Society Satisfaction Research Articles

Job satisfaction and happiness keys in the prosocial behavior of citizens in Europe

BackgroundSatisfaction and happiness are two widely studied topics in current literature. Human beings need to find happiness. However, for many authors, satisfaction is a prerequisite for happiness. Satisfaction, in turn, can be approached from different perspectives, such as job satisfaction, health satisfaction, and social life satisfaction. This research analyses the relationship between these variables and their influence on proactive social behaviour.MethodsThe present study utilised the European Social Survey, an academic survey conducted across Europe in its round 10, carried out between 2022 and 2023, with a database of 25,311 valid responses. Structural equation modelling analysis conduct using PLS-SEM with the Smart PLS software.ResultsThe results demonstrate a direct and significant relationship between overall satisfaction and happiness and between happiness and prosocial behaviour. Similarly, a solid indirect relationship exists between satisfaction and prosocial behaviour in society. Furthermore, job satisfaction is among the variables influencing overall satisfaction and happiness. However, it is not the most important, with satisfaction with social life being the most influential on satisfaction.Conclusions and implicationsHappiness is one of the main variables that influence people’s lives. As we have observed, this happiness has a direct and solid relationship with the individual’s level of satisfaction, with job satisfaction and satisfaction with social life being the most influential in this relationship between satisfaction and happiness. Therefore, these conclusions must be understood by both workers and employers and public administrations. Additionally, the relationship between happiness and prosocial behaviour is an interesting topic that the governments of countries and regions in Europe should consider.

Predictors of patient satisfaction in the surgical treatment of cervical spondylotic myelopathy.

Patients with cervical spondylotic myelopathy (CSM) experience progressive neurological impairment. Surgical intervention is often pursued to halt neurological symptom progression and allow for recovery of function. In this paper, the authors explore predictors of patient satisfaction following surgical intervention for CSM. This is a retrospective review of prospectively collected data from the multicenter Quality Outcomes Database. Patients who underwent surgical intervention for CSM with a minimum follow-up of 2 years were included. Patient-reported satisfaction was defined as a North American Spine Society (NASS) satisfaction score of 1 or 2. Patient demographics, surgical parameters, and outcomes were assessed as related to patient satisfaction. Patient quality of life scores were measured at baseline and 24-month time points. Univariate regression analyses were performed using the chi-square test or Student t-test to assess patient satisfaction measures. Multivariate logistic regression analysis was conducted to assess for factors predictive of postoperative satisfaction at 24 months. A total of 1140 patients at 14 institutions with CSM who underwent surgical intervention were included, and 944 completed a patient satisfaction survey at 24 months postoperatively. The baseline modified Japanese Orthopaedic Association (mJOA) score was 12.0 ± 2.8. A total of 793 (84.0%) patients reported satisfaction (NASS score 1 or 2) after 2 years. Male and female patients reported similar satisfaction rates (female sex: 47.0% not satisfied vs 48.5% satisfied, p = 0.73). Black race was associated with less satisfaction (26.5% not satisfied vs 13.2% satisfied, p < 0.01). Baseline psychiatric comorbidities, obesity, and length of stay did not correlate with 24-month satisfaction. Crossing the cervicothoracic junction did not affect satisfactory scores (p = 0.19), and minimally invasive approaches were not associated with increased patient satisfaction (p = 0.14). Lower baseline numeric rating scale neck pain scores (5.03 vs 5.61, p = 0.04) and higher baseline mJOA scores (12.28 vs 11.66, p = 0.01) were associated with higher satisfaction rates. Surgical treatment of CSM results in a high rate of patient satisfaction (84.0%) at the 2-year follow-up. Patients with milder myelopathy report higher satisfaction rates, suggesting that intervention earlier in the disease process may result in greater long-term satisfaction.

Is Upper Extremity or Lower Extremity Function More Important for Patient Satisfaction? An Analysis of 24-Month Outcomes from the QOD Cervical Spondylotic Myelopathy Cohort.

