Department of Orthopaedics, University of Utah, Salt Lake City, Utah.
J Arthroplasty. 2018 Aug;33(8):2417-2422. doi: 10.1016/j.arth.2018.03.044. Epub 2018 Mar 27.
Patient delivery of care satisfaction surveys have emerged as instruments to assess the quality of health care at both the hospital and provider levels. We evaluated the correlation between these care satisfaction surveys and patient-reported outcomes (PROs).
We reviewed secondary data on 540 patients with 540 random visits who underwent primary total joint arthroplasty between January 2014 and February 2017. The Press Ganey Outpatient Medical Practice Survey was collected from outpatient clinical encounters to measure patient satisfaction with their experience and matched to PRO measures from the same encounter. The PROs evaluated included the Patient-Reported Outcomes Measurement Information System physical function computerized adaptive test, v1.2, and the Patient-Reported Outcomes Measurement Information System Global 10 health survey. In addition to the random selection, we reviewed separate cross-sections of the data including preoperative visits within 90 days of the index procedure, all postoperative visits at least 1 year from the index procedure, and the magnitude of change in PRO scores from preoperative to a minimum 1-year postoperative visit. Data were evaluated using the Spearman correlation coefficient (r).
There was little if any correlation between the Press Ganey scores and PROs at all time points evaluated (all, r: -0.13 to 0.14). When evaluating knee and hip arthroplasty cases separately, the data demonstrated similar results (all, r: -0.33 to 0.18).
We found little, if any, correlation between a patient's satisfaction with their care experience and their own perception of physical function and global health measures at all time points evaluated. These data question the utility of these scores as surrogate measures of health care quality, especially when reimbursements become tied to these metrics.
患者提供的护理满意度调查已成为评估医院和医疗服务提供者层面医疗保健质量的工具。我们评估了这些护理满意度调查与患者报告的结果（PRO）之间的相关性。
我们回顾了 2014 年 1 月至 2017 年 2 月期间接受初次全关节置换术的 540 名患者的 540 次随机就诊的二级数据。从门诊临床就诊中收集了盖恩尼（Press Ganey）门诊医疗实践调查，以衡量患者对其就诊体验的满意度，并与同一就诊的 PRO 测量结果相匹配。评估的 PRO 包括患者报告的结果测量信息系统物理功能计算机自适应测试，v1.2 和患者报告的结果测量信息系统全球 10 项健康调查。除了随机选择之外，我们还审查了数据的单独横断面，包括索引手术前 90 天内的术前就诊、索引手术后至少 1 年的所有术后就诊以及从术前到至少 1 年的术后就诊期间 PRO 评分的变化幅度。使用 Spearman 相关系数（r）评估数据。
在评估的所有时间点，盖恩尼评分与 PRO 之间几乎没有相关性（均为 r：-0.13 至 0.14）。当分别评估膝关节和髋关节置换术病例时，数据显示出类似的结果（均为 r：-0.33 至 0.18）。
我们发现，在评估的所有时间点，患者对其护理体验的满意度与其对身体功能和全球健康状况的自我感知之间几乎没有相关性。这些数据质疑这些评分作为医疗保健质量替代衡量标准的效用，尤其是当报销与这些指标挂钩时。
