Tyser A R, Abtahi A M, McFadden M, Presson A P
Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
Department of Internal Medicine, Division of Epidemiology, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
BMC Health Serv Res. 2016 Aug 4;16(a):350. doi: 10.1186/s12913-016-1595-z.
Measures of patient satisfaction have gained prominence in recent years as changes to the American health care system have led to the incorporation of such metrics into reimbursement models. The response rate for widely-used outpatient satisfaction metrics and variables influencing the probability of survey nonresponse remain largely unknown.
We reviewed all unique adult patients (16,779) who completed an outpatient encounter in the Department of Orthopaedic surgery at our academic institution from 1/1/13 to 10/24/13. Survey data was linked to each clinic visit, and patient factors including age, sex, insurance type, zip code, and orthopaedic subspecialty visited were recorded. The overall survey response rate was calculated. Logistic regression was performed, and unadjusted and adjusted odds ratios of patients' probability of responding to the Press-Ganey survey were calculated.
Two thousand seven hundred sixty two (16.5 %) of individuals completed a Press-Ganey patient satisfaction survey and 14017 patients did not respond. For those patients considered responders, 906 patients (32.8 %) did not complete all the survey items. Among these 906 patients, the mean number of missing items was 2.24 (Standard Deviation SD: 2.19). Age, sex, insurance type, and orthopaedic subspecialty were all found to be associated with the odds of responding to our patient satisfaction survey. Advancing age increased the odds of responding to the survey (Adjusted Odds Ratio (OR) = 3.396 for ≥65 vs. 18-29, p < 0.001). Several variables were associated with a decreased odds of survey response, and included male sex (Adjusted OR = 0.782 for Males vs. Females, p < 0.001), insurance type (Adjusted OR = 0.311 for Medicaid/Self-Pay vs. Private), and subspecialty type (Adjusted OR = 0.623 for Trauma vs. Adult Reconstruction).
The response rate to the Press-Ganey Medical Practice Survey of outpatient satisfaction is low in an orthopaedic outpatient population, and furthermore, is impacted by patient characteristics such as age, sex, insurance type, and type of orthopaedic subspecialist encountered. The findings of the present study should inform future non-response weighting procedures in this area. More research is needed to assess non-response bias-including follow-up studies of non-respondents-in order to more accurately measure of patient satisfaction.
近年来，随着美国医疗保健系统的变革促使将患者满意度指标纳入报销模式，患者满意度测量变得愈发重要。广泛使用的门诊患者满意度指标的回复率以及影响调查无回复概率的变量在很大程度上仍不为人知。
我们回顾了2013年1月1日至2013年10月24日在我们学术机构骨科完成门诊诊疗的所有成年患者（16779例）。调查数据与每次门诊就诊相关联，并记录了患者的因素，包括年龄、性别、保险类型、邮政编码以及就诊的骨科亚专业。计算总体调查回复率。进行逻辑回归分析，并计算患者对Press-Ganey调查做出回应的概率的未调整和调整后的优势比。
2762例（16.5%）个体完成了Press-Ganey患者满意度调查，14017例患者未回复。对于那些被视为回复者的患者，906例（32.8%）未完成所有调查项目。在这906例患者中，缺失项目的平均数为2.24（标准差SD：2.19）。年龄、性别、保险类型和骨科亚专业均被发现与我们患者满意度调查的回应概率相关。年龄增长增加了回应调查的概率（≥65岁与18 - 29岁相比，调整后的优势比（OR）= 3.396，p < 0.001）。几个变量与调查回应概率降低相关，包括男性（男性与女性相比，调整后的OR = 0.782，p < 0.001）、保险类型（医疗补助/自费与私人保险相比，调整后的OR = 0.311）以及亚专业类型（创伤与成人重建相比，调整后的OR = 0.623）。
在骨科门诊人群中，Press-Ganey门诊患者满意度医疗实践调查的回复率较低，此外，还受到年龄、性别、保险类型以及所遇到的骨科亚专科类型等患者特征的影响。本研究结果应为该领域未来的无回复加权程序提供参考。需要更多研究来评估无回复偏差，包括对未回复者的随访研究，以便更准确地测量患者满意度。
