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Measuring Patient Satisfaction with Anesthesia Care: A Review of Current Methodology

I n clinical settings such as anesthesia, using patient satisfaction as an indicator to monitor the quality of clinical care has potential merit. For patients, satisfaction represents, at least in theory, an evaluation of the healthcare experience based on their own values, perceptions, and interactions with the healthcare environment. For healthcare providers, patient satisfaction can be used to assess the actual impact of healthcare processes on the patients themselves. Patients’ ratings of their satisfaction can reflect many facets of care not easily examined in any other manner: compassionate bedside skills, efficient attendance to needs, participation in decision-making, and adequate communication and information (1). An ideal measure of patient satisfaction could therefore provide unique feedback on the quality of practice for medical specialties such as anesthesia. A renewed focus has been sought for patient satisfaction as a clinical end point and a quality indicator of anesthesia care. Previous studies have demonstrated the limitations of using adverse anesthetic events to monitor anesthesia care (2). Major outcomes (death and complications such as myocardial infarction, cardiac arrest, and severe brain injury) are too rare to allow useful comparisons among institutions. Assessing minor outcomes (such as pain and nausea) pose significant methodological problems of uncertain case mix, inconsistent reporting compliance, imprecise definitions, and underand overreporting. Orkin et al. (3) emphasized the still unproven relationships between most intermediate events (for example, transient intraand postoperative hypoxemia) and clinically significant adverse events (death, myocardial infarction, etc.), as well as the difficulties in establishing those relationships. They also suggested that, in light of the