Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
J Arthroplasty. 2018 Apr;33(4):1008-1011. doi: 10.1016/j.arth.2017.10.033. Epub 2017 Nov 16.
Patient perception of care, commonly measured with Press Ganey (PG) surveys, is an important metric used to determine hospital and provider reimbursement. However, post-operative pain following total hip arthroplasty (THA) may negatively affect patient satisfaction. As a result, over-administration of opioids may occur, even without marked evidence of pain. Therefore, this study evaluated whether opioid consumption in the immediate postoperative period bears any influence on satisfaction scores after THA. Specifically, this study assessed the correlation between post-operative opioid consumption and 7 PG domains: (1) Overall hospital rating; (2) Communication with nurses; (3) Responsiveness of hospital staff; (4) Communication with doctors; (5) Hospital environment; (6) Pain Management; and (7) Communication about medicines.
Our institutional PG database was reviewed for patients who received THA from 2011 to 2014. A total of 322 patients (mean age = 65 years; 61% female) were analyzed. Patient's opioid consumption was measured using a morphine milli-equivalent conversion algorithm. Bivariate correlation analysis assessed the association between opioid consumption and Press-Ganey survey elements. Pearson's r assessed the strength of the association.
No correlation was found between total opioid consumption and Overall hospital rating (r = 0.004; P = .710), Communication with nurses (r = 0.093; P = .425), Responsiveness of hospital staff (r = 0.104; P = .381), Communication with doctors (r = 0.009; P = .940), Hospital environment (r = 0.081; P = .485), and Pain management (r = 0.075; P = .536). However, there was a positive correlation between total opioid consumption and "Communication about medicines" (r = 0.262; P = .043).
Our report demonstrates that PG patient satisfaction scores are not influenced by post-operative opioid use, with the exception of PG domain, "Communication about medications." These results suggest that opioid medications should be administered based solely on patient requirements without concern about patient satisfaction survey results.
患者对护理的感知，通常通过使用盖洛普民意调查（PG）来衡量，是用于确定医院和提供者报销的重要指标。然而，全髋关节置换术（THA）后的术后疼痛可能会降低患者的满意度。因此，即使没有明显的疼痛迹象，也可能会过度使用阿片类药物。因此，本研究评估了术后即刻阿片类药物的使用是否会对 THA 后的满意度评分产生影响。具体来说，本研究评估了术后阿片类药物消耗与 PG 七个领域之间的相关性：（1）整体医院评分；（2）与护士的沟通；（3）医院员工的响应能力；（4）与医生的沟通；（5）医院环境；（6）疼痛管理；和（7）药物沟通。
我们回顾了 2011 年至 2014 年接受 THA 的患者的机构 PG 数据库。共分析了 322 名患者（平均年龄= 65 岁；61%为女性）。患者的阿片类药物消耗使用吗啡毫当量换算算法进行测量。双变量相关分析评估了阿片类药物消耗与 PG 调查要素之间的关联。皮尔逊 r 评估了关联的强度。
总阿片类药物消耗与整体医院评分（r = 0.004；P =.710）、与护士的沟通（r = 0.093；P =.425）、医院员工的响应能力（r = 0.104；P =.381）、与医生的沟通（r = 0.009；P =.940）、医院环境（r = 0.081；P =.485）和疼痛管理（r = 0.075；P =.536）之间均无相关性。然而，总阿片类药物消耗与“药物沟通”之间存在正相关（r = 0.262；P =.043）。
我们的报告表明，PG 患者满意度评分不受术后阿片类药物使用的影响，除了 PG 领域“药物沟通”之外。这些结果表明，应根据患者的需求给予阿片类药物，而不必担心患者满意度调查结果。
