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Modifiable and nonmodifiable factors associated with patient satisfaction in spine surgery and other orthopaedic subspecialties: A retrospective survey analysis

Steinmetz, Leah BA; Vasquez-Montes, Dennis MS; Johnson, Bradley C. MD; Buckland, Aaron J. MBBS, FRACS; Goldstein, Jeffrey A. MD, FACS; Bendo, John A. MD; Errico, Thomas J. MD; Fischer, Charla R. MD

doi: 10.1097/BCO.0000000000000800
Practice Management

Background: The Press Ganey (PG) satisfaction survey is the most common measure to assess ambulatory patient satisfaction. Understanding how factors affecting spine patient satisfaction compare with other orthopedic subspecialties may allow for interventions to increase satisfaction. This study aimed to determine if patient satisfaction predictors differ between spine and nonspine orthopaedic subspecialties.

Methods: PG surveys from 2013-2017 were retrospectively analyzed. Correlation analysis was performed between each survey question, and overall experience as measured by Likelihood of Recommending the provider (LTR) and Provider Rating (PR). Regression modeling was utilized to identify differences between ambulatory patients in spine and other nonspine orthopaedic subspecialties.

Results: Overall, 16,175 orthopaedic patient surveys were analyzed, of which 1,400 surveys were from spine patients. The mean age for respondents was 55.4 yr, and 41.2% were female. Poor ratings were predicted by higher education level in both groups. Female physicians (PR OR=1.320 P=0.07, LTR OR=1.529 P=0.04) and a high school education (PR OR=1.488 P=0.05, LTR OR=1.968 P=0.01) were significant predictors of satisfaction in nonspine orthopaedic subspecialties, but not in spine patients. Provider communication, staff communication, concordant ethnicity, and age bias were predictors for PR (Spine R2=0.735, Orthopedics R2=0.665) and LTR (Spine R2:0.642, Orthopedics R2=0.599) in both groups. Provider communication was the strongest independent predictor of high satisfaction for spine (PR R2=0.728, LTR R2=0.627) and nonspine orthopaedic patients (R2=0.662, R2=0.583) followed by staff communication, ethnicity, and age.

Conclusions: Satisfaction for both spine and nonspine orthopaedic patients is driven by provider communication, followed by staff communication, ethnicity, and age.

Level of Evidence: Level IV.

Department of Orthopedics, Division of Spine, NYU Langone Orthopedic Hospital, New York, NY, USA

Financial Disclosure: The following financial relationships outside of this work were reported as follows: Dr. Buckland, Corin, Pfizer, and Nuvasive; Jeffrey A. Goldstein, Altus Spine, Globus Medical, Regeneration Technologies, Zimmer, Nuvasive, Johnson & Johnson, and St. Teresa Medical, with board memberships on ISASS, Journal ISASS, Spine, Spine Surgery Today, and The Spine Journal; Dr. Errico, Fastenetix, Metronic, Paradigm Spine, Pfizer, and K2M, with board memberships on Harms Study Group and International Spine Study Group; Dr. Fischer, Expert Connect and Stryker. The other authors have no disclosures. No funding was received for this study. The authors report no conflicts of interest in regard to this work.

Correspondence to Bradley C. Johnson, MD, NYU Medical Center – NYU Langone Orthopedic Hospital, Department of Orthopaedic Surgery, Division of Spine, 310 East 17th Street, Suite 400, New York, NY 10003 Tel: +(212) 598-6509; fax: +(212) 598-6581; e-mail:

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