Schwartz Tayler M, Tai Miao, Babu Kavita M, Merchant Roland C
Alpert Medical School of Brown University.
Department of Biostatistics, School of Public Health, Brown University; Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI.
Ann Emerg Med. 2014 Nov;64(5):469-81. doi: 10.1016/j.annemergmed.2014.02.010. Epub 2014 Mar 27.
We explore the relationship between Press Ganey emergency department (ED) patient satisfaction scores and ED administration of analgesic medications, including amount of opioid analgesics received, among patients who completed a patient satisfaction survey.
We conducted a secondary data analysis of Press Ganey ED patient satisfaction surveys from patients discharged from 2 academic, urban EDs October 2009 to September 2011. We matched survey responses to data on opioid and nonopioid analgesics administered in the ED, demographic characteristics, and temporal factors from the ED electronic medical records. We used polytomous logistic regression to compare quartiles of overall Press Ganey ED patient satisfaction scores to administration of analgesic medications, opioid analgesics, and number of morphine equivalents received. We adjusted models for demographic and hospital characteristics and temporal factors.
Of the 4,749 patients who returned surveys, 48.5% received analgesic medications, and 29.6% received opioid analgesics during their ED visit. Mean overall Press Ganey ED patient satisfaction scores for patients receiving either analgesic medications or opioid analgesics were lower than for those who did not receive these medications. In the univariable polytomous logistic regression analysis, receipt of analgesic medications, opioid analgesics, and a greater number of morphine equivalents were associated with lower overall scores. However, in the multivariable analysis, receipt of analgesic medications or opioid analgesics was not associated with overall scores, and receipt of greater morphine equivalents was inconsistently associated with lower overall scores.
Overall Press Ganey ED patient satisfaction scores were not primarily based on in-ED receipt of analgesic medications or opioid analgesics; other factors appear to be more important.
我们探讨了在完成患者满意度调查的患者中，Press Ganey急诊科（ED）患者满意度评分与ED给予止痛药物之间的关系，包括阿片类止痛药物的使用量。
我们对2009年10月至2011年9月从两家学术性城市ED出院的患者的Press Ganey ED患者满意度调查进行了二次数据分析。我们将调查回复与ED中给予的阿片类和非阿片类止痛药物数据、人口统计学特征以及ED电子病历中的时间因素进行匹配。我们使用多分类逻辑回归来比较Press Ganey ED患者总体满意度评分的四分位数与止痛药物、阿片类止痛药物的使用以及吗啡当量的接受数量。我们对人口统计学和医院特征以及时间因素进行了模型调整。
在4749名回复调查的患者中，48.5%在ED就诊期间接受了止痛药物，29.6%接受了阿片类止痛药物。接受止痛药物或阿片类止痛药物的患者的Press Ganey ED患者总体满意度评分均值低于未接受这些药物的患者。在单变量多分类逻辑回归分析中，接受止痛药物、阿片类止痛药物以及更多的吗啡当量与较低的总体评分相关。然而，在多变量分析中，接受止痛药物或阿片类止痛药物与总体评分无关，而接受更多的吗啡当量与较低的总体评分之间的关联并不一致。
Press Ganey ED患者总体满意度评分并非主要基于在ED中接受止痛药物或阿片类止痛药物；其他因素似乎更为重要。
