Does Anesthesia Provider Type Affect Veteran Satisfaction With Care?

Anesthesia care is delivered by Certified Registered Nurse Anesthetists (CRNAs) working independently, physician anesthesiologists working alone, and anesthesia care teams with CRNAs supervised by physician anesthesiologists. The impact of these models and CRNA supervision on patient satisfaction remains unclear.

To identify associations between anesthesia care team credentials, CRNA supervision, and patient satisfaction with care access, provider ratings, and overall satisfaction.

We linked survey data on patient satisfaction with administrative data from the Veterans Health Administration (VHA) to gather veteran demographics, staffing, and clinical features of each surgical case.

Our sample included 45,757 veterans who responded to the Survey of Healthcare Experiences of Patients following an invasive surgical procedure performed in a VHA operating room between 2016 and 2023.

Satisfaction was assessed using 4 outpatient survey items: overall VHA satisfaction, provider ratings, whether the provider listened carefully, and whether the provider showed respect. Inpatient measures included hospital ratings, doctors' courtesy and respect, doctors' attentiveness, willingness to recommend the VHA, and preference for VHA over free care elsewhere.

Anesthesia care models and supervision ratios were not significantly associated with veterans' overall satisfaction, provider or hospital ratings, or likelihood of recommending the VHA. Small positive effects of CRNA involvement were observed on provider attentiveness and respect. Satisfaction was high across all provider types, and findings were robust to exclusion of COVID-19 data and lower-complexity cases.

Veterans' overall satisfaction with anesthesia care reflects a consistently high standard across models and credentials, with subtle benefits from CRNA involvement in patient-provider communication.