Lynch Jason, Kaveeshwar Samir, Moshyedi Matthew, Buitrago Ivan, Schneider Matheus B, Tran Andrew, Honig Evan L, Pensy Raymond A, Langhammer Christopher G, Henn R Frank
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
J Hand Microsurg. 2024 Mar 22;16(3):100051. doi: 10.1016/j.jham.2024.100051. eCollection 2024 Aug.
As stakeholders seek to improve patient outcomes while maintaining cost-effectiveness in an increasingly expensive healthcare system, metrics such as patient satisfaction are becoming more important. This present study sought to identify factors associated with and independently predictive of better surgical satisfaction two years following hand and wrist surgery.
Patients undergoing hand and wrist surgery at an urban outpatient institution were enrolled preoperatively into a surgical registry and assessed two years postoperatively. Patient satisfaction with surgery was measured at two years postoperatively with the Surgical Satisfaction Questionnaire (SSQ-8). Bivariate analysis determined associations between postoperative satisfaction and patient demographics, injury specifiers, medical history, and multiple patient-reported outcomes (PROs). Multivariable analysis determined independent predictors of two-year postoperative satisfaction following hand and wrist surgery.
Better surgical satisfaction was associated with having never smoked, no preoperative opioid use, lack of an accompanying legal claim, lack of a workers compensation claim, no clinical history of depression/anxiety, less comorbidities, and higher preoperative expectations.Various PROs relating to function, pain, activity, and general health at both baseline and two years demonstrated associations with postoperative satisfaction. Multivariable analysis confirmed that never smoking, lack of a legal claim, and better preoperative Brief Michigan Hand Questionnaire scores were independently predictive of better surgical satisfaction two years following hand and wrist surgery.
At two years following hand and wrist surgery, better patient satisfaction was best predicted by never smoking, no related legal claim, and better baseline Brief Michigan Hand Questionnaire scores.
III.
在日益昂贵的医疗保健系统中，利益相关者在寻求改善患者治疗效果的同时保持成本效益，患者满意度等指标变得越发重要。本研究旨在确定与手部和腕部手术后两年更好的手术满意度相关的因素以及独立预测因素。
在一家城市门诊机构接受手部和腕部手术的患者在术前被纳入手术登记册，并在术后两年进行评估。术后两年使用手术满意度问卷（SSQ - 8）测量患者对手术的满意度。双变量分析确定术后满意度与患者人口统计学、损伤特征、病史以及多个患者报告结局（PROs）之间的关联。多变量分析确定手部和腕部手术后两年术后满意度的独立预测因素。
更好的手术满意度与从不吸烟、术前未使用阿片类药物、没有附带法律索赔、没有工伤赔偿索赔、没有抑郁/焦虑临床病史、合并症较少以及术前期望较高有关。在基线和两年时与功能、疼痛、活动和总体健康相关的各种PROs都显示出与术后满意度有关联。多变量分析证实，从不吸烟、没有法律索赔以及术前更好的简短密歇根手部问卷评分是手部和腕部手术后两年更好手术满意度的独立预测因素。
在手部和腕部手术后两年，从不吸烟、没有相关法律索赔以及更好的基线简短密歇根手部问卷评分最能预测患者有更高的满意度。
III级
