Keys to improving patient satisfaction in the pediatric urology clinic: A starting point

Carol A Davis-Dao; Louis Ehwerhemuepha; Joshua D Chamberlin; William Feaster; Antoine E Khoury; Michelle A Fortier; Zeev N Kain

doi:10.1016/j.jpurol.2020.03.013

Keys to improving patient satisfaction in the pediatric urology clinic: A starting point

J Pediatr Urol. 2020 Jun;16(3):377-383. doi: 10.1016/j.jpurol.2020.03.013. Epub 2020 Mar 29.

Authors

Carol A Davis-Dao¹, Louis Ehwerhemuepha², Joshua D Chamberlin³, William Feaster², Antoine E Khoury¹, Michelle A Fortier⁴, Zeev N Kain⁵

Affiliations

¹ Division of Pediatric Urology, CHOC Children's, Orange, CA, Department of Urology, University of California, Irvine, CA, USA.
² Information Systems Department, CHOC Children's, Orange, CA, USA.
³ Division of Pediatric Urology, CHOC Children's, Orange, CA, Department of Urology, University of California, Irvine, CA, USA; Department of Urology, Loma Linda University Children's Hospital, Loma Linda, CA, USA.
⁴ Center on Stress & Health, University of California School of Medicine, Irvine, CA, USA; Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA; Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA; Department of Pediatric Psychology, Children's Hospital of Orange County, Orange, CA, USA.
⁵ Center on Stress & Health, University of California School of Medicine, Irvine, CA, USA; Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA; Yale Child Study Center, Yale University, New Haven, CT, USA; Health Policy Research Institution, University of California, Irvine, CA, USA. Electronic address: zkain@uci.edu.

PMID: 32295742
DOI: 10.1016/j.jpurol.2020.03.013

Abstract

Background: Recent developments in healthcare have placed increased focus on patient satisfaction. Among adult populations, validated patient satisfaction tools have now been incorporated into routine practice. This process has been much slower and is significantly less standardized in pediatric populations.

Objective: The objective of this analysis was to evaluate various factors that predict patient satisfaction in pediatric urology settings.

Materials and methods: Data from the National Research Corporation (NRC) Health Patient Survey were collected from children receiving urological care between 2017 and 2019. Survey data were merged with demographic and visit-related information from electronic health records (EHR). Rating of provider on the NCR Health survey was chosen as the primary outcome. Two multivariable models were analyzed by logistic regression. The first model contained only demographic and clinic-based predictor variables. The second model contained the NRC survey questions.

Results: This analysis includes a total of 3232 surveys. Multivariable analysis of EHR demographic and visit data found that low income insurance (Medicaid) (OR = 1.3, p = 0.035), primary language Spanish (OR = 1.5, p = 0.012), and shorter in-office wait time (OR = 0.94, p < 0.001) were predictors for higher patient satisfaction scores. Multivariable analysis of NCR Health survey data identified physician explanation, listening, respect for patient, time spent with patient and communication between physicians and nurses as highly significant predictors of satisfaction (p < 0.001).

Discussion: This analysis has identified several modifiable and non-modifiable variables that predict patient satisfaction in a population of children receiving care in a pediatric urology clinic. Limitations of this study include the possibility for response bias and lack of data on other potentially important but unmeasured factors.

Conclusions: Certain patient populations are more satisfied with the outpatient urology clinic experience. Several factors related to physician-patient communication are modifiable areas to improve patient satisfaction. Further intervention studies focusing on the modifiable areas are needed to increase patient satisfaction in pediatric urology.

MeSH terms

Adult
Ambulatory Care Facilities
Child
Humans
Patient Satisfaction*
Physician-Patient Relations
Physicians*
United States
Urology*