Research Article
Volume 2 Issue 1 - 2019
Evaluation of Patient Satisfaction of Anaesthetic Assessment in a District Hospital in Ghana
Joshua Annovi Kunfah1, Alexis DB Buunaaim2 and Sylvanus Kampo3*
1Department of Anaesthesia, Wa regional Hospital, Upper West Region, Ghana
2Department of Surgery, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana
3Department of Anesthesia and Intensive Care, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana
*Corresponding Author: Sylvanus Kampo, Department of Anesthesia and Intensive Care, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana.
Received: June 13, 2019; Published: July 17, 2019
Abstract
Background: Patient satisfaction about perioperative anesthesia assessment is an essential aspect of quality health-care management. Visiting the anesthesia clinic gives the patients an opportunity to discuss the choices of the anesthetic technique, methods for pain relief and the risks, in a calmer atmosphere than immediately before the operation. At the St. Elizabeth Catholic district hospital Hwidiem, Ghana, the service of anesthesia clinic has been introduced for the past three (3) years and yet there is no documented data indicating patient’s satisfaction with the anesthesia service.
Objective: To evaluate inpatients satisfaction with the anesthesia service assessment quality in St. Elizabeth Catholic Hospital Hwidiem, Ghana.
Methods: An institutional based cross-sectional study was conducted at the St. Elizabeth Catholic hospital in Hwidiem; all patients who had elective surgery were included in the study within 24 hours after the operation. A structured questionnaire was used to collect data which consisted of patient socio-demography and satisfaction levels. All items in the structured questionnaire were scored on a four-point Likert scale which was entered and analyzed using statistical package for social sciences (SPSS) version 23. Chi-square was used to analyze the relationship between overall satisfaction and the socio-demography of the patients using P-value 0.05 and 95% confident interval as the point limit.
Results: One hundred and fifty-four 154 patients were recruited, and out of that, two patients refused to participate. The Mean age of patients recruited for this study was 30.03(10.71) years. The majority of the respondents (38.2%) were in the 29 to 38 age group. The overall patient satisfaction was 96.1%. On the aspect of anesthetists introducing themselves to patients before rendering the anesthesia service, 69.1% of the patients said the anesthetists did introduce themselves, 86.9% of them said they received adequate medical information about anesthesia from the anesthetists, 98.0% of them said the type of anesthetic plan was explained to them before surgery, and 81.0% said they were given the opportunity to ask questions about the anesthesia plans and received appropriate answers from the anesthetists. When asked whether or not they received enough education on the post-anesthesia care before the surgery, 86.9% responded that the anesthetists gave them adequate information about the postoperative anesthesia care especially on postoperative pain and analgesia and 56.5% said they were given adequate information on postoperative nausea and vomiting (PONV).
Conclusions: The results of this study suggest that patients going in for surgery are mostly satisfied with the anesthesia service in Ghana which has no link with the ethnicity, cultural or demography factors of the individual patient.
Keywords: Patient satisfaction; Anaesthetic assessment; Anesthesia service; Surgery; Cultural or demography factors
Introduction
Satisfaction is a subjective feeling of pleasure or disappointment resulting from comparing product or services, perceived performance, or outcome about one's expectations.It is the degree of gratifying the patient’s anticipation, which is an important component and quality indicator in the preoperative anesthetic evaluation. Satisfaction commonly refers to how well the patient expectations about the services of medical care have been met (Young G.J, Meterko M, Desai K.R, 2000). Providers of medical services have awakened to consumer challenges, competition, quality, and the realities of marketing. With these changes, equally important issues have emerged, the client-provider relationship on the overall medical service quality evaluation. Clients are increasingly frustrated with the commercialization of medical services, proliferated bureaucratic health care system, and weakened client-provider relationship (Bryant C., et al. 1998).
Patient satisfaction about perioperative anesthesia assessment is an essential aspect of quality health-care management.  Visiting the anesthesia clinic gives the patients an opportunity to discuss the choices of the anesthetic technique, methods for pain relief and the risks, in a calmer atmosphere than immediately before the operation (Conway J.B.Goldberg J, Chung F, 1992).  Preoperative anesthetist visit and preparation ensures the best care and satisfactory outcomes while maintaining reasonable cost and assuring patient satisfaction with the care received (Higgins TL, Thompson G.E, and Tuman K.J, 1996).
