手外科门诊患者满意度：对影响Press Ganey调查因素的分析
Patient Satisfaction in the Hand Surgery Clinic: An Analysis of Factors That Impact the Press Ganey Survey.
作者信息
Rane Ajinkya A, Tyser Andrew R, Presson Angela P, Zhang Chong, Kazmers Nikolas H
机构信息
Department of Orthopaedics.
Division of Public Health, University of Utah, Salt Lake City, UT.
出版信息
J Hand Surg Am. 2019 Jul;44(7):539-547.e1. doi: 10.1016/j.jhsa.2019.03.015. Epub 2019 May 15.
PURPOSE
Our purpose was to test the null hypothesis that no patient or clinic visit characteristics affect satisfaction of hand surgery outpatients, as measured by the Press Ganey Outpatient Medical Practice Survey (PGOMPS).
METHODS
Adult patients (≥ 18 years) evaluated by 5 fellowship-trained hand surgeons between January 2014 and December 2016 for a new patient clinic visit at a single tertiary academic medical center, were included. Prospectively collected PGOMPS data were reviewed retrospectively for each visit. Chart review was performed to collect demographic and visit characteristics data. Satisfaction was defined a priori as achieving a PGOMPS score above the 33rd percentile. Both the PGOMPS Total Score (primary outcome) and Provider Subscore (secondary outcome) were analyzed using univariate and multivariable logistic regression.
RESULTS
Of 748 included patients, the mean age was 51.7 ± 15.5 years, and 64% were women. Leading diagnoses included tendinitis (19%), neuropathy (19%), arthritis (16%), and fracture-dislocation (13%). Multivariable modelling of the PGOMPS Total Score revealed that older age, shorter wait times, and scheduling surgery were significantly associated with greater satisfaction. The PGOMPS Provider Sub-Score multivariable modelling revealed that older age, shorter wait times, scheduling surgery, and administering injections were significantly associated with greater satisfaction. Diagnostic category and insurance status did not affect satisfaction.
CONCLUSIONS
Increasing patient age, decreased wait time, and receiving an intervention (scheduling of surgery or receiving an injection) are associated with increased satisfaction among newly presenting hand surgery clinic patients as measured by the Press Ganey Outpatient Medical Practice Survey. Diagnosis and access to health care (insurance status and distance to clinic) did not influence patient satisfaction.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic III.
目的
我们的目的是检验零假设，即没有患者或门诊就诊特征会影响手外科门诊患者的满意度，该满意度通过Press Ganey门诊医疗实践调查（PGOMPS）来衡量。
方法
纳入2014年1月至2016年12月期间在一家单一的三级学术医疗中心由5名接受过 fellowship 培训的手外科医生进行初诊的成年患者（≥18岁）。对每次就诊时前瞻性收集的PGOMPS数据进行回顾性审查。进行病历审查以收集人口统计学和就诊特征数据。满意度预先定义为PGOMPS得分高于第33百分位数。使用单变量和多变量逻辑回归分析PGOMPS总分（主要结局）和提供者子得分（次要结局）。
结果
在748名纳入患者中，平均年龄为51.7±15.5岁，64%为女性。主要诊断包括肌腱炎（19%）、神经病变（19%）、关节炎（16%）和骨折脱位（13%）。PGOMPS总分的多变量建模显示，年龄较大、等待时间较短和安排手术与更高的满意度显著相关。PGOMPS提供者子得分的多变量建模显示，年龄较大、等待时间较短、安排手术和注射与更高的满意度显著相关。诊断类别和保险状况不影响满意度。
结论
根据Press Ganey门诊医疗实践调查，患者年龄增加、等待时间减少以及接受干预（安排手术或接受注射）与新就诊的手外科门诊患者满意度提高相关。诊断和获得医疗保健的机会（保险状况和到诊所的距离）不影响患者满意度。
研究类型/证据水平：诊断性III级。
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