Predictors of patient satisfaction and survey participation after spine surgery: a retrospective review of 17,853 consecutive spinal patients from a single academic institution. Part 1: Press Ganey

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  • Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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OBJECTIVE

Press Ganey surveys are common modalities used to assess patient satisfaction scores in an outpatient setting. Despite the existence of data, neurosurgical and orthopedic literature on patient satisfaction following spinal surgery is scarce.

METHODS

A total of 17,853 patients who underwent spinal procedures at the authors’ institution were analyzed retrospectively for Press Ganey survey participation. Appropriate demographic, surgical, comorbidity, and complication data were collected; 1936 patients had patient satisfaction survey data, and further survey metrics were collected for this subset of patients.

RESULTS

Male patients, patients with urgent/emergency procedures, and patients with longer length of stay (LOS) were less likely to fill out Press Ganey surveys (OR 0.822, p < 0.001; OR 0.781, p = 0.010; and OR 0.983, p < 0.001, respectively). Posterior approach was negatively associated with Press Ganey participation (OR 0.907, p = 0.055). Patients undergoing fusion procedures were more likely to participate in Press Ganey surveys (OR 1.419, p < 0.001). Of the patients who filled out surveys, there were no positive predictors associated with receiving perfect scores on Press Ganey surveys. High Charlson Comorbidity Index (OR 0.959, p = 0.02), increasing elapsed time since surgery or discharge (OR 0.996, p = 0.03), and increasing LOS (OR 0.965, p = 0.009) were all negatively associated with receiving a perfect score. Patients who underwent a posterior-approach procedure compared with other approaches were less likely to report a low Press Ganey score (OR 0.297, p = 0.046). Patient sex and race did not influence the likelihood of receiving perfect or low Press Ganey scores. Finally, the perceived skill of the surgeon was not a significant predictor for perfect (p > 0.99) or low (p = 0.828) Press Ganey scores.

CONCLUSIONS

Patient participation in Press Ganey surveys strongly correlated with preoperative factors such as procedure approach and type, as well as postoperative factors such as LOS and complications. No factors were associated with an increased likelihood of receiving a perfect Press Ganey score. Similarly, LOS and time elapsed since surgery to survey completion were significant negative predictors of perfect Press Ganey scores. Skill of surgeon, sex, and race did not correlate with a predictive value for Press Ganey outcomes. In addition, overall comorbid disease burden was found to be a significant negative predictor for high patient satisfaction scores. Further study on predictors of patient satisfaction within spine surgery is needed to better assist physicians in improving the surgical experience for patients.

ABBREVIATIONS

CCI = Charlson Comorbidity Index; EDW = Electronic Data Warehouse; LOS = length of stay; MI = myocardial ischemia; VTE = venous thromboembolism.

Image from Barath et al. (pp 332–336).

 

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Contributor Notes

Correspondence Nader S. Dahdaleh: Northwestern University Feinberg School of Medicine, Chicago, IL. nader.dahdaleh@northwestern.edu.

INCLUDE WHEN CITING Published online January 4, 2019; DOI: 10.3171/2018.8.SPINE18594.

Disclosures Dr. Dahdaleh: consultant for DePuy, Stryker, and Spinal Elements.

  • 1

    Abtahi AM, Presson AP, Zhang C, Saltzman CL, Tyser AR: Association between orthopaedic outpatient satisfaction and non-modifiable patient factors. J Bone Joint Surg Am 97:10411048, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Al-Abri R, Al-Balushi A: Patient satisfaction survey as a tool towards quality improvement. Oman Med J 29:37, 2014

  • 3

    Bernstein DN, Brodell D, Li Y, Rubery PT, Mesfin A: Impact of the economic downturn on elective lumbar spine surgery in the united states: a national trend analysis, 2003 to 2013. Global Spine J 7:213219, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Bible JE, Shau DN, Kay HF, Cheng JS, Aaronson OS, Devin CJ: Are low patient satisfaction scores always due to the provider?: determinants of patient satisfaction scores during spine clinic visits. Spine (Phila Pa 1976) 43:5864, 2018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Biraben A, Allaf B: An instrument to assess patient satisfaction with epilepsy treatment. Epilepsy Behav 43:2429, 2015

