TY - JOUR
T1 - Better Patient-Reported Experiences with Health Care Are Associated with Improved Clinical Outcome after Carpal Tunnel Release Surgery
AU - Schrier, Verena J.M.M.
AU - Poelstra, Ralph
AU - Selles, Ruud W.
AU - Slijper, Harm P.
AU - Amadio, Peter C.
AU - Hovius, Steven E.R.
AU - Porsius, Jarry T.
N1 - Funding Information:
Disclosure: Dr. Porsius was supported by a Rubicon Fellowship (446-16-017) from the Netherlands Organisation for Scientific Research (NWO) and by the Medical Delta. The funding sources did not influence the design, analysis, or reporting of this study. None of the other authors has a financial interest in any of the products or devices mentioned in this article.
Funding Information:
The authors would like to thank all patients who filled out questionnaires as part of their clinical care and have agreed to let their data be used anonymously for the present study. In addition, they would like to acknowledge the members of the Hand-Wrist Study Group, caregivers and personnel of Xpert Clinic, Handtherapie Nederland, and Equipe Zorgbedrijven for assisting in the routine outcome measurements that are the basis for this article.
Publisher Copyright:
© 2019 Lippincott Williams and Wilkins. All rights reserved.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background: In hand surgery, and specifically carpal tunnel syndrome, it is currently unknown whether experiences with health care influence surgical outcome. To investigate whether there is an association between patient-reported experience measures and symptom relief, data were gathered using a cohort of patients undergoing surgical treatment for carpal tunnel syndrome. Methods: Patient-reported experience measures and patient-reported outcome measures were registered in a national database of 16 hand surgery practices. The experience measure data were gathered at 3 months after surgery and included six subscales on different health care delivery aspects (e.g., provided information, communication, facility, operative care). The outcome measure data were acquired before and 3 months after surgery with the Boston Carpal Tunnel Assessment Questionnaire. The association was tested using linear regression analyses. Results: A total of 1607 patients were included in the analysis. The experience measure scores were good to excellent, with a median value between 8.0 and 8.5 on a 10-point scale. Regression analyses showed a significant (p < 0.001) association with the Boston Carpal Tunnel Assessment Questionnaire for all individual patient-reported experience measure subscales. The greatest effects were found in physician communication and treatment information. Patient-reported experience measures accounted for more than 5 percent of the explained variance, with patient characteristics explaining an approximately additional 3 percent. Conclusions: In this large data set of carpal tunnel syndrome patients who underwent surgical release, a significant impact of health care experiences on self-reported clinical outcome was found. This is relevant information, not only for directing care providers in improving health care experiences as a quality-of-health care measure but now also potentially to achieve better clinical outcome. (Plast. Reconstr. Surg. 143: 1677, 2019.) CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
AB - Background: In hand surgery, and specifically carpal tunnel syndrome, it is currently unknown whether experiences with health care influence surgical outcome. To investigate whether there is an association between patient-reported experience measures and symptom relief, data were gathered using a cohort of patients undergoing surgical treatment for carpal tunnel syndrome. Methods: Patient-reported experience measures and patient-reported outcome measures were registered in a national database of 16 hand surgery practices. The experience measure data were gathered at 3 months after surgery and included six subscales on different health care delivery aspects (e.g., provided information, communication, facility, operative care). The outcome measure data were acquired before and 3 months after surgery with the Boston Carpal Tunnel Assessment Questionnaire. The association was tested using linear regression analyses. Results: A total of 1607 patients were included in the analysis. The experience measure scores were good to excellent, with a median value between 8.0 and 8.5 on a 10-point scale. Regression analyses showed a significant (p < 0.001) association with the Boston Carpal Tunnel Assessment Questionnaire for all individual patient-reported experience measure subscales. The greatest effects were found in physician communication and treatment information. Patient-reported experience measures accounted for more than 5 percent of the explained variance, with patient characteristics explaining an approximately additional 3 percent. Conclusions: In this large data set of carpal tunnel syndrome patients who underwent surgical release, a significant impact of health care experiences on self-reported clinical outcome was found. This is relevant information, not only for directing care providers in improving health care experiences as a quality-of-health care measure but now also potentially to achieve better clinical outcome. (Plast. Reconstr. Surg. 143: 1677, 2019.) CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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U2 - 10.1097/PRS.0000000000005516
DO - 10.1097/PRS.0000000000005516
M3 - Article
C2 - 31136483
AN - SCOPUS:85067302780
SN - 0032-1052
VL - 143
SP - 1677
EP - 1684
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 6
ER -