Patient Satisfaction in Spine Surgery: A Systematic Review of the Literature

Joshua York Menendez,Nidal Bassam Omar,Gustavo Chagoya,Borna Ethan Tabibian,Galal Ashraf Elsayed,Beverly Claire Walters,Barton Lucius Guthrie,Mark Norman Hadley 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.6

Patient satisfaction reflects the patients’ perception of the outcome of care and is being considered for use in future reimbursement schemes. No consensus exists regarding the best instrument to measure patient satisfaction in the field of spine surgery. This systematic review aimed to determine how patient satisfaction for spine surgery has been measured previously and whether a disease-specific, comprehensive instrument to measure patient satisfaction has been established; we also aimed to define the dimensions of care that determine patient satisfaction in spine surgery. A systematic search of three online databases, unpublished sources, and citations was undertaken to identify 156 empirical studies that reported on patient satisfaction in the field of spine surgery. Manuscripts were reviewed in terms of the patient satisfaction instrument used, and the instruments were categorized as per content and method axes. Taxonomy of patient satisfaction with spine surgery identified the major characteristics of providers and medical care that influenced patient satisfaction and acted as a structure to categorically define the dimensions of patient satisfaction in spine surgery. The reviewed studies predominantly used global (108/156) rather than multidimensional (46/156), instruments. Most studies (96.2%) reported satisfaction with outcome rather than with care, and only 18.5% of the studies (29/156) utilized a disease-specific instrument. The following seven dimensions of patient status, outcome, and care experience that affected patient satisfaction were identified: pain, function, patient expectations/preference, specific patient health characteristics, caregiver interpersonal manner, efficacy/clinical outcomes, and postoperative care/therapy. Currently, no disease-specific instrument that includes all dimensions of patient satisfaction in spine surgery has been developed. Such a patient satisfaction instrument should be designed, tested for reliability and validity, and widely implemented.

외국인 환자의 한국 병원 의료서비스 만족도 및 재이용의사 영향요인 분석 : 러시아권 환자를 대상으로

손진석(Son, Jinsuk),허경옥(Huh, Kyungok),최애연(Choi, Aeyeon) 충북대학교 생활과학연구소 2021 생활과학연구논총 Vol.25 No.3

The purpose of this study was to verify that the three types of medical service satisfaction, patient-oriented satisfaction, and the willingness to reuse Korean hospitals differ depending on the characteristics of foreign patients. Second, we investigate the factors affecting these four variables. The main analysis results shown in this study are as follows. First, most foreign patients were found to be highly satisfied with Korean hospital doctors and patient-oriented hospitals. In addition, more than 75 percent of foreign patients were willing to reuse Korean hospitals in the future. Second, a regression analysis of variables that affect satisfaction with Korean hospital doctors showed that the presence of long-term diseases affected. Specifically, if there is a disease in the long term, the satisfaction level of Korean hospital doctors is high. The factors that affect foreign patients satisfaction with the Korean hospital system were income and health conditions. The lower the income of foreign patients, the higher the satisfaction with the Korean hospital system in the case of positive perception of their health conditions. Meanwhile, the impact on the satisfaction of foreign patients with patient orientation in Korean hospitals was on whether they lived in Korea and recognized their health conditions. Foreign patients living abroad, not domestic residents, and foreign patients with positive perceptions of their health conditions showed high satisfaction with the patient-orientedness of Korean hospitals. Third, the regression analysis was conducted to identify the factors affecting the willingness of foreign patients to reuse Korean hospitals, and found that the medical expenses were borne by themselves, doctor satisfaction, and hospital system satisfaction. Foreign patients who do not pay for medical expenses showed high willingness to reuse Korean hospitals, while foreign patients with high satisfaction with Korean hospital doctors showed high willingness to reuse Korean hospitals.