Retrospective analysis of a prospective, multicenter registry. To assess whether upper or lower limb mJOA improvement more strongly associates with patient satisfaction after surgery for cervical spondylotic myelopathy (CSM). The modified Japanese Orthopaedic Association (mJOA) is commonly used to assess functional status in patients with CSM. Patients present with upper and/or lower extremity dysfunction, and it is unclear whether improvement in one and/or both symptoms drives postoperative patient satisfaction. This study utilizes the prospective Quality Outcomes Database (QOD) CSM data set. Clinical outcomes included mJOA and North American Spine Society (NASS) satisfaction. The upper limb mJOA score was defined as upper motor plus sensory mJOA, and the lower limb mJOA as lower motor plus sensory mJOA. Ordered logistic regression was used to determine whether upper or lower limb mJOA was more closely associated with NASS satisfaction, adjusting for other covariates. Overall, 1141 patients were enrolled in the QOD CSM cohort. In all, 780 had both preoperative and 24-month mJOA scores, met inclusion criteria, and were included for analysis. The baseline mJOA was 12.1±2.7, and postoperatively, 85.6% would undergo surgery again (NASS 1 or 2, satisfied). Patients exhibited mean improvement in both upper (baseline:3.9±1.4 vs. 24 mo:5.0±1.1, P<0.001) and lower limb mJOA (baseline:3.9±1.4 vs. 24 mon:4.5±1.5, P<0.001); however, the 24-month change in the upper limb mJOA was greater (upper:1.1±1.6 vs. lower:0.6±1.6, P<0.001). Across 24-month NASS satisfaction, the baseline upper and lower limb mJOA scores were similar (pupper=0.28, plower=0.092). However, as satisfaction decreased, the 24-month change in upper and lower limb mJOA decreased as well (pupper<0.001, plower<0.001). Patients with NASS scores of 4 (lowest satisfaction) did not demonstrate significant differences from baseline in upper or lower limb mJOA (P>0.05). In ordered logistic regression, NASS satisfaction was independently associated with upper limb mJOA improvement (OR=0.81; 95% CI: 0.68-0.97; P=0.019) but not lower limb mJOA improvement (OR=0.84; 95% CI: 0.70-1.0; P=0.054). As the magnitude of upper and lower mJOA improvement decreased postoperatively, so too did patient satisfaction with surgical intervention. Upper limb mJOA improvement was a significant independent predictor of patient satisfaction, whereas lower limb mJOA improvement was not. These findings may aid preoperative counseling, stratified by patients' upper and lower extremity treatment expectations. Level-III.

471 Using the QOD to Identify Minimum Clinically Important Differences for Patients With Cervical Spondylotic Myelopathy

INTRODUCTION: Minimum clinically important differences (MCID) for quality-adjusted life years (QALYs) and arm pain patient-reported outcome metrics (PROMs) in cervical spondylotic myelopathy (CSM) have yet to be determined, while data for myelopathy severity, impairment, and neck pain remain limited by small series and low rates of follow-up. METHODS: The CSM database of the QOD Study Group was utilized for this analysis. Patients were prospectively enrolled and followed for 24 months, with a follow-up rate of 85.2%. The MCIDs were computed for five standardized instruments: Neck Disability Index (NDI), five-dimension Euro-QoL (EQ-5D) in QALYs, neck and arm pain numeric rating scale (NRS), and modified Japanese Orthopedic Association score (mJOA) at both 3 and 24-month follow-up. Seven previously validated measures of MCID were compared using the area-under-the-curve (AUC). The North American Spine Society (NASS) satisfaction scale was the anchor, with scores of 1-2 meeting criteria for satisfaction. RESULTS: A total of 1,141 patients underwent surgery for CSM. Improvement of =30% from baseline was the optimal MCID across time points for NDI and neck/arm NRS. At 24 months, 30% improvement for these three instruments resulted in AUCs of 0.73, 0.71, and 0.67, respectively. Numeric cut-offs (0.065 at 3 months and 0.149 at 24 months) were the superior MCIDs for EQ-5D-derived QALYs. For mJOA, a severity-adjusted MCID outperformed the other methods, yielding an AUC of 0.67 at 24 months. CONCLUSIONS: We used the QOD dataset to define previously unknown MCIDs for several outcome measures. A =30% improvement from baseline was a consistent, high-performing MCID in NDI and arm/neck NRS. However, an absolute numeric cut-off (0.149) was the superior MCID for EQ-5D QALYs. mJOA exhibited the lowest predictive capacity for patient satisfaction.

