Surgical Cancellations and Postponements by Surgeon and Patient Sex: A Retrospective Cohort Study in Alberta, Canada.

OBJECTIVE

The objective of this work was to estimate the association between surgeon sex with surgical postponements or cancellations.

SUMMARY BACKGROUND DATA

Female surgeons receive lower hourly, per patient, and total compensation than their male colleagues. Bias in the decision to postpone or cancel surgical cases may contribute to compensation inequality, since this results in unpaid surgeon time.

METHODS

This retrospective cohort study used administrative health data to identify surgeries performed at four hospitals in Calgary, Alberta, Canada that were cancelled or postponed due to surgeon/operating room overbooking or to accommodate an emergency case between April 1, 2015, and March 31, 2020. Surgeries performed in dedicated operating or procedure rooms (e.g., bronchoscopy, cardiac surgery, etc.) were excluded. The exposure of interest was surgeon sex, identified by matching their name to the provincial regulatory body record of self-identified sex, which allowed for selection between female and male only during the time of this study.

RESULTS

There were 214,832 eligible surgical cases, of which 1,481 and 2,473 were postponed or cancelled due to overbooking and to accommodate an emergency, respectively. After adjusting for surgical specialty, whether the procedure was a day case, and for patient sex, female surgeons were more likely to be cancelled or postponed to accommodate an emergency case compared to male surgeons (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.05-1.38).

CONCLUSION

There may be sex-bias in the decision about which surgical cases to postpone or cancel to accommodate emergency surgeries in our setting. This bias may contribute to compensation inequality in a fee-for-service setting.

Informations de copyright

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Déclaration de conflit d'intérêts

Conflicts of Interest: The authors have no relevant conflicts to declare.