Postsurgical pain scores were highly correlated with reports of overall patient satisfaction during hospital stays, more for some types of surgery than others, according to new research.
The investigators, who presented results March 6 in a scientific poster in Phoenix at the 30th annual meeting of the American Academy of Pain Medicine, stressed the importance of improving patient care in the perioperative setting in alignment with new federal requirements tying performance to pay.
Dermot Maher, MD, and colleagues from Cedars Sinai Medical Center in Los Angeles set out to clarify the relationship between pain control after surgery and the answers provided by patients on the Hospital Consumer Assessment of Healthcare Providers and Systems. The HCAHPS is the first national, standardized, publicly reported survey of patients perspectives on the care they receive in the hospital and is filled out at the time of discharge. The Affordable Care Act makes the 27-question HCAHPS a factor in value-based incentive payments.
This study illustrates the crucial role that pain management in the acute postoperative setting can have, not only on a patients perception of pain management, but also on the global perception of their hospitalization, Maher said in a news release.
Researchers examined HCAHPS responses from 2,933 surgical patients who were hospitalized at a single trauma center between March 2012 and February 2013. Four questions, two assessing satisfaction with in-hospital pain management and two addressing general satisfaction, showed a statistically robust relationship when retrospectively compared to patient pain scores assessed via the post-anesthesia care unit visual analog scale.
Maher said the results are important to hospital care providers and patients.
Patients consider a number of factors when evaluating physicians and hospitals, he said in the release. One of the most influential factors is a patients perception of pain. The universal unpleasantness and complicated nature of pain, especially in the postoperative setting, has the potential to negatively impact overall satisfaction if not optimally managed.
Further analyses of the data showed patients who had surgery related to spine, nonspine orthopedics and OB/GYN showed significantly larger correlations of PACU pain scores with HCAHPS responses than did patients who had other types of surgeries. According to Maher, the stronger association between HCAHPS scores and postop pain in certain populations may call into question the appropriateness of universal application of patient satisfaction surveys, or at least the pain component, as a means of reimbursement.
The study findings show the need for better postop pain control for patients, Maher said, and also suggest it might be helpful to identify anesthetic techniques that might improve patient satisfaction. Preadmission, preoperative and intraoperative interventions, and changes in PACU patient care, all could influence HCAHPS scores, he said.
Poster abstract: www.painmed.org/2014posters/abstract-115/
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