Richman Evan H, Kuttner Nicolas P, Foster Lukas O, Bruske Christopher J, Pollock Jordan R, Brinkman Joseph C, Little Milton T M
From the Department of Orthopedic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO (Richman), the Department of Orthopedic Surgery, Mayo Clinic Rochester, MN (Kuttner), the Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA (Foster and Little), the Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ (Bruske), the Mayo Clinic Alix School of Medicine, Scottsdale, AZ (Pollock), and the Department of Orthopedic Surgery, Mayo Clinic Scottsdale, AZ (Brinkman).
J Am Acad Orthop Surg. 2023 Apr 15;31(8):397-404. doi: 10.5435/JAAOS-D-22-00631. Epub 2023 Jan 18.
The purpose of this study was to characterize factors that contribute to 1-star negative reviews regarding orthopaedic trauma surgeons.
A search was done for Orthopaedic Trauma Association members on Yelp.com , Healthgrade.com , and Vitals.com in New York, Boston, San Francisco, Los Angeles, Dallas, Phoenix, Seattle, Baltimore, Denver, Houston, Philadelphia, and Washington, DC. All single-star reviews (out of a possible 5 stars) were included in this study. Reviews were categorized as either clinical or nonclinical and then further subcategorized. Categorical variables were analyzed using a chi-square test. The rate ratio (the ratio of the rate for nonsurgical divided by surgical reviews) was determined for each category.
Two hundred eighty-eight single-star reviews were included in the study, comprising 655 total complaints. Of all complaints, 274 (41.8%) were clinically related and 381 (58.2%) were nonclinical. Of the 288 single-star reviews, 96 (33.3%) were from surgically treated patients and 192 (66.7%) were from nonsurgical patients. Most complaints were in reference to nonclinical aspects of care such as physician bedside manner (173 reviews, 60%), not enough time spent with provider (58 reviews, 20%), and wait time (42 complaints, 15%). The most common clinical complaints were for complication (61 reviews, 21%), disagree with decision/plan (49 reviews, 17%), and uncontrolled pain (45 reviews, 16%). Surgical patients had a significantly higher rate of clinical complaints than nonsurgical patients (1.57 vs. 0.64 clinical complaints per review, P < 0.001). Nonsurgical patients had a significantly higher rate of nonclinical complaints than surgical patients (1.43 vs. 1.10 nonclinical complaints per review, P < 0.001).
Most 1-star reviews referenced a nonclinical aspect of care with a physician's bedside manner being the most common complaint. Surgical patients were markedly more likely to reference a clinical aspect of care, such as complications or misdiagnosis compared with nonsurgical patients, who more commonly referenced nonclinical aspects of care.
本研究的目的是确定导致骨科创伤外科医生获得一星差评的因素。
在Yelp.com、Healthgrade.com和Vitals.com上搜索纽约、波士顿、旧金山、洛杉矶、达拉斯、菲尼克斯、西雅图、巴尔的摩、丹佛、休斯顿、费城和华盛顿特区的骨科创伤协会成员。本研究纳入了所有一星评价（满分5星）。评价被分为临床或非临床两类，然后进一步细分。分类变量采用卡方检验进行分析。确定每个类别的比率比（非手术评价的比率除以手术评价的比率）。
本研究纳入了288条一星评价，共包含655条投诉。在所有投诉中，274条（41.8%）与临床相关，381条（58.2%）与非临床相关。在288条一星评价中，96条（33.3%）来自接受手术治疗的患者，192条（66.7%）来自非手术患者。大多数投诉涉及护理的非临床方面，如医生的床边态度（173条评价，60%）、与医护人员相处时间不足（58条评价，20%）和等待时间（42条投诉，15%）。最常见的临床投诉是并发症（61条评价，21%）、不同意治疗决策/方案（49条评价，17%）和疼痛控制不佳（45条评价，16%）。手术患者的临床投诉率明显高于非手术患者（每条评价的临床投诉率分别为1.57和0.64，P<0.001）。非手术患者的非临床投诉率明显高于手术患者（每条评价的非临床投诉率分别为1.43和1.10，P<0.001）。
大多数一星评价提到了护理的非临床方面，其中医生的床边态度是最常见的投诉。与非手术患者相比，手术患者明显更有可能提到护理的临床方面，如并发症或误诊，而非手术患者更常提到护理的非临床方面。
