What determines patient satisfaction with surgery? A prospective cohort study of 4709 patients following total joint replacement

Abstract

ObjectivesTo investigate the factors which influence patient satisfaction with surgical services and to explore the relationship between overall satisfaction, satisfaction with specific facets of outcome and measured clinical outcomes (patient reported outcome measures (PROMs)).DesignProspective cohort study.SettingSingle National Health Service (NHS) teaching hospital.Participants4709 individuals undergoing primary lower limb joint replacement over a 4-year period (January 2006–December 2010).Main outcome measuresOverall patient satisfaction, clinical outcomes as measured by PROMs (Oxford Hip or Knee Score, SF-12), satisfaction with five specific aspects of surgical outcome, attitudes towards further surgery, length of hospital stay.ResultsOverall patient satisfaction was predicted by: (1) meeting preoperative expectations (OR 2.62 (95% CI 2.24 to 3.07)), (2) satisfaction with pain relief (2.40 (2.00 to 2.87)), (3) satisfaction with the hospital experience (1.7 (1.45 to 1.91)), (4) 12 months (1.08 (1.05 to 1.10)) and (5) preoperative (0.95 (0.93 to 0.97)) Oxford scores. These five factors contributed to a model able to correctly predict 97% of the variation in overall patient satisfaction response. The factors having greatest effect were the degree to which patient expectations were met and satisfaction with pain relief; the Oxford scores carried little weight in the algorithm. Various factors previously reported to influence clinical outcomes such as age, gender, comorbidities and length of postoperative hospital stay did not help explain variation in overall patient satisfaction.ConclusionsThree factors broadly determine the patient's overall satisfaction following lower limb joint arthroplasty; meeting preoperative expectations, achieving satisfactory pain relief, and a satisfactory hospital experience. Pain relief and expectations are managed by clinical teams; however, a fractured access to surgical services impacts on the patient's hospital experience which may reduce overall satisfaction. In the absence of complications, how we deliver healthcare may be of key importance along with the specifics of what we deliver, which has clear implications for units providing surgical services.

Perioperative local infiltration anesthesia with ropivacaine has no effect on postoperative pain after total hip arthroplasty

“…In the present study, the patients had low postoperative pain scores irrespective of which study group they belonged to, both at rest and during mobilization. This indicates that the multimodal pain regimen that we used was safe, simple, and satisfactory—and that the patient’s preoperative expectations were met through information and education (Hamilton et al 2013). …”

Influence of Elective versus Emergent Hospital Admission on Patient Satisfaction

“…31,32 While receipt of discretionary care may contribute to higher patient satisfaction with health care providers, we do not believe it is the sole determinant of patient satisfaction. Many features of the health care experience likely contribute to satisfaction with health care providers, including whether care met patients' expectations, 11,[33][34][35] shorter rather than longer waiting times, 36 -38 and the quality of communication with physician and nonphysician staff. 36,38,39 In particular, patient-centered communication may enhance the doctor-patient relationship while encouraging efficient, effective care.…”

A Comparative Analysis of Single Umbilical Tangential Incision vs. Conventional Three-port Totally Extraperitoneal Inguinal Hernia Repair

“…Also patient satisfaction is perhaps one of the most important criterion of success, especially in service industries. 7 The potential advantage of SUTI is its reduction in the number of skin incisions, which in turn might translate into less postoperative pain, a shorter convalescence, 3 and also a good wound cosmesis. 4 The safety and feasibility outcome results from a current study, which is designed to compare SUTI-TEP and C-TEP procedures, have shown no differences in length of hospital stay, POD 7 th pain VAS score, postoperative complications, and chronic pain just like as demonstrated by other papers.…”

“…After putting all three factors together; (1) meeting preoperative expectations (cosmetic outcome) (2) satisfaction with pain relief (3) satisfaction with hospital environment. 7 Patient demographics and perioperative outcomes of SUTI-TEP were analyzed and compared with those of C-TEP.…”