Evaluation of the effectiveness of Preoperative Anesthesia Consultation Clinic: an experience of surgical patients in a medical center

• Main Authors: Fu-Jie Liang, 梁富傑
• Other Authors: Senyeong Kao
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/45076047279600973623

碩士 === 國防醫學院 === 公共衛生學研究所 === 99 === Abstract Background: Patients before surgery, according to flow arrangement anesthesiologist to ward implementation of the Preoperative Anesthetic Visiting(PAV), but found some of the patients physical condition was not suitable for surgical anesthesia and post-implementation, such a result would lead to increase length of stay, thereby increasing health care utilization. In addition, the hospital established Preoperative Anesthesia Consultation Clinic (PACC) in order to be able to distribute medical resources more efficiently and ongoing maintenance of quality of care under the implementation of TW-DRG (Taiwan Diagnosis Related Groups) system. And it hopes that this new way can substitute the existing PAV mode. Objectives: The aim of this study was to investigate whether Preoperative Anesthesia Consultation Clinic affects preoperative outcomes in terms of medical utilization, indicators of quality, patient’s satisfaction, emotional expression, and ideological concerns about anesthesia in surgical patients. Methods: This study design was a cross-sectional study. All subjects were surgical patients and were recruited from 3 different specialty divisions (General surgery, Urological surgery, and Orthopedics surgery) in a medical center. In order to explore the effectiveness of PACC, the data were collected from questionnaire survey and computerized database of hospital. Data analysis was performed using the SPSS 18.0 and using chi-square test, Student’s t-test, ANOVA analysis, and multiple linear regression test. Results: Out of 344 surgical patients, 142 were received PACC, and 202 were received PAV. Our results indicated that the patients of PACC had a significantly smaller amount of laboratory fees than did those of PAV (P value=0.037), but there was no significant difference in anesthesia fees (P value =0.192). Furthermore, the patients of PACC had a significantly higher performance of emotional expression, the feeling of trust, and health education than did those of PAV (P value<0.001), but there was no significant difference in the score of anxiety (P value=0.458). Conclusions: This study demonstrated that the implementation of PACC helped to reduce the laboratory fees, improved the feelings of trust, provided better perception of health education, and obtained the higher score of the patient’s satisfaction. Keywords: TW-DRG, Preoperative Anesthesia Consultation Clinic, Preoperative Anesthetic Visiting