의사의 커뮤니케이션 스타일이 환자만족에 미치는 영향에 관한 연구

서판수 ( Pan Soo Seo ) 한국병원경영학회 2002 병원경영학회지 Vol.7 No.4

These days, the environment of hospital marketing is changing rapidly. The level of expectation and demand of patients have become greater and more diversified, and patients have more alternatives in selecting hospitals. The standard of hospital selection and the type of using hospital have been changed, and competition among hospitals has been accelerated due to the opening of the medical market through globallzation. Accordingly, differentiation strategies are critical in hospital marketing. The quality of medical service oriented toward patient satisfaction becomes a strong strategic weapon to secure a hospital`s competitive advantage. Therefore, marketing and communication strategies should be focused on patient-oriented, rather than hospitdoriented. Considering the changes in the hospital environment and the increase in the patients` expectation level, this study categorizes doctors` communication styles into four different ones: trust-type, professional-type, cooperation-type, and control-type. The effects of these communication styles on patient satisfaction were empirically examined. The moderating roles of the patient s characteristics and clinical characteristics between the doctors communication styles and patient satisfaction were also investigated to find out managerial implications for hospital management. To achieve such goals, data were collected from patients of 12 general hospitals in Busan. The data were analyzed to test research hypotheses that examine 1) the relationships between doctors communication styles and patient satisfaction, 2) the moderating roles of the patient characteristics and clinical characteristics in the research model, and 3) the impact of patient satisfaction on positive word-of-mouth and repurchase. The following summarizes the major results of ths research. First, the data showed that patient satisfaction varied across doctors communication styles. Trust-type style had the strongest impact on patient satisfaction whde control-type style had the weakest influence on patient satisfaction. Rofessional-type style and cooperation-type style also had positive effects on patient satisfaction but the impact of the two are not statistically different. Second, significant differences in terms of patient satisfaction were found depending upon demographic variables such as gender, marital status, age, occupation, and education. Patient satisfaction, however, was consistent across varying income groups. Third, patients medical insurance types were also related to patient satisfaction. It implies that a doctor may need to use different communication styles depending on a patient s medical insurance type. Fourth, out-patient and in-patient showed a different level of satisfaction with varying communication styles. Fifth, highly professional knowledge and strong control can influence patient satisfaction depending on the characteristics of the patient treatment field. Sixth, patient satisfaction were proved to have significantly positive effects on word-of-mouth and repurchase. The implications drawn from this study must be tempered by its limitations. First of all, the subjects used in this study were patients in Busan and small- and medium-size hospitals were excluded from the research. Therefore, future research should examine the research model by using a variety of hospitals and clinics throughout Korea. Another research agenda has to do with finding more determinant and moderating variables which will increase an explanatory power of the model. In short, this study may be the first empirical research that investigates the effects of doctors` communication styles on patient satisfaction. Interestingly enough, the results showed that each communication style had a unique impact on patient satisfaction. The findings from this research can be very useful in developing hospital marketing strategies.

Independent predictors of satisfaction in impacted third molar surgery patients

Kim, YuKyoung,Kim, SoungMin,Myoung, Hoon Blackwell Publishing Ltd 2010 community dentistry and oral epidemiology Vol.38 No.3

