Bernstein David N, Fear Kathleen, Mesfin Addisu, Hammert Warren C, Mitten David J, Rubery Paul T, Baumhauer Judith F
University of Rochester School of Medicine & Dentistry, Rochester, New York, USA.
University of Rochester Medical Center, Rochester, New York, USA.
Musculoskeletal Care. 2019 Mar;17(1):120-125. doi: 10.1002/msc.1379. Epub 2019 Jan 7.
The Patient-Reported Outcomes Measurement Information System (PROMIS) is growing in popularity as healthcare shifts towards a value-based system. However, it remains unclear if PROMIS use improves the patient experience. The aim of the present study was to determine if PROMIS use as part of routine orthopaedic clinical care is associated with improved patient experience, as measured by the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) survey.
All patient visits to an orthopaedic surgery clinic at a single academic medical centre between February 2015 and September 2016 were reviewed. Accounting for known patient factors that have an impact on clinic visit satisfaction, CGCAHPS scores were compared between patients who had PROMIS used as part of their routine care and those who had not had PROMIS used as part of their routine care. A p-value of <0.05 was considered significant.
A total of 8,607 patient visits fitted our inclusion criteria. Of these, surgeons elected not to use PROMIS in 8,422 patient encounters, leaving 185 patient visits in which PROMIS was actively used. When PROMIS was used, patients were significantly more likely to feel that the provider had spent enough time with them, to recommend this provider office to another patient and to rate the provider significantly higher on a scale from 0 to 10. Although not significant, a trend was found between use of PROMIS and whether a patient felt that a provider explained health information in way that the patient understood.
PROMIS use in an orthopaedic clinic visit can have a positive impact on the patient experience, which is currently part of a number of alternative payment models.
随着医疗保健向基于价值的体系转变,患者报告结果测量信息系统(PROMIS)越来越受欢迎。然而,PROMIS的使用是否能改善患者体验仍不清楚。本研究的目的是确定在常规骨科临床护理中使用PROMIS是否与改善患者体验相关,这通过医疗服务提供者和系统的临床医生及团体消费者评估(CGCAHPS)调查来衡量。
回顾了2015年2月至2016年9月期间在单一学术医疗中心的骨科手术诊所的所有患者就诊情况。在考虑已知会影响就诊满意度的患者因素后,比较了将PROMIS用作常规护理一部分的患者和未将PROMIS用作常规护理一部分的患者的CGCAHPS评分。p值<0.05被认为具有统计学意义。
共有8607次患者就诊符合我们的纳入标准。其中,外科医生在8422次患者会诊中选择不使用PROMIS,剩下185次患者就诊积极使用了PROMIS。当使用PROMIS时,患者更有可能觉得医疗服务提供者与他们相处的时间足够,更有可能向另一位患者推荐该医疗服务提供者办公室,并且在0至10的评分中对医疗服务提供者的评分显著更高。虽然不显著,但在使用PROMIS与患者是否觉得医疗服务提供者以患者能理解的方式解释健康信息之间发现了一种趋势。
在骨科诊所就诊中使用PROMIS可对患者体验产生积极影响,而患者体验目前是多种替代支付模式的一部分。