Predictors of patient satisfaction after cardiac pacemaker implantation or ICD implantation.

BACKGROUND AND AIM OF THE STUDY: The study aimed to identify predictors of satisfaction of patients receiving a cardiac pacemaker or an implantable cardioverter-defibrillator (ICD). METHODS: This was a cross-sectional study measuring patient satisfaction postdischarge by using a mailed questionnaire. Study participants included a random sample of hospitalized patients who had undergone implantation of a pacemaker or ICD in 30 hospitals in Germany. RESULTS: Data from 548 respondents (response rate 17.3%) were available for analyses. Logistic regression analysis revealed the following factors associated with satisfaction of inpatients (P < .05): outcome of treatment (odds ratio [OR] = 11.51, 95% confidence interval [CI] = 4.62-28.64), individualized medical care by physicians (OR = 5.04, 95% CI = 2.13-11.92), kindness of nurses (OR = 4.83, 95% CI = 1.52-15.42), and physicians (OR = 3.46, 95% CI = 1.03-11.65), organization of procedures and operations, respectively (OR = 4.45, 95% CI = 1.85-10.75) and thoroughness of the discharge instructions (OR = 2.69, 95% CI = 1.17-6.20). CONCLUSIONS: This study identified six predictors of satisfaction among pacemaker and ICD patients that can be addressed by healthcare providers to increase patients' evaluation of the hospitalization. Identified predictors of satisfaction are alterable by health care professionals and, thus, should be focused on to increase satisfaction ratings of patients who have undergone implantation of a pacemaker or ICD.

Algorithms to identify COPD in health systems with and without access to ICD coding: a systematic review.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) causes significant morbidity and mortality worldwide. Estimation of incidence, prevalence and disease burden through routine insurance data is challenging because of under-diagnosis and under-treatment, particularly for early stage disease in health care systems where outpatient International Classification of Diseases (ICD) diagnoses are not collected. This poses the question of which criteria are commonly applied to identify COPD patients in claims datasets in the absence of ICD diagnoses, and which information can be used as a substitute. The aim of this systematic review is to summarize previously reported methodological approaches for the identification of COPD patients through routine data and to compile potential criteria for the identification of COPD patients if ICD codes are not available. METHODS: A systematic literature review was performed in Medline via PubMed and Google Scholar from January 2000 through October 2018, followed by a manual review of the included studies by at least two independent raters. Study characteristics and all identifying criteria used in the studies were systematically extracted from the publications, categorized, and compiled in evidence tables. RESULTS: In total, the systematic search yielded 151 publications. After title and abstract screening, 38 publications were included into the systematic assessment. In these studies, the most frequently used (22/38) criteria set to identify COPD patients included ICD codes, hospitalization, and ambulatory visits. Only four out of 38 studies used methods other than ICD coding. In a significant proportion of studies, the age range of the target population (33/38) and hospitalization (30/38) were provided. Ambulatory data were included in 24, physician claims in 22, and pharmaceutical data in 18 studies. Only five studies used spirometry, two used surgery and one used oxygen therapy. CONCLUSIONS: A variety of different criteria is used for the identification of COPD from routine data. The most promising criteria set in data environments where ambulatory diagnosis codes are lacking is the consideration of additional illness-related information with special attention to pharmacotherapy data. Further health services research should focus on the application of more systematic internal and/or external validation approaches.

Patient satisfaction and willingness to return to the provider among women undergoing gynecological surgery.

