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  • The impact of subjective pain assessment on patient satisfaction scores in a surgical spine practice

    Final Number:

    Sara M. McEvoy; Meic H Schmidt; Erica Fay Bisson MD, FAANS

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: With the rise of outcomes-based practice and quality improvement assessments, patient satisfaction has become a controversial topic. Over the past several years, there has been an increase in the use of surveys to document patient experience. We aim to evaluate the relationship between pain/disability scores and Press Ganey Patient Satisfaction Scores, a nationally recognized survey tool. Our secondary objective was to identify a relationship between these patient satisfaction scores and recommendations for or against surgery.

    Methods: Retrospective chart review of all patients, who presented for a new spine consultation between January and December 2011. To be included in the study, patients must have filled out a Press Ganey patient satisfaction survey. Patients were then stratified into two groups: those that filled out either the Oswestry Disability Index (ODI) or Neck Disability Index (NDI) (group 1), and those that were seen by a spine surgeon and were given a clear recommendation for or against surgery (group 2). The seven major categories of patient satisfaction were compared to the subjective pain and disability scores. Additionally, we evaluated the relationship of whether or not a patient was offered surgery and their satisfaction scores on each of the categories.

    Results: 164 patients filled out Patient Satisfaction Surveys. 82 patients were included in the ODI/NDI arm of the study. 124 patients were included in the surgical recommendation arm. There was a statistically significant decrease in patient satisfaction scores in patients with severe disability compared to those with mild disability. (p values: 0.0256, 0.0009, 0.0381, respectively). In group two, there was a statistically significant decrease in satisfaction scores for those who were not recommended to have surgery (p=0.0101).

    Conclusions: Although patient satisfaction surveys may be important tools for improvement and growth within a clinical practice, there are factors that may impact the survey results. Level of pain and disability, as well as recommendations against surgery, are significant factors that adversely impacted the patient satisfaction scores in our study.

    Patient Care: If we better understand the factors that affect patient satisfaction, and hence patient expectation, we can create a more ideal provider-patient relationship, potentially impacting true outcomes.

    Learning Objectives: By the conclusion of this session participants should be able to (1) discuss the relationship between pain/disability and patient satisfaction scores, and (2) discuss the relationship between surgical recommendation and patient satisfaction scores

    References: Bilberg R, Norgaard B, Overgaard S, Roessler KK. Patient anxiety and concern as predictors for the perceived quality of treatment and patient reported outcome (PRO) in orthopaedic surgery. BMC Med Inform Decis Mak. 2012; 12: 101. Zwiinenber N, et al. Understanding and using comparative healthcare information; the effect of the amount of information and consumer characteristics and skills. Cochran Database Systematic Review 2011 Sep 7;(9):CD008451. doi: 10.1002/14651858.CD008451.pub2. Hussey P, PhD; Wertheimer S MPH; and Mehrotra A, MD, MPH. The Association Between Health Care Quality and Cost: A Systematic Review. Ann Intern Med. 1 January 2013;158(1):27-34 . Center for Medicare/Medicaid Services Online. Value Based Purchasing. White B. Measuring patient satisfaction: how to do it and why to bother. Fam. Pract Management 1999 Jan;6(1):40-4. Press Ganey Online. Riskind P, Fossey L, Brill K. Why measure patient satisfaction? J Med Pract Manage. 2011 Jan-Feb;26(4):217-20 MacDermid JC, Walton DM, Avery S, Blanchard A, Etruw E, McAlpine C, Goldsmith CH. Measurement properties of the neck disability index: a systematic review. J Orthop Sports Phys Ther. 2009 May;39(5):400-17.

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