Satisfaction with surgeon care as measured by the Surgery-CAHPS survey is not related to NSQIP outcomes

Abstract

Background: Patient satisfaction is a patient-centered outcome of particular interest. Previous work has suggested that global measures of satisfaction may not adequately evaluate surgical care; therefore, the surgery-specific S-CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey was developed. It remains unclear how traditional outcome measures such as morbidity impact patient satisfaction. Our aim was to determine whether NSQIP-defined complications impacted satisfaction with the surgeon as measured by a surgery-specific survey, the S-CAHPS. Methods: All patients undergoing a general surgical operation from 6/13-11/13 were sent the S-CAHPS survey after discharge. Retrospective chart review was conducted using NSQIP variable definitions, and major complications were defined. Data were analyzed as a function of response to the overall surgeon-rating item, and those surgeons rated as the "best possible" or "topbox" were compared with those rated lower. Univariate and logistic regression were used to determine variable importance. Results: 529 patients responded, and 71.5% (378/529) rated the surgeon as topbox. The overall NSQIP complication rate was 14.2% (75/529) with 26.7% of those (20/75) being major complications. On univariate analysis, patients who rated their surgeon more highly were somewhat older (59 vs. 54yrs: p <0.001), more often underwent elective surgery (81% vs. 57%: p <0.001), and had an increased rate of operation for malignancy (31% vs. 17%). Neither the complication rate (total or major) nor the number of complications were associated with satisfaction scores. Conclusions: When examined on a patient-level with surgery-specific measures and outcomes, the presence of complications after an operation does not appear to be associated with overall patient satisfaction with surgeon care. This finding suggests that satisfaction may be an outcome distinct from traditional measures.

Chronic Pain Practices: An Evaluation of Positive and Negative Online Patient Reviews

“…First, the present investigation only evaluated 1,296 positive reviews and 331 negative reviews of pain management practices, and it is possible if a larger number of reviews were evaluated our findings may be different. However, these findings with regard to the themes common in positive and negative reviews have been reported in other publications (1,2,(8)(9)(10)(11)(12)(13). Second, this study looks at reviews of 4 large cities, thus we may have excluded patient populations with substantially different preferences as health care consumers.…”

“…Further obscuring the mechanistic relationship between patient feedback and objective provider quality is the heterogeneity with which Web reviews can predict outcomes across clinical sites and medical specialties. Existing literature suggests that surgical outcomes, for example, may be poorly or insignificantly correlated with standardized patient survey data (11,12). Furthermore, a recent study of exclusively third-party Web reviews by Chen et al (13) showed satisfaction was very poorly correlated with objective outcomes.…”

Are Online Patient Reviews Associated With Health Care Outcomes? A Systematic Review of the Literature

“…In contrast, however, it is unclear if even validated patient experience surveys are actually associated with quality. Although a few studies have found some linkages (Anhang-Price et al, 2014), recent rigorous research has found no associations between HCAHPS surveys and clinical outcomes (Mohan et al, 2020; Schmocker et al, 2019). Thus, although there are consistent associations between OPRs and patient experience surveys, it is unclear how these measures actually affect clinical and organizational outcomes.…”

Evidence Relating Health Care Provider Burnout and Quality of Care

“…Although patient satisfaction is an important outcome, it is not consistently indicative of care quality or improved medical outcomes, suggesting that it may be related to factors outside the provider's immediate control such as facility amenities and access to care. (17)(18)(19)(20) Thus, for the purposes of this review we excluded metrics solely indicative of patient satisfaction to reduce bias from these non-provider related factors that may affect satisfaction.…”