Predictors Of Patient Satisfaction Research Articles

Predictors of Patient Satisfaction with Hand Function after Fasciectomy for Dupuytren's Contracture.

This study examined patient satisfaction with hand function after fasciectomy for Dupuytren's contracture and determined which preoperative patient- and disease-specific factors predicted this satisfaction. Demographics and disease-specific factors were assessed from a prospective cohort of 194 patients who completed the Michigan Hand Outcomes Questionnaire preoperatively and underwent limited fasciectomy between 2011 and 2014 at six hand surgery practice sites. To evaluate satisfaction with hand function, patients were asked to complete the Michigan Hand Outcomes Questionnaire during the first year after fasciectomy. After patients were classified into a satisfied and an unsatisfied category using the question that specifically pertains to satisfaction with hand function, the authors applied multivariate logistic regression modeling to identify independent predictors of patient satisfaction. At an average of 10 months (range, 6 to 12 months) after fasciectomy, 84 percent (n = 163) of the patients were satisfied with their hand function. In multivariate analyses adjusting for the degree of postoperative residual contracture (p < 0.001) and complications (p < 0.001), a higher preoperative Michigan Hand Outcomes Questionnaire hand appearance subscore and male gender predicted a higher likelihood of becoming satisfied after fasciectomy. Other patient- and disease-specific factors did not show evidence for an association with patient satisfaction. The findings of this study suggest that providers should consider assessing concerns about the appearance of the hand in patients with Dupuytren's contracture. They also highlight the importance of complication prevention and full contracture correction from the patient's perspective. Risk, III.

Levels and predictors of patient satisfaction with doctor home-visit services in Australia.

The Australian after-hours house-call (AHHC) services has grown rapidly in the past few years. Even though recent studies have looked at aspects of the service as it concerns the medical personnel involved, no national study has explored patient satisfaction with the service. This study aims to assess patient satisfaction with Australian AHHC services and its predictors, with the hope of improving quality and patient outcomes. The findings might also have international relevance, given the developing nature of the AHHC in most countries. A cross-sectional survey of all 10838 patients known to have patronized the AHHC service in Australia over a 1-week period. The main outcome measure was the Patient Satisfaction Questionnaire 18 (PSQ-18). A total of 1228 questionnaires were returned. General Satisfaction (GS) level was found to be 85.2% (mean 4.16/5). Other Scales of Satisfaction, in decreasing order, were 'Financial Aspects, FA' (87.4%; 4.36/5), 'Communication, CM' (87.3%; 4.18), 'Technical Quality, TA' (82.1%; 4.09), 'Time Spent with Doctor, TSD' (77.7%; 3.91), 'Interpersonal Manner, IM' (75.7%; 3.87) and 'Accessibility and Convenience, A&C' (72.9%; 3.82). The major predictor of increased satisfaction was the time it took the doctor to arrive, with increased satisfaction on GS (T < 4 hours; P < 0.01), IM (T < 30 minutes; P = 0.03), FA (T < 2 hours; P = 0.01), TSD (T < 2 hours; P < 0.01) and A&C (T < 4 hours; P < 0.01). Other positive predictors of aspects of satisfaction included 'being a student', 'age of patient ≤ 16' and 'being Australian born', while 'being on a pension' was negatively associated with Communication (P = 0.03). No associations were found with gender, marital status, employment status, family income or having children in the household. This study concludes that satisfaction in Australian AHHC is high on all scales but recommends that the service providers should aim to attend to patients within 4 hours of their initial calls.

Predictors of patient satisfaction in an emergency care centre in central Saudi Arabia: a prospective study

AimThis study aimed to (i) assess the level of patient satisfaction and its association with different sociodemographic and healthcare characteristics in an emergency care centre (ECC) in Saudi Arabia and...

