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全髋关节置换术后患者的盖恩斯调查反应与结果之间无相关性。

No Correlation Between Press Ganey Survey Responses and Outcomes in Post-Total Hip Arthroplasty Patients.

机构信息

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.

Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.

出版信息

J Arthroplasty. 2018 Mar;33(3):783-785. doi: 10.1016/j.arth.2017.09.037. Epub 2017 Oct 6.

Abstract

BACKGROUND

In the era of the online orthopedic market, patients tend to equate publicly available online satisfaction surveys with what they presume their ultimate surgical outcome will be. Therefore, the purpose of this study was to assess whether there is a correlation between Press Ganey (PG) scores and (1) Hip Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip Score; (2) Short Form-12 and Short Form-36 scores; (3) University of California Los Angeles and Visual Analog Scale scores assessed at a mean of 3 years (range, 1 to 6 years) after surgery. In addition, we assessed whether (4) these correlations persist in patients who were evaluated under 2 years and 3 or more years after surgery.

METHODS

Six-hundred ninety-two patients from November 2009 to January 2015 were identified from our institutional PG database. One-hundred ninety (27%) responded to the survey. One-hundred forty-nine (78%) patients were given the total hip arthroplasty assessment tools at a minimum of 2-year follow-up, and 33 patients (17%) completed their survey before 2 years after surgery. We assessed whether overall hospital rating scores correlated with the above assessment tools.

RESULTS

Pearson correlation analysis revealed no correlation between the PG survey score and the assessment tools. HHS had the highest correlation coefficient (r = .120; P = .316); however, this was not significant. After removing the patients who had their follow-up survey administered under 2 years after surgery (33 patients), there was still no statistically significant correlation between the above-mentioned outcome scores and PG overall hospital rating (P > .05).

CONCLUSION

No statistically significant relationship was found between commonly used total hip arthroplasty assessment tools and the PG overall hospital rating. Based on these results, PG surveys may not be a suitable implementation of the Center for Medicare and Medicaid services. A set of measures that can be widely collected and reported by hospitals for patients to use in order to evaluate hip arthroplasty outcomes needs to be developed. These results are of paramount importance, indicating a necessary reevaluation of PG surveys as a major determinant for reimbursements rendered by orthopedists and their use by patients.

摘要

背景

在在线骨科市场时代,患者倾向于将公开提供的在线满意度调查等同于他们认为自己最终手术结果的情况。因此,本研究的目的是评估 PG 评分与以下内容之间是否存在相关性:(1) 西部安大略省和麦克马斯特大学骨关节炎指数和 Harris 髋关节评分;(2) 36 项简短健康调查问卷和 12 项简短健康调查问卷评分;(3) 在手术后平均 3 年(范围为 1 年至 6 年)时使用加利福尼亚大学洛杉矶分校和视觉模拟量表进行评估。此外,我们评估了在手术后 2 年和 3 年或更长时间接受评估的患者中,这些相关性是否仍然存在。

方法

从我们的机构 PG 数据库中确定了 2009 年 11 月至 2015 年 1 月期间的 692 名患者。有 190 名(27%)患者对调查做出了回应。149 名(78%)患者在至少 2 年的随访中接受了全髋关节置换术评估工具的评估,而 33 名(17%)患者在手术后 2 年内完成了调查。我们评估了医院总体评分与上述评估工具之间是否存在相关性。

结果

Pearson 相关分析显示 PG 调查评分与评估工具之间没有相关性。Harris 髋关节评分具有最高的相关系数(r=0.120;P=0.316);然而,这并不显著。去除手术后 2 年内接受随访调查的患者(33 名)后,PG 医院总体评分与上述结果评分之间仍无统计学显著相关性(P>0.05)。

结论

在常用的全髋关节置换术评估工具和 PG 医院总体评分之间未发现统计学显著关系。基于这些结果,PG 调查可能不是 Medicare 和 Medicaid 服务中心的合适实施方式。需要开发一套可由医院广泛收集和报告并供患者用于评估髋关节置换术结果的措施。这些结果至关重要,表明需要重新评估 PG 调查作为支付给骨科医生的主要决定因素以及患者对其的使用。

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