Background: The Affordable Care Act of 2010 identifies "patient experience of care" as one of five domains of excellent care. We hypothesized that there are specific demographic factors associated with higher or lower physician satisfaction (PS) scores in trauma patients.
Methods: Press-Ganey PS scores for September 2004 to December 2010 were compared with trauma variables and the association of a mean PS greater than or equal to 75 (high score) or less than or equal to 50 (low score). Those variables that proved significant on univariate analysis were subjected to multivariate logistic regression analysis. Significance was at p < 0.05.
Results: There were 12,196 admissions, of whom 1,631 (13.4%) returned patient satisfaction survey. A total of 1,174 patients (75.5%) returned a high PS (≥75), and 126 patients (8.1%) returned a low PS (≤50). In the multiple logistic regression analysis, 65 years or older (odds ratio [OR], 1.7), having had a surgical procedure (OR, 1.6), and having a positive impression of the hospital care (OR, 7.0) proved significant for a high PS. Those patients who scored a low PS were significantly more likely to be younger (18-29 years: OR, 2.4; 30-64 years: OR, 1.8), to have not had surgery (OR, 2.2), had an Injury Severity Score (ISS) of 16 or lower (OR, 2.6), had a complication of care (OR, 4.4), and rated the hospital care as poor (OR, 9.2).
Conclusion: A trauma patient who is satisfied with his or her physician care is one who is 65 years or older, requires surgery, and is predominantly satisfied with other aspects of their hospital care. Unsatisfied patients are younger, are nonoperative, had lower ISS, had a complication of care, and rated their hospital care as poor. Understanding the specific characteristics of Press-Ganey results for trauma patients will allow trauma surgeons and their hospital partners to develop strategies to improve patients' satisfaction with their trauma surgeon's care.
Level Of Evidence: Epidemiologic study, level III; therapeutic study, level IV.
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http://dx.doi.org/10.1097/TA.0b013e318298484f | DOI Listing |
The purpose of this study was to identify whether NHS Trusts where discrimination in the delivery of care to patients from the South Asian community had been demonstrated had taken any actions to address the issue over the subsequent year. Freedom of information requests were sent to three trusts which had provided evidence of disparate provision of biologic therapy to patients with Crohn's disease, their associated Clinical Commissioning Groups and Healthwatch organisations to seek evidence whether they had remedied the situation. Requests were also sent to the Care Quality Commission, NHS Improvement and the Equality and Human Rights Commission seeking examples where they had responded to inequitable delivery of care related to ethnicity.
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