Despite the introduction of pre-anesthetic evaluation clinic in St. Elizabeth Catholic hospital for three (3) years, no scientific evaluation of patients’ level of satisfaction about this service has been conducted and also no publication is available in Ghana to show the level of patient satisfaction with preoperative anesthetic assessment clinic in our literature search. The purpose of this study was to evaluate patient satisfaction with preoperative anesthetic assessment and quality among patients booked for elective surgery.
Methods
Descriptive cross-sectional study design was used to evaluate patient satisfaction regarding the quality of preoperative anesthetic assessment.
After obtaining ethical approval from the institutional ethical committee of Tamale Teaching Hospital of the University For Development Studies and St Elizabeth Catholic Hospital Hwidiem, Ghana, the study was conducted at the St. Elizabeth Catholic hospital, Hwidiem-Ghana from 8th of February to the 8th of April, 2017.
All elective surgical patients who were operated under anesthesia during the period of the study were included. Patients who were discharged before 24 hours after operation were excluded in the data collection as well as all emergency surgeries. Parents of patients less than 18 years answered the questionnaires for their children.
Two (2) trained research assistants not involved in anesthesia services were employed to administer structured questionnaires printed out to the selected patient for the study. The data collected; the socio-demographic characteristics of the respondent and their satisfaction level with the different components of pre-anesthetic assessment, which includes, physical facility, anesthetist communication skills, and quality of services. It was written in the English language but interpreted and explained in the local language of respondents during the scheduled interview period as necessary. Respondents were interviewed within a time range of 10 to 15 minutes using the questionnaire post-operatively within 24 hours.
The response to questionnaires was rated on a four-point Likert scale as strongly agree (4), agree (3), disagree (2), strongly disagree (1)
Data was entered, organized, and analyzed using SPSS version 23.  Each question was coded for easy matching. The five-point Likert’s scale was grouped into two with strongly agree and agree used as satisfied and disagree and strongly disagree with dissatisfaction for analysis. Chi-square test was used to analyze the relationship between patient satisfaction and the patient's socio-demographic parameters with P value = 0.05 and confident interval of 95%. Tables and pie chart were used for the presentation of statistical description.
Results
Two hundred and fifteen (215) patients were operated during the study period of which 61(28.37%) were emergencies, one hundred and fifty-four 154(71.63%) patients were recruited, 2(1.30%) patient refused to participate, and 152(98.70%) patients responded.
Out of the one hundred and fifty-three patients who responded in this study, 96.1% said they were satisfied with anesthesia services. (Figure 1)
Figures 1: Distribution of overall satisfaction of patients with relation to anesthesia services at the St. Elizabeth Catholic hospital, Hwidiem, Ghana 2017.
The mean age of the participants was 30.03(±10.71) years. Majority of the respondents were within the age group of 29 to 38 years (38.2%). On Gender, 85.5% were female, 63.2% married, and 32.9% single with 2.6% divorced and 1.3% widows. With regards to Education, 33.6% completed elementary education, 28.9% secondary school, 25.0% were illiterate, 6.6% had Diploma, 4.6% could read and write, and 1.3% had other educational qualification. However, most of the respondents, 51.6%, were from rural areas. (Table 1)
Factor Frequency Percent
Patient gender Male 22 14.5
Female 130 85.5
Total 152 100.0
Patient Age Les or Equal to 18 19 12.5
19 – 28 52 34.2
29 – 38 58 38.2
39 – 48 15 9.9
49 and above 8 5.3
Total 152 100
Marital status Single 50 32.9
Married 96 63.2
Divorced 4 2.6
Widowed 2 1.3
Total 152 100.0
Level of education Illiterate 38 25.0
Read and write 7 4.6
Elementary 51 33.6
Secondary 44 28.9
Diploma 10 6.6
Others 2 1.3
Total 152 100.0
Residence Urban 73 48.0
Rural 79 52.0
Total 152 100.0
Job status Housewife 8 5.3
Farmer 34 22.4
Government 10 6.6
Private 16 10.5
Student 16 10.5
Merchant 67 44.1
Other 1 0.7
Total 152 100.0
Family income Less than 270 30 19.7
270 – 500 45 29.6
Greater than 500 77 50.7
Total 152 100.0
Mode of payment Paying self 26 17.1
NHIS 126 82.9
Total 152 100.0
Frequency of visit New 38 25.0
Repeat 115 75.0
Total 152 100.0
Table 1: Socio-Demography of Participants.
