Predictors Of Patient Satisfaction Research Articles

Oral health-related quality of life and patient-reported outcome measures after 10 years of supportive periodontal care

ObjectiveThe aim of this retrospective study was to evaluate the oral health-related quality of life (oHRQoL) and patient-reported outcome measures (PROMs) after 10 years of supportive periodontal care (SPC).Material and methodsPatients were re-examined 120±12 months after active periodontal therapy. Dental and periodontal status and oHRQoL by completing Oral Health Impact Profile-G49 (OHIP-G49) and PROMs by marking a visual analogue scale (VAS) for self-perceived esthetics (VASe), chewing function (VASc), and hygiene ability (VASh) were assessed. Patient- and tooth-related factors (age, insurance status, number of SPC, compliance, change of therapist, smoking, tooth loss, need for surgery or antibiotic intake, bleeding on probing (BOP), periodontal inflamed surface area) influencing oHRQoL and PROMs were evaluated.ResultsOne hundred eight periodontally compromised patients (59 female, mean age 65.4±10.7 years) lost 135 teeth during 10 years of SPC. At re-examination, 1.8% of all sites showed PPD ≥6mm. The mean OHIP-G49 sum score was 17.6±18.5, and VAS resulted in 76.0±22.5 (VASe), 86.3±16.3 (VASc), and 79.8±15.8 (VASh). Linear regression analyses identified a positive correlation with oHRQoL and/or PROMs for private insurance status (OHIP-G49, p=0.015, R2=0.204; VASc, p=0.005, R2=0.084; VASh, p=0.012, R2=0.222) and compliance to SPC (VASe, p=0.032; R2=0.204), as well as a negative correlation for active smoking (VASc, p=0.012, R2=0.084), increased BOP (VASh, p=0.029, R2=0.222) at the start of SPC, and number of lost molars (VASh, p=0.008, R2=0.222).ConclusionIt is realistic to obtain satisfactory oHRQoL and PROM values in most of the patients after 10 years of SPC. The identified factors may help to predict patient satisfaction in the long-term course of therapy.Clinical relevanceSystematic therapy of periodontally compromised patients provides values for oHRQoL and PROMs in a favorable range 10 years after therapy. This should encourage dentists to implement SPC in their daily routine.Clinical trial numberNCT03048045

Safety and Efficacy of Midface Augmentation Using Bio-Oss Bone Powder and Bio-Gide Collagen Membrane in Asians.

(1) Background: Asians tend to have a regressive midface. Midface augmentation is an effective treatment, and various materials have been used as fillers for this purpose. Bio-Oss bone powder has a strong positive effect on promoting new bone regeneration, and has been used in the dental field for over 30 years. However, it has not been used and reported as a filler in midface augmentation. (2) Objective: To evaluate the safety and efficacy of midface augmentation using Bio-Oss bone powder in treating midface retrusion and resulting nasolabial folds, and to develop a predictive model for patient satisfaction. (3) Methods: 85 patients underwent midface augmentation through an intraoral approach with Bio-Oss. Treatment efficacy was assessed by blinded investigators. The data on safety were collected from patient interviews at each follow-up visit. A questionnaire was used for investigating patient satisfaction. The influencing factors of satisfaction were analyzed by univariate and multivariate analysis. A nomogram to predict the risk of dissatisfaction was built based on significant factors with R software. Results: Compared to baseline, there was a significant improvement (p < 0.001) in Wrinkle Severity (4) Rating Scale scores at week 24, with a mean decrease of 0.52 ± 0.57. The aesthetic improvement rate evaluated by the Global Aesthetic Improvement Scale was 92.9%. Four mild treatment-related adverse events were noted. The majority of patients were satisfied overall. A nomogram with good prediction performance was plotted. (5) Conclusions: This new procedure yielded safe and satisfactory aesthetic results. A nomogram with good test performance and discriminative ability was established for predicting patient satisfaction.

Predicting Patient Satisfaction With Medications for Treating Opioid Use Disorder: Case Study Applying Natural Language Processing to Reviews of Methadone and Buprenorphine/Naloxone on Health-Related Social Media.

