Introduction: Patient-rated evaluation of quality of care is a source of controversy. We hypothesize that patients can distinguish between their perceived outcome and their satisfaction with care.
Methods: From 2009 to present, patients evaluated for surgery at the University of Chicago Spine Clinic were asked to participate in a prospective registry of outcome. We included two separate subjective scales, 1) perceived outcome(PO) on a 7 point scale, 4 - no change, 1 best and 7 worst; 2) satisfaction with care(SC) on a 5 point scale, 1 best and 5 - worst. Data were collected at baseline 3, 12 and 24 months. Providers were blinded to the results. Data was available for 404 patients.
Results: 33 patients were lost to follow up. More than 90% of all patients reported good outcomes in both categories at all times. A significant positive correlation between PO and SC was found at every time, Pearson´s rho correlation of 0,536; 0,668 and 0,65 at 3, 12 and 24 months respectively (p<0,01). When PO and SC were dichotomized to Good or Bad the correlation was lost at 3 month but remained significant at months 12 and 24 (Pearsons´s rho of 0,496 and 0,225, p<0,01). Although patients that completed all the follow up have a positive correlation at all times, 7, 7 and 20 patient had opposite opinions about PO and SC variables at 3, 12 and 24 months respectively.
Conclusions: 1) Most patients had a positive perception of both outcome and care. 2) Some of the patients differentiated between outcome and satisfaction with care. 3) There was correlation between PO and SC. 4)Patient opinion about both SC and PO changed with time.
Patient Care: Our data sheds light on the question of correlation between perceived outcome and perceived quality of care. These are different parameters, but may be interrelated. The understanding of this relationship through direct comparison in a prospectively collected cohort can influence the way we study and understand patient outcomes.
Learning Objectives: 1. The learner will be able to discuss patient perception of outcome as a separate metric from perception of quality of care
2. The learner will be able to recognize the change in patient perceptions, with the two metrics orrelating and tending to merge over time