The Relationship Between Patient Satisfaction and Healthcare Expenditures in Adults with Spine Related Disorders: An Analysis of the 2008 to 2015 Medical Expenditures Panel Survey (MEPS).
The Relationship Between Patient Satisfaction and Healthcare Expenditures in Adults with Spine Related Disorders: An Analysis of the 2008 to 2015 Medical Expenditures Panel Survey (MEPS).
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DOI：
10.1097/brs.0000000000004047
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发表时间：
2021-10-15
期刊：
影响因子：
3
通讯作者：
Egede LE
中科院分区：
文献类型：
--
作者：
Gliedt JA;Walker RJ;Lu K;Dawson AZ;Egede LE
横断面研究。本研究旨在探讨成人脊柱相关疾病(SRDS)患者满意度(PS)与医疗支出(HCE)之间的关系。SRD很普遍，给社会带来了高昂的成本。PS和HCE尚未在该人群中进行研究。分析了来自医疗支出小组调查(MEP)(2008-2015)的15,850名患有SRD的成年人。MEPS医疗条件文件用于根据ICD-9代码识别SRD。计算样本人口统计的频率和百分比。医疗费用是指在调查年度内提供的护理的直接付款总额。综合PS评分是使用0-10分的医疗保健提供者，结合患者感到他们被倾听、得到可理解的解释、受到尊重和得到足够时间的频率构建的。每一年未调整的平均HCE按PS的四分位数计算。一个由概率模型和随后的伽马分布的广义线性模型组成的两部分模型被执行，并调整了相关的协变量。利润率命令用于计算HCE的增量估计值。对于患有SRDS的成年人，未调整的平均HCE从2008年的7,057美元(95%CI，6,516美元，7,597美元)增加到2015年的9,820美元(95%CI，8,811美元，10,830美元)。调整易感因素后，PS的第二、第三和第四四分位数的个体与第一四分位数的个体有显著差异。对易感因素和促成因素进行调整后，只有第四个四分位数与第一个四分位数有显著差异。在对易感、使能和需要因素进行调整后，第二、第三和第四个四分位数与第一个四分位数不再有显著差异。患有SRDS的成年人的支出随着时间的推移而增加。在控制了诱因和促成因素后，PS与支出显著相关，但在控制需求因素后，PS与支出没有显著关联。需求因素似乎解释了患有SRDS的成年人PS水平较低和HCE水平较高之间的关系。
Cross-sectional study. The aim of this study was to investigate the relationship between patient satisfaction (PS) and healthcare expenditures (HCE) in adults with spine related disorders (SRDs). SRDs are widespread and pose a high cost to society. PS and HCE have yet to be studied in this population. 15,850 adults with SRDs from the Medical Expenditures Panel Survey (MEPS) (2008-2015) were analyzed. The MEPS Medical Conditions files were used to identify SRDs based on ICD-9 codes. Frequencies and percentages of sample demographics were calculated. HCE was measured as total direct payments for care provided during the survey year. A composite PS score was constructed using a 0-10 rating of their healthcare providers combined with the frequency in which patients felt they were listened to, were given understandable explanations, were respected, and were given enough time. Mean unadjusted HCE were calculated for each year and by quartile of PS. A two-part model consisting of a probit model and subsequent generalized linear model with gamma distribution was performed, adjusting for relevant covariates. Margins command was used to calculate incremental estimates of HCE. Mean unadjusted HCE increased annually from $7,057 (95% CI, $6,516, $7,597) in 2008 to $9,820 (95% CI, $8,811, $10,830) in 2015 for adults with SRDs. Adjusting for predisposing factors, individuals in second, third and fourth quartiles of PS were significantly different from the first quartile. Adjusting for predisposing and enabling factors, only fourth quartile was significantly different from first quartile. After adjusting for predisposing, enabling and need factors, second, third and fourth quartiles were no longer significantly different from the first quartile. Expenditures have increased over time in adults with SRDs. PS is significantly associated with expenditures after controlling for predisposing and enabling factors, but not significant after controlling for need factors. Need factors appear to explain the relationship between lower levels of PS and higher HCE in adults with SRDs.