[Limited effect of Health Council guideline on outpatient preoperative evaluation clinics in the Netherlands: an inventory].
OBJECTIVE
To investigate the current status of preoperative evaluation in the Netherlands and the implementation of the Health Council recommendations.


METHODS
Cross-sectional study.


METHODS
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.


CONCLUSIONS
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.
van Klei
W A
WA
Divisie Perioperatieve zorg, anesthesie en pijnbestrijding, Universitair Medisch Centrum, Postbus 85500, 3508 GA Utrecht. w.a.vanklei@azu.nl
Rutten
C L
CL
Moons
K G
KG
Lo
B
B
Knape
J T
JT
Grobbee
D E
DE
D000328:Adult; D000761:Anesthesia Department, Hospital / Q000592:standards; D000776:Anesthesiology / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010808:Physical Examination / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
Gering effect van Gezondheidsraadrichtlijn over preoperatieve poliklinieken in Nederland; een inventariserend onderzoek.