Rane Ajinkya A, Tyser Andrew R, Kazmers Nikolas H
Department of Orthopaedics, University of Utah, Salt Lake City, Utah.
JB JS Open Access. 2019 Oct 18;4(4):e0014. doi: 10.2106/JBJS.OA.19.00014. eCollection 2019 Oct-Dec.
The Press Ganey Outpatient Medical Practice Survey is a commonly utilized questionnaire that attempts to measure satisfaction with outpatient health care. A wide variety of factors have been associated with lower satisfaction scores among orthopaedic patients, including age, sex, presence of psychological disorders, and driving distance to the point of care. The impact of clinic workflows is less clear. In this study, we hypothesized that an increased clinic wait time was an independent predictor of lower patient satisfaction as measured by the Press Ganey survey.
We retrospectively reviewed 4,216 new outpatient orthopaedic surgery visits between January 1, 2014, and December 31, 2016, at a single academic institution. For patients with multiple visits, only the first new patient visit was analyzed. Satisfaction was defined as achieving a score above the 33rd percentile of the cohort. Univariate analysis followed by multivariable binary logistic regression was used to detect factors associated with patient satisfaction.
Of the 4,216 unique patients, the mean age (and standard deviation) was 52.8 ± 15.8 years, and 58.9% of the patients were female. The mean total wait time was 17.8 ± 19.4 minutes. Univariate analysis revealed greater odds of achieving satisfaction on the Press Ganey survey for a wait time of <15 minutes compared with a wait time of ≥15 minutes; the odds ratio (OR) was 3.78 (95% confidence interval [CI], 3.30 to 4.33; p < 0.01). The multivariable model revealed an association between satisfaction and wait time while controlling for other potential contributing factors: the odds of achieving satisfaction after waiting for 15 to 29 minutes were 0.36 (95% CI, 0.31 to 0.43; p < 0.01) compared with waiting for <15 minutes, with significantly decreasing odds (p < 0.01 for all) observed with further increments of increased wait time.
A wait time exceeding 15 minutes in an outpatient orthopaedic clinic was an independent predictor of scoring at or below the 33rd percentile on the Press Ganey survey. Further increases in wait time significantly increased the odds of dissatisfaction. Measures to reduce clinic wait time may improve the patient experience and satisfaction with the orthopaedic encounter.
Press Ganey门诊医疗实践调查是一种常用的问卷,旨在衡量对门诊医疗保健的满意度。多种因素与骨科患者较低的满意度得分相关,包括年龄、性别、心理障碍的存在以及到医疗机构的驾车距离。诊所工作流程的影响尚不清楚。在本研究中,我们假设增加的诊所等待时间是Press Ganey调查所衡量的患者满意度较低的独立预测因素。
我们回顾性分析了2014年1月1日至2016年12月31日期间在单一学术机构进行的4216例新的骨科门诊手术就诊情况。对于多次就诊的患者,仅分析首次新患者就诊情况。满意度定义为得分高于队列的第33百分位数。采用单因素分析,随后进行多变量二元逻辑回归,以检测与患者满意度相关的因素。
在4216例独特患者中,平均年龄(及标准差)为52.8±15.8岁,58.9%的患者为女性。平均总等待时间为17.8±19.4分钟。单因素分析显示,与等待时间≥15分钟相比,等待时间<15分钟时在Press Ganey调查中获得满意度的几率更高;优势比(OR)为3.78(95%置信区间[CI],3.30至4.33;p<0.01)。多变量模型显示,在控制其他潜在影响因素的情况下,满意度与等待时间之间存在关联:等待15至29分钟后获得满意度的几率为0.36(95%CI,0.31至0.43;p<0.01),与等待<15分钟相比,随着等待时间进一步增加,几率显著降低(所有p<0.01)。
骨科门诊等待时间超过15分钟是Press Ganey调查得分在第33百分位数及以下的独立预测因素。等待时间的进一步增加显著增加了不满意的几率。减少诊所等待时间的措施可能会改善患者体验和对骨科就诊的满意度。