Parent reported outcomes of quality care and satisfaction in the context of a life-limiting fetal diagnosis

Objective: To identify which quality indicators (QI) predict patient satisfaction. Methods: A cross-sectional design using a validated tool was administered using a Web-based platform. Parents (n = 405) who experienced a life-limiting fetal diagnosis and opted to continue their pregnancy provided feedback on 37 QI and satisfaction with prenatal care. Descriptive analyses and logistic regression identified relationships among variables. Results: Parental satisfaction with care was 75.6%. Statistically significant differences in mean scores were reported with satisfied patients reporting higher agreement with quality indicators. Parents who were satisfied with their care had 1.9 times the odds of reporting that consistent care was provided (CI: 1.4–2.4, p < 0.01), 1.8 times the odds of reporting compassionate care (CI: 1.4–2.5, p < 0.01) and 1.8 times the odds that they received help to cope with their emotions (CI: 1.4–2.3, p < 0.01). The model correctly predicted parent satisfaction 92% of the time. Conclusion: Provision of consistent prenatal care is an important quality indicator for this population of parents. The odds of securing satisfied parents increase when families are treated with compassion and given resources to help them cope with the emotionally devastating experiences associated with a life-limiting fetal diagnosis.

Pain Management as a Predictor of Patient Satisfaction in the Emergency Department

Patient satisfaction has become an increasingly important metric of quality of care and of the patient experience. It has also become an important driver of reimbursement for provider services. Components of patient satisfaction include provision of timely care, keeping the patient and their families apprised of the progress of their diagnostic work-up and treatment, cleanliness of the environment, responsiveness of the treatment team, as well as relief of pain and discomfort. In an era of increasing patient expectations of care, as well as the recent epidemic of opiate abuse, the emergency provider is presented with clinical challenges which did not exist until recently.

Predictors of patient satisfaction with inpatient hospital pain management across the United States: A national study.

Satisfactory pain management of hospitalized patients remains a national unmet need for the United States. Although prior research indicates that inpatient pain management may be improving nationally, not all populations of patients rate pain management as equally satisfactory. County-level predictors, such as demographics and population density, and hospital-level predictors (eg, hospital-bed number), are understudied determinants of pain management patient satisfaction. We created a multivariate regression model of pain management patient satisfaction scores as indicated by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results based on county and hospital level predictors. Number of hospital beds (β = -0.16), percent foreign-born (β = -0.16), and population density (β = -0.08) most strongly predicted unfavorable ratings, whereas African American (β = 0.23), white (β= 0.23), and younger population (β = 0.08) most strongly predicted favorable ratings. Greater attention should be placed on pain management in larger hospitals that serve foreign-born patients in population-dense areas. Journal of Hospital Medicine 2016;11:498-501. © 2016 Society of Hospital Medicine.

Interpretation of the QuickDASH score after open carpal tunnel decompression: threshold values associated with patient satisfaction.

We studied the correlation between change in the QuickDASH score and the absolute post-operative QuickDASH score with patient satisfaction after open carpal tunnel decompression. Threshold values in the QuickDASH score, the point at which the sensitivity and specificity are maximal in predicting patient satisfaction, were identified. During the study period, outcome data were compiled for 937 carpal tunnel decompressions, which included 219 (23%) male and 718 (77%) female patients with a mean age of 58 years (standard deviation (SD) 14). There was a significant improvement (mean difference 32, 95% confidence interval (CI) 30 to 34) in the QuickDASH from a mean of 54 (SD 20) to 22 (SD 23) at 1 year after surgery. There were 808 (86%) patients who defined their outcome as satisfactory at 1 year. The identified threshold values for the post-operative QuickDASH score (⩽34 points) and the change (⩾20 points) in the score were highly predictive of patient satisfaction. However, these threshold values varied significantly according to the baseline pre-operative score. The threshold values identified in the QuickDASH can be used to interpret the score. However, the influence of the pre-operative baseline score should be taken into account when comparing different cohorts of patients or using the values to power future studies. Prognosis, observational cohort study.