<P>Kim YK, Kim SM, Myoung H. Independent predictors of satisfaction in impacted third molar surgery patients. Community Dent Oral Epidemiol 2010; 38: 274–286. © 2010 John Wiley & Sons A/S</P><P>Abstract – </P><P>Objectives: </P><P>Patient satisfaction and dissatisfaction are critical dimensions leading to favorable or unfavorable treatment outcomes. Although impacted third molar (ITM) surgery is one of the most common dental surgical procedures, it is a challenging operation because of numerous potential complications and patients generally suffer from severe psychosomatic symptoms as a result of severe perioperative anxiety. We hypothesize that multiple independent factors, including perioperative anxiety and various postoperative complications, affect satisfaction of the ITM surgery patients.</P><P>Methods: </P><P>Survey data from 219 participants encompassed basic patient demographic traits, difficulty of surgery, perioperative anxiety, pain sensation and common postoperative complications. The <I>t</I>-test and one-way <SMALL>ANOVA</SMALL> with Duncan’s multiple-range tests were applied to detect differences in mean values of perioperative anxiety, perioperative pain sensation and satisfaction based on basic demographic characteristics and postoperative complications. The significance of postoperative complications according to demographic data and difficulty of extraction was also analyzed. A paired <I>t</I>-test was applied to detect the significance of anxiety level and pain sensation changes over time. Lastly, univariate and multiple stepwise regression analyses were used to analyze the relationships among perioperative anxiety, pain sensation and satisfaction to determine the predictive factor of patient satisfaction.</P><P>Results: </P><P>Basic demographic traits proved not to have a direct significant effect on satisfaction in ITM surgery patients, but some demographic factors and difficulty of surgery showed significant relationships with postoperative complications. Univariate analysis revealed that perioperative anxiety, pain sensation, postoperative infection, numbness/paresthesia and ecchymoses have a significant influence on patient satisfaction. In particular, preoperative anxiety level and numbness/paresthesia were independent predictive factors of patient satisfaction upon multivariate analysis.</P><P>Conclusions: </P><P>This study demonstrates that the patients who undergo ITM surgery often have severe anxiety that seriously impacts patient satisfaction and resultant treatment outcomes. In addition, patient satisfaction directly depends on the occurrence of some postoperative complications. Appreciation of these predictive factors and increasing patient satisfaction may help clinicians to provide optimal care for ITM surgery patients.</P>

일 상급종합병원의 전문간호사에 대한 환자만족도

최은주,장인실,황지현,강영아,김성렬,노주희,김정혜 병원간호사회 2015 임상간호연구 Vol.21 No.3

목적 : 환자만족도는 의료서비스 질에 대한 평가를 측정하는 중요한 지표이다. 본 연구의 목적은 La Monica-Oberst Patient Satisfaction Scale (LOPSS)을 사용하여 전문간호사의 간호를 받는환자를 대상으로 전문간호사에 대한 환자만족도를 파악하고자 하였다. 방법 : 일 종합병원에서 41명의 전문간호사의 업무수행과 중재방법을 경험한 입원 또는 외래 환자 263명을 대상으로 2012년 10월 22일부터 12월 31일까지 설문지를 통하여 시행하였다. 전문간호사에 대한 환자 만족도는 총 41문항의 LOPSS도구를 번역한 설문지를 이용하여 자료 수집하였다. SPSS/WIN 20.0프로그램을 이용하여 일반적인 특성을 기술통계를 사용하고 환자와 전문간호사의 특성에 따른 환자만족도는 independent t-test 와 one-way ANOVA를 이용하여 분석하였다. 결과 : 전문간호사에 대한 환자만족도는 총 195.93점이었으며, 하부 영역별로 좋은 인상영역 52.26점, 대인간 지지영역 61.75점, 불만족영역은 81.32점으로 나타났다. 환자만족도가 가장 높게 평가된 항목은 불만족영역의 ’전문간호사는 내게 반말로 얕보듯이 말한다’ 이었으며, 이 항목은 역코딩한 것으로 점수가 높을수록 만족도가 높은 것을 의미한다. 환자 특성에 따른 전문간호사에 대한 환자만족도는 연령과 주 간호제공자에 따라 유의한 차이가 나타났으며, 전문간호사의 특성에 따른 환자만족도는 전문간호사 경력에서 유의한 차이가 나타났다. 결론 : 본 연구는 다양한 분야의 전문간호사를 대상으로 환자만족도를 조사하였다. 전문간호사가제공하는 간호에 대한 높은 환자만족도는 전문간호사가 임상에서 의료서비스의 질향상에 기여하고 있음을 보여준다. 추후 전문간호사의 성과를 규명하기 위한 지속적인 노력이 필요하다. Purpose: The purpose of this study was to identify patient satisfaction about nursing care provided by Advanced Practice Nurses (APN) using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Methods: The investigation was conducted including 263 patients who experienced care provided by 41 APNs at a tertiary hospital in Korea. Patient satisfaction with nursing care was measured using 41-item LOPSS. We analyzed the data using descriptive statistics, independent t-test and one-way ANOVA. Results: Overall patient satisfaction with APN care was high. The LOPSS scores for APNs were 52.26 for good impression, 61.75 for interpersonal support, 81.32 for dissatisfaction and 195.93 for total score. "APNs talk down to me" was a reverse coding item which demonstrated the highest score for patient satisfaction. Among patients' characteristics, age and type of main caregiver were independent factors related to patients’s satisfaction. Among APN's characteristics, work experience was significantly related to patients' satisfaction. Conclusion: This study identified patient satisfaction regarding nursing care provided by APNs. High patient satisfaction in APN services demonstrated APNs’ contribution to quality improvement in health care services. It is recommended that various outcome research about APN service needs to be performed.

