R. K. Schmocker1, L. Cherney-Stafford1, E. R. Winslow1 1University Of Wisconsin,Surgery,Madison, WI, USA
Introduction: Patient satisfaction has been increasingly emphasized. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Press Ganey (PG) surveys are widely used to measure patient satisfaction. Despite the financial implications of patient experience scores, little is known about their clinical/structural determinants. Because patients with diverticulitis are admitted to a variety of services and present with a wide spectrum of disease severity, this subgroup offers the opportunity to investigate these relationships. We therefore aimed to determine if clinical or structural factors impact hospital satisfaction in patients admitted with diverticulitis.
Methods: Adult patients who were admitted between 2009-2012 and completed either the HCAHPS or PG surveys were identified using ICD-9 codes for diverticulitis. Retrospective chart review was used to confirm that the admission was for acute colonic diverticulitis, and to collect clinical and structural variables. Correlational analysis demonstrated a highly significant (p < 0.001) association between the overall hospital rating measures for the surveys. Patients were then divided into two groups based on the highest rating given to the hospital (topbox vs non-topbox). Severity of illness was assigned using the Hinchey Classification (HC) and Anatomic Severity of Disease in Emergency General Surgery Grade (EGS).
Results:66 patients were identified with 56% female. The average age was 63±14 yrs, length of stay (LOS) 5±5 days. 74% of patients rated the hospital as topbox. 41% were admitted to a surgical service, and 21% of all patients underwent an operation. Patients admitted to a surgical service, and those who required surgery had a higher severity of disease (all p <0.001). When comparing the topbox to the non-topbox group, the following characteristics were similar: age, LOS, and severity of disease. Interestingly, the choice of treatment modality (surgical, percutaneous, or medical) did not influence satisfaction. Further, patients who required diversion with colostomy had similar satisfaction scores when compared to those with non-operative therapy. Admitting service also did not influence satisfaction. Admission service and treatment type also did not impact satisfaction with physician communication.
Conclusion:Disease severity, intervention type, and admission service do not seem to impact overall satisfaction with hospital care for patients admitted for diverticulitis. This highlights the fact that perhaps other less tangible aspects of in-hospital care may be the primary determinants of hospital satisfaction. Efforts aimed at defining these variables are needed in order to improve patient satisfaction.
