Department of Orthopedics, Georgetown University Medical Center, Washington, District of Columbia.
Department of Orthopedics, University of Maryland School of Medicine, Baltimore, Maryland.
J Knee Surg. 2023 May;36(6):673-681. doi: 10.1055/s-0041-1741394. Epub 2022 Jan 3.
Patient satisfaction is increasingly used as a metric to evaluate the quality of healthcare services and to determine hospital and physician compensation. The aim of this study was to identify preoperative factors associated with Press Ganey Ambulatory Surgery (PGAS) satisfaction scores, and to evaluate the effect of each PGAS domain score on the total PGAS score variability in patients undergoing anterior cruciate ligament reconstruction (ACLR). A review of a Press Ganey (PG) database at a single center was performed for patients undergoing ACLR between 2015 and 2019. Ninety-nine patients completed the PGAS survey and 54 also completed preoperative demographic and patient-reported outcome measures (PROMs) for an orthopaedic registry. PGAS scores were calculated and bivariate analysis was performed. Multivariable linear regression determined the effect of each of the six PGAS domains on the total PGAS score variability. In the total cohort of 99 patients, no factors were significantly associated with the total PGAS score or any domain scores. For the 54 patients who also participated in the orthopaedic registry, none of the preoperative PROMs were significantly correlated with total PGAS score. However, having a college degree (89 vs. 95 or 97 points; = 0.02) and continuous femoral nerve catheter (92 vs. 100 points; = 0.04) was associated with lower personal issue domain scores, while patients with a greater number of prior surgeries had worse registration domain scores ( = -0.27; = 0.049). For the entire cohort, the registration and facility domains contributed the most variability to the total PGAS score, while the physician domain contributed the least. Few preoperative factors are associated with PGAS scores, and total PGAS scores do not significantly correlate with baseline PROMs. Surgeons may have limited ability to improve their PGAS scores given most of the variability in total scores stems from systemic aspects of the patient experience.
患者满意度越来越多地被用作评估医疗服务质量和确定医院及医生薪酬的指标。本研究旨在确定与 PG 门诊手术满意度评分相关的术前因素，并评估每个 PG 域评分对接受前交叉韧带重建 (ACLR) 患者总 PG 评分变异性的影响。对一家单中心的 PG 数据库进行了回顾性研究，该数据库纳入了 2015 年至 2019 年期间接受 ACLR 的患者。99 例患者完成了 PGAS 调查，54 例患者还完成了接受 ACLR 手术前的人口统计学和患者报告的结果测量 (PROM) 登记。计算了 PGAS 评分并进行了双变量分析。多变量线性回归确定了六个 PG 域中每个域对总 PGAS 评分变异性的影响。在总共 99 例患者中，没有任何因素与总 PGAS 评分或任何域评分显著相关。对于同时参加骨科登记的 54 例患者，术前 PROM 与总 PGAS 评分均无显著相关性。然而，具有大学学历 (89 分与 95 分或 97 分； = 0.02) 和连续股神经导管 (92 分与 100 分； = 0.04) 与较低的个人问题域评分相关，而接受过更多次手术的患者的登记域评分较差 ( = -0.27； = 0.049)。对于整个队列，登记和设施域对总 PGAS 评分的变异性贡献最大，而医生域的贡献最小。很少有术前因素与 PGAS 评分相关，总 PGAS 评分与基线 PROM 无显著相关性。鉴于总评分的大部分变异性来自患者体验的系统性方面，外科医生可能改善其 PGAS 评分的能力有限。