Role of the Medical Practitioners Emotional Intelligence on Patient Satisfaction

Physician-patient communication skills linked to improved patient satisfaction. More emotionally intelligent persons might succeed at communicating in pleasing ways. Physicians communication skills are potentially valuable assets to improve quality of care. This study examined the relationship between physicians emotional intelligence (EI) and patient satisfaction. The sample comprised physicians of different specializations and their patients. EI was measured using Genos Emotional Intelligence Inventory. Patient satisfaction was assessed by Patient Satisfaction Questionnaire-III. The Karl Pearsons coefficient of correlation resulted positive and significant association between EI and patient satisfaction. Moreover, EI scores of a physician showed strong positive associations with communication sub-scales of patient satisfaction. Linear regression analysis showed EI is a significant predictor of patient satisfaction. ANOVA results depicted that physicians EI changes across age and experience and also patient satisfaction changes across gender, age, follow-up visit, education, and marital status. It has implications for physicians that improved EI abilities contribute to increased communication quality. Increased communication skills act as a better predictor of patients needs that ultimately contribute to satisfy the patient. Physicians EI abilities are strengthened through training programs on EI, which are necessarily effective in the workplace.

Inability of Physicians and Nurses to Predict Patient Satisfaction in the Emergency Department.

IntroductionPatient satisfaction is a commonly assessed dimension of emergency department (ED) care quality. The ability of ED clinicians to estimate patient satisfaction is unknown. We sought to evaluate the ability of emergency medicine resident physicians and nurses to predict patient-reported satisfaction with physician and nursing care, pain levels, and understanding of discharge instructions.MethodsWe studied a convenience sample of 100 patients treated at an urban academic ED. Patients rated satisfaction with nursing care, physician care, pain level at time of disposition and understanding of discharge instructions. Resident physicians and nurses estimated responses for each patient. We compared patient, physician and nursing responses using Cohen’s kappa, weighting the estimates to account for the ordinal responses.ResultsOverall, patients had a high degree of satisfaction with care provided by the nurses and physicians, although this was underestimated by providers. There was poor agreement between physician estimation of patient satisfaction (weighted κ=0.23, standard error: 0.078) and nursing estimates of patient satisfaction (weighted κ=0.11, standard error: 0.043); physician estimation of patient pain (weighted κ=0.43, standard error: 0.082) and nursing estimates (weighted κ=0.39, standard error: 0.081); physician estimates of patient comprehension of discharge instruction (weighted κ=0.19, standard error: 0.082) and nursing estimates (weighted κ=0.13, standard error: 0.078). Providers underestimated pain and patient comprehension of discharge instructions.ConclusionED providers were not able to predict patient satisfaction with nurse or physician care, pain level, or understanding of discharge instructions.

Quadriceps strength affects patient satisfaction after total knee arthroplasty

BackgroundTotal knee arthroplasty is one of the most successful surgeries with respect to relieving pain and restoring function of the knee. However, some studies have reported that patients are not always satisfied with their results after total knee arthroplasty. The aim of this study was to determine whether the muscle strength around the knee joint and the walking status influence patients' expectations and satisfaction before and after total knee arthroplasty. MethodsWe evaluated 28 patients who underwent 30 primary total knee arthroplasties from March 2012 to June 2013. We assessed patient-reported scores using the 2011 Knee Society Scoring System, knee extensor and flexor strength, the 10-m walking test, and the timed up-and-go test. All assessments were performed preoperatively and 1 year after total knee arthroplasty. We determined the correlation between the patient-reported scores and each variable. ResultsPreoperative patient satisfaction was significantly correlated with knee symptoms and functional activities, but not with muscle strength or walking status. Postoperative patient satisfaction was significantly correlated with knee symptoms, functional activities, knee extensor strength, and walking status, including the 10-m walking test and timed up-and-go test, after total knee arthroplasty. In stepwise regression analysis, predictors of patient satisfaction with total knee arthroplasty were knee symptoms, functional ability, and knee extensor strength. ConclusionsOur study demonstrates that pain relief and restoration of functional activity are highly correlated with increasing patient satisfaction after total knee arthroplasty. The results also indicate that the quadriceps is important for patient satisfaction and restoration of functional activity following total knee arthroplasty.

