A patient\u2019s perception of their hospital stay influences the functional outcome and satisfaction of total knee arthroplasty

N D Clement,R Burnett,A H R W Simpson,D Macdonald,C R Howie

doi:10.1007/s00402-017-2661-7

Abstract

IntroductionTo assess whether patient satisfaction with their hospital stay influences the early outcome of total knee arthroplasty (TKA).MethodsDuring a 5-year period patients undergoing primary TKA at the study centre had prospective outcome data recorded (n = 2264). The Oxford knee score (OKS) and the short form (SF)-12 were recorded pre-operatively and 1 year post-operatively when satisfaction with their TKA was also assessed. Patient satisfaction with their hospital stay was also evaluated and their reasons for it were qualitatively documented.ResultsDecreasing level of satisfaction with their hospital stay was associated with a significantly worse post-operative OKS (p < 0.001) and SF-12 score (p < 0.001). Multivariable regression analysis confirmed that the patient’s perceived level of satisfaction with their hospital stay was an independent predictor of change in the OKS (p < 0.001) and SF-12 score (p < 0.006) after adjusting for confounding variables. Patient satisfaction with their TKA was significantly influenced by their hospital experience, decreasing from 96% in those with an excellent experience to 42% in those with a poor experience. Food, staff/care, and the hospital environment were the most frequent reasons of why patients rated their hospital experience as fair or poor.ConclusionA patient’s perception of their inpatient hospital experience after surgery is an important modifiable predictor of early functional outcome and satisfaction with TKA.

Highlights

To assess whether patient satisfaction with their hospital stay influences the early outcome of total knee arthroplasty (TKA)
The primary aim of this study was to assess whether patient satisfaction with hospital stay influences the early functional outcome of TKA, measured by both generic and joint specific patient reported outcome measures (PROMs), and if it effects patient satisfaction with their TKA
Patient satisfaction with the hospital stay during their TKA was assessed at 6 months review by asking the question: “How satisfied were you with your hospital experience?”, which was measured using a five point Likert scale: excellent, very good, good, fair, and poor

Summary

Introduction

To assess whether patient satisfaction with their hospital stay influences the early outcome of total knee arthroplasty (TKA). The Oxford knee score (OKS) and the short form (SF)-12 were recorded pre-operatively and 1 year post-operatively when satisfaction with their TKA was assessed. Patient satisfaction with their hospital stay was evaluated and their reasons for it were qualitatively documented. Multivariable regression analysis confirmed that the patient’s perceived level of satisfaction with their hospital stay was an independent predictor of change in the OKS (p < 0.001) and SF-12 score (p < 0.006) after adjusting for confounding variables Patient satisfaction with their TKA was significantly influenced by their hospital experience, decreasing from 96% in those with an excellent experience to 42% in those with a poor experience. If patient perceived satisfaction with their hospital care influences their functional outcome and satisfaction with

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Results