How does society satisfaction affect the capital structure of firms? A two-part fractional regression approach

&lt;abstract&gt; &lt;p&gt;This paper examined the influence of society satisfaction on the capital structure decisions of small and medium–sized enterprises (SMEs). Applying data from an online questionnaire, we captured the well-being and perceptions that individuals hold about their own quality of life through a latent variable measuring satisfaction with life. In addition, the study used a sample of SMEs from Portugal for the pandemic year of 2020. Using fractional regression models, our findings revealed a statistically significant relationship between society satisfaction and SMEs' leverage. Specifically, we showed that higher levels of satisfaction decrease debt levels among SMEs. However, further investigation, employing a two-part fractional regression model, showed that the overall negative effect is, in fact, only explained by the increasing propensity for firms to remain debt-free in the presence of greater levels of society satisfaction. Consequently, while society satisfaction appears to influence the decision to engage in debt financing, this does not significantly impact the amount of debt taken on by SMEs. In summary, this paper highlights the importance of society satisfaction to SME capital structure decision-making and contributes to a deeper understanding of the mechanisms driving SME financing decisions amidst socio-economic dynamics.&lt;/p&gt; &lt;/abstract&gt;

НАЦИОНАЛЬНАЯ ИНФРАСТРУКТУРА КАК ЭЛЕМЕНТ УСТОЙЧИВОГО РАЗВИТИЯ РОССИЙСКОЙ ФЕДЕРАЦИИ

The article studies the concept of “infrastructure” as a factor in the sustainable development of any country, and typologizes infrastructure by sectors and areas of destination. An assessment is made of the problems of infrastructure development, which are defined as emerging issues related to attracting investments, as well as the implementation of infrastructure projects, their consideration, examination and execution, proposed by private individuals. Evidence of deviations from the standards of public administration is provided, which affects the results of infrastructure development and, accordingly, the satisfaction of society as consumers of the results of public administration.

ЕКОНОМІЧНА КОМПЕТЕНТНІСТЬ У РОЗВИТКУ ПРОФЕСІЙНОЇ МАЙСТЕРНОСТІ МАЙБУТНЬОГО ПЕДАГОГА

The article substantiates that at the moment of time, the state's need to solve the problem of providing economic education and forming the economic culture of a specialist, capable of changing the environment for the greater satisfaction of society's needs, is growing. In this regard, the role of economic competence in the development of professional skills of the future teacher has been determined. Economic competence has been characterized as a special type of organization of knowledge, skills aimed at economic activity, which allow an individual to solve problems and perform typical economic tasks that arise in real life situations. It has been established that the content of economic competence is: the ability to analyze and synthesize economic information; the ability to apply economic knowledge practically; the ability to adapt to new economic situations; systemic understanding of knowledge transfer (system competence); innovative abilities; moderation (ability to manage a group of colleagues, partners using administrative and management methods); the ability to integrate, encouragement to express different opinions and approaches; the ability to stimulate creative economic behavior. Groups of components in the structure of the future teacher's economic competence have been identified: fundamental (basic), functional (key) and practical, which is a systemic unity. The essence of each group of components has been revealed. It has been determined that economic competence presupposes the presence of specific skills on which its level depends. The dependence of the potential of the future teacher on the level of economic competence has been substantiated. Attention has been focused on the fact that the basis of the formation of economic competence will be the main methods and techniques that will provide an opportunity for innovative development and the formation of interest in the further improvement of both knowledge and skills. Specific methods and techniques of cognitive activity have been listed, their essence has been revealed. It has been concluded that the process of formation of professional skills is focused on the development of the personal and creative potential of future teachers, their accumulation of experience of interaction and communication when included in the real conditions of the living space. The formed economic competence contributes to the future teacher's development of analytical skills, skills in assessing the state of the economic base, and design abilities, ensuring competitiveness, adaptability, mobility to modern market relations and implementation of social and economic aspects of pedagogical activity.

NATIONAL SECURITY RISKS AND THEIR MANIFESTATION POSSIBILITY IN THE CONTEXT OF GLOBALISATION

Objective. The objective of the present article is analysis of features and probability of manifestation of national security risks in the conditions of globalization. Methods. The following methods and techniques of cognition were used in the research process: theoretical generalization and comparison, analysis and synthesis, induction and deduction, generalization and systematization. Results. It is established that national security should be understood as the ability of the State to respond effectively to internal and external challenges, to ensure the realisation of national interests in the short, medium and long term, using the available economic potential and the potential of force. It is determined that the concept of "national security" is closely related to the concepts of "national interests" and "threats and challenges". It is determined that in the context of increasing globalisation, the level of national security is increasingly determined not only by endogenous but also by exogenous factors. It is substantiated that despite the fact that the level of global risks of countries is closely correlated with the level of their involvement in globalisation processes, it is not the dominant determinant of the country's level of national security, since it is determined not only and not so much by the presence of threats and risks as by the effectiveness of the country's response to existing and potential threats, the effectiveness of the "challenge-response" system - the system of national resilience. It is established that the effectiveness of the "challenge-response" system - the system of national resilience to effectively respond to external threats and risks is determined by: the effectiveness of public administration; the level of development of public-private-social partnership (the level of development of relations between business and government, as well as society); the level of trust of society in general and business in particular in government and state institutions; the level of corruption; the level of satisfaction of society and business with public services, etc. On the basis of a thorough analysis of global risks in 2010-2023 (based on the World Economic Forum data), the main systemic risks to the security of the world economic system and humanity, national security in the twenty-first century were identified, with the time interval of their manifestation determined; the peculiarities of transformation of the nature of global risks (in 2010-2023, social and environmental risks became more important).

