Martin Luke, Presson Angela P, Zhang Chong, Ray David, Finlayson Samuel, Glasgow Robert
Department of Surgery, 3B 110 School of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah.
Department of Internal Medicine, 4C 104 School of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah.
J Surg Res. 2017 Jun 15;214:247-253. doi: 10.1016/j.jss.2017.03.029. Epub 2017 Apr 1.
Patient satisfaction surveys are an important tool in measuring physician performance. We hypothesized that nonmodifiable factors would be associated with surgical outpatient satisfaction scores.
Press Ganey Consumer Assessment of Health Providers and Systems outpatient satisfaction scores from completed surveys (18,373) at an academic department of surgery were reviewed. Data were collected on patient factors, provider specialty, practice setting, and first visit status. Patients were divided into groups based on satisfaction scores-completely satisfied (score = 100) or less satisfied (score ≤99). Generalized estimating equation logistic regression analysis was performed to identify factors predictive of patient satisfaction.
Patients less likely to be completely satisfied were younger (odds ratio [OR] 0.54; confidence interval [CI] 0.43-0.69, P < 0.001 for 18-29 y versus >80 y) and were more likely to be seeing their surgeon for the first time (OR 0.84; CI 0.78-0.89, P < 0.001 for first versus return patients). Compared with patients seen at hospital subspecialty clinics, patients were more likely to be satisfied if seen at a cancer center clinic (OR 1.22; CI 1.13-1.32, P < 0.001) or a community ambulatory clinic (OR 1.30; CI 1.18-1.43, P < 0.001). There was no difference in satisfaction among patients seen in General Surgery, Plastic Surgery, or Otolaryngology Clinics. Patients were less likely to be satisfied when seen in Urology (OR 0.82; CI 0.75-0.91, P < 0.001) and Vascular Surgery (OR 0.75; CI 0.62-0.92, P = 0.006) clinics compared with General Surgery Clinics.
Using satisfaction scores to evaluate providers should take into account nonmodifiable factors of the underlying patient population, the specialty of the provider, and the practice setting of the visit.
患者满意度调查是衡量医生表现的一项重要工具。我们推测不可改变因素与外科门诊患者满意度评分相关。
回顾了某学术外科科室已完成调查(共18373份)的Press Ganey医疗服务提供者及系统消费者评估门诊患者满意度评分。收集了患者因素、提供者专业、执业环境及首次就诊状态的数据。根据满意度评分将患者分为完全满意组(评分 = 100)或较不满意组(评分≤99)。进行广义估计方程逻辑回归分析以确定预测患者满意度的因素。
不太可能完全满意的患者更年轻(比值比[OR] 0.54;置信区间[CI] 0.43 - 0.69,18 - 29岁患者与80岁以上患者相比,P < 0.001),且更有可能是首次看外科医生(OR 0.84;CI 0.78 - 0.89,初诊患者与复诊患者相比,P < 0.001)。与在医院专科门诊就诊的患者相比,在癌症中心门诊(OR 1.22;CI 1.13 - 1.32,P < 0.001)或社区门诊(OR 1.30;CI 1.18 - 1.43,P < 0.001)就诊的患者更有可能感到满意。普通外科、整形外科或耳鼻喉科门诊的患者满意度无差异。与普通外科门诊相比,泌尿外科(OR 0.82;CI 0.75 - 0.91,P < 0.001)和血管外科门诊(OR 0.75;CI 0.62 - 0.92,P = 0.006)的患者满意度较低。
使用满意度评分评估医疗服务提供者时应考虑患者群体的不可改变因素、提供者的专业以及就诊的执业环境。