A Chi-square test for association was conducted between the patient’s satisfaction and patient’s demography, which reveal no statistical significance between the two variable (Table 2). The test was further conducted to include family income, Mode of payment, the frequency of visit, comorbidities, comorbidities identified and ASA classification of patients, and there was no statistical significance with p < 0.05 (Table 3).
  Satisfied Dissatisfied    
Frequency Percent Frequency Percent X2 P
Patient age 18 years or less 18 11.8 1 0.7 1.263 .876
19 – 28 years 50 32.9 2 1.3    
29 – 38 years 55 36.2 3 2.0    
39 – 48 years 15 9.9 0 0.0    
49 years and above 8 5.3 0 0.0    
Total 146 96.1 6 3.9    
Patient gender male 21 13.8 1 0.7 .024 .876
female 125 82.2 5 3.3    
Total 146 96.1 6 3.9    
Marital status single 50 32.7 1 0.7 1.149 .765
married 91 59.5 5 3.3    
divorced 4 2.6 0 0.0    
widowed 2 1.3 0 0.0    
Total 147 96.1 6 3.9    
 Level of education   illiterate 36 23.7 2 1.3 .996 .963
read and write 7 4.6 0 0.0    
elementary 49 32.2 2 1.3    
secondary 42 27.6 2 1.3    
diploma 10 6.6 0 0.0    
others 2 1.3 0 0.0    
Total 146 96.1 6 3.9    
Residence urban 70 46.1 3 2.0 .010 921
rural 76 50.0 3 2.0    
Total 146 96.1 6 3.9    
Job status house wife 7 4.6 1 0.7 3.376 .760
farmer 32 21.1 2 1.3    
government 10 6.6 0 0.0    
private 16 10.5 0 0.0    
student 15 9.9 1 0.7    
merchant 65 42.8 2 1.3    
other 1 0.7 0 0.0    
Total 146 96.1 6 3.9    
Table 2: Bivariate analysis of Socio-demography and level of satisfaction in the pre-anesthetic assessment of participants at the St. Elizabeth Catholic Hospital Hwidiem, Ghana 2017.
  Satisfied Dissatisfied    
Frequency Percent Frequency Percent X2 P
Family income less than 270 28 18.4 2 1.3 .939 .625
270 - 500 44 28.9 1 0.7    
greater than 500 74 48.7 3 2.0    
Total 146 96.1 6 3.9    
Mode of payment paying self 25 16.4 1 0.7 .001 .977
NHIS 122 79.6 5 3.3    
Total 146 96.1 6 3.9    
Frequency of visit new 36 23.7 2 1.3 .231 .631
repeat 111 72.4 4 2.6    
Total 146 96.1 6 3.9    
Comorbidities yes 18 11.8 1 0.7 .099 .753
no 128 84.2 5 3.3    
Total 146 96.1 6 3.9    
Comorbidities identified asthma 6 31.6 0 0.0 1.173 .760
hypertension 8 42.1 1 5.3    
diabetes 3 15.8 0 0.0    
others 1 5.3 0 0.0    
Total 18 94.7 1 3.9    
ASA classification ASA I 128 84.2 5 3.3 .099 .753
ASA II 18 11.8 1 0.7    
Total 146 96.1 6 3.9    
Table 3: Socio-demography of study participant preoperative anaesthetic satisfaction about family income, mode of payment, frequency of visit, comorbidities, and ASA classification at St. Elizabeth Catholic Hospital Hwidiem, Ghana 2017.
However, patients within the age group of 29-29 who said they were satisfied with anaesthesia services had the highest percentage of satisfaction (36.2%) and 3(2%) dissatisfied among the groups respectively. More females said they were satisfied (82.2%) than the males (13.8%). Despite the significant variation in satisfaction, more females were also said they were dissatisfied (3.3%), and males (0.7%), and there was no statistical significance (p ˂ 0.05) (Figure1)
All the patients who participated said they were satisfied with the level of neatness and the amount of waiting chairs available at the anesthesia clinic, 99.30% said they were satisfied when asked if it was easy to locate the preoperative clinic (Figure 2).
