Anesthesia-specific patient satisfaction scores should be risk-adjusted for contextual factors such as seasonality, workload, and number of comparator institutions before being tied to payment.
Risk-adjust anesthesia satisfaction scores for workload before payment linkage; challenges unadjusted metrics and extends contextual evidence.
BACKGROUND: While patient satisfaction is a major marker of quality in healthcare, predictors of Press Ganey scores for anesthesia survey questions have not been well explored. This study aimed to explore factors associated with anesthesia-specific patient satisfaction scores. MATERIAL AND METHODS: Univariable and multivariable regression analyses were performed to identify predictors of percentile ranking on patient satisfaction questions. We conducted a retrospective analysis of the patient experiences with anesthesia at our institution. Three questions were added to the Press Ganey surveys: (1) rating of anesthesia services, (2) explanations provided by the anesthesiologists, (3) friendliness/courtesy of the anesthesiologist. A total of 3,218, 3,294, and 3,200 patients, respectively, answered the questions on a Likert scale. Covariates included attending anesthesiologist workload, number of comparator healthcare institutions, and season of year. RESULTS: Lower percentile rank with rating of anesthesia services was associated with greater attending anesthesiologist workload (-13.7; 95% CI: -24.8 to -2.6; P = 0.017), season of year (-9.0; 95% CI: -16.2 to -1.8; P = 0.016), and smaller number of comparator healthcare institutions (2.4; 95% CI: 0.5 to 4.3; P = 0.015). Lower percentile rank with explanations provided by the anesthesiologists (0.7; 95% CI: 0.1 to 1.3; P = 0.021) and friendliness/courtesy of the anesthesiologist (0.9; 95% CI: 0.2 to 1.5; P = 0.008) were associated with decreasing number of comparator healthcare institutions. CONCLUSIONS: Improving patient satisfaction may require reduction or redistribution of anesthesiologist workload, improvement in resident communication skills, and increased supervision of junior residents. Anesthesia-specific patient satisfaction scores should be risk-adjusted for contextual factors such as seasonality, workload, and number of comparator institutions before being tied to payment.
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Drzymalski et al. (2026) studied this question.
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