The willingness of patients to pay for intravenous patient-controlled analgesia in Korea

임형선,이덕형,한영진,최훈,손지선 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.6

Background: The use of intravenous patient-controlled analgesia (IV-PCA) has been increasing because it has advantages such as improved pain relief, greater patient satisfaction, and fewer postoperative complications. However, current research has not considered the patients’ thoughts about IV-PCA’s cost-effectiveness. The purpose of this study was to investigate the willingness to pay (WTP) for IV-PCA and the relationship between patients’ characteristics and WTP in Korea. Methods: We enrolled 400 adult patients who were scheduled for elective surgery. The patient was requested to indicate a series of predefined amounts of money (Korean won; 30,000/50,000/100,000/150,000/200,000/300,000/500,000). We also recorded patient characteristics, such as age, sex, type of surgery, IV-PCA history, education level, the person responsible for medical expenses, type of insurance, net annual income, and residential area. Three days after surgery, we asked about the degree of satisfaction and the WTP for IV-PCA. Results: For IV-PCA, the median WTP was 100,000 won (25-75%; 50,000-200,000 won: US$1 = W1078.04; July 19, 2011) before surgery. All patients’ characteristics were not related to preoperative WTP for IV-PCA, whereas the increase in WTP after surgery showed a tendency correlated to higher IV-PCA satisfaction. Conclusions: The median WTP was 100,000 won. The satisfaction of IV-PCA increased patients’ WTP after surgery, but the WTP may be independent of patient characteristics in Korea. Background: The use of intravenous patient-controlled analgesia (IV-PCA) has been increasing because it has advantages such as improved pain relief, greater patient satisfaction, and fewer postoperative complications. However, current research has not considered the patients’ thoughts about IV-PCA’s cost-effectiveness. The purpose of this study was to investigate the willingness to pay (WTP) for IV-PCA and the relationship between patients’ characteristics and WTP in Korea. Methods: We enrolled 400 adult patients who were scheduled for elective surgery. The patient was requested to indicate a series of predefined amounts of money (Korean won; 30,000/50,000/100,000/150,000/200,000/300,000/500,000). We also recorded patient characteristics, such as age, sex, type of surgery, IV-PCA history, education level, the person responsible for medical expenses, type of insurance, net annual income, and residential area. Three days after surgery, we asked about the degree of satisfaction and the WTP for IV-PCA. Results: For IV-PCA, the median WTP was 100,000 won (25-75%; 50,000-200,000 won: US$1 = W1078.04; July 19, 2011) before surgery. All patients’ characteristics were not related to preoperative WTP for IV-PCA, whereas the increase in WTP after surgery showed a tendency correlated to higher IV-PCA satisfaction. Conclusions: The median WTP was 100,000 won. The satisfaction of IV-PCA increased patients’ WTP after surgery, but the WTP may be independent of patient characteristics in Korea.

