Patient satisfaction with health-care professionals and structure is not affected by longer hospital stay and complications after lung resection: a case-matched analysis.
OBJECTIVE
The objective of this investigation was to assess satisfaction with care of patients with long hospital stay (LHS) or complications after pulmonary resection in comparison with case-matched counterparts with a regular postoperative course.


METHODS
This is a prospective observational analysis on 171 consecutive patients submitted to pulmonary resections (78 wedges, 8 segmentectomies, 83 lobectomies, 3 pneumonectomies) for benign (35), primary (93) or secondary malignant (43) diseases. A hospital stay >7 days was defined as long (LHS). Major cardiopulmonary complications were defined according to the ESTS database. Patient satisfaction was assessed by the administration of the EORTC IN-PATSAT32 module at discharge. The questionnaire is a 32-item self-administered survey including different scales, reflecting the perceived level of satisfaction about the care provided by doctors, nurses and other personnel. To minimize selection bias, propensity score case-matching technique was applied to generate two sets of matched patients: patients with LHS with counterparts without it; patients with complications with counterparts without it.


RESULTS
Median length of postoperative stay was 4 days (range 2-43). Forty-one patients (24%) had a hospital stay>7 days and 21 developed cardiopulmonary complications (12%). Propensity score yielded two well-matched groups of 41 patients with and without LHS. There were no significant differences in any patient satisfaction scale between the two groups. The comparison of the results of the patient satisfaction questionnaire between the two matched groups of 21 patients with and without complications did not show significant differences in any scale.


CONCLUSIONS
Patients experiencing poor outcomes such as long hospital stay or complications have similar perception of quality of care compared with those with regular outcomes. Patient-reported outcome measures are becoming increasingly important in the evaluation of the quality of care and may complement more traditional objective indicators such as morbidity or length of stay.
St James's University Hospital, Leeds, West Yorkshire, UK.
Cecilia
C
Pompili
Ospedali Riuniti Ancona, Ancona, Italy.
Michela
M
Tiberi
Ospedali Riuniti Ancona, Ancona, Italy.
Michele
M
Salati
Ospedali Riuniti Ancona, Ancona, Italy.
Majed
M
Refai
Ospedali Riuniti Ancona, Ancona, Italy.
Francesco
F
Xiumé
St James's University Hospital, Leeds, West Yorkshire, UK brunellialex@gmail.com.
Alessandro
A
Brunelli
D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007902:Length of Stay; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009723:Nurse-Patient Relations; D017060:Patient Satisfaction; D010465:Perception; D010817:Physician-Patient Relations; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D019984:Quality Indicators, Health Care / Q000592:standards; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
Complications; Hospital stay; Lung resection; Patient satisfaction; Quality of care