Introduction: Patient ratings of care and outcome are increasing in importance as greater emphasis is placed on quality of care. Questionnaires of satisfaction with care were criticized for not representing the surgical outcome and for being a poor tool to evaluate the the performance of the surgical team. In this study, we analyze and compare patient satisfaction with care, with their perception of surgical outcome.
Methods: 1400 patients were prospectively enrolled in a operative spine outcome registry at the University of Chicago; 599 patients for whom at least two years of follow up was expected by 3/8/2016 were included in this analysis.
Results: Response rate was 86% at 3 months, 85% at 6 months and 82% at 12 months postoperatively. There were 303 females, 296 males; average age was 58.78 years. 388 had lumbar disease and 211 had cervical spine disease. Satisfaction with care and positive perception of outcome demonstrated a significant correlation (r=0.67; p < 0.0001). However, there were patients with divergent opinions: 5.49%, 7.20% and 9.80% were satisfied with outcome but not care, whereas 3.14%, 3.31% and 2.45% percent were satisfied with care but not outcome, at 3,6 and 12 months respectively. Perceived poor outcome at three months was associated with loss to follow up at 12 months. Of 16 patients who at three months felt that they did not improve or became worse after the operation, 14 dropped out and only 2 returned the follow up forms at 12 months. Among those who perceived a good outcome but bad care, 20 out of 28 dropped out.
Conclusions: Most patients were satisfied with their care and had a positive perception of outcome.
Patients may have divergent opinions regarding their outcome and the quality of their care.
Poor outcome or dissatisfaction with care lead to loss to follow up.
Patient Care: 1) Improve understanding of patient perceptions of care and outcome
2) Improve understanding of the influence of patient perception of outcome and quality of care on follow up rate.
Learning Objectives: 1) recognize the difference between patient rating of quality of care and their perception of outcome
2) Identify and discuss the influence of perception of outcome on loss to follow up.