Determinants of caregiver satisfaction in pediatric orthopedics
Singleton IM, Garfinkel R, Temkit H, and Belthur MV. Determinants of caregiver satisfaction in pediatric orthopedics. J Investig Med 2020; 68(1):A124.
J Investig Med
Purpose of study With healthcare transitioning from volume-based to value-based, patient satisfaction is becoming increasingly tied to physician reimbursement as well as publicly reported. Aside from its use as a quality metric, it is also a key component of patient-centered care. This study investigates determinants of pediatric orthopedic patients' parent or guardian (caregiver) satisfaction with the provider as measured by the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS). Methods used This was a prospective cross-sectional study of 200 English-speaking caregivers of pediatric patients that checked into the Phoenix Children's Hospital orthopedic clinic from March 1, 2017 to November 1, 2018. All patients saw the same attending physician. Questionnaires given in clinic included the Newest Vital Sign (NVS) and the Literacy in Musculoskeletal Problems (LiMP) survey to measure general and musculoskeletal health literacy, respectively, demographic information, wait time, Consultation and Relational Empathy Measure (CARE) to measure perceived physician empathy, and CG-CAHPS. Summary of results Of the factors measured, perceived physician empathy correlated the strongest with the caregiver's overall physician satisfaction. Pearson correlation coefficient yielded an r of 0.740 and a p-value of <0.0001. Using multivariable modeling, physician empathy alone accounted for 53% of the variation in satisfaction scores. Other factors such as health literacy as measured by the NVS (r=0.004; p=0.964), LiMP (r=0.013; p=0.879), wait time (r= -0.003; p=0.974), and time spent with the physician (r=0.016; p=0.866) did not independently affect satisfaction. Conclusions The main determinant of caregiver satisfaction with the provider in a pediatric orthopedic setting is perceived physician empathy, accounting for over half of the variation in satisfaction. Health literacy, wait time, and time spent with the physician do not significantly affect satisfaction. This highlights the importance of quality over quantity patient-physician interactions. This is the first study, to our knowledge, that directly correlates pediatric caregivers' perceived physician empathy with provider satisfaction.