What is the Relationship Between the Perceived Quality of Neighbourhood and the Self-reported Life Satisfaction in Immigrants Versus Natives in Europe?

Subjective well-being (SWB) is emerging as an important measure of individual and societal progress. Among the many individual factors associated with SWB, the quality of the neighbourhood is recently receiving growing attention as a factor shaping self-reported life satisfaction in contemporary societies. However, to the best of our knowledge, studies focusing on the perceived quality of the neighbourhood are still scant. We aim to fill this gap, comparing self-reported life satisfaction of different population groups (i.e., immigrants and natives) living in European countries, and to analyse the association between self-reported life satisfaction and the perceived quality of the neighbourhood, controlling for individual socio-demographic and human capital variables and socio-economic characteristics of the country of residence. The data are drawn from the cross-sectional European Quality of Life Survey (EQLS) of 2016. Our findings reveal that first and second-generation immigrants report lower self-reported life satisfaction compared to natives. Moreover, our findings show that the positive subjective evaluation of the characteristics and services available in the immediate neighbourhood where people live is positively associated with self-reported life satisfaction. There is also a positive relationship between contacts and social networks in the neighbourhood and self-reported life satisfaction. Finally, the characteristics of the country of residence matter for both native and immigrants’ life satisfaction, with immigrants being more satisfied in countries with higher quality of life captured by country gross domestic product (GDP) per capita, life expectancy and unemployment rate.

Examining Autonomy in Teaching and Job Satisfaction among Learning Facilitators

Teaching autonomy has become an important factor in the modern context of an educational institution. Teachers are becoming more and more interactive with students, especially in managing students' educational work. A teacher's teaching style depends greatly on the environment and the decisions they can make independently. Teachers can work without restriction or fear. This study took place at a private Dominican Catholic school in the Philippines. The teachers of this educational institution are called learning facilitators because the school believes in the supporting role of teachers in the teaching and learning process. Learning facilitators can teach in their preferred method if they have enough autonomy to do so. Independence in the classroom can create more opportunities for instructors to teach lessons more expressively. In this way, instructors can enthusiastically carry out educational activities that will make students more satisfied. Student satisfaction in today's society is clearly very important. Their learning strategies are dynamic and dependent on the environment.

Tourist satisfaction in era Society 5.0 as a marketing strategy

This research aims to develop a marketing strategy for the Society 5.0 era by increasing tourist satisfaction in the lodging industry's business sector. Utilizing a quantitative approach with online data distribution, the sample in this study is 128 respondents. The PLS-SEM data analysis technique was used to analyze the questionnaire data. The study's results indicate that technological innovation services and tourist engagement influenced tourist satisfaction. In contrast, human innovation services, which have no direct impact on tourist satisfaction, must first be filtered through the variable measuring tourist engagement. The engagement of tourists is a moderating variable that influences tourist satisfaction. As technological and human innovation services directly experienced by tourists, they will affect tourist satisfaction. This research allows business actors in the lodging establishment industry to develop marketing strategies that increase tourist satisfaction, thereby increasing tourist trust and repeated visits in the future.

Cervical laminoplasty versus laminectomy and posterior cervical fusion for cervical myelopathy: propensity-matched analysis of 24-month outcomes from the Quality Outcomes Database.

