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
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 (HCAH...
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Published in | Journal of the American Academy of Orthopaedic Surgeons Vol. 29; no. 7; p. 301 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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United States
01.04.2021
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Abstract | 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.
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.
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.
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. |
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AbstractList | 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.
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.
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.
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. |
Author | Kim, Ryan L Mir, Hassan R Ramsamooj, Harry Roberts, Michael Downes, Katheryne Ahmed, Adil S |
Author_xml | – sequence: 1 givenname: Adil S orcidid: 0000-0002-7064-8430 surname: Ahmed fullname: Ahmed, Adil S organization: From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Ahmed, Ramsamooj, Mir), the Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA (Kim), the Department of Orthopaedics and Rehabilitation (Roberts), University of Vermont Larner College of Medicine, Burlington, VT, and the Florida Orthopaedic Institute, Tampa, FL (Downes, Mir) – sequence: 2 givenname: Ryan L orcidid: 0000-0002-5205-5172 surname: Kim fullname: Kim, Ryan L – sequence: 3 givenname: Harry orcidid: 0000-0002-0077-5768 surname: Ramsamooj fullname: Ramsamooj, Harry – sequence: 4 givenname: Michael surname: Roberts fullname: Roberts, Michael – sequence: 5 givenname: Katheryne surname: Downes fullname: Downes, Katheryne – sequence: 6 givenname: Hassan R orcidid: 0000-0002-0260-3468 surname: Mir fullname: Mir, Hassan R |
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SubjectTerms | Adult Analgesics, Opioid - therapeutic use Health Personnel Hospitals Humans Middle Aged Opiate Alkaloids Orthopedics Pain Patient Satisfaction Perception Personal Satisfaction Practice Patterns, Physicians Retrospective Studies Surveys and Questionnaires |
Title | 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 |
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