  • 6

    Borghans I, Kleefstra SM, Kool RB, Westert GP: Is the length of stay in hospital correlated with patient satisfaction? Int J Qual Health Care 24:443451, 2012

  • 7

    Boulding W, Glickman SW, Manary MP, Schulman KA, Staelin R: Relationship between patient satisfaction with inpatient care and hospital readmission within 30 days. Am J Manag Care 17:4148, 2011

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD: Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 468:5763, 2010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Burkle CM, Keegan MT: Popularity of internet physician rating sites and their apparent influence on patients’ choices of physicians. BMC Health Serv Res 15:416, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Chapin L, Ward K, Ryken T: Preoperative depression, smoking, and employment status are significant factors in patient satisfaction after lumbar spine surgery. Clin Spine Surg 30:E725E732, 2017

    • Search Google Scholar
    • Export Citation
  • 11

    Cooper ME, Torre-Healy LA, Alentado VJ, Cho S, Steinmetz MP, Benzel EC, et al. : Heterogeneity of reporting outcomes in the spine surgery literature. Clin Spine Surg 31:E221E229, 2018

    • Search Google Scholar
    • Export Citation
  • 12

    Crawford CH III, Carreon LY, Bydon M, Asher AL, Glassman SD: Impact of preoperative diagnosis on patient satisfaction following lumbar spine surgery. J Neurosurg Spine 26:709715, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Davis H: Increasing rates of cervical and lumbar spine surgery in the United States, 1979–1990. Spine (Phila Pa 1976) 19:11171124, 1994

  • 14

    Elsamadicy AA, Reddy GB, Nayar G, Sergesketter A, Zakare-Fagbamila R, Karikari IO, et al. : Impact of gender disparities on short-term and long-term patient reported outcomes and satisfaction measures after elective lumbar spine surgery: a single institutional study of 384 patients. World Neurosurg 107:952958, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Etier BE Jr, Orr SP, Antonetti J, Thomas SB, Theiss SM: Factors impacting Press Ganey patient satisfaction scores in orthopedic surgery spine clinic. Spine J 16:12851289, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Hall JA, Dornan MC: Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med 30:811818, 1990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Hanauer DA, Zheng K, Singer DC, Gebremariam A, Davis MM: Public awareness, perception, and use of online physician rating sites. JAMA 311:734735, 2014

  • 18

    Hopkins BS, Patel MR, Yamaguchi JT, Cloney MB, Dahdaleh NS: Predictors of patient satisfaction and survey participation after spine surgery: a retrospective review of 17,853 consecutive spinal patients from a single academic institution. Part 2: HCAHPS. J Neurosurg [epub ahead of print January 4, 2019. DOI: 10.3171/2018.8.SPINE181024]

    • Search Google Scholar
    • Export Citation
  • 19

    Iachinski RE, de Meneses MS, Simão CA, da Rocha SF, de Oliveira Braga F, Kowacs PA: Patient satisfaction with temporal lobectomy/selective amygdalohippocampectomy for temporal lobe epilepsy and its relationship with Engel classification and the side of lobectomy. Epilepsy Behav 31:377380, 2014

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Jaipaul CK, Rosenthal GE: Are older patients more satisfied with hospital care than younger patients? J Gen Intern Med 18:2330, 2003

  • 21

    Kane RL, Maciejewski M, Finch M: The relationship of patient satisfaction with care and clinical outcomes. Med Care 35:714730, 1997

  • 22

    Levin JM, Winkelman RD, Smith GA, Tanenbaum J, Benzel EC, Mroz TE, et al. : The association between the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and real-world clinical outcomes in lumbar spine surgery. Spine J 17:15861593, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Levin JM, Winkelman RD, Smith GA, Tanenbaum JE, Benzel EC, Mroz TE, et al. : Impact of preoperative depression on hospital consumer assessment of healthcare providers and systems survey results in a lumbar fusion population. Spine (Phila Pa 1976) 42:675681, 2017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24

