title: Postoperative complications and patient satisfaction: does payer status have an impact?
abstract: BACKGROUND
  Patient demographics and outcomes may influence patient satisfaction. We aim to investigate the relationship between postoperative complications and survey-based satisfaction in the context of payer status.
  
  
  METHODS
  Institutional data were used to identify major complication occurrence and linked to patient satisfaction surveys. The impact of complication occurrence on satisfaction was investigated and stratified by payer status.
  
  
  RESULTS
  In all, 1,597 encounters were identified with an 18% major complication rate. Satisfaction scores in specific domains were significantly more likely to be above the median for patients without complications (P < .01) and for payer status Medicaid/low income (P < .05). In sensitivity analyses, we found no significant interactions among payer status, complications, and satisfaction scores.
  
  
  CONCLUSIONS
  Significant differences exist for individual satisfaction survey domains between patients with and without major postoperative complications and by payer status. Payer status was not found to have an impact on the intersection of major complications and patient satisfaction.
authors.affiliation: Department of Surgery, The University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Armstrong
authors.affiliation: Department of Health Management and Policy, College of Public Health, The University of Iowa, Iowa City, IA, USA.
authors.forename: Paula A M
authors.initials: PA
authors.lastname: Weigel
authors.affiliation: Department of Surgery, The University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Cromwell
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, University of Michigan Health System, 2124 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA. Electronic address: jcbyrn@med.umich.edu.
authors.forename: John C
authors.initials: JC
authors.lastname: Byrn
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D019538:Health Care Surveys; D006295:Health Resources / Q000639:trends; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D061214:Patient Safety; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D058996:Quality Improvement; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000191:economics / Q000379:methods; D014481:United States
keywords: Complications; Payer status; Satisfaction