Medication-assisted treatment (MAT) is an effective method for treating opioid use disorder (OUD), which combines behavioral therapies with one of three Food and Drug Administration-approved medications: methadone, buprenorphine, and naloxone. While MAT has been shown to be effective initially, there is a need for more information from the patient perspective about the satisfaction with medications. Existing research focuses on patient satisfaction with the entirety of the treatment, making it difficult to determine the unique role of medication and overlooking the views of those who may lack access to treatment due to being uninsured or concerns over stigma. Studies focusing on patients' perspectives are also limited by the lack of scales that can efficiently collect self-reports across domains of concerns. A broad survey of patients' viewpoints can be obtained through social media and drug review forums, which are then assessed using automated methods to discover factors associated with medication satisfaction. Because the text is unstructured, it may contain a mix of formal and informal language. The primary aim of this study was to use natural language processing methods on text posted on health-related social media to detect patients' satisfaction with two well-studied OUD medications: methadone and buprenorphine/naloxone. We collected 4353 patient reviews of methadone and buprenorphine/naloxone from 2008 to 2021 posted on WebMD and Drugs.com. To build our predictive models for detecting patient satisfaction, we first employed different analyses to build four input feature sets using the vectorized text, topic models, duration of treatment, and biomedical concepts by applying MetaMap. We then developed six prediction models: logistic regression, Elastic Net, least absolute shrinkage and selection operator, random forest classifier, Ridge classifier, and extreme gradient boosting to predict patients' satisfaction. Lastly, we compared the prediction models' performance over different feature sets. Topics discovered included oral sensation, side effects, insurance, and doctor visits. Biomedical concepts included symptoms, drugs, and illnesses. The F-score of the predictive models across all methods ranged from 89.9% to 90.8%. The Ridge classifier model, a regression-based method, outperformed the other models. Assessment of patients' satisfaction with opioid dependency treatment medication can be predicted using automated text analysis. Adding biomedical concepts such as symptoms, drug name, and illness, along with the duration of treatment and topic models, had the most benefits for improving the prediction performance of the Elastic Net model compared to other models. Some of the factors associated with patient satisfaction overlap with domains covered in medication satisfaction scales (eg, side effects) and qualitative patient reports (eg, doctors' visits), while others (insurance) are overlooked, thereby underscoring the value added from processing text on online health forums to better understand patient adherence.

Preoperative Oswestry Disability Index Cannot Reliably Predict Patient Satisfaction After Single and Double Level Lumbar Transforaminal Interbody Fusion Surgery.

The role of patient-reported outcomes in preoperative assessment is not well studied. There is recent interest in studying whether Patient-reported outcomes scores can be used either independently, or in conjunction with clinical findings, in the assessment of patients for surgery. To investigate if improvement in clinically significant scores correlate with post-operative patient satisfaction in 1-2 level transforaminal lumbar interbody fusion (TLIF) surgery. We also aim to define a threshold Oswestry Disability Index (ODI) which correlate with achieving post-operative MCID and patient satisfaction. 1001 patients who underwent single or double level TLIF (Minimally invasive and Open) in our institution with at least 2years follow up were included in this study. We studied self-reported measures including patient satisfaction and ODI score. At 2-year follow-up, the overall mean ODI score improved from 49.7 ± 18.3 to 13.9 ± 15.2 (P < 0.001) with 74.6% of patients meeting the MCID. Patient satisfaction was achieved in 95.3% of all patients. In the MIS group, the preoperative cut-off was determined to be 37.2 at maximal Youden index associated with AUC of 0.72 (95% CI 0.65-0.86). In the open group, the preoperative cut-off was determined to be 37.2 at maximal Youden index associated with AUC of 0.70 (95% CI 0.62-0.77). Using the preoperative cut-offs found, there was no significant difference in patient satisfaction in both MIS and open groups. Overall, our patients undergoing TLIF had good 2-year ODI score improvement and patient satisfaction after surgery. While meeting the MCID for ODI score correlates with patients' satisfaction postoperatively, 75% of patients not meeting the MCID for ODI score remained satisfied with the surgery. We are unable to define a threshold pre-operative ODI which correlates with achieving post-operative MCID and patient satisfaction.

Ethnocaring Model in Predicting Patient Satisfaction: How Powerful Is It?

