Patient Perception of Pain Control (Not Opiate Amount) Affects Hospital Consumer Assessment of Healthcare Providers and Systems and Press Ganey Satisfaction Scores After Orthopaedic Trauma
| Autor: | Harry Ramsamooj, Michael Roberts, Katheryne Downes, Ryan L. Kim, Adil S. Ahmed, Hassan R. Mir |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Health Personnel Pain Poison control Personal Satisfaction 03 medical and health sciences 0302 clinical medicine Patient satisfaction Psychiatric history Surveys and Questionnaires Injury prevention Humans Medicine Orthopedics and Sports Medicine Practice Patterns Physicians' Medical prescription Retrospective Studies Opiate alkaloid 030222 orthopedics business.industry Opiate Alkaloids Trauma center Retrospective cohort study 030229 sport sciences Middle Aged Hospitals Analgesics Opioid Orthopedics Patient Satisfaction Physical therapy Perception Surgery business |
| Zdroj: | Journal of the American Academy of Orthopaedic Surgeons. 29:301-309 |
| ISSN: | 1940-5480 1067-151X |
| DOI: | 10.5435/jaaos-d-20-00069 |
| Popis: | INTRODUCTION Opiate abuse is a public health issue linked to prescribing. Prescribing increased partly in response to adopting pain as the fifth vital sign. Assessing pain control on patient satisfaction surveys, including government-mandated Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and optional private surveys (Press Ganey) administered on hospital discharge, may contribute. This study evaluates whether opiate amounts affect orthopaedic trauma patient perception of pain control and overall hospital rating on HCAHPS and Press Ganey surveys. METHODS Consecutive adult patients >18 years surgically treated for isolated fractures (UE = upper extremity, LE = lower extremity, and PA = pelvis/acetabulum) at a level 1 trauma center between January 1, 2014, and December 31, 2016, were retrospectively analyzed. Hospital charts, HCAHPS, and Press Ganey data were reviewed; patients without survey responses were excluded. Data included comorbidities, psychiatric history, substance use, injury type, and surgery. Analysis included Spearman's rho for correlations, Wilcoxon rank-sum and Kruskal-Wallis for continuous variables, and adjusted ordinal regression to estimate association between opioid prescribing and patient ratings. RESULTS One hundred fifty-two total patients (UE 29, LE 112, and PA 11) with mean age of 57 years and median length of stay 3 days were included. Adjusted models showed longer duration outpatient prescriptions were associated with lower rating on how often inpatient pain was controlled (P = 0.002), lower total MME inpatient was associated with higher ratings (HCAHPS P = 0.015; Press Ganey, P = 0.03), lower average daily MME inpatient was associated with lower ratings (HCAHPS P = 0.008; Press Ganey, P = 0.037), and shorter outpatient prescription duration was associated with lower ratings (P = 0.008). Patient perception of pain control was strongly associated with overall HCAHPS (P < 0.05) and Press Ganey (P < 0.001) ratings. DISCUSSION Inpatient and outpatient opiate amounts and duration demonstrated some associations with overall scores. However, patients' pain control perception seems to have the strongest relationship with hospital rating. Counseling and multimodal pain control may lead to strong satisfaction scores without needing high opiates after orthopaedic trauma. |
| Databáze: | OpenAIRE |
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