Figures 2: Level of satisfaction of patients attending anesthesia clinic at the St. Elizabeth Catholic Hospital Hwidiem with regards to the Physical facility, Ghana 2017.
Regarding Anaesthetist communication skill, 69.1% of the patients said anesthetist introduced themselves, 86.9% said they were given adequate information about postoperative analgesia while 56.5% of patients said they were giving enough information on PONV management while (43.5%) said they were not satisfied (Figure 3).
Figures 3: Patients Satisfaction with Communication of preoperative anesthesia services at the St. Elizabeth Catholic Hospital Hwidiem, Ghana 2017.
When patients were questioned about the quality of services, 94.1% of the patients said that they were satisfied with the chance given in describing their health condition with the anesthetist, 99.4% said they would recommend the services and 96.8% of patients also said they were satisfied with the quality of care by the anesthetist, 97.4% said they were satisfied with waiting time and 100% of the patients said they would return to the hospital for services (Figure 4).
Figures 4: Level of patients’ satisfaction about Quality of services at St. Elizabeth Catholic Hospital, Hwidiem, Ghana.
Discussion
Patient Satisfaction with Pre-anesthetic Assessment.
Overall, 96.1% of patients said they were satisfied with anesthesia services provided with 3.9% dissatisfied in the hospital. The findings in this study are similar to a study conducted in Greece, where overall patient satisfaction of anesthesia services was in the range of 96.3%. (Kouki P, Matsota P, Christodoulaki K., et al. 2012). In a study done in 2010 Aminu Kano, Northern Nigeria, 83% of patients were satisfied with the services received which were low compared to our study (Iliyasu Z., et al. 2010) this might be due to the difference in methods of data collection and sociodemography.  A study in the medical out-patient department of Khmer-Soviet Friendship hospital, Phnom Penh city, Cambodia indicated that 93.5% of patients were satisfied with health care services and 6.5% dissatisfied in the department (Mao Vadhana, 2012).
A study conducted by Gebremedhn., et al. at the University of Gondar Hospital indicated that 51.3% of patients said anaesthetist  introduced him/herself, 98.1% said the  approaches of the anaesthetists was satisfactory, 50.6% of patients said they were not given adequate information about anaesthesia, 73.1% of respondents said  a chance was not given  to choose type of anaesthesia and 76.3% of respondents were not given a chance to  ask questions about anaesthesia, and overall satisfaction with the  anaesthesia services was 90.4% at the Gondar University Hospital(Endale Gebregziabher Gebremedhn., et al. 2015).
It appears from our study that the overall satisfaction level and communication skills of the anesthetist at the clinic is better than that reported in the Gondar hospital study. This could be due to socio-demography variations and study design as this study was conducted in Ghana with a four-point Likert scale in English while Amharic version questionnaire translated into English with checklist was used in Gondar university hospital.
Also, a similar level of satisfaction in our study was reported in a study in Australia in which patient satisfaction and other predetermined outcomes such as nausea; vomiting, pain, and complications were assessed. The overall level of satisfaction was high (96.8%), 2.3% of patients were somewhat dissatisfied, and 0.9% were dissatisfied with their anesthetic care (Saal D., et al. 2011)
The findings of our study indicated that 86.9% of patients said they were adequately informed about postoperative analgesia and 56.5% said they were informed about PONV management. This is higher than what was reported in a study conducted in Mannar district hospital, Sri Lanka where 35.44% were satisfied with the explanation of postoperative analgesia management by anesthetist (Ganeshanathan Vyhunthan, N.G. Aeshana de Silva, 2012).
The findings were probably higher than that in Sri Lanka because patients for emergency surgery were included in their study while in this study, it was mainly elective patients. There was not enough time for them to explain to patients understanding during emergencies leading to low satisfaction. However, we think more efforts should be made to explain to emergency patients after the surgery, which can help them appreciate what they are going through.
Also, all patients (100%) who participated in our study said they were satisfied with cleanliness and availability of waiting for chairs at the anesthesia clinic, and 99.30% believed preoperative clinic was easy to find. This was higher compare to the study conducted in 2013 at Bahirdar Felege Hiwot Referral Hospital, North West Ethiopia where 93.2% of patients said they were satisfied with the cleanliness of service delivery rooms, while 70.8% were dissatisfied with availability of sign and direction indicators to ease the way in the hospital(Yeshambel A. A, Amsalu F Demise and Measho G Gebregziabher, 2014).
