The relationship between patient experience with service quality and survival in pancreatic cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14697-e14697
Author(s):  
Christopher G. Lis ◽  
Maurie Markman ◽  
Mark Rodeghier ◽  
Digant Gupta
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Quality Of Care ◽  
Service Quality ◽  
Patient Experience ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Patient Reported ◽  
The Relationship

e14697 Background: Despite the recognized relevance of symptom burden in pancreatic cancer, there has been limited exploration of whether an individual patient’s assessment of the overall quality-of-care received might influence outcome. To assess this issue we evaluated the relationship between patient-reported experience with service quality and overall survival. Methods: We evaluated 496 returning pancreatic cancer patients treated at Cancer Treatment Centers of America between July 2007 and December 2010. Overall patient experience “considering everything, how satisfied are you with your overall experience with CTCA?” was measured on a 7-point Likert scale ranging from “completely dissatisfied” to “completely satisfied.” It was dichotomized into 2 categories: top box response (7) versus all others (1-6). Patient survival was the primary end point. Cox regression was used to evaluate the association between patient experience and survival. Results: 317 patients were newly diagnosed while 179 were previously treated. 16, 93, 81 and 306 patients had stage I, II, III and IV disease respectively. 292 were males and 204 females. Mean age was 57.3 years. 387 (78%) patients had expired at the time of this analysis. 345 patients were “completely satisfied” while 151 were not. Median overall survival was 7.9 months (95% CI: 7.3-8.6 months). On univariate analysis, “completely satisfied” patients had a significantly lower risk of mortality compared to those not “completely satisfied” (HR=0.62; 95% CI: 0.50-0.78; p<0.001). On multivariate analysis controlling for stage at diagnosis, treatment history, age and gender, “completely satisfied” patients demonstrated significantly lower mortality (HR=0.61; 95% CI: 0.49-0.76; p<0.001) compared to those not “completely satisfied”. Conclusions: Patient experience with service quality was an independent predictor of survival in pancreatic cancer. This finding underscores the importance of psychosocial factors in patient prognosis. Patients who evaluate their quality of care more favorably may in turn have more positive attitudes toward their treatment outcomes, and may engage in other health behaviors that could potentially increase survival.

Patient experience with service quality: Implications for survival outcomes in prostate cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 39-39
Author(s):  
Christopher G. Lis ◽  
Maurie Markman ◽  
Mark Rodeghier ◽  
Digant Gupta
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Regression Analysis ◽  
Service Quality ◽  
Patient Experience ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Risk Of Mortality ◽  
Patient Reported

39 Background: Prostate cancer is the second leading cause of cancer death among U.S. men. While self-reported quality of life has been shown to be prognostic of survival, there has been limited exploration of whether a patient’s assessment of the overall quality-of-care received might influence survival in prostate cancer. We evaluated the relationship between patient-reported experience with service quality and overall survival in prostate cancer. Methods: 832 returning prostate cancer patients treated at Cancer Treatment Centers of America between July 2007 and December 2010. Overall patient experience (“considering everything, how satisfied are you with your overall experience?”) was measured on a 7-point Likert scale ranging from “completely dissatisfied” to “completely satisfied”. It was dichotomized into 2 categories: top box response (7) versus all others (1-6). Cox regression was used to evaluate the association between patient experience and survival. Results: 560 patients were newly diagnosed while 272 had been previously treated. Majority of patients (n=570, 68.5%) had stage II disease at diagnosis. The mean age was 63.6 years. By the time of this analysis, 93 (11.2%) patients had expired. 710 (85.3%) patients were “completely satisfied” with the service quality they received while 122 (14.7%) patients were not. Median overall survival was 47.9 months. On univariate Cox regression analysis, “completely satisfied” patients had a significantly lower risk of mortality compared to those not “completely satisfied” (HR=0.48; 95% CI: 0.30-0.78; p=0.003). On multivariate Cox regression analysis controlling for stage at diagnosis, treatment history and age, “completely satisfied” patients demonstrated significantly lower mortality (HR=0.50; 95% CI: 0.29-0.87; p=0.01) compared to those not “completely satisfied”. Conclusions: Patient experience with service quality was an independent predictor of survival in prostate cancer. Based on this provocative observation, it is reasonable to suggest that further exploration of a possible meaningful relationship between patient perceptions of the care they have received and outcome in prostate cancer is indicated.

Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery

Neurosurgery ◽  
2015 ◽  
Vol 77 (5) ◽  
pp. 769-776 ◽  
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.

