Association between surgical patient satisfaction and nonmodifiable factors

Luke Martin, Angela P. Presson, Chong Zhang, David Ray, Samuel Finlayson, Robert Glasgow

Patient satisfaction surveys are an important tool in measuring physician performance. We hypothesized that nonmodifiable factors would be associated with surgical outpatient satisfaction scores. Press Ganey Consumer Assessment of Health Providers and Systems outpatient satisfaction scores from completed surveys (18,373) at an academic department of surgery were reviewed. Data were collected on patient factors, provider specialty, practice setting, and first visit status. Patients were divided into groups based on satisfaction scores-completely satisfied (score = 100) or less satisfied (score ≤99). Generalized estimating equation logistic regression analysis was performed to identify factors predictive of patient satisfaction. Patients less likely to be completely satisfied were younger (odds ratio [OR] 0.54; confidence interval [CI] 0.43-0.69, P < 0.001 for 18-29 y versus >80 y) and were more likely to be seeing their surgeon for the first time (OR 0.84; CI 0.78-0.89, P < 0.001 for first versus return patients). Compared with patients seen at hospital subspecialty clinics, patients were more likely to be satisfied if seen at a cancer center clinic (OR 1.22; CI 1.13-1.32, P < 0.001) or a community ambulatory clinic (OR 1.30; CI 1.18-1.43, P < 0.001). There was no difference in satisfaction among patients seen in General Surgery, Plastic Surgery, or Otolaryngology Clinics. Patients were less likely to be satisfied when seen in Urology (OR 0.82; CI 0.75-0.91, P < 0.001) and Vascular Surgery (OR 0.75; CI 0.62-0.92, P = 0.006) clinics compared with General Surgery Clinics. Using satisfaction scores to evaluate providers should take into account nonmodifiable factors of the underlying patient population, the specialty of the provider, and the practice setting of the visit.