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Obstetrical Anesthesia Workforce Survey: 30 Year Update
Abstract Number: BP 3
Abstract Type: Original Research
Background: Surveys investigating the obstetrical anesthesia workforce were conducted in 1981, 1992 and 2001 to characterize and understand obstetrical anesthesia practice. The thirty-year update of this survey was conducted in 2012. Anesthesia providers from hospitals in the United States were surveyed to identify the number and types of providers, services, and methods used to provide obstetric anesthesia.
Methods: Using the American Hospital Association Annual Survey of Hospitals, a randomized stratified sample of hospitals was generated based on number of births per year and U.S. census region. Strata were defined as: Stratum I ≥ 1,500 births, Stratum II ≥ 500-1,499 births, Stratum III < 500 births. A total of 341 Stratum I, 440 Stratum II, and 415 Stratum III hospitals were identified. Phone calls were placed to each hospital to obtain contact information for the anesthesia group providing obstetrical services. Providers were personally contacted via phone by a physician to obtain email contact information. Electronic questionnaires (Survey Monkey) were sent via email.
Results: Data collection for Stratum I hospitals is complete, with the other Strata to follow. Of the hospitals and providers contacted, 56% provided accurate contact information and 12% declined to participate. The response rate was 45% from those who provided contact information and 25% overall. Initial results from Strata I responses show administration of regional labor analgesia has increased compared to 2001 and is available 24 hours per day at 100% of Strata I hospitals, with 97% of providers in-house. PCEA use in Strata I hospitals was 35% in 2001 and is now approximately 84%. Independent nurse anesthetists provided obstetrical anesthesia services in 4.5% of hospitals, which is increased from 2001. While 93% of Strata I hospitals allow postpartum tubal ligations, 22% state that inadequate staffing interferes with provision of anesthesia for these cases either always or at off-hours.
Conclusion: In the 10 years since the last survey, there have been some significant changes in how hospitals provide obstetric anesthesia. Additionally, the ubiquitous use of technology has changed survey techniques since 2001, with email being the primary method for data collection. Obstetric anesthesia surveys continue to provide useful information about the practice of obstetric anesthesia.
References: Anesthesiology 2005;103:645-653; Anesthesiology 1997;87:135–43; Anesthesiology 1986;65:298–3