Correlation of neutrophil lymphocyte ratio, platelet lymphocyte ratio and rate of change of CA 19.9 in predicting outcome for metastatic pancreatic cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 326-326
Author(s):  
Andrew Peter Dean ◽  
Dom Higgs ◽  
Adarsh Das ◽  
Madeline Rogers-Seeley ◽  
Sean Fennessy ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Rate Of Change ◽  
Cox Proportional Hazards Model ◽  
Metastatic Pancreatic Cancer ◽  
Lymphocyte Ratio ◽  
Daily Rate ◽  
Ca 19.9

326 Background: CA19.9, NLR and PLR have all been proposed as prognostic in pancreatic cancer. We analysed correlation between NLR, PLR and rate of change of CA19.9. Methods: A total of 63 metastatic pancreatic cancer patients were identified from our database and evaluated retrospectively for blood count, NLR, PLR and serial CA19.9 levels during treatment. Daily Rate of Change of CA19.9 levels were calculated for the first 90 days (DRC90) of the patient’s treatment. Kaplan-Meir curves, univariate and multivariate Cox-regression analyses were calculated to assess the effects of these 3 markers on overall survival. Results: In a univariate analysis, PLR > 240, NLR > 5 and DRC90 > 0.4% were all significantly associated with deceased overall survival. The Cox proportional hazards model showed that NLR < 5 (HR 0.475, 95% CI 0.259 to 0.873, P = 0.017), PLR < 240 (HR 0.444, 95% CI 0.229 to 0.861, P = 0.016), and a DRC90 < 0.4% (HR 0.294, 95% CI 0.102 to 0.851, P = 0.024) were independent predictors of good prognosis (22.6 months vs. 9.6 months, 22.3 months vs 12.4 months and 23.9 months vs. 9.3 months respectively). In multivariate analysis, only a DRC90 < 0.4% was independently associated with a longer survival (HR 0.239, 95% CI 0.076 to 0.752, P = 0.014). The formula (F) {PLR + (NLRxNLR) + (DRC90 x 100)} was predictive for survival, as patients with F > 190 (HR 3.295, 95% CI 1.232 to 8.807, P = 0.017), having a significantly lower survival rate than patients with F < 190 (25.1 months vs. 10.6 months, log-rank P = 0.009). Conclusions: These findings indicate the prognostic utility of the rate of CA 19.9 decline - measured as a standardised daily percentage change in value over 90 days. Our data validates daily rate of change of CA 19.9 over 90 days as an independent variable that correlates with prognosis, independent of PLR and NLR. We also identified a novel formula - PLR + (NLRxNLR) + (DRC90 x 100) - as being predictive for survival. We would like to increase the sample size to further validate our initial findings and investigate possible relationships in combining these variables for better prognostication in metastatic pancreatic cancer.

scholarly journals The relationship between RECK Gene Polymorphisms and the prognosis of cholangiocarcinoma

2020 ◽  
Author(s):  
Ning Wang ◽  
Yanni Li ◽  
Yanfang Zheng ◽  
Huoming Chen ◽  
Xiaolong Wen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Overall Survival Rate ◽  
Chi Square ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Chi Square Test ◽  
The Relationship

Abstract Background The study was designed to examine the reversion inducing cysteine rich protein with Kazal motifs (RECK) levels in patients with cholangiocarcinoma (CCA) and assess its role in CCA prognosis. Methods Quantitative real-time PCR (qRT-PCR) was used to determine the expression of RECK mRNA in 127 pairs of CCA samples and controls. Chi-square test was conducted to analyze the effects of clinical features on RECK expression. Kaplan-Meier curves were plotted to determine the overall survival rate of CCA patients with different RECK expression. The prognostic biomarkers for CCA patients were identified using the Cox regression analysis. Results Significantly down-regulated expression of RECK mRNA was determined in CCA tissues compared to noncancerous controls (P < 0.05). Chi-square test suggested reduced RECK expression was related with invasion depth (P = 0.026), differentiation (P = 0.025), lymphatic metastasis (P = 0.010) and TNM stage (P = 0.015). However, age, sex, tumor size and family history had no significant links with RECK expression (all, P > 0.05). The survival curves showed that patients with low RECK expression had a shorter overall survival rate than those with high RECK expression. Both the univariate analysis (P = 0.000, HR = 5.290, 95%CI = 3.195–8.758) and multivariate analysis (P = 0.000, HR = 5.376, 95%CI = 2.231–8.946) demonstrated that RECK was an independent biomarker for predicting the outcomes of CCA patients. Conclusions Taken together, the expression of RECK was down-regulated in CCA and it might be an efficient biomarker for CCA patients.