Introduction: Caring is the most important to get patient satisfaction. However, currently caring is only considered as empathy without regard to the patient's cultural background. This study aims to investigate patient satisfaction regarding nursing services in a multicultural area by using the ethnocaring model as a predictor.&#x0D; Methods: A cross-sectional study was conducted on patients in a nursing service in Subang District (n = 135 using consecutive sampling). Maintaining beliefs (MB), culture care preservation (CP), knowing (KN), being with (BW), negotiating (NE), doing for (DF), enabling (EN), and restructuring (RE) are used as independent variables, and patient satisfaction (PS) as the dependent variable. The instrument used was developed in accordance with ethnocaring model and PSQ-18. Multiple linear regression was used to analyze the ability of the ethnocaring model as a predictor of patient satisfaction.&#x0D; Results: The results showed that patient satisfaction had a mean score of 14.42 (score interval = 0-18). The following are the p-values for each variable: MB (0.021); CP (0.032); KN (0.015); BW (0.038); NE (0.026); DF (0.033); EN (0.043); and RE (0.034); they can all significantly predict PS with R-Square = 0.815.&#x0D; Conclusion: The strength of the ethnocaring model in predicting patient satisfaction was 81.5%. The construct of ethnocaring model could help nurses in understanding patient satisfaction.

Patient-centered care and patient satisfaction: Validating the patient-professional interaction questionnaire in China.

To introduce patient-centered approach in China and to relate it with Chinese patient satisfaction via validating the Chinese version of Patient-Professional Interaction Questionnaire (PPIQ-C). This cross-sectional survey was conducted through face-to-face interviews from June to September in 2019. Participants rated their patient-centered care experience via the 16-item translated PPIQ, their experience of the received medical service, and their overall satisfaction. Kunshan Huaqiao People's Hospital in Jiangsu, China. A total of 230 participants (87 males and 143 females; 108 outpatients and 122 inpatients). PPIQ-C exhibited acceptable psychometric properties. Data revealed a single factor model of the 16 PPIQ-C items [ = 12.394, p = 0.823, CFI = 1.000, TLI = 1.019, RMSEA = 0.000, SRMR = 0.032] had a superior model fit over the original first-order with four correlated factors and the second-order structures. The overall reliability was excellent (McDonald's ω = 0.975). In terms of patient satisfaction, process, treatment quality, and communication significantly predicted patient satisfaction, while environment, staff attitude, and medical ethics did not [R 2 = 0.427, F (6) = 24.887, p < 0.001]. Most importantly, the total score of PPIQ-C predicted patient satisfaction above and beyond the above-mentioned medical service perspectives (B = 0.595, SE = 0.207, p = 0.004). Finally, the constructive effect of PCC on patient satisfaction was stronger for departments of Pediatrics than Surgery. The Chinese version of the PPIQ scale (PPIQ-C) exhibited acceptable psychometric properties. Yet the distinction among the four factors was not supported, suggesting potential difference(s) across cultures. Patient-centered care (PCC), reflected by the overall PPIQ-C score, predicted overall patient satisfaction above and beyond other medical service perspectives. Adopting PCC approach in appropriate situations will probably advance the development of performance evaluation systems in China, thus improving the overall health care and patient satisfaction.

Unmet health care needs: factors predicting satisfaction with health care services among community-dwelling Canadians living with neurological conditions

BackgroundNeurological conditions (NCs) can lead to long-term challenges including functional impairments and limitations to activities of daily living. People with neurological conditions often report unmet health care needs and experience barriers to care. This study aimed to (1) explore the factors predicting patient satisfaction with general health care, hospital, and physician services among Canadians with NCs, (2) examine the association between unmet health care needs and satisfaction with health care services among neurological patients in Canada, and (3) contrast patient satisfaction between physician care and hospital care among Canadians with NCs.MethodsWe conducted a secondary analysis on a subsample of the 2010 Canadian Community Health Survey - Annual Component data (N = 6335) of respondents with neurological conditions, who received general health care services, hospital services, and physician services within twelve months. Multivariate logistic regression fitted the models and odds ratios and 95% confidence intervals were reported using STATA version 14.ResultsExcellent quality care predicts higher odds of patient satisfaction with general health care services (OR, 95%CI–237.6, 70.4–801.5), hospital services (OR, 95%CI–166.9, 67.9–410.6), and physician services (OR, 95%CI–176.5, 63.89–487.3). In contrast, self-perceived unmet health care needs negatively predict patient satisfaction across all health care services: general health care services (OR, 95%CI–0.59, 0.37–0.93), hospital services (OR, 95%CI–0.41, 0.21–0.77), and physician services (OR, 95%CI–0.29, 0.13–0.69). Other negative predictors of patient satisfaction include some post-secondary education (OR, 95%CI–0.36, 0.18–0.72) for general health services and (OR, 95%CI–0.26, 0.09–0.80) for physician services. Those with secondary (OR, 95% CI–0.32, 0.13–0.76) and post-secondary graduation (OR, 95%CI– 0.28, 0.11–0.67) negatively predicted patient satisfaction among users of physician services while being an emergency room patient most recently (OR, 95%CI– 0.39, 0.20–0.77) was also negatively associated with patients satisfaction among hospital services users.ConclusionThis study found self-perceived unmet health care needs as a significant negative predictor of neurological patients’ satisfaction across health care services and emphasizes the importance of ensuring coordinated efforts to provide appropriate and accessible care of the highest quality for Canadians with neurological conditions.

