Does Gender Influence How Patients Rate Their Patient Experience after Total Knee Arthroplasty?

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

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