TY - JOUR
T1 - Association of Patient-reported Experiences and Surgical Outcomes among Group Practices
T2 - Retrospective Cohort Study
AU - Liu, Jason B.
AU - Pusic, Andrea L.
AU - Gibbons, Christopher J.
AU - Opelka, Frank G.
AU - Sage, Jill S.
AU - Thompson, Vanessa M.
AU - Ko, Clifford Y.
AU - Hall, Bruce L.
AU - Temple, Larissa K.
N1 - Publisher Copyright:
© 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Objective:The aim of the study was to determine the association of patient-reported experiences (PREs) and risk-adjusted surgical outcomes among group practices.Background:The Centers for Medicare and Medicaid Services required large group practices to submit PREs data for successful participation in the Physician Quality Reporting System (PQRS) using the Consumer Assessment of Healthcare Providers and Systems for PQRS survey. Whether these PREs data correlate with perioperative outcomes remains ill defined.Methods:Operations between January 1, 2014 and December 31, 2016 in the American College of Surgeons' National Surgical Quality Improvement Program registry were merged with 2015 Consumer Assessment of Healthcare Providers and Systems for PQRS survey data. Hierarchical logistic models were constructed to estimate associations between 7 subscales and 1 composite score of PREs and 30-day morbidity, unplanned readmission, and unplanned reoperation, separately, while adjusting for patient- A nd procedure mix.Results:Among 328 group practices identified, patients reported their experiences with clinician communication the highest (mean±standard deviation, 82.66±3.10), and with attention to medication cost the lowest (25.96±5.14). The mean composite score was 61.08 (±6.66). On multivariable analyses, better PREs scores regarding medication cost, between-visit communication, and the composite score of experience were each associated with 4% decreased odds of morbidity [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.92-0.99], readmission (OR 0.96, 95% CI 0.93-0.99), and reoperation (OR 0.96, 95% CI 0.93-0.99), respectively. In sensitivity analyses, better between-visit communication remained significantly associated with fewer readmissions.Conclusions:In these data, patients' report of better between-visit communication was associated with fewer readmissions. More sensitive, surgery-specific PRE assessments may reveal additional unique insights for improving the quality of surgical care.
AB - Objective:The aim of the study was to determine the association of patient-reported experiences (PREs) and risk-adjusted surgical outcomes among group practices.Background:The Centers for Medicare and Medicaid Services required large group practices to submit PREs data for successful participation in the Physician Quality Reporting System (PQRS) using the Consumer Assessment of Healthcare Providers and Systems for PQRS survey. Whether these PREs data correlate with perioperative outcomes remains ill defined.Methods:Operations between January 1, 2014 and December 31, 2016 in the American College of Surgeons' National Surgical Quality Improvement Program registry were merged with 2015 Consumer Assessment of Healthcare Providers and Systems for PQRS survey data. Hierarchical logistic models were constructed to estimate associations between 7 subscales and 1 composite score of PREs and 30-day morbidity, unplanned readmission, and unplanned reoperation, separately, while adjusting for patient- A nd procedure mix.Results:Among 328 group practices identified, patients reported their experiences with clinician communication the highest (mean±standard deviation, 82.66±3.10), and with attention to medication cost the lowest (25.96±5.14). The mean composite score was 61.08 (±6.66). On multivariable analyses, better PREs scores regarding medication cost, between-visit communication, and the composite score of experience were each associated with 4% decreased odds of morbidity [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.92-0.99], readmission (OR 0.96, 95% CI 0.93-0.99), and reoperation (OR 0.96, 95% CI 0.93-0.99), respectively. In sensitivity analyses, better between-visit communication remained significantly associated with fewer readmissions.Conclusions:In these data, patients' report of better between-visit communication was associated with fewer readmissions. More sensitive, surgery-specific PRE assessments may reveal additional unique insights for improving the quality of surgical care.
KW - Clinician and Group-Consumer Assessment of Healthcare Providers and Systems
KW - National Surgical Quality Improvement Program
KW - patient experience
KW - readmissions
KW - surgical outcomes
UR - http://www.scopus.com/inward/record.url?scp=85079774196&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000003034
DO - 10.1097/SLA.0000000000003034
M3 - Article
C2 - 30188401
AN - SCOPUS:85079774196
SN - 0003-4932
VL - 271
SP - 475
EP - 483
JO - Annals of Surgery
JF - Annals of Surgery
IS - 3
ER -