Abstract 12284: Hospital Patient Satisfaction Scores and 30-day Readmission and Mortality Rates of Heart Failure Patients

Introduction: Heart failure (HF) is associated with significant mortality and hospital readmissions. High quality health care is associated with improved outcomes in HF patients. A widely used metric to assess the quality of health care provided by hospitals is patient satisfaction. However, the relationship between a hospital’s patient satisfaction scores and that hospital’s mortality rate and readmissions for HF patients is unclear. Methods: We used most recent publicly available data from the Hospital Compare website to examine the relationship between patient satisfaction and 30-day unplanned readmissions and mortality for HF patients. Readmission and mortality rates are reported after adjusting for clinical risk factors. We used multivariable linear regression to explore the relationship between patient satisfaction and HF readmissions and mortality adjusting for hospital and local characteristics (hospital ownership, provision of emergency services, teaching hospital status, survey response rate, percentage insured and poverty). Results: Of the 3595 hospitals, 965(27%) were teaching hospitals. Mean (SD) survey response rate was 31.6%(7.3), satisfaction 69.8%(8.7), readmission rate 22.7(1.6) and mortality rate 12.0(1.5). In unadjusted regression, lower 30-day readmission rate but higher mortality rate were associated with high patient satisfaction (-1.4%/unit increase in readmission rate, p&lt;0.001 and 0.2%/unit increase in mortality rate, p=0.03). After adjusting for potential confounders, the readmission rate remained a strong negative predictor of patient satisfaction (-0.75%, P&lt;0.001), however, there was no significant association with mortality (-0.09%, P=0.26). Conclusions: We found that 30-day readmission rate, but not mortality rate, in HF patients is a strong negative predictor of patient satisfaction with hospitals. Strategies aimed at reducing HF readmissions may increase patient satisfaction with hospitals.

Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study.

BackgroundHealth care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure.ObjectiveThe aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample.MethodsUsing data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States.ResultsThe results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction.ConclusionsWe found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties.

Demographic factors and hospital size predict patient satisfaction variance--implications for hospital value-based purchasing.

Hospital Value-Based Purchasing (HVBP) incentivizes quality performance-based healthcare by linking payments directly to patient satisfaction scores obtained from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Lower HCAHPS scores appear to cluster in heterogeneous population-dense areas and could bias Centers for Medicare & Medicaid Services (CMS) reimbursement. Assess nonrandom variation in patient satisfaction as determined by HCAHPS. Multivariate regression modeling was performed for individual dimensions of HCAHPS and aggregate scores. Standardized partial regression coefficients assessed strengths of predictors. Weighted Individual (hospital) Patient Satisfaction Adjusted Score (WIPSAS) utilized 4 highly predictive variables, and hospitals were reranked accordingly. A total of 3907 HVBP-participating hospitals. There were 934,800 patient surveys by the most conservative estimate. A total of 3144 county demographics (US Census) and HCAHPS surveys. Hospital size and primary language (non-English speaking) most strongly predicted unfavorable HCAHPS scores, whereas education and white ethnicity most strongly predicted favorable HCAHPS scores. The average adjusted patient satisfaction scores calculated by WIPSAS approximated the national average of HCAHPS scores. However, WIPSAS changed hospital rankings by variable amounts depending on the strength of the predictive variables in the hospitals' locations. Structural and demographic characteristics that predict lower scores were accounted for by WIPSAS that also improved rankings of many safety-net hospitals and academic medical centers in diverse areas. Demographic and structural factors (eg, hospital beds) predict patient satisfaction scores even after CMS adjustments. CMS should consider WIPSAS or a similar adjustment to account for the severity of patient satisfaction inequities that hospitals could strive to correct.

