Factors associated with non-response in routine use of patient reported outcome measures after elective surgery in England
Factors associated with non-response in routine use of patient reported outcome measures after elective surgery in England
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DOI：
10.1186/1477-7525-10-34
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发表时间：
2012-03-30
影响因子：
3.6
通讯作者：
van der Meulen, Jan
中科院分区：
文献类型：
--
作者：
Hutchings, Andrew;Neuburger, Jenny;van der Meulen, Jan
背景：患者报告的结局指标越来越多地用于比较提供者。我们研究了术后问卷调查的无应答率是否与患者的特征和组织特征的providers.Methods：131 447例患者进行了髋关节或膝关节置换术，疝修补术或静脉曲张手术在2009-10年在英格兰。多变量逻辑回归计算患者特征和提供者组织特征的无应答调整比值比。对缺失的患者特征进行多重插补。结果：髋关节置换术（n = 37 961），膝关节置换术（n = 44 422），疝修补术（n = 34 964）和静脉曲张手术（n = 14 100）的术后问卷调查的应答率分别为85.1%，85.3%，72.9%。在这四个程序中，男性的无反应水平更高（比值比1.03 [95% CI 0.95-1.11] - 1.35 [1.25-1.46]），年轻患者（55岁以下患者3.01 [2.72-3.32] - 6.05 [5.49-6.67]），非白人患者（1.24 [1.11-1.38] - 2.08 [1.89-2.31]），社会经济地位最贫困的五分之一的患者（1.47 [1.34- 1，62] - 1.86 [1.71-2.03]），那些独居的人（1.11 [0.99-1.23] -1.27 [1.18-1.36]）和在完成术前问卷时得到帮助的患者（1.26 [1.10-1.46] - 1.67 [1.56-1.79]）。术前健康状况较差的患者的无应答率也较高（3种或3种以上合并症：1.14 [0.96-1.35] 1.45 [1.30-1.63]）。供应商的病人招聘率手术前和手术前问卷管理的时间并没有影响的反应率术后questionnaires.Conclusion：如果无反应可以被证明是与结果，然后率术后问卷调查的无反应将需要考虑到这些措施时，被用来比较供应商的性能或评估手术程序。
Background: Patient-reported outcome measures are increasingly being used to compare providers. We studied whether non-response rates to post-operative questionnaires are associated with patients' characteristics and organisational features of providers.Methods: 131 447 patients who underwent a hip or knee replacement, hernia repair or varicose vein surgery in 2009-10 in England. Multivariable logistic regression to calculate adjusted odds ratios of non-response for characteristics of the patients and organisational characteristics of providers. Multiple imputation was used for missing patient characteristics. Providers were included as random effects.Results: Response rates to the post-operative questionnaire were 85.1% for hip replacement (n = 37 961), 85.3% for knee replacements (n = 44 422), 72.9% for hernia repair (n = 34 964), and 64.8% for varicose vein surgery (n = 14 100). Across the four procedures, there were higher levels of non-response in men (odds ratios 1.03 [95% CI 0.95-1.11] - 1.35 [1.25-1.46]), younger patients (those under 55 years 3.01 [2.72-3.32] - 6.05 [5.49-6.67]), non-white patients (1.24 [1.11-1.38] - 2.08 [1.89-2.31]), patients in the most deprived quintile of socio-economic status (1.47 [1.34-1,62] - 1.86 [1.71-2.03]), those who lived alone (1.11 [0.99-1.23] -1.27 [1.18-1.36]) and those who had been assisted when completing their pre-operative questionnaire (1.26 [1.10-1.46] - 1.67 [1.56-1.79]). Non-response rates were also higher in patients who had poorer pre-operative health (three or more comorbidities: 1.14 [0.96-1.35] 1.45 [1.30-1.63]). Providers' patient recruitment rates before surgery and the timing of pre-operative questionnaire administration did not affect the rates of response to post-operative questionnaires.Conclusion: If non-response can be shown to be associated with outcome, then rates of non-response to postoperative questionnaires would need to be taken into account when these measures are being used to compare the performance of providers or to evaluate surgical procedures.