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使用Press Ganey®门诊医疗实践调查评估社会剥夺对物理医学与康复门诊介入脊柱及肌肉骨骼医学患者满意度的影响。

The impact of social deprivation on patient satisfaction in physical medicine and rehabilitation outpatient interventional spine and musculoskeletal medicine using the press Ganey® outpatient medical practice survey.

作者信息

Stephens Andrew R, McCormick Zachary L, Burnham Taylor R, Conger Aaron

机构信息

University of Rochester Medical Center, Department of Physical Medicine and Rehabilitation, 601 Elmwood Ave, Rochester, NY 14642, USA.

University of Utah, Department of Orthopaedics, 590 Wakara Way, Salt Lake City, UT 84108, USA.

出版信息

Interv Pain Med. 2023 Aug 31;2(3):100276. doi: 10.1016/j.inpm.2023.100276. eCollection 2023 Sep.

Abstract

INTRODUCTION

Multiple factors (patient age, wait time, depression, etc.) have been associated with lower patient satisfaction as assessed by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS). Social deprivation has been shown to impact multiple aspects of patient care but its impact on patient satisfaction in Physical Medicine and Rehabilitation (PM&R) is limited.

OBJECTIVE

We hypothesized that increased social deprivation would independently predict lower patient satisfaction, as measured by the PGOMPS.

DESIGN

Retrospective large cohort study.

SETTING

Single tertiary academic institution.

PATIENTS

Adult patients seen by PM&R physicians practicing outpatient interventional spine and musculoskeletal medicine who completed PGOMPS between January 1, 2014 and December 31, 2019.

INTERVENTIONS

Independent variables include: Social deprivation as measured by 2015 Area Deprivation Index (ADI), wait time, patient age, and sex.

MAIN OUTCOME MEASURE

Patient satisfaction was defined as receiving a perfect PGOMPS Total Score.

RESULTS

A totla of 64,875 patients (mean age 52.7 ± 21.8 years, 41.4% male, mean ADI 29.9 ± 18.8) were included. Univariate analysis showed a decreased odds of achieving satisfaction for each decile increase in ADI (odds ratio 0.965; 95% confidence interval 0.957-0.973; p < 0.001). The most socially deprived quartile was significantly less likely to report satisfaction on PGOMPS compared to the least deprived quartile (91.1 vs 93.2; p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction was 0.99 (95% confidence interval 0.980 to 0.997; p = 0.009) for the Total Score, independent of age, wait time, and patient sex for each decile increase in ADI.

CONCLUSIONS

In this cohort, increased social deprivation independently predicted patient dissatisfaction in PM&R.

摘要

引言

多项因素(患者年龄、等待时间、抑郁等)与患者满意度较低相关,这是通过Press Ganey®门诊医疗实践调查(PGOMPS)评估得出的。社会剥夺已被证明会影响患者护理的多个方面,但它对物理医学与康复(PM&R)中患者满意度的影响有限。

目的

我们假设,社会剥夺程度的增加会独立预测患者满意度降低,这是通过PGOMPS来衡量的。

设计

回顾性大样本队列研究。

地点

单一的三级学术机构。

患者

接受门诊介入脊柱和肌肉骨骼医学治疗的PM&R医生诊治的成年患者,他们在2014年1月1日至2019年12月31日期间完成了PGOMPS。

干预措施

自变量包括:用2015年地区剥夺指数(ADI)衡量的社会剥夺、等待时间、患者年龄和性别。

主要观察指标

患者满意度定义为获得完美的PGOMPS总分。

结果

共纳入64,875名患者(平均年龄52.7±21.8岁,41.4%为男性,平均ADI为29.9±18.8)。单因素分析显示,ADI每增加一个十分位数,获得满意度的几率就会降低(优势比0.965;95%置信区间0.957 - 0.973;p < 0.001)。与最不贫困的四分位数相比,社会剥夺程度最高的四分位数报告PGOMPS满意度的可能性显著更低(91.1对93.2;p < 0.001)。多变量分析显示,对于总分而言,ADI每增加一个十分位数,获得满意度的几率为0.99(95%置信区间0.980至0.997;p = 0.009),独立于年龄、等待时间和患者性别。

结论

在这个队列中,社会剥夺程度的增加独立预测了PM&R患者的不满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c911/11372889/64149c3e3b68/gr1.jpg

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