Patient Satisfaction: Implications and Predictors of Success

Shirley, Eric D.; Sanders, James O.

doi:10.2106/jbjs.l.01048

Cited by 218 publications

(159 citation statements)

References 32 publications

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“…The importance of simple, reliable, and validated self-assessed outcome measures to evaluate patient function and to show satisfactory results after surgery has continued to increase as greater emphasis is placed on quality, outcomes, and patient satisfaction [1,15]. One challenge of using such outcome instruments is adequately determining the clinical relevance of any change in score during the course of treatment.…”

Section: Introductionmentioning

confidence: 99%

What Change in American Shoulder and Elbow Surgeons Score Represents a Clinically Important Change After Shoulder Arthroplasty?

Werner

Chang

Nguyen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

177

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Background The American Shoulder and Elbow Surgeons (ASES) questionnaire was developed to provide a standardized method for evaluating shoulder function. Previous studies have determined the clinical responsiveness of this outcome measure for heterogenous populations or patients with nonoperatively treated rotator cuff disease. Currently, to our knowledge, no studies exist that establish the clinically relevant change in the ASES score after shoulder arthroplasty. Questions/purposes We asked: (1) What are the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) for the ASES score after primary and reverse shoulder arthroplasties? (2) Are the MCID and SCB for the ASES score different between primary and reverse shoulder arthroplasties? (3) What patient-related factors are associated with achieving the MCID and SCB after total shoulder arthroplasty and reverse shoulder arthroplasty? Methods A longitudinally maintained institutional shoulder arthroplasty registry was retrospectively queried for patients who underwent primary shoulder arthroplasty, including anatomic or reverse total shoulder arthroplasty from 2007 to 2013, with a minimum 2-year followup. Seven hundred ninety-four patients were identified and eligible; 304 of these patients did not have 2 years of followup or complete datasets, resulting in a study cohort of 490 patients (62% of the 794 potentially eligible). The MCID and SCB of the ASES score for these patients was calculated using an anchor-based method, using four different anchors measuring satisfaction with work, activities, overall, and activity from the SF-36. The MCID (anchored to somewhat satisfied) and SCB (very satisfied) of the ASES score were calculated for the entire cohort and stratified by arthroplasty type. Multivariate logistic regression of patient-related factors that influence the MCID and SCB achievement was performed. Results The MCID for all patients combined ranged from 6.3 to 13.5; for the overall satisfaction anchor, the MCID was 13.5 ± 4.5 (95% CI, 4.8-22.3). The SCB for the overall cohort ranged from 12.0 to 36.6; for the overall satisfaction anchor, the SCB was 36.6 ± 3.8 (95% CI, 29.1-44.1). There were no differences in the MCID of the ASES score between anatomic and reverse shoulder arthroplasty for any of the anchors (p = 0.159-0.992) or the SCB for any of the anchors (p = 0.467-0.977). CombiningOne of the authors certifies that he (LVG), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000-USD 100,000 from Biomet, Inc (Warsaw, IN, USA). One of the authors certifies that he, (DMD) or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000-USD 100,000 from Biomet, Inc (Warsaw, IN, USA). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certif...

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Section: Introductionmentioning

confidence: 99%

What Change in American Shoulder and Elbow Surgeons Score Represents a Clinically Important Change After Shoulder Arthroplasty?

Werner

Chang

Nguyen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

177

View full text Add to dashboard Cite

show abstract

“…Scales such as the 100 mm Visual Analog Scale (VAS), Likert Scales, and Numeric Rating Scale (NRS) are incorporated into some of the commonly utilized methods for determining patient outcomes like the Rolland-Morris disability questionnaire, Euro-Qol-5D (EQ-5D), Neck Disability Index (NDI), Cervical Spine Outcomes Questionnaire (CSOQ), and the Oswestry Disability Index (ODI) by monitoring the changes in patients' functional status from pre-to postoperative [7][8][9][10][11][12][13][14][15][16]. The studies that we reviewed also used the Zung Depression Scale and the Modified Somatic Perception Questionnaire (MSPQ) in attempts to correlate patients' emotional states to their outcomes and reported satisfaction [9].…”

