Patterns of Anesthesia in France Compared, 1980–1996. Clergue et al. (page 1509)

Abstract

Clergue et al. collected and analyzed data from all French private, public, and military hospitals in 1996. Initiated by the Anesthesia Patient Safety committee of the French Society of Anesthesia, the survey was designed to analyze the growth and evolving patterns of use of anesthetic activity from 1980 to 1996. In collaboration with the French National Institute of Health and Medical Research, all anesthetics were documented and collected on questionnaires provided by study investigators for three consecutive days at each site.Investigators contacted anesthesiologists at every French hospital and created a regional steering committee in each of 30 regions to ensure full cooperation in the project. At the end of the 3-day survey at each institution, coordinating anesthesiologists collected all completed questionnaires from the anesthesiologists and submitted them to the INSERM office.In addition, 5% of all institutions in each region were randomly assigned to be audited. The rate of participation was high—98%. The analysis of 62,415 collected questionnaires allowed extrapolation of the anesthetic activity to 7,937,000 anesthetics performed in 1996, with a confidence interval of ± 387,000. The annual rate of anesthetics was 13.5 per 100 in the population, compared with 6.6 per 100 in 1980, an increase of 120%. Other observed trends included more anesthetics being used in patients ≥ 75 years of age and in patients with American Society of Anesthesiologists physical status III. The number of regional anesthetics increased 14-fold over the rate in 1980. In obstetrics, the practice of epidural analgesia had increased from 1.5% of all deliveries in 1980 to 51% of all deliveries in 1996. Because these values represent practice patterns in a highly developed nation with a sophisticated care delivery system, they should provide useful comparative information regarding practice patterns in many countries, including the United States.