Patient Reported Readiness for Discharge is Associated with Lower Readmission Rates and Higher Patient Satisfaction

OBJECTIVEIn spine surgery, racial disparities have been shown to impact various aspects of surgical care. Previous studies have associated racial disparities with inferior surgical outcomes, including increased complication and 30-day readmission rates after spine surgery. Recently, patient-reported outcomes (PROs) and satisfaction measures have been proxies for overall quality of care and hospital reimbursements. However, the influence that racial disparities have on short- and long-term PROs and patient satisfaction after spine surgery is relatively unknown. The aim of this study was to investigate the impact of racial disparities on 3- and 12-month PROs and patient satisfaction after elective lumbar spine surgery.METHODSThis study was designed as a retrospective analysis of a prospectively maintained database. The medical records of adult (age ≥ 18 years) patients who had undergone elective lumbar spine surgery for spondylolisthesis (grade 1), disc herniation, or stenosis at a major academic institution were included in this study. Patient demographics, comorbidities, postoperative complications, and 30-day readmission rates were collected. Patients had prospectively collected outcome and satisfaction measures. Patient-reported outcome instruments—Oswestry Disability Index (ODI), visual analog scale for back pain (VAS-BP), and VAS for leg pain (VAS-LP)—were completed before surgery and at 3 and 12 months after surgery, as were patient satisfaction measures.RESULTSThe authors identified 345 medical records for 53 (15.4%) African American (AA) patients and 292 (84.6%) white patients. Baseline patient demographics and comorbidities were similar between the two cohorts, with AA patients having a greater body mass index (33.1 ± 6.6 vs 30.2 ± 6.4 kg/m2, p = 0.005) and a higher prevalence of diabetes (35.9% vs 16.1%, p = 0.0008). Surgical indications, operative variables, and postoperative variables were similar between the cohorts. Baseline and follow-up PRO measures were worse in the AA cohort, with patients having a greater baseline ODI (p < 0.0001), VAS-BP score (p = 0.0002), and VAS-LP score (p = 0.0007). However, mean changes from baseline to 3- and 12-month PROs were similar between the cohorts for all measures except the 3-month VAS-BP score (p = 0.046). Patient-reported satisfaction measures at 3 and 12 months demonstrated a significantly lower proportion of AA patients stating that surgery met their expectations (3 months: 47.2% vs 65.5%, p = 0.01; 12 months: 35.7% vs 62.7%, p = 0.007).CONCLUSIONSThe study data suggest that there is a significant difference in the perception of health, pain, and disability between AA and white patients at baseline and short- and long-term follow-ups, which may influence overall patient satisfaction. Further research is necessary to identify patient-specific factors associated with racial disparities that may be influencing outcomes to adequately measure and assess overall PROs and satisfaction after elective lumbar spine surgery.

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Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery

Neurosurgery ◽

10.1227/neu.0000000000000931 ◽

2015 ◽

Vol 77 (5) ◽

pp. 769-776 ◽

Cited By ~ 11

Author(s):

Elina Reponen ◽

Hanna Tuominen ◽

Juha Hernesniemi ◽

Miikka Korja

Keyword(s):

Patient Satisfaction ◽

Quality Of Care ◽

Health Status ◽

Patient Experience ◽

University Hospital ◽

Term Outcome ◽

Major Morbidity ◽

Patient Reported ◽

Relationship Of

Abstract BACKGROUND: Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. OBJECTIVE: To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. METHODS: We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. RESULTS: Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. CONCLUSION: Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

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Early outcomes and predictors of patient satisfaction after TKA: a prospective study of 200 cases with a contemporary cemented rotating platform implant design

Journal of Experimental Orthopaedics ◽

10.1186/s40634-021-00347-w ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Corné van Loon ◽

Niels Baas ◽

Verdonna Huey ◽

James Lesko ◽

Geert Meermans ◽

...

