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质量对我们的患者重要吗?手术结果和患者满意度之间的关系。

Is quality important to our patients? The relationship between surgical outcomes and patient satisfaction.

机构信息

Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

出版信息

BMJ Qual Saf. 2018 Jan;27(1):48-52. doi: 10.1136/bmjqs-2017-007071. Epub 2017 Nov 3.

Abstract

BACKGROUND

With greater transparency in health system reporting and increased reliance on patient-centred outcomes, patient satisfaction has become a priority in delivering quality care. We sought to explore the relationship between patient satisfaction and short-term outcomes in patients undergoing general surgical procedures.

METHODS

Satisfaction surveys were distributed to patients following discharge from the general surgery service at an academic hospital between June 2012 and March 2015. Short-term clinical outcomes were obtained from the American College of Surgeons National Surgical Quality Improvement Program database. Patients rated their level of satisfaction on a 5-point Likert scale, and ordered logistic regression model was used to determine predictors of high patient satisfaction.

RESULTS

757 patient satisfaction surveys were completed. The mean age of patients surveyed was 52.2 years; 60.0% of patients were female. The majority of patients underwent a laparoscopic procedure (85.9%) and were admitted as inpatients following surgery (72%). 91.5% of patients rated satisfaction of 4-5, and 95.0% said they would recommend the service. The odds of overall satisfaction were lower in patients who had complications (OR: 0.52, 95% CI 0.31 to 0.87) and 30-day readmission (OR: 0.35, 95% CI 0.17 to 0.70). Having elective surgery was associated with higher odds of satisfaction (OR: 1.62, 95% CI 1.07 to 2.47).

CONCLUSIONS

We found a significant association between patient satisfaction and both 30-day readmission and the occurrence of postoperative surgical complications. Given this association, further study is warranted to evaluate patient satisfaction as a healthcare quality indicator.

摘要

背景

随着医疗体系报告透明度的提高和对以患者为中心的结果的依赖程度的增加,患者满意度已成为提供优质护理的首要任务。我们试图探讨接受普通外科手术的患者的满意度与短期结果之间的关系。

方法

在 2012 年 6 月至 2015 年 3 月期间,在一家学术医院的普通外科服务出院后,向患者分发满意度调查。从美国外科医师学院国家外科手术质量改进计划数据库中获得短期临床结果。患者对满意度进行 5 分制 Likert 评分,使用有序逻辑回归模型确定高患者满意度的预测因素。

结果

完成了 757 份患者满意度调查。调查患者的平均年龄为 52.2 岁;60.0%的患者为女性。大多数患者接受腹腔镜手术(85.9%),术后住院(72%)。91.5%的患者评分为 4-5 分,95.0%表示会推荐该服务。有并发症(OR:0.52,95%CI 0.31-0.87)和 30 天再入院(OR:0.35,95%CI 0.17-0.70)的患者总体满意度较低。择期手术与满意度较高相关(OR:1.62,95%CI 1.07-2.47)。

结论

我们发现患者满意度与 30 天再入院率和术后手术并发症的发生之间存在显著关联。鉴于这种关联,有必要进一步研究将患者满意度作为医疗保健质量指标。

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