Psychometric Evaluation of the Patient-Nurse Trust Scale among Sexual and Gender Minorities

ABSTRACT Purpose: To assess thepsychometric properties of a newly developed instrument patient-nurse trustscale (PNTS) among sexual and gender minorities (SGM). Design: Secondary dataanalysis. Methods: Reliabilityand construct validity of the PNTS were assessed. Findings:The PNTS showed high internal consistency (Cronbach’s alpha= 0.96). It also demonstrateda good fit to the data and confirmed construct validity. Conclusions:PNTS is a reliable and valid instrument to measure trust in the nurse-patientrelationship with SGM youth. Clinical Evidence:PNTS is a valid and reliable tool that quantifies patient-nurse trustrelationship and can predict patient satisfaction, health behaviors and healthoutcomes.

The Effect of Acceptance of Cosmetic Surgery, Body Appreciation, and Nasal Obstruction on Patient Satisfaction After Rhinoplasty.

Background: It is difficult to predict functional and aesthetic results and provide patient satisfaction after rhinoplasty. Objective: To investigate the effect of nasal obstruction, body appreciation, and acceptance of cosmetic surgery (ACS) in predicting patient satisfaction postrhinoplasty. Methods: We prospectively included 97 consecutive participants who underwent rhinoplasty. We recorded age, gender, marital status, education, and body mass index (BMI), and nasal obstruction symptom evaluation (NOSE) scale, body appreciation scale-2 (BAS-2), acceptance of cosmetic surgery scale (ACSS), and rhinoplasty outcome evaluation (ROE) scale were determined preoperatively and at the 3-month postoperative follow-up. Results: The preoperative and postoperative NOSE, BAS-2, ACSS, and ROE scores differed significantly. The mean ROE score improved from 36.8 preoperatively to 82.1 postoperatively. The ROEpostop score was not correlated significantly with age, BMI, ACSSpreop, BAS-2postop, or ACCSpostop. The BAS-2preop scores were correlated significantly with ACCSpreop and ACSSpostop scores. The NOSEpreop and BAS-2preop scores were significant predictors of the ROEpostop scores in the regression analysis. Conclusion: Preoperative nasal obstruction and body appreciation, but not ACS, are factors that might affect patient satisfaction after rhinoplasty.

The Effect of Service Quality, Facilities and Image / Brand image on The Satisfaction of Inpatients of Royal Prima Hospital Medan

The hospital seeks to build a marketing strategy that raises the image in the community to increase satisfaction through improving the quality of services, facilities, image, price, and other factors. If customer expectations are greater than the quality of service received, consumers are not satisfied. Similarly, if expectations are equal to or less than the quality of service received, then the patient is not satisfied. The purpose of this study is to see the effect of service quality, facilities, and image/brand image on the satisfaction of inpatients of Royal Prima Hospital Medan. The research approach used in this study is a quantitative research method. The population of the entire inpatient. data from the last three months obtained patient data of 15,691 patients with an average per month of 6,653 patients. The minimum number of samples using SEM, then the number of samples taken in this study was determined to be 100 people. The sample determination technique used in this study is based on the nonprobability sampling method. The validity test compares the r-count value with the r-table for the degree of freedom = n- k, in alpha 0.05. Reliability test with Cronbach Alpha statistical test &gt; 0.70. Data analysis using multiple regression analysis models, coefficient of determination (R2), F test (simultaneous testing), and t-test (partial testing). The results of the Service Quality variable, obtained t count (6.026) &gt; t-table (1.66) and probability value (0.006) &lt; 0.05, Health Facility Variable, obtained t-count (5,442) &gt; t-table (1.66) and probability value (0.001) &lt; 0.05, variable Image / Brand image, obtained t-count (5,109) &gt; t-table (1.66) and probability value (0.004) &lt; 0.05, thus partially variables of service quality, facilities, and image have an influence on Patient Satisfaction. The calculated F value is 60.554 with a probability of 0.004, since the probability is smaller than 0.05, then the regression model can be used to predict Patient Satisfaction. This can also be seen from the F-count (60,554) &gt; F-table (2.70), then H4 is accepted which means that the variables of Service Quality, Health Facilities, and Image / Brand image affect the Satisfaction of Inpatients of Royal Prima Hospital. In conclusion, based on partial analysis of t-tests and simultaneous F tests, variables of service quality, facilities, and image have a significant influence on the level of satisfaction of inpatients at Royal Prima Hospital Medan

Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany

BackgroundPatient numbers in emergency departments are on the rise. The DEMAND intervention aims to improve the efficacy of emergency services by computer-assisted structured initial assessment assigning patients to emergency departments or primary care practices. The aims of our study were to evaluate patient satisfaction with this intervention and to analyse if reduced patient satisfaction is predicted by sociodemographic data, health status or health literacy.MethodsWe conducted a cross-sectional patient survey in emergency departments and co-located primary care practices. Each intervention site was planned to participate for two observation periods, each with a duration of one full week. Study participants were recruited by the local staff. The patients filled out a written questionnaire during their waiting time. Patient satisfaction was assessed by agreement to four statements on a four point Likert scale. Predictors of patient satisfaction were identified by multilevel, multivariable logistic regression models adjusted for random effects at the intervention site level.ResultsThe sample included 677 patients from 10 intervention sites. The patients had a mean age of 38.9 years and 59.0% were women. Between 67.5% and 55.0% were fully satisfied with aspects of the intervention. The most criticised aspect was that the staff showed too little interest in the patients’ personal situation. Full satisfaction (“clearly yes” to all items) was reported by 44.2%. Reduced patient satisfaction (at least one item rated as “rather yes”, “rather no”, “clearly no”) was predicted by lower age (odds ratio 0.79 for ten years difference, 95% confidence interval 0.67/0.95, p = 0.009), presenting with infections (3.08,1.18/8.05,p = 0.022) or injuries (3.46,1.01/11.82,p = 0.048), a higher natural logarithm of the symptom duration (1.23,1.07/1.30,p = 0.003) and a lower health literacy (0.71 for four points difference, 0.53/0.94,p = 0.019).ConclusionsThe patients were for the most part satisfied with the intervention. Assessment procedures should be evaluated a) regarding if all relevant patient-related aspects are included; and whether patient information can be improved b) for patients with strong opinions about cause, consequences and treatment options for their health problem; and c) for patients who have problems in the handling of information relevant to health and healthcare.Trial registrationGerman Clinical Trials Register (https://www.drks.de/drks_web/setLocale_EN.do) no. DRKS00017014.

Do Patient Expectations Represent a More Important Clinical Difference? A Study of Surgical Outcomes in the Cervical Spine

Objective: This study aims to compare the impact of achieving an MCID or meeting preoperative expectations on patient satisfaction following cervical spine procedures.Methods: A surgical database was retrospectively reviewed for cervical spine surgery patients from 2016 to 2020. Inclusion criteria were primary or revision, single- or multilevel cervical disc arthroplasty or anterior cervical discectomy and fusions (ACDF). Visual analogue scale (VAS) neck and arm pain was assessed preoperatively and postoperatively (6-week, 12-weeks, 6-months, 1-year). Preoperative patient expectation and postoperative satisfaction were recorded. MCID achievement was determined using previously established values. Expectations met and MCID achievement were compared as possible predictors of satisfaction.Results: One hundred and six cervical spine patients were included. Both meeting expectations and achieving MCID were significant predictors of satisfaction for arm pain at 6-weeks and 12-weeks (all p≤0.007). Achieving MCID significantly predicted satisfaction for neck pain at all timepoints (all p≤0.007) and meeting expectations predicted satisfaction for neck pain at 6-weeks, 12-weeks, and 1-year (all p≤0.003). Comparison of coefficients revealed no significant difference in effect size between meeting expectations and achievement of MCID as predictors of patient satisfaction (all p&gt;0.050).Conclusion: MCID achievement and meeting expectations were significant predictors of satisfaction for neck pain and short-term arm pain. Both measures may be similarly useful for interpretation of patient outcomes and the optimal choice of metric may depend on practice-specific factors.

