Introduction: The Patient Experience of Care - composed of nine dimensions derived from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey - is being used by the Centers for Medicare and Medicaid Services to adjust hospital reimbursement. Currently, there are minimal data on how scores on the constituent HCAHPS items impact the global dimension of satisfaction, Overall Hospital Rating (OHR). The objective of our study was to determine the key drivers of overall patient satisfaction in the inpatient lumbar spine surgery setting.
Methods: Demographic and preoperative patient characteristics were obtained. Patients selecting a top-box score for OHR (a 9 or 10 out of 10) were considered “satisfied”. A baseline multivariable logistic regression model was then developed to analyze the association between patient characteristics and top-box OHR. Then multivariable logistic regression models adjusting for patient-level covariates were used to determine the association between individual components of the HCAHPS survey and a top-box OHR.
Results: 460 patients undergoing lumbar spine surgery were included, 79.8% of which selected a top-box OHR. The survey items that were associated with the greatest increased odds of selecting a top-box OHR included: staff always did everything they could to help with pain (OR 12.6, 95% CI 6.7 - 23.8), and nurses were always respectful (OR 11.7, 95% CI 5.7 - 23.8).
Conclusions: Patient experience of care is increasingly being used to determine hospital and physician reimbursement. The present study analyzed the key drivers of patient experience among patients undergoing lumbar spine surgery and found several important associations. Staff always doing everything they could to help with pain and nurses always being respectful were the strongest predictors of overall satisfaction in this population. These findings highlight opportunities for quality improvement efforts in the spine care setting.
Patient Care: Our research will help drive quality improvement efforts in lumbar spine surgery that aim to increase patient satisfaction with the hospital experience
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Identify which components of the patient experience of lumbar spine surgery is most strongly associated with high overall satisfaction