Aust H, Eberhart L H J, Kalmus G, Zoremba M, Rüsch D
Klinik für Anästhesie und Intensivtherapie, Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg, Deutschland.
Anaesthesist. 2011 May;60(5):414-20. doi: 10.1007/s00101-010-1828-1. Epub 2010 Dec 15.
Due to a variety of reasons (e.g. increase in outpatient surgery and legal restrictions related to working hours) it has become increasingly more difficult to have the pre-anesthesia visit and the anesthesia carried out by the same anesthetist. In the light of these organizational changes as well as increasing economical pressure it has become common practice to implement pre-anesthesia assessment clinics. It is unclear, however, if these changes in anesthetic patient care respect patient needs.
By means of a survey using the willingness to pay method, the relative significance of five quality aspects (location of pre-anesthesia visit, waiting time, patient-physician relationship, use of multimedia and ambience) were studied. Participation during a 12-month study period was on a voluntary basis.
Of the 1,058 questionnaires, 1,014 were eligible for analysis. A pre-anesthesia visit performed by the anesthetist who would deliver anesthesia was the most important aspect for almost two thirds (624 out of 1,014) of the patients with on average more than one third of the money available spent on this item. Waiting time was the second most important factor with about one third of the patients rating this item as the most relevant factor and on average approximately one quarter of the total money available spent on it. Location of the pre-anesthesia visit, use of multimedia and ambience were considered least important. The order of these preferences was regardless of age and gender of subjects. However, there was a trend to age and gender-specific differences concerning the amount of money spent on these five items. For instance, with increasing age, patient-physician relationship and location of the pre-anesthesia visit become more important.
These results suggest that the integration of a pre-anesthesia assessment clinic in anesthetic patient care is not favorable from the patients' point of view because getting to know the anesthetist who will deliver anesthesia is of paramount importance to most patients. In cases where a pre-anesthetic assessment clinic is indispensable, other measures to build up confidence compensating for the lack of personal patient-physician relationship should be developed. In this respect, the promotion of a corporate identity of the whole anesthesia department may be beneficial. Furthermore, keeping the waiting time as short as possible should be a high priority as this item was rated the second most important factor.
由于多种原因（如门诊手术增加以及与工作时间相关的法律限制），由同一位麻醉师进行麻醉前访视和实施麻醉变得越来越困难。鉴于这些组织架构的变化以及日益增加的经济压力，实施麻醉前评估诊所已成为常见做法。然而，目前尚不清楚这些麻醉患者护理方面的变化是否符合患者需求。
通过采用意愿支付法进行调查，研究了五个质量方面（麻醉前访视地点、等待时间、医患关系、多媒体使用和环境氛围）的相对重要性。在为期12个月的研究期间，参与调查是自愿的。
在1058份问卷中，有1014份符合分析条件。对于近三分之二（1014名患者中的624名）的患者而言，由即将实施麻醉的麻醉师进行麻醉前访视是最重要的方面，平均有超过三分之一的可用资金花费在这一项上。等待时间是第二重要的因素，约三分之一的患者将此因素列为最相关因素，平均约有四分之一的可用资金花费在这方面。麻醉前访视地点、多媒体使用和环境氛围被认为是最不重要的。这些偏好顺序与受试者的年龄和性别无关。然而，在这五个项目上的花费金额存在年龄和性别差异的趋势。例如，随着年龄的增长，医患关系和麻醉前访视地点变得更加重要。
这些结果表明，从患者的角度来看，在麻醉患者护理中整合麻醉前评估诊所并不有利，因为对大多数患者来说，了解即将实施麻醉的麻醉师至关重要。在麻醉前评估诊所不可或缺的情况下，应制定其他措施来建立信心，以弥补缺乏个人医患关系的不足。在这方面，提升整个麻醉科室的企业形象可能会有所帮助。此外，应将尽可能缩短等待时间作为高度优先事项，因为这一因素被评为第二重要因素。