Predictors for patient satisfaction of a single intra-articular injection of crosslinked hyaluronic acid combined with mannitol (HANOX-M-XL) in patients with temporomandibular joint osteoarthritis. Results of a prospective open-label pilot study (HAPPYMINI-ARTEMIS trial)

BackgroundChronic pain and functional impairment interfere with the quality of life of subjects suffering from temporomandibular joint (TMJ) disorders. Intra-articular (IA) hyaluronic acid (HA) injections have been shown to alleviate pain and improve mandibular mobility in patients with TMJ osteoarthritis (OA).ObjectivesThe primary aim of the study was to identify the prognostic factors of patient satisfaction for a single IA injection of a mannitol-modified crosslinked HA (HANOX-M-XL) in patients with TMJ-OA. The second goal was to obtain clinical data on effectiveness, safety and mandibular mobility throughout a six-month follow-up period.Patients and methodsThis was an observational single-arm prospective trial with a six-month follow-up. Inclusion criteria: patients with TMJ-OA which is not relieved by analgesics and/or non-steroidal-anti-inflammatory drugs and/or orthotics, with radiological evidence of TMJ-OA. All patients received a single IA injection of 1 ml HANOX-M-XL in the target TMJ. The primary endpoint was patient satisfaction on day 180. The main secondary outcome measures were pain variation on a 11-point numeric scale (0–11) between the date of injection and month six, the variation over time of the Maximum Inter-Incisal Opening Distance (MIIOD) and the patient’s assessment of effectiveness. Predictive factors of success or failure were also studied. All adverse events were recorded.Results36 subjects (mean age 55.3 years, mean disease duration 98 months), covering a total of 52 injected TMJs, were included. Between baseline and endpoint, the average pain while chewing decreased dramatically from 6.9 ± 1.2 to 2.9 ± 1.3 (p < 0.0001) and the MIIOD increased from 29 ± 7 to 35 ± 5 mm (p < 0.01). On day 180, all patients were satisfied with the treatment, with 34 patients (94%) rating it as highly effective or effective. Tolerability was good in all but one patient. In the multivariate analysis, patient satisfaction on day 180 was highly correlated with the pain while chewing score, pain on palpation score and the decrease of pain over time (all p < 0.0001) but not with MIIOD, gender, age, bruxism, articular noise and symptom duration. Previous viscosupplementation was also related to higher satisfaction (p = 0.01).ConclusionDespite a long history of pain, most of the patients with symptomatic TMJ-OA benefited from a single injection of HANOX-M-XL, as shown by the sustained (up to 6 months) decrease in pain and improvement in mandibular mobility, with no safety concerns.

The Relationship Between Medical Ethics and Patient Satisfaction an Effective Communication-Cultural Model

Background: Physician-patient interactions are a complex process and inappropriate communication can become a problem. Due to the importance of this issue, this study was conducted to identify the relationship between physician ethics and patient satisfaction and provide an effective communication-cultural model. Methods: The research method used in this study was descriptive - correlation and using the calculated correlation coefficients, a structural model was developed. The statistical population of the present study was all patients admitted to medical centers affiliated to Kermanshah University of Medical Sciences and Health Services in 1398 and the sample size was selected based on Cochran's formula equivalent to 171 people. Necessary information was collected through two questionnaires: standard questionnaire of communication with patient Vakili et al. In order to assess interpersonal communication skills and a researcher-made questionnaire of observance of physician's medical ethics and patient satisfaction taken from the patient rights charter approved by the Ministry of Health. Results: The findings indicate that the patriarchal model has been able to predict patient satisfaction. The results also showed that there is a significant relationship between the informative model and patient satisfaction. Also, based on the results, it was found that the interpretive model, bilateral participation model and instrumental model could not predict patient satisfaction. The results also show that the contract model has been able to predict patient satisfaction with an effect factor of 0.33 and a significant level of P &lt; 0.01. Finally, there is a significant relationship between the contract model and patient satisfaction. Conclusions: Based on the analysis of the obtained data, the most type of model approved by patients was the paternal model, in which there is much less interaction between the patient and the physician than other communication models.

