Patient Satisfaction After Lung Cancer Surgery: Do Clinical Outcomes Affect Hospital Consumer Assessment of Health Care Providers and Systems Scores?

Abstract

Background. Little is known about patients' hospital experience and satisfaction after lung cancer surgery. We sought to determine how length of hospital stay (LOS) and postoperative complications affect hospital consumer assessment of health care providers and systems (HCAHPS) scores.Methods. Patients undergoing lung resection for cancer at a single academic cancer center between years 2014 and 2018 were analyzed. Clinical data were derived from The Society of Thoracic Surgeons institutional database and supplemented with HCAHPS survey data. Endpoints were "top-box" satisfaction scores and domain-specific scores for physicians and nurses communication.Results. In total, 181 of 478 patients (38%) who underwent pulmonary resection for lung cancer completed HCAHPS surveys. Median age was 65 years, and most patients underwent lobectomy (94%). The top-box rating for the overall hospital experience, physician communication, and nurse communication were 92%, 84%, and 69%, respectively. Overall and major complication rates were 43% and 3%, and were not associated with top-box HCAHPS scores. Increasing length of stay was associated with worse satisfaction with provider communication. Adjusted for patient factors, increasing length of stay was associated with worse patient satisfaction in the domains of communication with physicians and nurses. Patients with length of stay more than 6 days were less likely to endorse that doctors gave understandable explanations (odds ratio 0.15, 95% confidence interval, 0.04 to 0.56) and that nurses listened carefully (odds ratio 0.11, 95% confidence interval, 0.06 to 0.69).Conclusions. Overall HCAHPS satisfaction scores after lung resection for cancer were high and were negatively associated with increasing length of stay. Patient satisfaction may be affected more by the perception of effective communication during prolonged hospitalizations than by complications.

Factors influencing patient satisfaction after treatments for early-stage non-small cell lung cancer

“…More recently, a US study found that patient satisfaction scores amongst patients undergoing surgery for lung cancer were not significantly affected by postoperative complications. Satisfaction in the areas of communication with doctors and nurses, however, decreased significantly with increasing length of stay suggesting an important role on enhancing provider communication skills (Singer et al 2019). However, it is not easy to put these results in the context of studies exploring possible correlation between socio-economic level and patient satisfaction.…”

Predictors of a Top-Box Patient Experience: A Retrospective Observational Study of HCAHPS Data at a Safety Net Institution

“…Centers for Medicare and Medicaid Services adjust HCAHPS scores for Patient-Mix Adjustment (PMA) factors, which are unrelated to a hospital's performance but influence patients' responses and impact scores (2,14,15). Prior studies have evaluated additional variables suspected to impact patient experience (10,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). As hospitals seek to improve patient experience, understanding whether there are additional nonperformance-related factors for which HCAHPS scores should be adjusted may help target performance-related variables amenable to quality improvement initiatives.…”

Improving patient engagement, adherence, and satisfaction in lung cancer surgery with implementation of a mobile device platform for patient reported outcomes

“…The goal of all physicians is to provide the highest quality of care to their patients; however, the sole use of measures such as hospital length of stay and complication rates do not always provide the most holistic perspective on can provide insight into not only the effectiveness of a surgeon's craftsmanship but also into whether different medical interventions are addressing and improving patient concerns (1). Patient satisfaction in health care can be thought of as the degree to which a patient feels they received high quality care (2). Their satisfaction is likely to be higher if they believe their quality of care was higher.…”