Compared with laminectomy with posterior cervical fusion (PCF), cervical laminoplasty (CL) may result in different outcomes for those operated on for cervical spondylotic myelopathy (CSM). The aim of this study was to compare 24-month patient-reported outcomes (PROs) for laminoplasty versus PCF by using the Quality Outcomes Database (QOD) CSM data set. This was a retrospective study using an augmented data set from the prospectively collected QOD Registry Cervical Module. Patients undergoing laminoplasty or PCF for CSM were included. Using the nearest-neighbor method, the authors performed 1:1 propensity matching based on age, operated levels, and baseline modified Japanese Orthopaedic Association (mJOA) and visual analog scale (VAS) neck pain scores. The 24-month PROs, i.e., mJOA, Neck Disability Index (NDI), VAS neck pain, VAS arm pain, EQ-5D, EQ-VAS, and North American Spine Society (NASS) satisfaction scores, were compared. Only cases in the subaxial cervical region were included; those that crossed the cervicothoracic junction were excluded. From the 1141 patients included in the QOD CSM data set who underwent anterior or posterior surgery for cervical myelopathy, 946 (82.9%) had 24 months of follow-up. Of these, 43 patients who underwent laminoplasty and 191 who underwent PCF met the inclusion criteria. After matching, the groups were similar for baseline characteristics, including operative levels (CL group: 4.0 ± 0.9 vs PCF group: 4.2 ± 1.1, p = 0.337) and baseline PROs (p > 0.05), except for a higher percentage involved in activities outside the home in the CL group (95.3% vs 81.4%, p = 0.044). The 24-month follow-up for the matched cohorts was similar (CL group: 88.4% vs PCF group: 83.7%, p = 0.534). Patients undergoing laminoplasty had significantly lower estimated blood loss (99.3 ± 91.7 mL vs 186.7 ± 142.7 mL, p = 0.003), decreased length of stay (3.0 ± 1.6 days vs 4.5 ± 3.3 days, p = 0.012), and a higher rate of routine discharge (88.4% vs 62.8%, p = 0.006). The CL cohort also demonstrated a higher rate of return to activities (47.2% vs 21.2%, p = 0.023) after 3 months. Laminoplasty was associated with a larger improvement in 24-month NDI score (-19.6 ± 18.9 vs -9.1 ± 21.9, p = 0.031). Otherwise, there were no 3- or 24-month differences in mJOA, mean NDI, VAS neck pain, VAS arm pain, EQ-5D, EQ-VAS, and distribution of NASS satisfaction scores (p > 0.05) between the cohorts. Compared with PCF, laminoplasty was associated with decreased blood loss, decreased length of hospitalization, and higher rates of home discharge. At 3 months, laminoplasty was associated with a higher rate of return to baseline activities. At 24 months, laminoplasty was associated with greater improvements in neck disability. Otherwise, laminoplasty and PCF shared similar outcomes for functional status, pain, quality of life, and satisfaction. Laminoplasty and PCF achieved similar neck pain scores, suggesting that moderate preoperative neck pain may not necessarily be a contraindication for laminoplasty.

Comparing Patient-Reported Outcomes, Complications, Readmissions, and Revisions in Posterior Lumbar Fusion With, Versus Without, an Interbody Device.

Retrospective analysis on prospectively collected data. To compare posterior lumbar fusions with versus without an interbody in: (1) Patient-reported outcomes (PROs) at 1 year and (2) postoperative complications, readmission, and reoperations. Elective lumbar fusion is commonly used to treat various lumbar pathologies. Two common approaches for open posterior lumbar fusion include posterolateral fusion (PLF) alone without an interbody and with an interbody through techniques, like transforaminal lumbar interbody fusion. Whether fusion with or without an interbody leads to better outcomes remains an area of active research. The Lumbar Module of the Quality Outcomes Database was queried for adults undergoing elective primary posterior lumbar fusion with or without an interbody. Covariates included demographic variables, comorbidities, primary spine diagnosis, operative variables, and baseline PROs, including Oswestry Disability Index, North American Spine Society satisfaction index, numeric rating scale-back/leg pain, and Euroqol 5-dimension. Outcomes included complications, reoperations, readmissions, return to work/activities, and PROs. Propensity score matching and linear regression modeling were used to estimate the average treatment effect on the treated to assess the impact of interbody use on patient outcomes. After propensity matching, there were 1044 patients with interbody and 215 patients undergoing PLF. The average treatment effect on the treated analysis showed that having an interbody or not had no significant impact on any outcome of interest, including 30-day complications and reoperations, 3-month readmissions, 12-month return to work, and 12-month PROs. There were no discernible differences in outcomes between patients undergoing PLF alone versus with an interbody in elective posterior lumbar fusion. These results add to the growing body of evidence that posterior lumbar fusions with and without an interbody seem to have similar outcomes up to 1 year postoperatively when treating degenerative lumbar spine conditions.

Association of prolonged symptom duration with poor outcomes in lumbar spine surgery: a Michigan Spine Surgery Improvement Collaborative study.

