University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA.
Department of Physical Medicine and Rehabilitation, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.
Spine J. 2020 Feb;20(2):207-212. doi: 10.1016/j.spinee.2019.09.024. Epub 2019 Sep 26.
Hospitals and policy makers have placed increasing importance on patient satisfaction with medical care. Minimal research exists on patient satisfaction in the context of epidural steroid injections (ESIs) for radicular pain.
Describe patient satisfaction with ESIs for the treatment of radicular pain and identify patient demographic and clinical characteristics associated with patient satisfaction.
STUDY DESIGN/SETTING: This was a retrospective study conducted at a large, academic medical center.
This was a single-center retrospective study of prospectively collected registry data including patients treated with ESIs from August 2006 to May 2018. The primary outcomes were: overall Press Ganey (PG) score, patient satisfaction with the physician, and likelihood to recommend both the physician and the practice. Age, body mass index, Charlson Comorbidity Index, immediate change in pain, sex, spinal segmental level of injection, prior opioid use, insurance status, and ethnicity were compared with the four PG measures of satisfaction using both univariable and multivariable regression analysis. No sources of funding were used for this project. The authors report no conflict of interest in relation to this manuscript.
Two-hundred ninety patients underwent 377 injections. Overall, patients were highly satisfied; 86% recommend their physician and 85% recommend the practice, each with the highest possible PG score. The median overall PG score was 97.2 (interquartile range [IQR]: 89.3, 100), and the median physician satisfaction score was 100 (IQR: 95, 100). The median immediate reduction in pain was 3 points (IQR: -5,-2) on the numerical rating scale scale postinjection. Increased age was associated with increased satisfaction with the physician (reported rate ratios [Relative Risk (RR)] for dissatisfaction: 0.73, 95% confidence interval [CI]: 0.58, 0.93, p=.011) and increased likelihood to recommend the physician (odds ratio: 1.46, 95% CI: 1.06, 2.01, p=.022) in multivariable analysis. Medicare as opposed to private insurance was associated with higher dissatisfaction with the physician (RR: 2.04, 95% CI: 1.15, 3.61, p=.014) and decreased likelihood to recommend the practice (RR: 0.38, 95% CI: 0.15, 0.94, p=.037).
The present data, based on PG scores, demonstrated that ESIs are associated with greater patient satisfaction with increasing age, but lower satisfaction in patients with Medicare compared with private insurance when controlling for other demographic factors. Satisfaction was not associated with the degree of pain relief.
医院和政策制定者越来越重视患者对医疗服务的满意度。关于硬膜外类固醇注射（ESI）治疗神经根痛患者满意度的研究甚少。
描述接受 ESI 治疗神经根痛患者的满意度，并确定与患者满意度相关的患者人口统计学和临床特征。
研究设计/设置：这是在一家大型学术医疗中心进行的回顾性研究。
这是一项单中心回顾性研究，对 2006 年 8 月至 2018 年 5 月前瞻性收集的登记数据进行分析。主要结局指标为：整体盖恩尼（PG）评分、患者对医生的满意度以及对医生和实践的推荐意愿。采用单变量和多变量回归分析，比较年龄、体重指数、Charlson 合并症指数、疼痛即刻变化、性别、脊柱节段注射水平、既往阿片类药物使用、保险状况和种族与 4 项 PG 满意度测量指标。本项目未使用任何资金来源。作者声明与本手稿无关的利益冲突。
290 例患者接受了 377 次注射。总体而言，患者非常满意；86%的患者推荐他们的医生，85%的患者推荐他们的治疗机构，每个患者的推荐得分都达到了 PG 评分的最高分。整体 PG 评分中位数为 97.2（四分位距[IQR]：89.3，100），医生满意度评分中位数为 100（IQR：95，100）。疼痛数字评分量表（numerical rating scale scale）上疼痛即刻减轻 3 分（IQR：-5，-2）。年龄增加与医生满意度增加相关（不满意的报告比率比[相对风险（RR）]：0.73，95%置信区间[CI]：0.58，0.93，p=.011），推荐医生的可能性增加（优势比：1.46，95%CI：1.06，2.01，p=.022）。与私人保险相比，医疗保险与对医生的满意度降低（RR：2.04，95%CI：1.15，3.61，p=.014）和对实践的推荐意愿降低（RR：0.38，95%CI：0.15，0.94，p=.037）相关。
基于 PG 评分，本研究数据表明，ESI 与患者满意度增加相关，年龄越大，满意度越高，但在控制其他人口统计学因素后，与私人保险相比，医疗保险患者的满意度较低。满意度与疼痛缓解程度无关。
