Marlene T. O'Brien1, James C. Iannuzzi2, Steven A. Kahn3, Mark L. Gestring3, John R. Monson2, David L. Gillespie1
1Division of Vascular Surgery, Heart and Vascular Center, University of Rochester School of Medicine and Dentistry, Rochester, NY; 2Surgical Health Outcomes & Research Enterprise (SHORE), University of Rochester Medical Center, Rochester, NY; 3Department of Surgery, University of Rochester Medical Center, Rochester, NY.
OBJECTIVES: Under the Affordable Care Act, patient satisfaction and the quality of care delivered as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) will assume an increasingly important role. While HCAHPS is a standardized patient satisfaction survey, there is minimal published data describing factors associated with high scores. This study evaluates factors associated with HCAHPS satisfaction in vascular surgery patients.
METHODS: This study is a retrospective review of vascular surgery HCAHPS surveys at a single academic center from 2011-2012. Global satisfaction, evaluated by hospital satisfaction and willingness to recommend the hospital, was the primary endpoint. Other survey domains, demographics and clinical variables including complications, procedure and ICU stay were also evaluated. Only top answers were considered positive ("always"; 10/10 satisfaction; definite recommendation).
RESULTS: There were 92 vascular surgery HCAHPS responses. Eighty-seven (94.6%) were white and 64 (69.6%) were male. Important factors associated with satisfaction included nurse/doctor listening, respect and explanations (all p<0.01). Pain control (p<0.05), prompt assistance (p<0.02) and a quiet atmosphere (p<0.05) also correlated with satisfaction. Complications, LOS, emergent admission and insurance were not associated with overall satisfaction. Patient's self-health assessment and procedure type (endovascular, open, or both) were the only clinical variables associated with satisfaction (p<0.05).
CONCLUSIONS: Among vascular surgery patients, patient-provider interactions, pain control, quiet environment, self-assessment of health and procedure type are associated with patient satisfaction. The latter clinical variables warrant further investigation. This study reinforces the importance of patient-provider interactions and identifies factors that may increase patient satisfaction and the successful delivery of quality care under the Affordable Care Act.
AUTHOR DISCLOSURES: M. L. Gestring: Nothing to disclose; D. L. Gillespie: Nothing to disclose; J. C. Iannuzzi: Nothing to disclose; S. A. Kahn: Nothing to disclose; J. R. Monson: Nothing to disclose; M. T. O'Brien: Nothing to disclose.
Posted April 2013