MP5-18 A MULTI-INSTITUTIONAL ANALYSIS OF THE IMPACT OF OBESITY ON COMPLICATIONS AFTER ROBOTIC VS. OPEN RADICAL PROSTATECTOMY

with RP outcome and whether expectations regarding functional outcomes were accurate. Multivariable logistic regression models were fit to identify the association between patient expectations, change in functional outcomes, and satisfaction. RESULTS: Overall, 87.9% of men were satisfied with their treatment outcomes following RP, and 81.2% and 52.9% responded that their expectations were moderately to extremely accurate for the urinary and sexual functional outcomes, respectively. The relationship between mean change in functional scores vs. patient satisfaction and expectations of functional outcomes vs. patient satisfaction are shown in Table 1. In a multivariate analysis, both lesser changes in functional scores and accuracy of patient expectations were independent predictors of patient satisfaction (Table 2). CONCLUSIONS: Both changes in functional status and accurate patient expectations are important predictors of long-term satisfaction following open RP. Evidence-based preoperative counseling and expectations management are critical to ensure long-term patient satisfaction following RP.

Can the pre-operative Western Ontario and McMaster score predict patient satisfaction following total hip arthroplasty?

In this study we evaluated whether pre-operative Western Ontario and McMaster Universities (WOMAC) osteoarthritis scores can predict satisfaction following total hip arthroplasty (THA). Prospective data for a cohort of patients undergoing THA from two large academic centres were collected, and pre-operative and one-year post-operative WOMAC scores and a 25-point satisfaction questionnaire were obtained for 446 patients. Satisfaction scores were dichotomised into either improvement or deterioration. Scatter plots and Spearman's rank correlation coefficient were used to describe the association between pre-operative WOMAC and one-year post-operative WOMAC scores and patient satisfaction. Satisfaction was compared using receiver operating characteristic (ROC) analysis against pre-operative, post-operative and δ WOMAC scores. We found no relationship between pre-operative WOMAC scores and one-year post-operative WOMAC or satisfaction scores, with Spearman's rank correlation coefficients of 0.16 and -0.05, respectively. The ROC analysis showed areas under the curve (AUC) of 0.54 (pre-operative WOMAC), 0.67 (post-operative WOMAC) and 0.43 (δ WOMAC), respectively, for an improvement in satisfaction. We conclude that the pre-operative WOMAC score does not predict the post-operative WOMAC score or patient satisfaction after THA, and that WOMAC scores can therefore not be used to prioritise patient care.

Predictors of Dental Patients’ Satisfaction in a Greek Sample

Aims: To evaluate patien t factors, provider factors, and factors related to the patient - provider experience which may predict patient satisfaction with dental appointments. Study Design : A cross - sectional design was used. Place and Duration of Study: Data were gathered from denta l students and their patients at Aristotle University of Thessaloniki, Greece between October, 2010 and April, 2011. Methodology: Data from 157 dental students and 484 of their patients were included. Patients completed questionnaires including the Patient Communication Style Scale, the Patient Assessment Questionnaire, and the Dental Visit Satisfaction Scale, and items measuring the patient’s prior experience with his/her student dentist. Dental students completed questionnaires included the Toronto Compos ite Empathy Scale and the Attitudes Toward Patient Education Scale. Participants also provided demographic information, and the type of dental treatment received was recorded. Results: Patient satisfaction was associated with student communication skills ( P <.001) and dyadic congruence about patient participation in treatment - planning ( P <.001). Empathy was

Predictors of patient satisfaction with tertiary hospitals in Korea.

This study examined the general and system-related predictors of outpatient satisfaction with tertiary health care institutions in Korea. A cross-sectional descriptive study design was employed. The subjects were 1,194 outpatients recruited from 29 outpatient clinics of a university medical center in Korea. Measurements included 5 outpatient service domains (i.e., doctor service, nurse service, technician service, convenience, and physical environment of facility) and patient satisfaction. Of the five domains, nurse service was the domain with the highest mean score (M = 4.21) and convenience was the domain with the lowest mean score (M = 3.77). The most significant predictor of patient satisfaction was the constructs of convenience (β = 0.21). The results of this study suggest that the concept of patient satisfaction with health care institutions in modern hospitals reflects an integrative process that includes not only the concerned health care personnel but also improved convenience such as user-friendly reservation system and comfortable waiting areas.