There is a scarcity of large multicenter data on how preoperative lumbar symptom duration relates to postoperative patient-reported outcomes (PROs). The objective of this study was to determine the effect of preoperative and baseline symptom duration on PROs at 90 days, 1 year, and 2 years after lumbar spine surgery. The Michigan Spine Surgery Improvement Collaborative registry was queried for all lumbar spine operations between January 1, 2017, to December 31, 2021, with a follow-up of 2 years. Patients were stratified into three subgroups based on symptom duration: < 3 months, 3 months to < 1 year, and ≥ 1 year. The primary outcomes were reaching the minimal clinically important difference (MCID) for the PROs (i.e., leg pain, Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF), EQ-5D, North American Spine Society satisfaction, and return to work). The EQ-5D score was also analyzed as a continuous variable to calculate quality-adjusted life years. Multivariable Poisson generalized estimating equation models were used to report adjusted risk ratios, with the < 3-month cohort used as the reference. There were 37,223 patients (4670 with < 3-month duration, 9356 with 3-month to < 1-year duration, and 23,197 with ≥ 1-year duration) available for analysis. Compared with patients with a symptom duration of < 1 year, patients with a symptom duration of ≥ 1 year were significantly less likely to achieve an MCID in PROMIS PF, EQ-5D, back pain relief, and leg pain relief at 90 days, 1 year, and 2 years postoperatively. Similar trends were observed for patient satisfaction and return to work. With the EQ-5D score as a continuous variable, a symptom duration of ≥ 1 year was associated with 0.04, 0.05, and 0.03 (p < 0.001) decreases in EQ-5D score at 90 days, 1 year, and 2 years after surgery, respectively. A symptom duration of ≥ 1 year was associated with poorer outcomes on several outcome metrics. This suggests that timely referral and surgery for degenerative lumbar pathology may optimize patient outcome.

Evaluation of Rehabilitation Service Capacity for Mildly Disabled Institutionalized Elderly - An Analysis Based on the Hierarchical Analysis and Entropy Method

Background: The quality of rehabilitation services plays an important role in the health and satisfaction of society, but it still has some significant deficiencies in different aspects at the same time. It is one of the main issues in the system of rehabilitation services in all countries. Objectives: This study aimed to investigate the rehabilitation service capacity for mildly disabled older adults in nursing homes. Methods: The data were used hierarchically and assigned entropy values, the final level of rehabilitation service capacity of mildly disabled older adults in nursing homes was derived, and hierarchical analysis and entropy power methods were combined. Results: In evaluating rehabilitation services for older adults with mild disabilities in nursing homes, the weight of the first-level risk indicators was 0.1454 for the rehabilitation environment, 0.3687 for the quality of rehabilitation services, and 0.4859 for the effectiveness of rehabilitation. Conclusions: Rehabilitation environment indicators for an elderly nursing home on their privacy and anti-slip design were ranked first, rehabilitation service quality indicators on the level of rehabilitation division, respectful treatment, and humanistic care, indicating that older people in nursing homes were more important physiological and psychological rehabilitation effect indicators analysis. Rehabilitation effect indicators, independent laundry, independent toileting, bathing, and independent dressing, are especially important in nursing homes for mildly disabled older adults who prefer the change the healthy physical effects.

406 Assessing Correlations Between NASS Patient Satisfaction Index and Patient-Reported Outcomes (PROs) at 3-month, 12-month, and 24-month Timepoints in Patients Undergoing Cervical Spine Surgery Using the QOD Registry

INTRODUCTION: In value-based healthcare, measuring appropriate outcomes is essential to accurately determine value. Tracked outcomes should reflect the desires of patients undergoing surgical interventions. METHODS: The Quality Outcomes Database (QOD), a prospectively collected multi-institutional database, was used to analyze North American Spine Society (NASS) satisfaction, Neck Disability Index (NDI), Visual analog scale for neck pain (NP-VAS) and arm pain (AP- VAS), EuroQoL-Visual Analog Scale (EQ-VAS), and modified Japanese Orthopedic Association (mJOA) at 3, 12, and 24-month follow up. RESULTS: 1141 patients were surgically treated (anterior approach n = 785, 69%; posterior approach n=356, 31%) for cervical spondylotic myelopathy. Average demographics were 60.5 years old, 52.6% male, 92.4% non-Hispanic, BMI 30.2, and length of stay 2.1 days. At 3 month follow up, satisfaction was positively correlated with NP-VAS (R = 0.298, p&lt;.001), AP-VAS (R = 0.315, p &lt; .001), NDI (R = 0.362, p &lt;.001), and negatively correlated with EQ-VAS (R = -0.294, p&lt;.001) and mJOA (R = -0.287, p &lt; .001). At 12 month follow up, satisfaction was positively correlated with NP-VAS (R = 0.442, p&lt;.001), AP-VAS (R = 0.384, p&lt; .001), NDI (R = 0.459, p &lt; .001), and negatively correlated with EQ-VAS (R = -0.357, p&lt;.001) and mJOA (R = -0.363, p &lt;.001). At 24 month follow up, satisfaction was positively correlated with NP-VAS (R = 0.490, p&lt;.001), AP-VAS (R = 0.358, p &lt; .001), NDI (R = 0.491, p &lt; .001), and negatively correlated with EQ-VAS (R= -0.310, p&lt;.001) and mJOA (R= -0.378, p &lt;.001). CONCLUSIONS: NDI was most correlated with satisfaction at 3, 12 and 24-month follow up. mJOA was least correlated with satisfaction at 3 month follow up, whereas EQ-VAS was the least correlated with satisfaction at 12 and 24-month follow up. These findings may better guide outcome selection in patient follow up and help clinicians appropriately counsel patients on expected outcomes.

