Understanding the determinants of patient satisfaction with surgical care using the Consumer Assessment of Healthcare Providers and Systems surgical care survey (S-CAHPS)

Abstract

Background: Patient satisfaction has been emphasized increasingly in all aspects of medicine, including the imposition of financial penalties for underperformance. Current measures of patient satisfaction, however, do not address aspects specific to the care of operative patients. Therefore, our aim was to examine the recently validated Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) to determine which aspects of perioperative care are predictive of satisfaction with the surgeon.

Methods: All patients undergoing a general surgery operation at our institution during a 5-month period were sent a modified S-CAHPS within 3 days of discharge. Patients were then divided into 2 groups: those who rated their surgeon as the best possible and those giving a lower rating. Univariate and multivariate analyses were used to determine predictors of satisfaction with operative care. S-CAHPS results were then compared with other satisfaction measures in a subset of patients.

Results: The response rate was 45.3% (456/1,007). The average age was 59 ± 16 years, duration of stay was 4.1 ± 6.6 days, and 23% underwent unscheduled operations. A total of 72% of patients rated their surgeon as the best surgeon possible. On multivariate analysis, preoperative communication and attentiveness on the day of operation were the most important determinants of overall surgeon rating. S-CAHPS scores correlated with other standard measures of satisfaction (HCAHPS scores).

Conclusion: S-CAHPS is a novel operative satisfaction tool and is feasible to administer to patients undergoing general operative procedures. Surgeon characteristics most predictive of high patient satisfaction are effective preoperative communication and attentiveness on the day of operation.

Conflict of interest statement

Dr. Winslow confirms that there are no conflict of interest disclosures to report.

Copyright © 2015 Elsevier Inc. All rights reserved.

Figures

Figure 1. Correlation of S-CAHPS with other Satisfaction Measures

Other survey ratings of physician communication and overall physician rating A. S-CAHPS demonstrates a statistically significant correlation with two inpatient satisfaction measures – the HCAHPS physician communication composite (n=87) and the Press Ganey overall physician rating (n=77). B. Individual outpatient patient satisfaction measures were unavailable, therefore the average Avatar rating for both likelihood of recommending the physician and communication composite for a specific surgeon during the studied period was compared with the average S-CAHPS for that surgeon. There were 20 surgeons that had both S-CAHPS and Avatar scores, and there was not a significant correlation between these measures.