Factors Influencing Satisfaction
The study showed there was no statistical significance between level of satisfaction of patients and patients’ demography factors of age (p =0.876), gender (p =0.876), marital status (p =0.765), level of education (p =0.963), job status (p =0.760), family income (p =0.625), frequency of visits (p =0.631), comorbidities (p =0.753), ASA (P =0.753).This finding is similar to an observational study conducted  at the  university hospital Leipzig, Germany where there was no statistical significance between the satisfaction and patient sociodemographic characteristics with age (p =0.875), gender (p =0.709), ASA (P =0.462) (Ulrike Babette J,Nils E,Thilo B and Joerg S, 2014) and consistent with another study conducted to determine concerns patients had before and after pre-anaesthetic assessment at the same university hospital Leipzig, Germany with gender (p =0.303), age (p =0.907),  ASA (P =0.737) (Joerg Schnoor, Ulrike Reuter, Nils Engelmann, Ulrich Burkhardt, 2013).  These similarities of results in the two studies with our study could be because probably there is no direct association between patient’s socio-demographic factors with the level of satisfaction.
However, a study conducted at Menelik university hospital, Addis Ababa indicated satisfaction of males 70.5 % and that of females 74.7 %. The binary analysis indicated that satisfaction was associated with age (P= 0.030) of the group of 29 – 38 years old and family incomes of the patient significantly associated with satisfaction (P= 0.029), the less the income the more the satisfaction ( Mohammed S. Obsa, Abateneh M.Wahidi Woseneyeleh Adams and Bedilu G. Woji, 2017) Another study conducted in the faculty of nursing, Sohag University, Egypt indicated statistical significance between level of satisfaction and the age group of 50+ (p =0.033)( Ghona Abd El-Nasser and Nadia Mohamed, 2013). This could be the fact that the two used a five Likert’s scale point questionnaire while we used a four Likert’s scale questionnaire. Our sample size was also small compared to the two studies and therefore liable to bias. However, we recommend further studies in multiple centers in this regard.
Even though from our study, more females (82.2%) said they were satisfied with the care given, more females were equally dissatisfied 5(3.3%) than males 1(0.7%). Also, the age group between 29 – 38 years were more satisfied, 36.2% compared to all the other age groups.
The age group below 39 years were more and also more satisfied with the services which might be because they are younger and have fewer experiences with surgery compared to those above 39 years who were older and probably have more experiences such that their responses were more critical or they have higher demands due to more comorbid conditions.  Some researchers also stated that some patients tend to medical services based on their reference groups ideas. For instance, if their group says this service is good to use, they are likely to use that particular service rather than others (Lebow JL, 1983). The above variations could be because more females were included in the study, or females easily speak out on their opinions about a service compared to men. In a study at Gondar university teaching hospital, more females 92.6% were satisfied than 88% males who were satisfied as well as more males 12% dissatisfied than the female, 7.4% (Endale Gebregziabher Gebremedhn et al., 2015). This swing in changes for dissatisfaction compared to our study might be due to the difference in cultures and the similarities in satisfaction might be the fact that women are more outspoken in our study area than the women in Gondar university hospital, Ethiopia.
With regards to quality of service, 94.1% of patients said they had a chance to describe their health conditions with the anaesthetist, 99.4% said they would recommend the services, 100.0% indicated they would return to the hospital in future, 96.8% said they were satisfied with quality of care by anaesthetist and waiting time before meeting the anaesthetist 96.7% said they were satisfied. The study at Menelik II hospital, Addis Ababa, Ethiopia indicated low results with 74.1% of patient who said they had a chance to describe their health conditions, 76.6% said they would recommend the services, 73.2% said they would return to the hospital in the future and 71.4% said they were satisfied with the quality of care by the anesthetist. This difference was a clear indication of the effect of the low overall satisfaction rate of 72.3% compared to our overall patient satisfaction of 96.1%. The difference could be due to differences in communication skills or set protocols. Also, differences in the sample sizes could account for the variation.
Study Limitation
This study was conducted at the St. Elizabeth Catholic hospital on surgical inpatient, and results cannot be generalized to all hospitals in Ghana. Also, the sample size for the study was rather small to be able to assess associations. Intra-operative and post-operative anesthetic services were not included in the study.
