Who presents satisfied? Non-modifiable factors associated with patient satisfaction among gyn oncology clinic patients

abstract
 June 11, 2016

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Highlights

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Domain-specific patient satisfaction scores are associated with non-modifiable demographic, financial and geographic patient factors.

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These non-modifiable factors affect the varying domains of patient satisfaction differently.

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Comparing hospitals to one another using summed domains of patient satisfaction scores may disproportionately penalize hospitals caring for underserved patients.

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Objective

To examine associations between non-modifiable patient factors and patient satisfaction (PS) among women presenting to a gynecologic oncology clinic.

Methods

This is a cross sectional analysis of patients presenting for surgical management by a gynecologic oncologist at a tertiary care academic medical center. The Patient Satisfaction Questionnaire (PSQ-18) that measures PS in seven domains of health care was administered. Scores were converted to “satisfied” versus “unsatisfied/equivocal”. Demographic and medical factors were obtained from the medical record. Chi-square, t-tests, and multivariable logistic regression were used.

Results

208 patients completed the baseline patient satisfaction questionnaire and the median PSQ-18 score was 70.5 (range: 42–90). Median age was 58 years (range: 22–93). Several non-modifiable factors were associated with PS. White patients had higher interpersonal PS than minorities (86% v 65%, p = 0.002). The uninsured had lower interpersonal (60% v 86%, p = 0.003) and accessibility PS (33% v 67%, p = 0.03). Increasing education and less time travelled to care were both associated with higher interpersonal (p = 0.03, p = 0.05) and accessibility PS (p = 0.01, p = 0.01). There was no association between clinical factors (BMI, comorbidities, cancer) and PS. In multivariable analysis, the strongest predictor of interpersonal PS was white race while the strongest predictors of accessibility PS were time travelled to care and insurance status.

Conclusions

Patient satisfaction scores among patients presenting to a gynecologic oncology clinic are associated with non-modifiable demographic, financial and geographic factors. Pay for performance measures that use summed patient satisfaction scores may penalize hospitals for patient-mix driven differences.