PURPOSE: To identify factors associated with 'patient satisfaction' and 'willingness to return to the provider' in gynecology and to assess similarities as well as differences between the two concepts. METHODS: Study data were obtained from 968 randomly selected gynecology patients discharged from 22 hospitals who responded to a mailed survey. The validated instrument consisted of 37 items and assessed medical and service aspects of care, patient and visit characteristics. The dependent variables consisted of ratings of willingness to return to the provider and overall satisfaction. Bivariate and multivariate techniques were used to reveal relationships between indicators and both dependent variables. RESULTS: The multivariate analyses identified individualized medical care, kindness of medical practitioners, treatment outcome and organization of discharge as the most consistent predictors of the patients' likelihood to return and overall satisfaction. Differences between both concepts pertained to the significance of service variables (cleanliness and quality of food) for patient satisfaction and visit-related characteristics (length of stay and occurrence of complications) for willingness to return. CONCLUSIONS: Study findings suggest that patient satisfaction and willingness to return to the provider do not reflect the same concepts. Although service aspects such as quality of food influence satisfaction ratings, they do not increase the likelihood that patients choose the same hospital in case of another treatment. Communication between patients and medical practitioners is highly important. Revealed predictors of both concepts are alterable by healthcare professionals and should be focused on to enhance patient satisfaction and to increase the probability patients return to their provider.

Analysis of factors associated with patient satisfaction in ophthalmology: the influence of demographic data, visit characteristics and perceptions of received care.

PURPOSE: To identify factors associated with satisfaction among patients receiving ophthalmic services and to indicate the intensity of this relationship. METHODS: The data used was obtained through a self-administered, post-visit questionnaire from randomly selected 507 patients treated in seven eye clinics in Germany. The instrument assessed satisfaction with several aspects of care and patient baseline and visit characteristics. Bivariate and multivariate techniques were used to reveal relations between indicators and overall satisfaction. RESULTS: Factor analysis yielded two factors, 'medical aspects of care' and 'performance of service', explaining 55% of total variance. Cronbach's α coefficient for both scales indicates acceptable internal consistency. Bivariate analysis showed strong relations between overall satisfaction and perceived care with weaker findings pertaining to visit characteristics. Not any of the demographic variables was associated with overall satisfaction. Perceived length of stay, intention to return to the clinic, and occurrence of complications were influential attributes on satisfaction ratings. The multivariate analysis identified seven factors associated with overall satisfaction including the treatment outcome (OR: 4.57), kindness of the nurses (OR: 5.27) and medical practitioners (OR: 2.23), room amenities (OR: 2.72), organization of procedures and operations (OR: 2.71), information about anaesthesia (OR: 1.95), and cleanliness (OR: 1.93). CONCLUSIONS: Factors associated with patient satisfaction in ophthalmology concern medical aspects like the organization of procedures and operations but also aspects that are not directly related to technical care, such as kindness of the nurses and cleanliness. Results show that patients' subjective experiences of received care and services relate more strongly and consistently to overall satisfaction than patient demographic data or visit characteristics. Revealed factors predicting patient satisfaction are alterable by health care managers. Therefore, focusing on these attributes represents an effective manner to enhance patient satisfaction in ophthalmology.

Factors associated with patient satisfaction in surgery: the role of patients' perceptions of received care, visit characteristics, and demographic variables.

BACKGROUND: Measures of satisfaction of surgical patients can be used to evaluate and redesign the process of care or to complement established procedures to improve quality of services. However, study findings regarding aspects of patient satisfaction are often inconsistent and depend on the setting. The primary goals of this research were to identify factors associated with satisfaction among patients in a surgical setting. MATERIALS AND METHODS: Data used in this study were obtained from randomly selected 2699 surgical patients discharged during January-December 2008 from 26 hospitals who responded to a mailed survey. The instrument assessed satisfaction regarding 23 items of perceived care, patient demographic, and visit characteristics. Bivariate and multivariate techniques were used to reveal relations between indicators and overall satisfaction. RESULTS: Bivariate statistics showed strong relations between overall satisfaction and perceived care with weaker findings pertaining to demographic and visit characteristics. The Multivariate logistic regression predicting overall satisfaction demonstrated that patients receiving surgical services predominantly have similar demands and priorities regardless of age and gender. The strongest factors were (P < 0.05) the interpersonal manner of medical practitioners and nurses, organization of operations, admittance, and discharge, as well as perceived length of stay. CONCLUSIONS: This study identified factors that are related to satisfaction of surgical patients and indicated the intensity of this relationship. These findings support health care providers and medical practitioners with valuable information to meet needs and preferences of patients receiving surgical services.