Section: Resultsmentioning

confidence: 99%

“…This movement is evidenced by the new reimbursement policies created by the Centers for Medicare and Medicaid Services (CMS) that are heavily dependent on this data [1,2]. Satisfaction plays an important role in patient care as discontented patients are less likely to attend follow-up appointments as well as comply with treatment plans [3]. Furthermore, while the exact link remains unclear, higher patient satisfaction has been associated with lower costs, mortality rates and minor complication rates [4,5].…”

Section: Introductionmentioning

confidence: 99%

Patient Reported Satisfaction and its Impact on Outcomes in Spinal Surgery: A Mini Review

Sure¹,

Tishelman²,

Moon³

et al. 2016

Ann Clin Lab Res

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Patient satisfaction has emerged as a critical metric in assessing patient-reported outcomes for healthcare services. The importance of accurately measuring satisfaction is evidenced by the implementation of patient-reported satisfaction as a tool for healthcare reimbursement by the Centers for Medicare and Medicaid Services (CMS). The Patient Protection and Affordable Care Act have formalized the grading of healthcare quality using patient-centric outcomes. Additionally, data indicate that patient satisfaction is directly governed by patient expectations and this expectation-actuality relationship may have a profound impact on patient outcomes. Healthcare providers must have an understanding of the parameters used to measure patient satisfaction and of the associated impact that treatment satisfaction has on patient-reported outcome measures (PROMs). The purpose of this manuscript is to provide a brief overview of how patient satisfaction is defined and measured and to evaluate the implications of poor patient satisfaction on patient-reported outcomes and perceived surgical success. Additionally, we explore the clinical utility of measuring satisfaction on an institutional scale.

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“…Lack of concern for patient expectation has a negative impact on the appreciation of care and overall satisfaction, and can be a source of conflict between the patient and the health system. [34][35][36][37] Since clinical outcomes are equal and patients seem to prefer the single port approach, the logical conclusion should be that uncomplicated gallbladder disease has to be operated on by single port laparoscopy. There are, however, some caveats.…”

Section: Discussionmentioning

confidence: 99%

Patient preference matters: cholecystectomy for uncomplicated gallbladder diseases should be performed by single port laparoscopy

et al. 2017

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Background: Laparoscopic cholecystectomy for uncomplicated gallbladder diseases (UGD) is a low-complexity procedure with little morbidity. Single port approach (SPA) benefits are unclear. Our aim is to identify any advantages by evaluating both the clinical outcomes of this approach and also patient opinion, following a year of implementation in our institution.Methods: Data from patients operated on during 2015 for UGD by SPA or conventional laparoscopic approach (CLA) were collected. Patients were asked to answer a telephone questionnaire 4-6 months after the operation.Results: 47 patients were operated on by SPA (SP group) and 117 by CLA (CL group). No differences were found between preoperative variables, surgical time, morbidity, length of stay or wound complications. More SP group patients reported no pain at discharge (72.3 vs 54.7%, p=0.037). 138 patients answered the questionnaire. No significant differences were found when comparing overall satisfaction. Wound aspect satisfaction was higher in the SP group (100 vs 80.9%, p=0.001). A higher proportion of CL group patients felt that had they had fewer scars, they would be more satisfied (46.8 vs 9.1%, p <0.001), and 35.1% of them opined that their satisfaction would be greater had they been operated on by SPA. In the multivariate analysis, the only variable associated with maximum overall satisfaction was wound aspect satisfaction.Conclusions: SPA is a valid alternative to CLA for UGD. It should be chosen when available, since it provides equal clinical outcomes, diminishes postoperative pain and is preferred by patients.

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Patient Satisfaction: Implications and Predictors of Success

Cited by 218 publications

References 32 publications

What Change in American Shoulder and Elbow Surgeons Score Represents a Clinically Important Change After Shoulder Arthroplasty?

What Change in American Shoulder and Elbow Surgeons Score Represents a Clinically Important Change After Shoulder Arthroplasty?

Patient Reported Satisfaction and its Impact on Outcomes in Spinal Surgery: A Mini Review

Patient preference matters: cholecystectomy for uncomplicated gallbladder diseases should be performed by single port laparoscopy

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