N. Bandealy1, V. R. Rendell1, K. A. LeRette2, M. A. Leaf2, E. R. Winslow1 2UW Health,Enterprise Analytics,Madison, WI, USA 1University Of Wisconsin,Department Of Surgery,Madison, WI, USA
Introduction: Growing emphasis on Value Based Purchasing and patient-reported outcomes has increased interest in drivers of patient satisfaction. While demographic and other patient-related factors are known to impact satisfaction, the role of disease-related factors, specifically primary diagnosis, is not well studied. We aimed to determine if primary diagnosis affects satisfaction scores in the surgical outpatient setting.
Methods: Primary diagnosis was examined in relation to patient experience scores as reported in Medical Practice Survey responses of general surgery patients seen in an outpatient setting from July 2016-2018. Diagnoses with similar presentations, treatments, and prognoses were merged into groups prior to viewing survey results to ensure unbiased sorting. Groups with fewer than 50 surveys were excluded. Chi squared univariate analyses compared the percentage of top box responses to three key survey questions regarding provider and overall clinic evaluation across patient, clinic, provider, and survey-related variables. Multivariate logistic regression was performed to determine factors associated with top box responses.
Results: Survey results were extracted for 1,262 patients across 6 clinical groups: breast cancer (n=411), benign gallbladder disease (n=83), hernias (n=285), thyroid/parathyroid hormonal disorders (n=161), and hormonally inactive thyroid masses and cancer (n=225). On univariate analyses, female patients had higher percent top box scores for question 1 (Time spent with provider) and question 3 (Likelihood of recommending the clinic) (p<0.05). Female providers had higher percent top box scores for question 1 and question 2 (Likelihood of recommending provider) (p<0.05). Responses to questions 2 and 3 differed by clinic location (p=0.01 and p=0.04, respectively) and by diagnosis group (p=0.001 and p=0.02, respectively). On multivariate analyses, only diagnosis group remained significant for all three questions (Table 1). Patients in the breast cancer group were more likely to recommend the clinic than patients in all but one diagnosis group. They were also more likely to recommend their provider than the thyroid/parathyroid hormonal disorders group. Clinic location was significant for the amount of time provider spent and likelihood of recommending clinic, but was not significant for the likelihood of recommending the provider.
Conclusion: For general surgery outpatients, breast cancer patients have higher satisfaction scores compared with patients with several other examined diagnoses on multivariate analyses. This suggests diagnosis alone may influence outpatient patient satisfaction survey results. Institutions should consider the role diagnosis plays when evaluating provider performance.