403 Inferior Clinical Outcomes for Patients with Medicaid Insurance Following Surgery for Degenerative Lumbar Spondylolisthesis: A Prospective Registry Analysis of 608 Patients

INTRODUCTION: It remains unclear how type of insurance coverage impacts long-term, spine-specific patient-reported outcomes (PROs). METHODS: The prospective Quality Outcomes Database registry was queried for patients with grade 1 degenerative lumbar spondylolisthesis who underwent single-segment surgery. 24-month PROs compared included Oswestry Disability Index (ODI), Numeric Rating Scale Back Pain (NRS-BP), NRS Leg Pain (NRS-LP), EuroQol-5D (EQ-5D), and North American Spine Society (NASS) Satisfaction. RESULTS: 608 patients undergoing surgery for grade 1 degenerative lumbar spondylolisthesis (mean age 62.5 ± 11.5 years and 59.2% women) were selected. Insurance types included private insurance (n = 319, 52.5%), Medicare (n = 235, 38.7%), Medicaid (n = 36, 5.9%), and VA/government (n =17, 2.8%). 1 patient (0.2%) was uninsured and was removed from the analyses. In adjusted multivariable analyses, when compared to patients with private insurance, Medicaid was associated with worse 24-month postoperative ODI β = 10.2, 95% CI 3.9 - 16.5) and NRS-LP β = 1.3, 95% CI 0.3 - 2.4). Medicaid was associated with worse EQ-5D scores compared to private insurance (β = -0.07, 95% CI -0.01 - -0.14), but not when compared to Medicare and VA/government insurance (p &gt; 0.05). Medicaid was associated with lower odds of reaching ODI minimal clinically important difference (OR = 0.2, 95% CI 0.03 - 0.7) compared to VA/government insurance. NRS-BP and NASS satisfaction did not differ by insurance coverage (p &gt; 0.05). CONCLUSIONS: Despite adjusting for potential confounding variables, Medicaid coverage was independently associated with worse 24-month PROs following lumbar spondylolisthesis surgery compared to other payer types. While all improved postoperatively, those with Medicaid coverage had relatively inferior improvements.

How closely are outcome questionnaires correlated to patient satisfaction after cervical spine surgery for myelopathy?

Patient-reported outcomes (PROs) have become the standard means to measure surgical outcomes. Insurers and policy makers are also increasingly utilizing PROs to assess the value of care and measure different aspects of a patient's condition. For cervical myelopathy, it is currently unclear which outcome measure best reflects patient satisfaction. In this investigation, the authors evaluated patients treated for cervical myelopathy to determine which outcome questionnaires best correlate with patient satisfaction. The Quality Outcomes Database (QOD), a prospectively collected multi-institutional database, was used to retrospectively analyze patients undergoing surgery for cervical myelopathy. The North American Spine Society (NASS) satisfaction index, Neck Disability Index (NDI), numeric rating scales for neck pain (NP-NRS) and arm pain (AP-NRS), EQ-5D, and modified Japanese Orthopaedic Association (mJOA) scale were evaluated. The analysis included 1141 patients diagnosed with myelopathy, of whom 1099 had an NASS satisfaction index recorded at any of the follow-up time points. Concomitant radiculopathy was an indication for surgery in 368 (33.5%) patients, and severe neck pain (NP-NRS ≥ 7) was present in 471 (42.8%) patients. At the 3-month follow-up, NASS patient satisfaction index scores were positively correlated with scores for the NP-NRS (r = 0.30), AP-NRS (r = 0.32), and NDI (r = 0.36) and negatively correlated with EQ-5D (r = -0.38) and mJOA (r = -0.29) scores (all p < 0.001). At the 12-month follow-up, scores for the NASS index were positively correlated with scores for the NP-NRS (r = 0.44), AP-NRS (r = 0.38), and NDI (r = 0.46) and negatively correlated with scores for the EQ-5D (r = -0.40) and mJOA (r = -0.36) (all p < 0.001). At the 24-month follow-up, NASS index scores were positively correlated with NP-NRS (r = 0.49), AP-NRS (r = 0.36), and NDI (r = 0.49) scores and negatively correlated with EQ-5D (r = -0.44) and mJOA (r = -0.38) scores (all p < 0.001). Neck pain was highly prevalent in patients with myelopathy. Notably, improvement in neck pain-associated disability rather than improvement in myelopathy was the most prominent PRO factor for patients. This finding may reflect greater patient concern for active pain symptoms than for neurological symptoms caused by myelopathy. As commercial payers begin to examine novel remuneration strategies for surgical interventions, thoughtful analysis of PRO measurements will have increasing relevance.

