Wertigkeit von 5 Kernaspekten der Prämedikationsvisite

Zusammenfassung

Hintergrund

Prämedikationsambulanzen bedingen organisatorische Veränderungen der anästhesiologischen Patientenbetreuung. Unklar bleibt, ob Patientenbedürfnisse dabei ausreichend abgebildet werden.

Methoden

Mithilfe der „Willingness-to-pay“-Methode wurde die relative Bedeutung von 5 Kernaspekten der Prämedikation (Prämedikationsort, Wartezeit, Arzt-Patient-Beziehung, Einsatz von Multimedia und Ambiente) bei 1058 Patienten untersucht.

Ergebnisse

Die Prämedikation durch den später behandelnden Arzt (Arzt) war das Kernanliegen der Patienten. Wartezeit, Prämedikationsort, Multimedia und Ambiente waren nachrangig. Diese Präferenz bestand trotz geschlechts- und altersspezifischer Investitionsvarianzen.

Schlussfolgerung

Die Ergebnisse sprechen gegen die Integration einer Prämedikationsambulanz in die anästhesiologische Patientenversorgung, da das persönliche Kennenlernen des behandelnden Anästhesisten für Patienten im Vordergrund steht. Ist eine Ambulanz dennoch erforderlich, müssen statt der persönlichen Arzt-Patient-Bindung andere vertrauensbildende Konzepte erarbeitet werden. Ein diesbezüglicher Ansatzpunkt könnte beispielsweise die Förderung einer „corporate identity“ der gesamten Anästhesieabteilung sein.

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.