병원 근무자의 태도에 따른 환자만족도 차이 : S시의 대학병원과 종합병원을 중심으로

최만규,정종찬,조미순 서울大學校保健大學院 2000 國民保健硏究所硏究論叢 Vol.10 No.1

Patient satisfaction has highlighted as one strategic management. Specifically the patient satisfaction approach by Moment of Truth(MOT) makes significant contribution to the settlement of bottlenecks on patient satisfaction. This study aims to find out the gap between recognition level of provider and patient about provider's attitude working in a University Hospital and General Hospital and to measure out-patients would return to the same hospital in the future and can be said as the essence of ascertaining patient's satisfaction. for the purpose of that aim, the questionnaire is applied. The number of sample used actually for this study analysis is 670 out-patients and 142 providers except 28people who responded unfaithfully. Investigation to collect necessary data is performed about 7 days form October 18 to October 25, 2000. The results of this study can be summarized as follows: First, There has gap between recognition level of provider and out-patient about provider's attitude working in a University Hospital and General Hospital. Namely, the satisfaction level of out-patient is less than level of recognition level of provider. Second, Out-patient's satisfaction is affected by provider's attitude measured SERVQUAL-5 dimensions from the viewpoint of MOT, Third, Patient's satisfaction level has influence on subsequent purchase intention of medical service. On the basis of the results of this study, hospital managers should draw up and carry out plans to improve patient's satisfaction about attitude of providers as a part of hospital marketing strategy.

A Long-Term Study of the Effects of the Tension-Free Vaginal Tape Procedure for Female Stress Urinary Incontinence on Voiding, Storage, and Patient Satisfaction: A Post-Hoc Analysis

한지연,송채린,박준수,정희창,이규성,주명수 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.1

Purpose: We assessed the long-term effects of the tension-free vaginal tape (TVT) procedure for stress urinary incontinence (SUI) on voiding, storage, and patient satisfaction. Materials and Methods: This retrospective study examined the records of 134 patients who had undergone the TVT procedure for SUI and were followed up for more than 5 years. Voiding function was evaluated by measuring maximum urinary flow rate (MFR), post-void residual urine volume (PVR), and storage function by using a voiding diary. Patients were asked to describe their satisfaction with the operation. Results: MFR was lower at 1 month compared with the preoperative level, but had recovered to preoperative levels by 5 years postoperatively. However, some patients with >50%, 25-50%, and <25% decreases in the MFR at 1 month postoperatively showed a decrease in the MFR of >50% at 5 years. PVR increased over the 5 postoperative years. Of the patients with urgency and urgency incontinence, 43.8% and 48.1% showed improvement, respectively, whereas new patients developed postoperatively. Thus, the total number of patients with urgency or urgency incontinence remained similar over the 5 years. In those with a changed voiding pattern, patient satisfaction was negatively affected by de novo urgency and urgency incontinence and decreased MFR. Conclusions: Any obstructive effect of the TVT procedure diminished over time in most patients, although a decrease in the MFR was sustained in some patients. With regard to overactive bladder symptoms, some patients were cured and some patients complained of de novo symptoms. The most major factor affecting patient satisfaction was de novo urgency. Purpose: We assessed the long-term effects of the tension-free vaginal tape (TVT) procedure for stress urinary incontinence (SUI) on voiding, storage, and patient satisfaction. Materials and Methods: This retrospective study examined the records of 134 patients who had undergone the TVT procedure for SUI and were followed up for more than 5 years. Voiding function was evaluated by measuring maximum urinary flow rate (MFR), post-void residual urine volume (PVR), and storage function by using a voiding diary. Patients were asked to describe their satisfaction with the operation. Results: MFR was lower at 1 month compared with the preoperative level, but had recovered to preoperative levels by 5 years postoperatively. However, some patients with >50%, 25-50%, and <25% decreases in the MFR at 1 month postoperatively showed a decrease in the MFR of >50% at 5 years. PVR increased over the 5 postoperative years. Of the patients with urgency and urgency incontinence, 43.8% and 48.1% showed improvement, respectively, whereas new patients developed postoperatively. Thus, the total number of patients with urgency or urgency incontinence remained similar over the 5 years. In those with a changed voiding pattern, patient satisfaction was negatively affected by de novo urgency and urgency incontinence and decreased MFR. Conclusions: Any obstructive effect of the TVT procedure diminished over time in most patients, although a decrease in the MFR was sustained in some patients. With regard to overactive bladder symptoms, some patients were cured and some patients complained of de novo symptoms. The most major factor affecting patient satisfaction was de novo urgency.

