Public perception of who is responsible for anesthesia-related care: a cross-sectional survey in Japan

PURPOSE: We aimed to assess the public perception of who is responsible for anesthesia-related hospital care tasks in Japan and examine associated factors. METHODS: We conducted a cross-sectional, nationwide, quota-based web survey of adults in Japan in July 2025. Of the 1,944 respondents who initiated the survey, 1,844 completed (94.9%) it, and 1,000 responses were analyzed after quota completion (ages 20-69 yr). The outcomes were attribution (yes/no) of four anesthesia-related hospital care tasks to anesthesiologists: intraoperative anesthesia, postoperative pain management, procedural sedation/analgesia (PSA), and labour neuraxial analgesia (LNA). For each outcome, we fitted multivariable logistic regression models adjusting for sociodemographic characteristics, the Health Interest Scale (HIS), Communicative and Critical Health Literacy (CCHL), board-certified anesthesiologist density, information sources, and task-matched experience, with Benjamini-Hochberg false discovery rate (FDR) control. RESULTS: Attribution was highest for intraoperative anesthesia (84.7%), followed by LNA (65.2%), PSA (37.4%), and postoperative pain management (13.5%). After FDR control, university education or higher was associated with greater attribution for intraoperative anesthesia (adjusted odds ratio [aOR], 2.08; 95% confidence interval [CI], 1.30 to 3.32), PSA (aOR, 1.62; 95% CI, 1.15 to 2.30), and LNA (aOR, 1.82; 95% CI, 1.30 to 2.55). Task-matched prior experience attributed to anesthesiologists was associated with higher attribution for intraoperative anesthesia (aOR, 3.75; 95% CI, 1.76 to 8.80) and PSA (aOR, 2.41; 95% CI, 1.34 to 4.43). Fictional media was the only information-source factor that remained significant after FDR control (intraoperative anesthesia: aOR, 2.73; 95% CI, 1.79 to 4.25; PSA: aOR, 1.90; 95% CI, 1.42 to 2.56). No factor met the FDR threshold for postoperative pain management. HIS, CCHL, and anesthesiologist density showed no consistent adjusted associations. CONCLUSIONS: Public attribution of anesthesiologists' roles in Japan varied by task. Educational attainment, task-matched experience, and information sources were more consistently associated with attribution than general health traits or workforce context, supporting the value of role-explicit, task-specific communication strategies.