Outcomes of hemiarthroplasty and concentric glenoid reaming: a systematic review and meta-analysis of the ream and run technique

BackgroundAnatomic total shoulder arthroplasty is the gold standard surgical treatment for glenohumeral arthritis. Concerns for this procedure are glenoid bone loss and glenoid component wear, particularly in young and active individuals. The ream and run procedure using hemiarthroplasty and concentric glenoid reaming without placing a glenoid component has been proposed as an alternative. Only a few studies have assessed its outcomes and complications. This systematic review and meta-analysis aims to better quantify the ream and run’s outcomes and revision rates. MethodsA systematic review on the outcomes of the ream and run procedure was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Descriptive statistics and pooled values were synthesized from the included studies to determine patient demographics, range of motion, patient-reported outcome measures, and revision rates. Values were compared with the minimum clinically important difference. ResultsFrom 82 initial search results, 5 studies (3 level III and 2 level IV) met our selection criteria. These included 470 shoulders from 468 patients with an average age of 56.7 years (range: 22-81 years) and average follow-up of 4.7 years (range: 0.7 – 16.0 years). Improvement in the Simple Shoulder Test (2 studies), Visual Analog Scale (2 studies), and American Shoulder and Elbow Surgeons score (4 studies) were 5.4, 4.5, and 43, respectively. This was greater than the minimum clinically important difference for each of these measures (2.4, 1.4, and 20.9, respectively). The mean postoperative forward elevation achieved was 143.5°, and external rotation was 44.0°. At the mean follow-up of 4.7 years, the revision rate was 7.6%, including 4.0% that underwent conversion to total shoulder arthroplasty. DiscussionThe ream and run technique to surgically treat glenohumeral arthritis leads to improvement of functional outcomes above the thresholds that predict patient satisfaction. These midterm results are similar to those achieved by anatomic total shoulder arthroplasty over the same follow-up period, but not enough long-term data exist to compare long-term survivorship. Outcomes across the same time frame are also very similar to those of traditional hemiarthroplasty. The ream and run remains an option for functional improvement and pain control in the short-term to midterm follow-up period.

Predictors of patient satisfaction after primary hamstring anterior cruciate ligament reconstruction

BackgroundPredictors of patient satisfaction (PS) after anterior cruciate ligament (ACL) reconstruction are not well known. This study investigated predictors of PS and whether PS was associated with pre-injury level of sport participation, patient reported knee function and quality of life after ACL reconstruction. MethodsPatients who underwent primary hamstring ACL reconstruction between January 2015 and December 2017 were retrospectively evaluated. An online survey was used to evaluate PS (yes = satisfied, no = unsatisfied), duration of supervised postoperative rehabilitation, timing of return to pre-injury level of sport, pre-injury level of sport participation, patient reported knee function and quality of life. Preoperative, operative and postoperative variables were collected from the medical records. ResultsA total of 183 patients completed the survey at a median of 3.6 (1.5) years after ACL surgery. At final follow-up, 82% of patients were satisfied with the outcome. Preoperative (e.g. age) and operative (e.g. meniscal tear) variables were not predictors of PS (p > 0.05). Duration of supervised postoperative rehabilitation, timing of return to pre-injury level of sport and postoperative ACL injury were predictors of PS (p = 0.018, p = 0.016 and p < 0.001, respectively). Pre-injury level of sport participation was significantly higher in satisfied compared to unsatisfied patients: 44.7% (n = 67) versus 18.2% (n = 6) (p = 0.005). In addition, satisfied patients reported significantly higher patient reported knee function and quality of life compared to unsatisfied patients (p < 0.001). ConclusionThis study provided data on predictors of PS after primary ACL reconstruction. Furthermore, PS was associated with pre-injury level of sport participation, patient reported knee function and quality of life.

Patient Satisfaction in the Era of COVID-19: Virtual Visit versus In-person Visit Satisfaction.

Teleophthalmology became widely used during the coronavirus 2019 pandemic; however, the quality of this care remains to be understood. This study aimed to compare patient satisfaction levels from virtual and in-person visits based on post-visit surveys, as well as investigate demographic characteristics that may predict patient satisfaction with virtual visits. Virtual (n = 2943) and in-person (n = 56,175) visits from March 19, 2020, to July 31, 2020, were identified using the electronic health record system. For in-person visits, a random subset of 3000 visits was acquired using a random number generator. Of these, 2266 virtual and 2590 in-person visits met the inclusion criteria. Patients who completed the Telemedicine for Medical Practice Survey and Medical Practice Survey were analyzed in this report. Nonparametric Mann-Whitney test was used to compare scores between groups. Two hundred eleven virtual patients (9.31%; 82 phone, 115 video, 14 hybrid) and 307 in-person patients (11.85%) completed the Telemedicine for Medical Practice Survey and Medical Practice Survey, respectively. Satisfaction scores were similar and high in both groups-virtual visit satisfaction scores averaged 4.82, whereas in-person visit satisfaction averaged 4.85 (P = .80, θ = 0.501 [0.493 to 0.509]). Only one question yielded significantly different satisfaction scores, and no demographic variables were significant predictors of satisfaction scores. Patient satisfaction is comparable between virtual and in-person visits, validating the continued usage of telemedicine for eye care visits.