Patient-reported satisfaction after robot-assisted hysterectomy among Korean patients with benign uterine disease

( Suyeon Park ),( Young-eun Lee ),( Seong-sik Cho ),( Sung-ho Park ),( Sung Taek Park ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.6

Objective This study aimed to evaluate patient-reported satisfaction following robot-assisted hysterectomy due to benign uterine disease, and to identify the factors associated. Methods We used a questionnaire to evaluate patients' satisfaction with robot-assisted hysterectomy. The questions concerned overall patient-reported satisfaction and specific factors affecting satisfaction, including postoperative pain, return to daily life, the hospital experience, wounds, cost, the doctor-patient relationship, whether expectations were met, and whether detailed information was provided. We also collected data from patient records, such as uterine weight, rate of pelvic adhesion, operation time, rate of transfusion, delayed discharge, and readmission. One hundred patients who underwent robot-assisted hysterectomy participated in the study. Seventy-three fully completed questionnaires were returned. Results The majority of patients (95.9%) were satisfied with robot-assisted hysterectomy. The doctor-patient relationship, whether expectations were met, the hospital experience, wounds, and whether detailed information was provided were statistically significant factors influencing patients' overall satisfaction. Payment of fees and clinical and surgical outcomes did not significantly influence patients' overall satisfaction. Conclusion Our findings show that most patients reported high levels of satisfaction following robot-assisted hysterectomy, regardless of cost or clinical and surgical outcomes. Therefore, if gynecologists consider robot-assisted hysterectomy suitable for patients they need not hesitate based on potential costs; they should feel confident in recommending the procedure to patients.

물리치료 내원환자의 만족도에 영향을 미치는 요인 분석

손애리,김미원,Sohn, Ae-Ree,Kim, Mi-Won 대한물리치료과학회 2002 대한물리치료과학회지 Vol.9 No.4

Patient satisfaction is an important factor in evaluating the quality of care. Patient satisfaction may be used to evaluate provider services and facilities, and used to predict the patient returns to a facility. The patients d whether the patient returns to a facility or whether the patient recommends the facility to other people may be affected by a variety of factors of patient satisfaction. Low satisfaction may result in poor compliance with the potential of waste of resources and suboptimal clinical outcome. This study is to identify factors of patient satisfaction that will affect patients decision whether the patient returns or not. A self-administered questionnaire survey was conducted in Seoul, Chung-Joo and Bu-Cheon cities, Survey data was obtained from 743 patients who visited the physical therapy practice at university hospitals, general hospitals and clinics. Response rate was 94.4%. The instrument developed by Goldstein et al. (2000) was used and translated into Korean. Several items were added to the instrument. Patient's opinions of service in each domain measured using 5-point Likert-type scales that ranged from strongly disagree to strongly agree. A multiple-regression analytic approach was used to predict overall satisfaction of physical therapy. Age, kindness, scheduling, convenience of parking, privacy, and waiting time predicted the overall satisfaction of physical therapy. The older patients had higher level of satisfaction with physical therapy compared with the younger patients. Patient satisfaction were more affected by access (scheduling and waiting time), administrative technical management (convenience of parking), and interpersonal management (kindness of physical therapists and other staffs) than clinical technical management (physical therapists' skills).