Patient Satisfaction With Care Is Associated With Better Outcomes in Function and Pain 1 Year After Lumbar Spine Surgery

Abstract

Purpose There has been increasing interest in patient-reported experience measures (PREMs) to evaluate the patient experience and satisfaction with care. We conducted a prospective multicenter cohort study to determine any association between patients' satisfaction of care and their outcomes 1 year after lumbar spine surgery. Methods Satisfaction with care was recorded through telephone interviews and a standardized questionnaire. Baseline data collection (300 patients) and 1-year follow-up (209 patients) were conducted through The Swedish National Register for Spine Surgery (Swespine). Exposures were patient experiences, health care professional (HCP) attitudes, shared decision-making, and overall satisfaction with care. Associations were evaluated using adjusted analysis of covariance (ANCOVA) models. Results Satisfaction with HCP attitudes was not associated with improvements at 1 year in Oswestry Disability Index (ODI) or back pain; however a significantly greater improvement in leg pain score was reported by patients who were highly satisfied (3.0 points) versus the moderate/low satisfaction group (1.3 points; P=0.008). For shared decision-making, high satisfaction was associated with significantly greater improvements, as compared to moderate/low satisfaction, in ODI (20 vs 11 points; P=0.001), back pain (2.6 vs 1.7 points; P=0.05), and leg pain (3.2 vs 1.9 points, P=0.007). Similarly, high overall satisfaction with care was associated with significantly greater improvements in ODI (18 vs 10 points; P=0.02), back pain (3.2 vs 0.6 points; P<0.001), and leg pain (2.6 vs 1.1 points; P=0.009). Conclusions Findings indicate that shared decision-making on perioperative care and patients' overall satisfaction with care were associated with better health outcomes 1 year after lumbar spine surgery.