Compton Jocelyn, Glass Natalie, Fowler Timothy
Department of Orthopedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
JB JS Open Access. 2019 Jun 11;4(2):e0003. doi: 10.2106/JBJS.OA.19.00003. eCollection 2019 Apr-Jun.
Rating the patient experience is an increasingly important component of value-based health care. Generation of lower ratings on validated functional assessments by patients with Workers' Compensation is well known; however, the relationship between Workers' Compensation status and patient satisfaction is poorly described in orthopaedic patient populations.
All orthopaedic outpatient patient satisfaction surveys (Press Ganey) generated over an 18-month period at a U.S. academic tertiary care center were included in this study. Data with regard to the primary payer, demographic characteristics, orthopaedic subspecialty, and planned surgical interventions with the provider for whom the survey was completed were analyzed in conjunction with patient satisfaction data.
During the study period, 3,720 consecutive patient satisfaction surveys were generated, and 244 surveys were generated by 215 patients with Workers' Compensation. Satisfied patients with Workers' Compensation were more likely to be male (p = 0.0007), to have higher mental health self-assessments (p = 0.004), and to be scheduled for surgical intervention (p = 0.03). Scheduling a surgical procedure was independently associated with improved patient satisfaction, whereas Workers' Compensation status was independently associated with dissatisfaction when adjusting for sex, language, race, and marital status. Across all patient satisfaction domains, patients with Workers' Compensation gave significantly lower scores (p < 0.05) compared with all other patients. Patients with Workers' Compensation were more likely to rate their overall health as lower compared with other patients (p < 0.0001). Patients with Workers' Compensation were more likely to give lower ratings to providers on a 1-to-10 scale (p < 0.0001) and were less likely to recommend the practice to others (p < 0.0001).
Workers' Compensation status is a non-modifiable independent predictor of dissatisfaction with health care compared with other primary payer groups. Further research is warranted to understand the factors influencing patient satisfaction ratings.
对患者体验进行评分是基于价值的医疗保健中日益重要的组成部分。工伤赔偿患者在经过验证的功能评估中获得较低评分是众所周知的；然而，在骨科患者群体中，工伤赔偿状态与患者满意度之间的关系描述甚少。
本研究纳入了美国一家学术三级医疗中心在18个月期间生成的所有骨科门诊患者满意度调查（Press Ganey）。结合患者满意度数据，分析了有关主要支付方、人口统计学特征、骨科亚专业以及完成调查的提供者所计划的手术干预等数据。
在研究期间，共生成了3720份连续的患者满意度调查，其中215名工伤赔偿患者生成了244份调查。工伤赔偿满意患者更可能为男性（p = 0.0007），心理健康自我评估得分更高（p = 0.004），且计划接受手术干预（p = 0.03）。安排手术与患者满意度提高独立相关，而在调整性别、语言、种族和婚姻状况后，工伤赔偿状态与不满独立相关。在所有患者满意度领域中，工伤赔偿患者的得分明显低于所有其他患者（p < 0.05）。与其他患者相比，工伤赔偿患者更可能将其整体健康状况评为较低（p < 0.0001）。工伤赔偿患者更可能在1至10分的量表上给提供者较低评分（p < 0.0001），且不太可能向他人推荐该医疗机构（p < 0.0001）。
与其他主要支付方群体相比，工伤赔偿状态是医疗保健不满的一个不可改变的独立预测因素。有必要进行进一步研究以了解影响患者满意度评分的因素。