    Levin JM, Winkelman RD, Smith GA, Tanenbaum JE, Xiao R, Mroz TE, et al. : Emergency department visits after lumbar spine surgery are associated with lower Hospital Consumer Assessment of Healthcare Providers and Systems scores. Spine J 18:226233, 2018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Levin JM, Winkelman RD, Tanenbaum JE, Benzel EC, Mroz TE, Steinmetz MP: Key drivers of patient satisfaction in lumbar spine surgery. J Neurosurg Spine 28:586592, 2018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Linzer P, Filip M, Jurek P, Šálek T, Gajdoš M, Jarkovský J: Comparison of biochemical response between the minimally invasive and standard open posterior lumbar interbody fusion. Neurol Neurochir Pol 50:1623, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Macrodimitris S, Sherman EM, Williams TS, Bigras C, Wiebe S: Measuring patient satisfaction following epilepsy surgery. Epilepsia 52:14091417, 2011

  • 28

    Mirza SK, Deyo RA, Heagerty PJ, Turner JA, Lee LA, Goodkin R: Towards standardized measurement of adverse events in spine surgery: conceptual model and pilot evaluation. BMC Musculoskelet Disord 7:53, 2006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Morath J: Analysis finds HCAHPS response rates matter. Higher response rate linked to increased performance ratings. California Hospital Association. July 19, 2017 (https://www.calhospital.org/cha-news-article/analysis-finds-hcahps-response-rates-matter) [Accessed September 27, 2018]

    • Search Google Scholar
    • Export Citation
  • 30

    Robarts S, Stratford P, Kennedy D, Malcolm B, Finkelstein J: Evaluation of an advanced-practice physiotherapist in triaging patients with lumbar spine pain: surgeon-physiotherapist level of agreement and patient satisfaction. Can J Surg 60:266272, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Rogers F, Horst M, To T, Rogers A, Edavettal M, Wu D, et al. : Factors associated with patient satisfaction scores for physician care in trauma patients. J Trauma Acute Care Surg 75:110115, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Saunders CLEM, Elliott MN, Lyratzopoulos G, Abel GA: Do differential response rates to patient surveys between organizations lead to unfair performance comparisons?: evidence from the English Cancer Patient Experience Survey. Med Care 54:4554, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Schroeder GD, Coric D, Kim HJ, Albert TJ, Radcliff KE: Are patient-reported outcomes predictive of patient satisfaction 5 years after anterior cervical spine surgery? Spine J 17:943952, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Soroceanu A, Ching A, Abdu W, McGuire K: Relationship between preoperative expectations, satisfaction, and functional outcomes in patients undergoing lumbar and cervical spine surgery: a multicenter study. Spine (Phila Pa 1976) 37:E103E108, 2012

    • Search Google Scholar
    • Export Citation
  • 35

    Toomey SL, Elliott MN, Zaslavsky AM, Quinn J, Klein DJ, Wagner S, et al. : Improving response rates and representation of hard-to-reach groups in family experience surveys. Acad Pediatr [epub ahead of print], 2018

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Tsai TC, Orav EJ, Jha AK: Patient satisfaction and quality of surgical care in US hospitals. Ann Surg 261:28, 2015

  • 37

    United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States, ed 4. Rosemont, IL: BMUS, 2014

  • 38

    Weinstein JN, Lurie JD, Olson PR, Bronner KK, Fisher ES: United States’ trends and regional variations in lumbar spine surgery: 1992–2003. Spine (Phila Pa 1976) 31:27072714, 2006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39

    Wiebe N, Fiest KM, Dykeman J, Liu X, Jette N, Patten S, et al. : Patient satisfaction with care in epilepsy: how much do we know? Epilepsia 55:448455, 2014

  • 40

    Williams JA, Meltzer D, Arora V, Chung G, Curlin FA: Attention to inpatients’ religious and spiritual concerns: predictors and association with patient satisfaction. J Gen Intern Med 26:12651271, 2011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41

    Yamashita K, Hayashi J, Ohzono K, Hiroshima K: Correlation of patient satisfaction with symptom severity and walking ability after surgical treatment for degenerative lumbar spinal stenosis. Spine (Phila Pa 1976) 28:24772481, 2003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

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