Keyword(s):

Patient Satisfaction ◽

Clinical Improvement ◽

Patient Characteristics ◽

Patient Reported Outcome ◽

Implant Design ◽

Rotating Platform ◽

Radiographic Outcomes ◽

Operative Outcomes ◽

Patient Reported ◽

Time Point

Abstract Purpose The purpose of the study was to identify the earliest time point where subjects realized the greatest clinical improvement after TKA, and the time when post-operative scores became superior to pre-operative scores. Post-hoc exploratory analyses were conducted to investigate predictors of early post-operative outcomes and patient satisfaction. Methods Six investigators across 4 sites in the Netherlands prospectively implanted 200 subjects with a contemporary cemented rotating platform device. Patient Reported Outcome Measurements (PROMs) KOOS-PS, PKIP, and EQ-5D were collected pre-operatively and post-operatively through 2-years. PROMs change from pre-operative baseline were summarized, along with radiographic outcomes and adverse events (AEs). Pre-operative patient characteristics were explored for correlation with patient outcomes, and patient satisfaction for correlation with KOOS-PS. Results Follow-up compliance was 99% at 6-months, and 95.5% at 2-years. The percentage with higher KOOS-PS compared to baseline was 81.3% at 6-months. KOOS-PS, PKIP, and PKIP subscore means were all better at 6-weeks versus baseline. Gender, BMI, hypertension, and pre-operative KOOS-PS were weakly correlated with 6-week KOOS-PS (multivariate R-squared = 14.1%), but only pre-operative KOOS-PS demonstrated correlation with post-operative KOOS-PS at 6-months or later (R-squared < 5% at 6-months and 2 years). Satisfaction was moderately correlated with concurrent KOOS-PS at each post-operative time point, with (R-squared = 35.3% at 6-months, and 37.5% at 2 years). Conclusion The greatest mean clinical improvement occurred within the first 6-weeks. Although some pre-operative factors were correlated with higher early post-operative KOOS-PS outcomes, these advantages disappeared by 6-months aside from weak correlation with pre-operative KOOS-PS. Post-operative KOOS-PS was moderately correlated with concurrent post-operative satisfaction. These results may be used for pre-operative counseling and management of patient’s postoperative expectations. Trial registration Clinicaltrials.gov, NCT02339610. Registered 15 January 2015.

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Patient Satisfaction, Patient-Reported Outcomes, and Quality

Quality in Obesity Treatment ◽

10.1007/978-3-030-25173-4_7 ◽

2019 ◽

pp. 51-57

Author(s):

Julietta Chang ◽

Matthew M. Hutter

Keyword(s):

Patient Satisfaction ◽

Patient Reported Outcomes ◽

Patient Reported

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The effect of coronal alignment on the docotr-derived outcome, patient-reported outcome, and the patient satisfaction after total knee arthroplasty

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2018.02.572 ◽

2018 ◽

Vol 26 ◽

pp. S283-S284

Author(s):

M. Kubo ◽

T. Maeda ◽

K. Kumagai ◽

S. Imai

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Knee Arthroplasty ◽

Patient Reported Outcome ◽

Coronal Alignment ◽

Patient Reported ◽

Total Knee

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Patient Satisfaction in Medicine and Dentistry: A Need to Advance to a Patient-Reported Outcome Measures (PROMs) Culture in Surgical Sciences

10.20944/preprints202009.0254.v1 ◽

2020 ◽

Author(s):

Kelvin I. Afrashtehfar ◽

Mansour K. A. Assery

Keyword(s):

Patient Satisfaction ◽

Dental Treatment ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Review Of The Literature ◽

Participant Satisfaction ◽

Patient Reported ◽

Current Article ◽

Negative Feelings ◽

Perceived Reasons

There is little understanding of patients' experiences and perceptions with satisfaction by health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.

