Patient satisfaction with service quality in an oncology setting: implications for prognosis in non-small cell lung cancer

Abstract

ObjectiveTo evaluate the relationship between self-reported satisfaction with service quality and overall survival in non-small cell lung cancer (NSCLC).DesignA prospective cohort study.SettingCancer Treatment Centers of America® from July 2007 and December 2010.ParticipantsNine hundred and eighty-six returning NSCLC patients.InterventionOverall patient experience ‘considering everything, how satisfied are you with your overall experience’ was measured on a 7-point Likert scale ranging from ‘completely dissatisfied’ to ‘completely satisfied.’.Main Outcome MeasurePatient survival was the primary end point.ResultsThe response rate for this study was 69%. Six hundred patients were newly diagnosed, while 386 were previously treated. Four hundred sixty-nine were males, while 517 were females. 101, 59, 288 and 538 patients had stage I, II, III and IV disease, respectively. Mean age was 58.9 years. Six hundred and thirty (63.9%) patients had expired at the time of this analysis. Seven hundred and sixty-two (77.3%) patients were ‘completely satisfied’. Median overall survival was 12.1 months (95% confidence interval (CI): 10.9–13.2 months). On univariate analysis, ‘completely satisfied’ patients had a significantly lower risk of mortality compared with those not ‘completely satisfied’ [hazard ratio (HR) = 0.70; 95% CI: 0.59–0.84; P < 0.001]. On multivariate analysis controlling for stage at diagnosis, prior treatment history, age and gender, ‘completely satisfied’ patients demonstrated significantly lower mortality (HR = 0.71; 95% CI: 0.60–0.85; P < 0.001) compared with those not ‘completely satisfied’.ConclusionsSelf-reported experience with service quality was an independent predictor of survival in NSCLC patients undergoing oncologic treatment, a novel finding in the literature. Based on these provocative findings, further exploration of this relationship is warranted in well-designed prospective studies.

Factors and Costs Associated With Delay in Treatment Initiation and Prolonged Length of Stay With Inpatient EPOCH Chemotherapy in Patients With Hematologic Malignancies

“…On average, outpatient chemotherapy wait period exceeded 60 min (8, 9, 12, 13). Patients with higher satisfaction related to their care experience may have better outcomes than less satisfied patients; a previous cohort study of 986 patients with lung cancer found, in a multivariable analysis, that patients who were completely satisfied with their care had significantly lower mortality (HR 0.71, 95% CI: 0.60–0.85) compared to patients who were not completely satisfied with their care (44). Recently, there has been increasing attention toward providing patient-centered care (45).…”

Methodological Considerations When Studying the Association between Patient‐Reported Care Experiences and Mortality

“…These studies showed that the provision of appropriate information by clinicians is associated with lower depression and anxiety scores and better health‐related quality of life scores among patients as measured by instruments such as the mental component summary of the SF‐12 and the European Organization for Research and Treatment of Cancer quality of life questionnaire. Patient‐reported experiences also have been found to be related to survival in cancer patients (Gupta, Rodeghier, and Lis ) and after hospitalization for a heart attack (Meterko et al. ).…”

The European organization for research and treatment of cancer — satisfaction with cancer care questionnaire: revision and extended application development

“…Patient satisfaction is now recognized as an important indicator of care quality. It is also related to treatment adherence [1] and clinical outcomes [2], and facilitates monitoring initiatives for care improvement over time [3].…”