Center for Spine Health, Cleveland Clinic, Cleveland, OH.
Case Western Reserve University School of Medicine, Cleveland, OH.
Spine (Phila Pa 1976). 2020 Aug 1;45(15):1073-1080. doi: 10.1097/BRS.0000000000003458.
Retrospective cohort study using prospectively collected data.
Determine the association between satisfaction with physician communication and patient-reported outcomes in the inpatient spine surgery setting.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys measure the patient experience of care and influence reimbursement for hospital systems and providers in the United States. It is not known whether patient satisfaction with physician communication is associated with better outcomes after spine surgery. Therefore, we evaluated the association between patient satisfaction with physician communication on the HCAHPS survey and improvements in validated patient-reported outcomes measures in a spine surgery population.
HCAHPS responses were obtained for patients undergoing elective cervical or lumbar spine surgery from 2013 to 2015. Patient-reported health status measures were the primary outcomes, including EuroQol Five Dimensions (EQ-5D), Pain Disability Questionnaire (PDQ), and Visual Analog Scores for Back and Neck Pain (VAS-BP/NP). The association between satisfaction with communication and preoperative to 1 year postoperative changes in each health status measure was evaluated utilizing multivariable linear regression models.
Our study included 648 patients, of which, 479 (74.4%) created our satisfied cohort. Demographically, our two cohorts were similar with regards to preoperative clinical measures; however, the satisfied cohort had a higher self-rating of their mental health (P < 0.01), and overall health (P < 0.01). After adjusting for clinically relevant confounders, our results demonstrated no significant association between satisfaction with physician communication and improvement in EQ-5D (P = 0.312), PDQ (P = 0.498), or VAS pain scores (P = 0.592).
Patient satisfaction with physician communication was not associated with 1-year postoperative improvement in EQ-5D, PDQ, and VAS-Pain after spine surgery. These findings do not diminish the importance of effective communication between doctor and patient, but instead suggest that within the spine surgery setting, using only patient experience data may not accurately reflect the true quality of care received during their inpatient stay.
使用前瞻性收集的数据进行回顾性队列研究。
确定住院脊柱手术环境中患者对医生沟通的满意度与患者报告的结果之间的关系。
医院消费者评估医疗保健提供者和系统（HCAHPS）调查衡量患者对护理的体验，并影响美国医院系统和提供者的报销。尚不清楚患者对医生沟通的满意度是否与脊柱手术后的更好结果相关。因此，我们评估了脊柱手术患者群体中 HCAHPS 调查中患者对医生沟通的满意度与经过验证的患者报告的结果测量指标改善之间的关系。
从 2013 年至 2015 年，获得接受择期颈椎或腰椎脊柱手术的患者的 HCAHPS 回复。患者报告的健康状况测量结果是主要结果，包括欧洲五维健康量表（EQ-5D）、疼痛残疾问卷（PDQ）以及背部和颈部疼痛的视觉模拟评分（VAS-BP/NP）。利用多变量线性回归模型评估满意度与每种健康状况测量的术前至 1 年术后变化之间的关系。
我们的研究包括 648 名患者，其中 479 名（74.4%）构成了我们的满意队列。从人口统计学上看，我们的两个队列在术前临床指标方面相似；然而，满意队列对自己的心理健康状况评价更高（P<0.01），对整体健康状况评价更高（P<0.01）。在调整了与临床相关的混杂因素后，我们的结果表明，患者对医生沟通的满意度与 EQ-5D（P=0.312）、PDQ（P=0.498）或 VAS 疼痛评分（P=0.592）的改善之间没有显著关联。
患者对医生沟通的满意度与脊柱手术后 1 年的 EQ-5D、PDQ 和 VAS 疼痛改善无关。这些发现并没有降低医生与患者之间有效沟通的重要性，而是表明在脊柱手术环境中，仅使用患者体验数据可能无法准确反映他们在住院期间接受的护理的真实质量。
3 级。
