Abstract
Patient satisfaction is increasingly used as a metric to evaluate the quality of healthcare
services and to determine hospital and physician compensation. The aim of this study
was to identify preoperative factors associated with Press Ganey Ambulatory Surgery
(PGAS) satisfaction scores, and to evaluate the effect of each PGAS domain score on
the total PGAS score variability in patients undergoing anterior cruciate ligament
reconstruction (ACLR). A review of a Press Ganey (PG) database at a single center
was performed for patients undergoing ACLR between 2015 and 2019. Ninety-nine patients
completed the PGAS survey and 54 also completed preoperative demographic and patient-reported
outcome measures (PROMs) for an orthopaedic registry. PGAS scores were calculated
and bivariate analysis was performed. Multivariable linear regression determined the
effect of each of the six PGAS domains on the total PGAS score variability. In the
total cohort of 99 patients, no factors were significantly associated with the total
PGAS score or any domain scores. For the 54 patients who also participated in the
orthopaedic registry, none of the preoperative PROMs were significantly correlated
with total PGAS score. However, having a college degree (89 vs. 95 or 97 points; p = 0.02) and continuous femoral nerve catheter (92 vs. 100 points; p = 0.04) was associated with lower personal issue domain scores, while patients with
a greater number of prior surgeries had worse registration domain scores (ρ = -0.27; p = 0.049). For the entire cohort, the registration and facility domains contributed
the most variability to the total PGAS score, while the physician domain contributed
the least. Few preoperative factors are associated with PGAS scores, and total PGAS
scores do not significantly correlate with baseline PROMs. Surgeons may have limited
ability to improve their PGAS scores given most of the variability in total scores
stems from systemic aspects of the patient experience.
Keywords
anterior cruciate ligament reconstruction - ACL - Press Ganey - satisfaction - ACLR
