BackgroundOperation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their elective surgery (...) rescheduled for non-medical reasons.MethodsIn this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test.ResultsSignificantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer.ConclusionsElderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery.Trial registration DRKS00015836. Retrospectively registered. (shrink)

Name der Zeitschrift: Das Mittelalter Jahrgang: 22 Heft: 2 Seiten: 332-350.

The traditional debate about having reasons for actions has focussed on the motivational and justificatory dimensions. I argue that discussion of these issues has neglected a further and important condition of reasons for action. A person can have a reason only if the considerations that provide the reason are accessible to her. Access means that the agent must be able to see that her reason speaks in favor of her φ-ing. I argue for my thesis by pointing out, first, that (...) theoretical reasons must be accessible in order to justify a person's beliefs and second, that the accessibility of theoretical reasons excludes the inaccessibility of practical reasons. (shrink)