Mouth breathing – A predictor for patient satisfaction after nasal septoplasty?

Background: No reliable marker exists to predict septoplasty outcome. Most patients suffering from nasal airway obstruction (NAO) caused by a deviation of the nasal septum report a bothersome mouth breathing and dryness. In this study our aim was to assess, whether mouth breathing could be objectified in these patients and whether mouth breathing could predict septoplasty outcome. Methods: A monocentric, prospective case-control study of 21 patients was conducted. The proportion of mouth breathing was measured in a blinded manner. As a measurement of patient satisfaction, subjective symptoms pre- and postoperatively, were assessed by using VAS, NOSE and SNOT-20 score. In the patient group an additional acoustic rhinometry and a clinical examination of the nose were performed. Results: With a mean of 25% (SD = 20%) the proportion of mouth breathing in patients with NAO did not differ significantly from the proportion in controls without NAO, with a mean of 27% (SD = 23%). Analysis of subjective scores revealed a significant reduction of subjective symptoms after septoplasty. A higher preoperative proportion of mouth breathing correlated with more remaining postoperative NAO. Conclusions: The percentage of mouth breathing is no different in patients with symptomatic septal deviation than in control patients. Mouth breathing in patients with NAO, evaluated for septoplasty, could be a negative predictive factor for patient satisfaction after nasal septoplasty. Mouth breathing in these patients should be observed carefully because more preoperative mouth breathing should make one more hesitant to consider septoplasty.

Assessment of the satisfaction with public health insurance programs by patients with chronic diseases in China: a structural equation modeling approach

BackgroundChina has successfully sustained its universal health insurance coverage over the past decade. Although patient satisfaction has been recognized as an important indicator to measure the performance of insurance programs in China, there is a lack of evidence on how patients with chronic diseases are satisfied with China’s public health insurance programs and whether their satisfaction differs by type of insurance. We aimed to fill the evidence gap.MethodsWe established a hypothetical model that comprised patients’ awareness of insurance policies, the fulfillment of patients’ expectations of insurance benefits, patients’ perceived value of health insurance coverage, patients’ satisfaction with health insurance programs, patients’ complaints, and trust in health insurance programs. We performed a confirmatory factor analysis by using a structural equation modeling (SEM) approach to examine the hypothesized model. A model-testing survey in 10 tertiary hospitals was conducted between June and October 2018, with a valid sample of 922 insured patients with chronic diseases.ResultsThe SEM model, with good fit indices, showed that patients’ awareness of health insurance policies, insurance program’s fulfillment of expectations, and patients’ perceived value of insurance coverage, positively predicted patient satisfaction (P < 0.01). The fulfillment of patients’ expectations of insurance benefits was the major predictor of satisfaction with health insurance (coefficient = 0.593, P < 0.001), while the patients’ perceived value of insurance coverage had the largest impact on their trust in health insurance (coefficient = 0.409, P < 0.01). Compared to patients with Urban-Rural Resident Basic Medical Insurance, Urban Employee Basic Medical Insurance enrollees had a higher degree of satisfaction with insurance on average (P < 0.01). Despite differences in the degree of satisfaction, the main findings from the SEM were also proved by the multi-group analysis.ConclusionsOur findings highlight the importance of incorporating patients’ perceived value as part of the ongoing efforts to increase satisfaction with health insurance by patients, especially those who have chronic diseases. Policymakers are also suggested to formulate evidence-informed reimbursement policies that meet patients’ expectations.

Predicting Patients' Satisfaction With Doctors in Online Medical Communities

Online medical communities have revolutionized the way patients obtain medical-related information and services. Investigating what factors might influence patients’ satisfaction with doctors and predicting their satisfaction can help patients narrow down their choices and increase their loyalty towards online medical communities. Considering the imbalanced feature of dataset collected from Good Doctor, we integrated XGBoost and SMOTE algorithm to examine what factors and these factors can be used to predict patient satisfaction. SMOTE algorithm addresses the imbalanced issue by oversampling imbalanced classification datasets. And XGBoost algorithm is an ensemble of decision trees algorithm where new trees fix errors of existing trees. The experimental results demonstrate that SMOTE and XGBoost algorithm can achieve better performance. We further analyzed the role of features played in satisfaction prediction from two levels: individual feature level and feature combination level.