Association of Age and Patient Satisfaction Scores: A Systematic Review.

Abstract

Patient satisfaction surveys, used as a quality indicator, play a role in determining reimbursement. Quality-based payments have been used by Medicare for physician reimbursement since 2015. Numerous papers report a scoring bias associated with nonmodifiable patient demographics, such as age or gender. Our systematic review across multiple specialties determines if patient age influences patient satisfaction scores. A focused literature search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using the PubMed database. Odds ratios (ORs), fixed-effects modeling, and presence of publication bias were calculated for an overall summary. Out of 387 reviewed papers, 12 articles were selected for this systematic review resulting in a total of 174,558 patients. Selected studies included hospital level and surgical specialty data of patient satisfaction scores of their physician providers only. Overall, our analysis revealed an OR of 1.36 (95% CI 1.23-1.50; I2 = 99.4%; P < .0001). The inpatient setting showed an OR of 1.18 (1.07-1.30; I2 = 99.1%; P < .001). The outpatient setting showed an OR of 1.38 (1.24-1.55; I2 = 99.5%; P < .001). Funnel plot and bias test did not show publication bias in both the inpatient and outpatient settings (P = .242, and .139, respectively). A positive and statistically significant relationship exists between patient age and satisfaction scores with their physicians, meaning that older patients are more satisfied with their physician providers. This relationship was more pronounced in the outpatient setting.