Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 1996
[Patient satisfaction as health care outcome--the example of surgical correction of the nasal septum].
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Dörning H, Bitzer E M, Schwartz F W
Аннотация
BACKGROUND: Presented is a study, that investigates the relevance of patient satisfaction as evaluative criteria for effectiveness of medical measures exemplary in patients who underwent surgery for a deviated nasal septum.
MATERIAL AND METHODS: A standardised Instrument was specifically developed and pretested (n = 30). In January 1995 all working members of a German sickness fund hospitalised between March and September 1994 for ICD-470 (deviated nasal septum) were surveyed retrospectively by means of a written questionnaire. The response rate was 85.2% (n = 334, 88.8% male; medium age: 35.2 years, average length of stay: 6.5 days). Descriptive and multivariate analysis were performed.
RESULTS: 10.6% of the study population reported a complete decrease of preoperative symptoms (100% relative improvement), whereas in 7.9% no alleviation of nasal related symptoms was reported. 45.2% of the patients are satisfied with the outcome of septal surgery, 35.6% are satisfied to a limited extent, 19.2% express their "dissatisfaction". Multivariate analysis was performed to investigate the main determinants of patient satisfaction. It can be seen that the percentage of satisfied patients increases if there is a large alleviation of that symptom cited as main reason for undergoing nasal surgery, if the discomfort caused by nasal packings is small and if the overall burden of nasal associated symptoms is low postoperatively.
CONCLUSION: Patient criteria for evaluating the surgical outcome are plausible and include dimensions also relevant from the clinician's perspective. Therefore, the integration of systematic patient-oriented assessments into the evaluation of medical care seems to be a promising approach. It might be used i.e. to identify high priority areas in the context of quality management.
MATERIAL AND METHODS: A standardised Instrument was specifically developed and pretested (n = 30). In January 1995 all working members of a German sickness fund hospitalised between March and September 1994 for ICD-470 (deviated nasal septum) were surveyed retrospectively by means of a written questionnaire. The response rate was 85.2% (n = 334, 88.8% male; medium age: 35.2 years, average length of stay: 6.5 days). Descriptive and multivariate analysis were performed.
RESULTS: 10.6% of the study population reported a complete decrease of preoperative symptoms (100% relative improvement), whereas in 7.9% no alleviation of nasal related symptoms was reported. 45.2% of the patients are satisfied with the outcome of septal surgery, 35.6% are satisfied to a limited extent, 19.2% express their "dissatisfaction". Multivariate analysis was performed to investigate the main determinants of patient satisfaction. It can be seen that the percentage of satisfied patients increases if there is a large alleviation of that symptom cited as main reason for undergoing nasal surgery, if the discomfort caused by nasal packings is small and if the overall burden of nasal associated symptoms is low postoperatively.
CONCLUSION: Patient criteria for evaluating the surgical outcome are plausible and include dimensions also relevant from the clinician's perspective. Therefore, the integration of systematic patient-oriented assessments into the evaluation of medical care seems to be a promising approach. It might be used i.e. to identify high priority areas in the context of quality management.