Nurses’ appraisal of organizational attractiveness and the role of management support, interdepartmental collaboration climate, and service quality of care

2020 ◽  
Author(s):  
Terje Slåtten ◽  
Gudbrand Lien
Keyword(s):  
Quality Of Care ◽  
Service Quality ◽  
Structural Equation ◽  
Public Hospitals ◽  
Equation Modeling ◽  
Management Support ◽  
Organizational Attractiveness ◽  
Employer Branding ◽  
The Relationship

Abstract Background: In recent years, there has been a growing interest in understanding factors that within employer branding are labeled organizational attractiveness (OA). Previous research on OA has mainly taken an external applicant perspective. In contrast, this study examined OA from an internal and current frontline nursing perspective. Consequently, by adopting this underexplored perspective, it extends previous studies on OA within healthcare service research.Methods: Quantitative survey data were collected from a sample of 164 nurses. All participants were employed in public hospitals. Confirmatory factor analysis and structural equation modeling in Stata were used to analyze the data. Furthermore, the indirect effects were tested by mediator analyses. Results: There are three main results from this study. First, the interdepartmental collaboration climate has a significant positive effect on OA (β = 0.311), as well as management support (β = 0.294), and service quality of care (β = 0.243). Second, the relationship between management support and OA is found to be mediated through the interdepartmental collaboration climate. Third, the relationship between interdepartmental collaboration climate and OA is found to be mediated through service quality of care.Conclusions: This study contributes to our understanding of OA from a current employee perspective. It stresses the importance for hospital managers to consider how their current nurses perceive the level of interdepartmental collaboration climate, management support, and service quality of care to patients. These three factors play a significant role as they explain approximately 50% (R2 = 0.47) of OA.

scholarly journals Towards patient-centred care in Ghana: health system responsiveness, self-rated health and experiential quality in a nationally representative survey

2020 ◽  
Vol 9 (2) ◽  
pp. e000886 ◽  
Author(s):  
Hannah L Ratcliffe ◽  
Griffith Bell ◽  
Koku Awoonor-Williams ◽  
Asaf Bitton ◽  
June-Ho Kim ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Patient Experience ◽  
Patient Reported Outcomes ◽  
World Health ◽  
Self Rated Health ◽  
Experience Of Care ◽  
Essential Components ◽  
Patient Reported ◽  
Nationally Representative

IntroductionPerson-centredness, including patient experience and satisfaction, is a foundational element of quality of care. Evidence indicates that poor experience and satisfaction are drivers of underutilisation of healthcare services, which in turn is a major driver of avoidable mortality. However, there is limited information about patient experience of care at the population level, particularly in low-income and middle-income countries.MethodsA multistage cluster sample design was used to obtain a nationally representative sample of women of reproductive age in Ghana. Women were interviewed in their homes regarding their demographic characteristics, recent care-seeking characteristics, satisfaction with care, patient-reported outcomes, and—using questions from the World Health Survey Responsiveness Module—the seven domains of responsiveness of outpatient care to assess patient experience. Using Poisson regression with log link, we assessed the relationship between responsiveness and satisfaction, as well as patient-reported outcomes.ResultsWomen who reported more responsive care were more likely to be more educated, have good access to care and have received care at a private facility. Controlling for respondent and visit characteristics, women who reported the highest responsiveness levels were significantly more likely to report that care was excellent at meeting their needs (prevalence ratio (PR)=13.0), excellent quality of care (PR=20.8), being very likely to recommend the facility to others (PR=1.4), excellent self-rated health (PR=4.0) and excellent self-rated mental health (PR=5.1) as women who reported the lowest responsiveness levels.DiscussionThese findings support the emerging global consensus that responsiveness and patient experience of care are not luxuries but essential components of high-performing health systems, and highlight the need for more nuanced and systematic measurement of these areas to inform priority setting and improvement efforts.

scholarly journals The Relationships Between Patient Experience and Quality and Utilization of Primary Care Services

2020 ◽  
Vol 7 (6) ◽  
pp. 1678-1684
Author(s):  
Jaya Aysola ◽  
Chang Xu ◽  
Hairong Huo ◽  
Rachel M Werner
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Patient Experience ◽  
Smoking Status ◽  
Care Quality ◽  
Cross Sectional ◽  
Process Measures ◽  
Care Services ◽  
Patient Reported

We lack knowledge on how patient-reported experience relates to both quality of care services and visit attendance in the primary care setting. Therefore, in a cross-sectional analysis of 8355 primary care patients from 22 primary care practices, we examined the associations between visit-triggered patient-reported experience measures and both (1) quality of care measures and (2) number of missed primary care appointment (no shows). Our independent variables included both overall patient experience and its subdomains. Our outcomes included the following measures: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status (nonsmoker vs smoker), diabetes control Hemoglobin A1c (HbA1c [<8]), blood pressure control, cholesterol control Low Density Lipoprotein (LDL) among patients with diabetes (LDL < 100), and visit no shows 2 and 5 years after the index visit that triggered the completed patient-experience survey. We found that patient experience, while an important stand-alone metric of care quality, may not relate to clinical outcomes or process measures in the outpatient setting. However, patient-reported experiences with their primary care provider appear to influence their future visit attendance.

