Division of General Surgery, Colon and Rectal Surgery, Vanderbilt University Medical Center, 1161 21st Ave South, Room D5248 MCN, Nashville, TN, 37232, USA.
Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA.
Surg Endosc. 2021 Jan;35(1):309-316. doi: 10.1007/s00464-020-07401-1. Epub 2020 Feb 10.
Healthcare reimbursement is rapidly moving away from a fee-for-service model toward value-based purchasing. An integral component of this new focus on quality is patient-centered outcomes. One metric used to define patient satisfaction is the Press Ganey Patient Satisfaction Survey. Data are lacking to accurately benchmark these scores based on diagnosis. We sought to identify if different colorectal disease processes affected a patient's perception of their healthcare experience.
Adult colorectal patients seen between July 2015 and September 2016 in a tertiary hospital colorectal clinic were mailed a Press Ganey survey. Patients were stratified based on diagnosis: neoplasia, IBD, anorectal and benign colorectal disease. Survey scores were compared across the groups with adjustment for confounding variables.
312 patients responded and formed the cohort. The mean age was 61 (range 18-93) and 56% were women. The cohort breakdown was 38% neoplasia, 32% anorectal, 21% benign, and 9% IBD. In a multivariable model, there was a difference in PG scores by diagnosis; patients with neoplasia had higher Overall scores (β 10.2; Std Error 4.0; p = 0.01), Care Provider scores (β 8.5; Std Error 4.2; p = 0.04), Nurse Assistant scores (β 15.0; Std Error 5.7; p = 0.01), and Personal Issues scores (β 11.8; Std Error 5/0; p = 0.01).
Press Ganey scores were found to vary significantly. Patients with a neoplasia diagnosis reported higher overall satisfaction, Care Provider, Nurse Assistant, and Personal Issues scores. Adjustment for disease condition is important when assessing patient satisfaction as an indicator of quality and as a metric for reimbursement. This study adds to increasing evidence about bias in these scores.
医疗保健报销正迅速从按服务收费模式向基于价值的购买模式转变。这种新的质量重点的一个组成部分是患者为中心的结果。用于定义患者满意度的一个指标是盖恩斯民意调查患者满意度调查。基于诊断准确地对这些分数进行基准测试的数据不足。我们试图确定不同的结直肠疾病过程是否会影响患者对其医疗保健体验的看法。
2015 年 7 月至 2016 年 9 月在一家三级医院结直肠诊所就诊的成年结直肠患者收到了一份盖恩斯民意调查。根据诊断将患者分层：肿瘤、炎症性肠病、肛门直肠和良性结直肠疾病。在调整混杂变量后，比较了各组的调查评分。
312 名患者做出了回应，并组成了队列。平均年龄为 61 岁（范围 18-93 岁），56%为女性。队列分为 38%的肿瘤、32%的肛门直肠、21%的良性和 9%的炎症性肠病。在多变量模型中，诊断之间的 PG 评分存在差异；患有肿瘤的患者总体评分较高（β 10.2；标准误差 4.0；p = 0.01）、护理人员评分（β 8.5；标准误差 4.2；p = 0.04）、护士助理评分（β 15.0；标准误差 5.7；p = 0.01）和个人问题评分（β 11.8；标准误差 5.0/0；p = 0.01）。
发现盖恩斯民意调查评分差异显著。患有肿瘤诊断的患者报告总体满意度、护理人员、护士助理和个人问题评分较高。在评估患者满意度作为质量指标和报销指标时，调整疾病状况很重要。本研究增加了这些评分存在偏差的证据。
