Navigating the Preoperative Labyrinth: A Complex Adaptive Systems Perspective on Time-to-Surgery in Surgical Hospitalizations

Managing operational complexity is critical for efficiency in hospital surgical pathways. This study investigates the impact of coordination complexity (proxied by inter-departmental Contacts) and logistical complexity intensity (proxied by Daily Movements) on phase-specific efficiency, measured using a novel DRG-adjusted Logarithmic Stay Efficiency Index (LSEI). Analyzing detailed process log data from 3,847 surgical hospitalizations at a specialized Italian hospital via OLS regression with robust standard errors and comprehensive controls (including patient, procedural, and hospital factors), we uncover non-linear relationships. The results offer significant insights for both healthcare operations management theory and practice regarding complexity management.