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Long-Term Patient Satisfaction and Quality of Life After Breast-Conserving Therapy: A Prospective Study Using the BREAST-Q

Annals of Surgical Oncology ◽

10.1245/s10434-021-10377-4 ◽

2021 ◽

Author(s):

Ilona Stolpner ◽

Jörg Heil ◽

Fabian Riedel ◽

Markus Wallwiener ◽

Benedikt Schäfgen ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Patient Satisfaction ◽

Repeated Measures ◽

Aesthetic Surgery ◽

Well Being ◽

Breast Conserving Therapy ◽

Patient Reported

Abstract Background Poor patient-reported satisfaction after breast-conserving therapy (BCT) has been associated with impaired health-related quality of life (HRQOL) and subsequent depression in retrospective analysis. This prospective cohort study aimed to assess the HRQOL of patients who have undergone BCT using the BREAST-Q, and to identify clinical risk factors for lower patient satisfaction. Methods Patients with primary breast cancer undergoing BCT were asked to complete the BREAST-Q preoperatively (T1) for baseline evaluation, then 3 to 4 weeks postoperatively (T2), and finally 1 year after surgery (T3). Clinicopathologic data were extracted from the patients’ charts. Repeated measures analysis of variance (ANOVA) was used to determine significant differences in mean satisfaction and well-being levels among the test intervals. Multiple linear regression was used to evaluate risk factors for lower satisfaction. Results The study enrolled 250 patients. The lowest baseline BREAST-Q score was reported for “satisfaction with breast” (mean, 61 ± 19), but this increased postoperatively (mean, 66 ± 18) and was maintained at the 1 year follow-up evaluation (mean, 67 ± 21). “Physical well-being” decreased from T1 (mean, 82 ± 17) to T2 (mean, 28 ± 13) and did not recover much by T3 (mean, 33 ± 13), being the lowest BREAST-Q score postoperatively and in the 1-year follow-up evaluation. In multiple regression, baseline psychosocial well-being, body mass index (BMI), and type of incision were risk factors for lower “satisfaction with breasts.” Conclusion Both the aesthetic/surgery-related and psychological aspects are equally important with regard to “satisfaction with breasts” after BCT. The data could serve as the benchmark for future studies.

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Effect of Social Support and Marital Status on Perceived Surgical Effectiveness and 30-Day Hospital Readmission

Global Spine Journal ◽

10.1177/2192568217696696 ◽

2017 ◽

Vol 7 (8) ◽

pp. 774-779 ◽

Cited By ~ 3

Author(s):

Owoicho Adogwa ◽

Aladine A. Elsamadicy ◽

Victoria D. Vuong ◽

Ankit I. Mehta ◽

Raul A. Vasquez ◽

...

Keyword(s):

Social Support ◽

Hospital Stay ◽

Marital Status ◽

Spine Surgery ◽

Patient Reported Outcomes ◽

Complication Rates ◽

Readmission Rates ◽

Outcomes Measures ◽

Significant Difference ◽

Patient Reported

Study Design: Retrospective cohort review. Objective: To determine whether higher levels of social support are associated with improved surgical outcomes after elective spine surgery. Methods: The medical records of 430 patients (married, n = 313; divorced/separated/widowed, n = 71; single, n = 46) undergoing elective spine surgery at a major academic medical center were reviewed. Patients were categorized by their marital status at the time of surgery. Patient demographics, comorbidities, and postoperative complication rates were collected. All patients had prospectively collected outcomes measures and a minimum of 1-year follow-up. Patient reported outcomes instruments (Oswestry Disability Index, Short Form–36, and visual analog scale–back pain/leg pain) were completed before surgery, then at 1 year after surgery. Results: Baseline characteristics were similar in all cohorts. There was no statistically significant difference in the length of hospital stay across all 3 cohorts, although “single patients” had longer duration of in-hospital stays that trended toward significance (single 6.24 days vs married 4.53 days vs divorced/separated/widowed 4.55 days, P = .05). Thirty-day readmission rates were similar across all cohorts (married 7.03% vs divorced/separated/widowed 7.04% vs single 6.52%, P = .99). Additionally, there were no significant differences in baseline and 1-year patient reported outcomes measures between all groups. Conclusions: Increased social support did not appear to be associated with superior short and long-term clinical outcomes after spine surgery; however, it was associated with a shorter duration of in-hospital stay with no increase in 30-day readmission rates.

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