Gering effect van Gezondheidsraadrichtlijn over preoperatieve poliklinieken in Nederland; een inventariserend onderzoek

To investigate the current status of preoperative evaluation in the Netherlands and the implementation of the Health Council recommendations.

Design

Cross-sectional study.

Method

All Dutch anaesthesiologic partnerships and their hospital managers in February 2000 received a structured questionnaire about the existence of an outpatient evaluation clinic, possible problems in creating such a clinic and the contents of preoperative evaluation.

Results

We received responses of 101 (80) and 111 (87) from anaesthesiologists and managers, respectively. From 119 hospitals (94) we received at least one useful questionnaire. On January 1, 2000, 24 (20) hospitals had a complete and 36 (30) a partial outpatient clinic. Within one year, 44 of the hospitals without a preoperative outpatient clinic expected to create one. The most common problem concerned financing this clinic. In hospitals with a complete clinic, anaesthesiologists were more often in employment (odds ratio (OR): 2.5; 95 confidence interval (95 CI): 1.0-10.0) and a routinely performed physical examination by the anaesthesiologist (or under his or her responsibility) was also conducted more often (OR: 5.0; 95 CI: 1.6-15.0). Not every patient saw an anaesthesiologist before entering the operating room in 70 of all hospitals. In hospitals without outpatient clinic, 57 of the day-surgery patients contacted the anaesthesiologist in the operating room.

Conclusion

The recommendations of the Health Council of the Netherlands with respect to contents and organisation of the preoperative evaluation had, 3 years after being published, limited effect.