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Patient satisfaction

Patient satisfaction ratings are increasingly used for hospital rankings, referral base and physician reimbursement. As such, online physician rating websites (PRWs) are quickly becoming a topic of interest.

Patient-reported experience is often used as a measure for quality of care.

Depression has been associated with poor outcomes in neurosurgical patients, including increased pain, poorer functional recovery, delayed return to work, and decreased patient satisfaction.

The satisfaction of a group of 205 patients with regard to anesthesia used and their future preferences were evaluated prospectively through a questionnaire. The reasons for dissatisfaction were assessed.

CEA was performed under general anesthesia (GA) in 159 cases (77.6%) and under local anesthesia (LA) in 46 cases (22.4%). In the GA group, 148 patients (93.1%) were satisfied; 30 patients (65.2%) in the LA group were satisfied (p < 0.0001). The reason for dissatisfaction with GA were postoperative nausea and vomiting (7 patients), postoperative psychological alteration (3), and fear of GA (1). The reasons for dissatisfaction with LA were intraoperative pain (9 patients), intraoperative discomfort and stress (5), and intraoperative breathing problems (2). Of the GA group, 154 (96.9%) patients would prefer GA again, and of the LA group, 28 (60.9%) patients would prefer LA if operated on again (p < 0.0001). Overall, 172 patients (83.9%) would prefer GA in the future, and 33 patients (16.1%) would prefer LA.

Overall patient satisfaction with CEA performed under both GA and LA is high. Nevertheless, in the GA group, patient satisfaction and future preference were significantly higher. Both GA and LA have advantages and disadvantages for CEA. An optimal approach is to make use of both anesthetic techniques based on their individual indications and patient preference 1).

Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery 2).

Patient satisfaction metrics are emerging as determinants of quality of care and reimbursement after spine surgery. Identifying modifiable factors that improve satisfaction is of utmost importance.

Patient satisfaction with outcome may accurately represent the effectiveness of surgical spine care in terms of 1-year improvement in pain and disability. However, healthcare stakeholders relying on satisfaction as a proxy of overall quality or effectiveness of care need to account for Medicaid/uninsured payer status and worse baseline pain and disability scores as confounders 3).

Mracek J, Kletecka J, Holeckova I, Dostal J, Mrackova J, Mork J, Priban V. Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy. J Neurol Surg A Cent Eur Neurosurg. 2019 Apr 29. doi: 10.1055/s-0039-1688692. [Epub ahead of print] PubMed PMID: 31035296.
Reponen E, Tuominen H, Hernesniemi J, Korja M. Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery. Neurosurgery. 2015 Aug 4. [Epub ahead of print] PubMed PMID: 26244270.
Chotai S, Sivaganesan A, Parker S, McGirt MJ, Devin CJ. Patient-Specific Factors Associated With Dissatisfaction After Elective Surgery for Degenerative Spine Diseases. Neurosurgery. 2015 Apr 23. [Epub ahead of print] PubMed PMID: 25910085.
patient_satisfaction.txt · Last modified: 2019/04/30 11:50 by administrador