Conclusions and Recommendations
Conclusions
Patients overall satisfaction was high 96.1%, and it also falls within the Royal college of anesthetists standards of satisfaction >90%. Also, more females were dissatisfied 3.3% than males 0.7%, and the age group that had the highest satisfaction of 35.9% were 29 – 38 years. 43.7% of patients were not satisfied with the information on nausea and vomiting management in our clinic.
There was, however, no statistically significant association between patient satisfaction and the sociodemographic factors studied.
Recommendations
Certain areas of the pre-operative clinic need to be improved, such as information on postoperative nausea and vomiting and anesthetists style of introduction to the patient. There is also the need to create awareness of the role of the anesthetist to patients.
Training in communication skill should, therefore, be conducted for the anesthetist in St. Elizabeth Catholic hospital.
Acknowledgment
We thank the Department of anaesthesia and intensive care, University for Development Studies for making available all the necessary materials needed for this study. Our thanks also go to the authorities of Tamale Teaching Hospital and St Elizabeth Catholic Hospital Hwidiem for their contributions to the studies.
References
  1. Bryant C, et al. "Increasing consumer satisfaction". Marketing Health Services 18.4 (1998): 4 -17.
  2. Conway JB., et al. "Preadmission anesthesia consultation clinic". Canadian J Anaesthesia (1992).
  3. Endale Gebregziabher Gebremedhn., et al. "Patient satisfaction with anesthesia services and associated factors at the University of Gondar hospital". BMC Research 8 (2015): 377.
  4. Ghona Abd El-Nasser and Nadia Mohamed. "Patient Satisfaction with Preoperative Care and Its Relationship with Patient Characteristics". Medical Journal of Cairo University  81.2 (2013).
  5. Higgins TL, Thompson GE, Tuman KJ, Ad Hoc committee on value - based Anaesthesia care.   The importance of outcomes in value-based anaesthesia. ASA Newsletter 60: 8 -10.
  6. Iliyasu Z., et al. "Patients satisfaction with services obtained from Aminu Kano Teaching hospital, Kano, Northern Nigeria". Nigerian Journal of Clinical Practice 13.4 (2010): 371 -8.
  7. Mohammed S. Obsa, Abateneh Wahidi Woseneyeleh Adams and Bedilu G. Woji. "Assessment of patient satisfaction with preoperative anesthetic evaluation and associated factor. Menelik II referral hospital Addis Ababa, Ethiopia". Journal of Medicine, Physiology and Biophysics 35 (2017).
  8. Joerg Schnoor., et al. "The balance of Concerns: Satisfactory Pre-Anesthetic Patient Education and the Extent of Patient Worries". Open Journal of Anesthesiology 3 (2013): 402-407.
  9. Kouki P., et al. "Greek surgical patient satisfaction related to preoperative anesthetic services in an academic institute". Patient Prefers Adherence 6 (2012): 569 - 578.
  10. Lebow JL. "Similarities and differences between mental health and health care evaluation studies assessing consumer satisfaction". Evaluation and Program Planning 6(3-4) (1983): 237 -45.
  11. Saal D., et al. "Does post-operative Visit increase patient satisfaction with anaesthesia care?" British Journal of Anaesthesia 107.5 (2011): 703–9.
  12. Ulrike Reuter., et al. "Residents Achieve High Patient Satisfaction in Pre-Anaesthetic Patient Assessment. An Observational Study". Open Journal of Anaesthesiology 4.11 (2014): 263-275.
  13. Vadhana M. "Assessment of Patient Satisfaction in an Outpatient Department of an Autonomous Hospital in Phnom Penh, Cambodia". Pulic Health Management (2012).
  14. Yeshambel AA., et al. "Patient satisfaction and associated factors among private Wing patients at Bahrdar Felege Hiwot Referral Hospital,North West Ethiopia". Science Journal of Public Health 2.5 (2014): 417 - 423.
  15. Young GJ., et al. "Patient satisfaction with hospital care: effects of demographic and institutional characteristics". Med care 38.3 (2000): 325 -334.
Citation: Sylvanus Kampo., et al. “Evaluation of Patient Satisfaction of Anaesthetic Assessment in a District Hospital in Ghana”. Anaesthesia, Critical Care and Pain Management 2.1 (2019): 1-12.
Copyright: © 2019 Sylvanus Kampo., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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