title: Patients' preferences regarding the delivery of health care in a hand surgical practice.
abstract: BACKGROUND
  The Patient Protection and Affordable Care Act of 2010 includes patient satisfaction scores in the calculation of reimbursement for services provided. The Medicare and Medicaid Electronic Health Care Record Incentive Program mandate that physicians provide electronic communication with patients. Little data exists regarding patient preferences that might guide the physician adhering to these guidelines. We performed a survey study to examine patients' attitudes regarding the delivery of their health care.
  
  
  METHODS
  We provided an anonymous survey to all outpatient hand surgery patients within a 1-month period at our level I academic center. The survey was structured to ascertain patients' attitudes toward outpatient wait times as well as delivery of patient-specific healthcare-related information. One-hundred and ninety-six surveys were available for review.
  
  
  RESULTS
  Of the 196 patients surveyed, 106 (54 %) were between the ages of 45 and 64. Patients aged 25 to 44 were the least willing to wait for an initial outpatient appointment. The majority of patients in all age groups demonstrated unwillingness to wait more than 1 week for evaluation of a new problem. One hundred and forty patients (71 %) were willing to wait longer for an appointment with an upper extremity specialist rather than have an earlier appointment with a non-upper extremity specialist. Wait times of 30 min after arrival in the office were acceptable to 174 patients (89 %) while 40 patients (20 %) were willing to wait an hour or more. Patients preferred a typed handout detailing their specific problem as opposed to referral to a website or an e-mail containing information.
  
  
  CONCLUSIONS
  The results of our study indicate that patients prefer typed information as opposed to e-mail or websites regarding their health care. Our study also suggests that patients are willing to endure longer wait times if they can be given a sooner appointment, and most prefer a specialist for their problems. These results will provide some guidance to the physician regarding what patients find most appealing.
authors.affiliation: St. Luke's University Hospital, PPHP 2, 801 Ostrum Street, Bethlehem, PA 18015 USA.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Caggiano
authors.affiliation: Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA 19140 USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Fegley
authors.affiliation: St. Luke's University Hospital, PPHP 2, 801 Ostrum Street, Bethlehem, PA 18015 USA.
authors.forename: Kristofer S
authors.initials: KS
authors.lastname: Matullo
keywords: Affordable Care Act; Electronic health records; Meaningful use; Patient preferences; Practice management; Wait times