68 Back Pain Patient Satisfaction Scores Did Not Change after Legislation Resulting in Opiate Prescription Decrease

Abstract

In response to the opiate crisis, New Jersey (NJ) enacted legislation in February 2017 that required physicians, when prescribing opiates, to look up patients’ previous opiate prescription history, counsel safe opiate use and document all this in the emergency department (ED) chart. We previously found ED opiate prescriptions markedly decreased by 62% in the ten months after the legislation. We hypothesized that the decrease in ED opiate prescriptions would lead to a drop in ED back pain patient satisfaction scores. Retrospective multihospital cohort of ED visits. The setting was 16 NJ urban and suburban EDs with annual visits from 21,000 to 99,000. Consecutive patients seen by ED physicians from 1/1/2016 to 8/31/2018. Using ICD 10 codes, we identified back pain patients. For patient satisfaction, we used the results of a mailed survey (Press Ganey Associates). Although the return rate on this survey is low, the survey is widely used nationally to judge performance in the ED. We computed and plotted the average ED physician patient satisfaction scores for each month over the time period of the study. A priori we chose to calculate the average satisfaction score for the 12 months before and the 12 months after February 2017 (See Table). We also calculated the linear regression coefficient of the plot for the entire period (1/1/2016 to 8/31/2018). Of the 3,888,502 visits in the database, 112,296 were for back pain and of these 1523 surveys were returned. There was no change in the average ED physician patient satisfaction scores for the 12 months before and after February 2017 (average score = 84 for both periods). The linear regression coefficient of the plot for the entire period 1/1/2016 to 8/31/2018 was R squared = 0.0004 (p = 0.91). Contrary to our hypothesis, there was no change in ED back pain patient satisfaction scores after legislation, despite a marked decrease in ED opiate prescriptions.Tabled 112 months before and 12 months after February 2017Back painYear and month of serviceVisitsAvg Satisfaction ScoreAvg Doc Score# of Responses2016023,33085.385.66012016033,44482.984.83812016043,48982.380.05312016053,50381.982.74412016063,47585.182.74612016073,57688.388.36612016083,53382.782.04412016093,53286.987.74212016103,62184.383.86612016113,18087.685.44112016123,46584.183.25712017013,60481.481.4411averages84.484.049.8122017033,42086.386.75812017043,61079.878.44512017053,86279.478.05612017063,72184.685.54612017073,70985.284.24012017083,82091.192.14012017093,47687.386.65012017103,73088.588.35412017113,47185.586.64312017123,25682.880.74712018013,66385.083.63812018023,18481.478.1441averages84.884.146.812 Open table in a new tab