Characteristics of patients who return to work after undergoing surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study.

Return to work (RTW) is an important surgical outcome for patients who are employed, yet a significant number of patients with cervical spondylotic myelopathy (CSM) who are employed undergo cervical spine surgery and fail to RTW. In this study, the authors investigated factors associated with failure to RTW in the CSM population who underwent cervical spine surgery and who were considered to have a good surgical outcome yet failed to RTW. This study retrospectively analyzed prospectively collected data from the cervical myelopathy module of a national spine registry, the Quality Outcomes Database. The CSM data set of the Quality Outcomes Database was queried for patients who were employed at the time of surgery and planned to RTW postoperatively. Distinct multivariable logistic regression models were fitted with 3-month RTW as an outcome for the overall population to identify risk factors for failure to RTW. Good outcomes were defined as patients who had no adverse events (readmissions or complications), who had achieved 30% improvement in Neck Disability Index score, and who were satisfied (North American Spine Society satisfaction score of 1 or 2) at 3 months postsurgery. Of the 409 patients who underwent surgery, 80% (n = 327) did RTW at 3 months after surgery. At 3 months, 56.9% of patients met the criteria for a good surgical outcome, and patients with a good outcome were more likely to RTW (88.1% vs 69.2%, p < 0.01). Of patients with a good outcome, 11.9% failed to RTW at 3 months. Risk factors for failing to RTW despite a good outcome included preoperative short-term disability or leave status (OR 3.03 [95% CI 1.66-7.90], p = 0.02); a higher baseline Neck Disability Index score (OR 1.41 [95% CI 1.09-1.84], p < 0.01); and higher neck pain score at 3 months postoperatively (OR 0.81 [95% CI 0.66-0.99], p = 0.04). Most patients with CSM who undergo spine surgery reenter the workforce within 3 months from surgery, with RTW rates being higher among patients who experience good outcomes. Among patients with good outcomes who were employed, failure to RTW was associated with being on preoperative short-term disability or leave status prior to surgery as well as higher neck pain scores at baseline and at 3 months postoperatively.

Analisis Indek Kepuasan Masyarakat / IKM Di Rumah Sakit Umum Hasanuddin Damrah Manna Kabupaten Bengkulu Selatan

At epoch of pandemi which now again world, health represent an elementary requirement to society. Requirement that's making society feel important to keep in good health and obtain;get service of health. These days society progressively aware of quality or quality service of health capable to give satisfaction [at] society itself. In a condition this time Hospital party/ side have have to know how quality of service of them can be accepted by its consumer, patient goodness take care of to lodge and also outpatient. Quality of service very closely related with cutomer/ client.&#x0D; Target doing/conducting of this research is to know analysis of indek satisfaction of society / IKM at home Common/ Public Pain of Hasanuddin Damrah Paradise Fruit Sub-Province of Bengkulu South. Type Research in this research is descriptive by wearing method research of Kusioner. While technique analyse data the used is by using measurement of value Make An Index To Satisfaction of Society / IKM pursuant to Regulation Of Minister Utilization Of State Aparatus And Reform Bureaucracy Republic Of Indonesia Number 14 Year 2017 About Guidance Of Compilation Of Survey Satisfaction Of Society Unit Organizer of Service of counted/calculated Public by using average value deliberated by the each service element.&#x0D; Result of this research can know that From 9 element service of society exist in common/ public hospital of Hasanuddin Damrah Paradise fruit, average value the got is equal to 3,09. Average value deliberated by at entire/all service element is 3,06. So that in earning conversion assess satisfaction of society exist in Common/ Public Hospital of Hasanuddin Damrah Paradise fruit is 76, 48 with quality of service " B" or predikat Whether.