years old with no underlying conditions; 2) patients < 45 years old with at least one underlying conditions; 3) patients ≥ 45 years old with no underlying conditions and 4) patients ≥ 45 years old with at least one underlying conditions. The first group had highest rate of performing inappropriate preoperative tests with blood urea nitrogen/creatinine as the most overuse test. The costs of inappropriateness preoperative tests were 39.8% of the total costs of preoperative assessment.
Conclusion: Almost 90% of the patients had inappropriate screening tests which increased the cost by about 40%. Hospital administrators should find appropriate mechanisms to reinforce doctors to strict their requests for only tests that are necessary.


Keywords: preoperative tests, preoperative screenings, appropriateness, unnecessary cost

Article Details

How to Cite
(1)
Likitdee, P.; Lumbiganon, P.; Thongrong, C.; Kietpeerakool, C.; Kongwattanakul, K. Appropriateness of Preoperative Screenings in Patients Undergoing Elective Gynecologic Surgery at Srinagarind Hospital, Khon Kaen University, Thailand: An Observational Study. Thai J Obstet Gynaecol 2017, 25, 223-231.
Issue
VOL. 25, NO. 4: (October - December 2017)
Section
Original Article

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