Psoriasis disease severity affects patient satisfaction with treatment

Patients with psoriasis are often dissatisfied with available treatments, but contributing factors are not well defined. Examine relationships between psoriasis severity, patient characteristics, and treatment satisfaction. Patients with psoriasis were classified into mild and moderate-to-severe groups based on self-reported data. Demographics, comorbidities, symptoms, and multiple treatment satisfaction outcomes were compared between groups. Predictors of patient satisfaction with treatment were examined using linear regression models. The analyses included 773 patients (407 mild; 366 moderate-to-severe). The percentage of patients reporting satisfaction with treatment was low overall, ranging from 8.6% to 61.7% for the mild and 13.9% to 49.5% for the moderate-to-severe group. Satisfaction among biologics users was also low (≤53%; 50% of satisfaction rates &lt;40%). Regression results consistently showed greater dissatisfaction with current treatment among moderately to severely affected patients. Many psoriasis patients were dissatisfied with their treatment; moderate-to-severe patients expressed significantly less satisfaction than mild patients.

Hypochondriacal attitudes and beliefs, attitudes towards complementary and alternative medicine and modern health worries predict patient satisfaction.

SummaryObjectiveTo investigate how hypochondriacal attitudes and beliefs, attitudes towards complementary and alternative medicine (CAM) and modern health worries (MHWs) related to patient satisfaction with their general practitioner.DesignParticipants completed a five-part questionnaire anonymously which measured satisfaction with one’s doctor, hypochondriacal beliefs, attitudes to CAM, MHWs and personality.SettingEnglandParticipantsIncluded 215 adults from a variety of cultural backgrounds.Main outcome measureThe Illness Attitudes Scales measuring the attitudes, fears and beliefs associated with hypochondriasis; Worry about Illness; Concerns about Pain, Health Habits, Hypochondriacal beliefs; Thanatophobia, Disease phobia, Bodily preoccupations; Treatment experience and Effects of symptoms.ResultsCorrelations (around r = .10 to .25) and Regressions (R square from .06 to .09) showed demographic and personality variables only modestly related to patient satisfaction. Hypochondriasis, CAM and MHWs were associated with greater patient dissatisfaction as predicted with the former as the most powerful correlate.ConclusionThe study indicates the different needs of potential patients in a typical medical consultation. It is important to ascertain patients’ health beliefs and practices with regard to medical history, attitudes to CAM and MHWs to increase consultation satisfaction.

Percutaneous sclerotherapy for venous malformations in the extremities: clinical outcomes and predictors of patient satisfaction.

The purpose of this study is to retrospectively evaluate the clinical outcomes and to identify the predictors ofpatient satisfaction after percutaneous sclerotherapy for venous malformations (VMs) in the extremities. A totalof 48 patients with VMs in the extremities over 10 years of age underwent sclerotherapy to relieve symptoms, such as pain, swelling, functional limitations, and cosmetic problems. Self-assessment questionnaires were sentto rate the degree of symptom improvement and level of satisfaction. Clinical and imaging data from medicalrecords were analyzed to obtain information about VMs and sclerotherapy. The predictors for patientsatisfaction were determined by univariate and multivariate analysis of clinical variables. Forty patients (meanage, 28.2 years; range, 11-69 years) responded to the survey. Sixteen patients had VMs in the upper extremities, and 24 patients had VMs in the lower extremities. In 12 patients (30%), adjacent bone change was seen. After amean of 2.6 (range 1-10) sclerotherapy sessions, good response to pain, swelling, dysfunction, and cosmeticproblems was obtained in 83%, 74%, 79%, and 50% of patients, respectively. Thirty-two patients (80%) weresatisfied with their outcomes. On univariate analysis, absence of adjacent bone change, maximum diameter (<6.7 cm), and number of sclerotherapy sessions (<3) were significantly associated with patient satisfaction.Multivariate analysis revealed absence of adjacent bone change (odds ratio, 7.56; 95% confidence interval, 1.02-55.8) as an independent predictor for satisfaction. Thus, adjacent bone change significantly portended adissatisfied patient. In conclusion, percutaneous sclerotherapy was effective to relieve symptoms of VMs in theextremities, and most patients were satisfied with the outcomes. However, adjacent bone change was asignificant predictor of patient dissatisfaction.