scholarly journals Low expression of CIP4 in predicting worse overall survival: A potential biomarker for laryngeal cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0253545
Author(s):  
Lucheng Fang ◽  
Licai Shi ◽  
Wen Wang ◽  
Xiu Wu ◽  
Tingting Hu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Wnt Signaling ◽  
Signaling Pathways ◽  
Laryngeal Cancer ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Gene Set Enrichment Analysis ◽  
Kaplan Meier ◽  
Potential Biomarker ◽  
The Relationship

Previous reports indicate that Cdc42-interacting protein-4 (CIP4) has previously been reported to plays an important role in the progression of various cancers. However, its correlation with laryngeal cancer (LC) remains unreported. Data from TCGA and GEO databases were used to evaluate the role of CIP4 in LC. Based on GEO and TCGA datasets, we analyzed the differences in CIP4 expression between normal and tumor samples. The Wilcoxon signed-rank test was used to analyze the relationship between clinical features and CIP4. Cox regression and the Kaplan-Meier analyses were used to identify the clinical characteristics associated with the overall survival. Also, the GEPIA database was used to confirm the relationship between CIP4 and overall survival. Lastly, Gene Set Enrichment Analysis (GSEA) was performed based on the TCGA dataset. CIP4 expression in LC was significantly associated with gender and tumor stage (p-values<0.05). Similar to GEPIA validation, Kaplan-Meier survival analysis demonstrated that LC with CIP4-low exhibited a worse prognosis than that with CIP4-high. Univariate analysis revealed that CIP4-high significantly correlated with better overall survival (HR: 0.522, 95% CI: 0.293–0.830, P = 0.026). Besides, multivariate analysis revealed that CIP4 remained independently associated with the overall survival (HR: 0.61, 95% CI: 0.326–0.912, P = 0.012). GSEA showed that the p53, WNT signaling, TGF-β signaling pathways, etc. were enriched in a phenotype high CIP4 expression. In summary, the CIP4 gene is a potential prognostic molecular marker for patients diagnosed with laryngeal cancer. Moreover, the p53, WNT signaling, and TGF-β signaling pathways are potentially associated with CIP4 in LC.

scholarly journals The Correlation Analysis of Baseline Serum CA199, CEA and CA125 in Patients with Advanced Pancreatic Cancer

2020 ◽  
Author(s):  
Guochao Deng ◽  
Huan Yan ◽  
Zhipeng Guo ◽  
Guanghai Dai
Keyword(s):  
Pancreatic Cancer ◽  
Tumor Markers ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Advanced Pancreatic Cancer ◽  
Rank Test ◽  
Fisher Exact Test ◽  
Primary Tumor Site ◽  
Baseline Serum ◽  
The Relationship

Abstract Background:CA199, CEA and CA125 were the most widely used tumor markers in pancreatic cancer. However, the studies associated with the relationship between the three markers and pancreatic cancer were limited. This study aimed to explore the correlation between baseline serum CA199, CEA, CA125 levels and clinical characteristics in pancreatic cancer. Methods:278 patients with advanced pancreatic cancer received first-line chemotherapy treatments enrolled in this research. Correlated analysis between tumor markers and disease characteristics was performed by Pearson’s Chi-squared test or Fisher exact test. We used Pearson’s correlation test to investigate the relationship between tumor markers and peripheral blood parameters. Univariate analysis was estimated by Kaplan-Meier method and compared using the log-rank test. Multivariate analysis and HR calculation was determined by the Cox regression model. Results: Baseline CA199, CEA, and CA125 both positively associated with the primary tumor site (p=0.007; p=0.012; p=0.003, respectively);liver metastasis (p=0.001; p=0.001; p=0.028, respectively); number of organ metastasis (p=0.001; p=0.008;p=0.042, respectively); baseline WBC levels (p<0.001; p<0.001; p<0.001, respectively), LDH levels (p<0.001; p=0.004; p<0.001, respectively). And CA199 also correlated with years of smoking(p=0.024); diabetes and year of diabetes (p=0.012; p=0.012); baseline glycemic levels (p=0.004). CA199 and CA125 levels had the relationship with baseline neutrophil counts (p<0.001; p<0.001, respectively). Years of smoking, baseline neutrophil counts, LDH levels, CA199 levels and CA125 levels were independent prognostic factors. Conclusion: Combinations of the four factors were also correlated with survival. It’s concluded that CA199, CEA, CA125 correlated with multi-factors of clinical factors. And combinations of baseline neutrophil counts, LDH levels, CA199 levels and CA125 levels were also prognostic factor.

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