Abstract
The Centers for Medicare and Medicaid Services has implemented the Value-Based Purchasing
(VBP) score as a pay-for-performance reimbursement model. Patient experience, as measured
by the Press Ganey (PG) survey, currently comprises 20% of total VBP score. It is
therefore beneficial for the orthopaedist to become familiar with these changes to
maximize profits. Currently, a paucity of data exists that elucidates which factors
influence PG scores between men and women following total knee arthroplasty (TKA).
Therefore, we asked: (1) which PG survey factors most influences hospital ratings
among men and women patients post-TKA and (2) is there a significant difference in
overall hospital ratings among men and women cohorts post-TKA? We queried the PG database
for patients who received a TKA between November 2009 and January 2015, yielding 224
men (mean age 64 years, range: 39–88) and 519 women (mean age 65 years; range, 25–92).
A multiple regression analysis was performed for each cohort with overall hospital
satisfaction as the dependent variable to assess the influence (β-weight) each PG
domain imparted on overall hospital rating. A chi-square analysis and t-test were performed to assess categorical and continuous variables, respectively.
For men, communication with nurses (β = 0.408, p = 0.016), followed by communication about medications (β = 0.261, p = 0.032), most influenced overall hospital rating. For women, communication with
nurses (β = 0.479, p < 0.001) most influenced overall hospital rating. This was followed by staff responsiveness
(β = 0.201, p = 0.046), pain management (β = 0.263, p = 0.015), and communication about medications (β = − 0.152, p = 0.029). It is of great advantage for the orthopaedist to focus on the PG domains
most pertinent to each patient gender post-TKA. For both genders, overall hospital
rating was significantly influenced by communication with nurses and information about
medication. However, staff responsiveness and pain control were of significant importance
in determining overall hospital rating for women. Therefore, orthopaedists should
consider focusing on these factors depending on the gender of the patient to optimize
satisfaction.
Keywords
total knee arthroplasty - patient satisfaction - Press Ganey - gender - reimbursement
