Hijji Fady Y, Narain Ankur S, Haws Brittany E, Witiw Christopher D, Kudaravalli Krishna T, Yom Kelly H, Deutsch Harel, Singh Kern
Department of Orthopaedic Surgery.
Department of Neurologic Surgery, Rush University Medical Center, Chicago, IL.
Clin Spine Surg. 2018 Mar;31(2):E127-E132. doi: 10.1097/BSD.0000000000000576.
A cross-sectional survey study.
The objective of this study is to determine if there are any differences in spine surgeon selection criteria between neurosurgery patients and orthopedic patients.
The evolution of the health care delivery system has allowed for increased patient autonomy in provider selection. However, the process and criteria by which patients choose particular spine surgeons is not well understood. Furthermore, differences in physician selection criteria used by patients who present either to a neurosurgery or orthopedic spine surgeon has not been previously established.
An anonymous questionnaire consisting of 26 questions was administered to 644 patients seeking treatment from either a single neurosurgery-trained or orthopedics-trained spine surgeon at an urban institution. Four questions pertained to demographic variables. Sixteen questions asked patients to rate specific spine surgeon selection criteria in terms of importance (scale, 1-10). Six questions were multiple choice, asking patients to select their preferences towards aspects of a spine surgeon. Patient responses were compared using χ analysis or Fisher exact test for categorical variables.
The 3 most important factors for selecting a spine surgeon were the same for neurosurgery and orthopedic surgery patients: board certification (neurosurgery, orthopedic surgery) (9.07±2.35, 9.22±1.79), in-network provider status (8.01±3.15, 8.09±3.03), and surgeon bedside manner (7.88±2.52, 8.07±2.29). When listing their preference regarding surgeon specialty training, 82.74% of neurosurgery patients and 48.81% of orthopedic surgery patients preferred a surgeon who was trained in neurosurgery.
The growth in patient autonomy within the current health care system has emphasized the importance of identifying patient preferences in the physician selection process.Board certification, in-network insurance status, and bedside manner may be the most influential factors for patients in spine surgeon selection irrespective of surgical subspecialty. Patients may also be more likely to seek spine surgeons with neurosurgery training over orthopedic surgery training. The present study provides spine surgeons a framework to improve both patient recruitment and patient satisfaction.
一项横断面调查研究。
本研究的目的是确定神经外科患者和骨科患者在脊柱外科医生选择标准上是否存在差异。
医疗保健提供系统的演变使患者在选择医疗服务提供者方面有了更大的自主权。然而，患者选择特定脊柱外科医生的过程和标准尚不清楚。此外，之前尚未确定向神经外科或骨科脊柱外科医生就诊的患者在医生选择标准上的差异。
向一家城市机构中寻求由单一神经外科培训或骨科培训的脊柱外科医生治疗的644名患者发放了一份由26个问题组成的匿名问卷。四个问题涉及人口统计学变量。十六个问题要求患者根据重要性（范围为1 - 10）对特定的脊柱外科医生选择标准进行评分。六个问题为多项选择题，要求患者选择他们对脊柱外科医生各方面的偏好。使用χ分析或Fisher精确检验对分类变量的患者回答进行比较。
神经外科和骨科手术患者选择脊柱外科医生的3个最重要因素相同：专业委员会认证（神经外科、骨科手术）（9.07±2.35，9.22±1.79）、网络内医疗服务提供者身份（8.01±3.15，8.09±3.03）以及医生的床边态度（7.88±2.52，8.07±2.29）。在列出他们对外科医生专业培训的偏好时，82.74%的神经外科患者和48.81%的骨科手术患者更喜欢接受过神经外科培训的医生。
当前医疗保健系统中患者自主权的增加凸显了在医生选择过程中确定患者偏好的重要性。无论手术亚专业如何，专业委员会认证、网络内保险状况和床边态度可能是患者选择脊柱外科医生时最具影响力的因素。与接受骨科手术培训的医生相比，患者也更有可能寻求接受过神经外科培训的脊柱外科医生。本研究为脊柱外科医生提供了一个改善患者招募和患者满意度的框架。
