Mark Rodeghier

Distribution and determinants of patient satisfaction in oncology: A review of the literature.

Cancer is one of the leading causes of morbidity and mortality in the United States. It places considerable mental, physical, and emotional stress on patients and requires them to make major adjustments in many key areas of their lives. As a consequence, the demands on health care providers to satisfy the complex care needs of cancer patients increase manifold. Of late, patient satisfaction has been recognized as one of the key indicators of health care quality and is now being used by health care institutions for monitoring health care improvement programs, gaining accreditation, and marketing strategies. The patient satisfaction information is also being used to compare and benchmark hospitals, identify best-performance institutions, and discover areas in need of improvement. However, the existing literature on patient satisfaction with the quality of cancer care they receive is inconsistent and heterogeneous because of differences in study designs, questionnaires, study populations, and sample sizes. The aim of this review was therefore to systematically evaluate the available information on the distribution and determinants of patient satisfaction in oncology.

Patient satisfaction with service quality in an oncology setting: implications for prognosis in non-small cell lung cancer

Objective To evaluate the relationship between self-reported satisfaction with service quality and overall survival in non-small cell lung cancer (NSCLC). Design A prospective cohort study. Setting Cancer Treatment Centers of America® from July 2007 and December 2010. Participants Nine hundred and eighty-six returning NSCLC patients. Intervention Overall patient experience ‘considering everything, how satisfied are you with your overall experience’ was measured on a 7-point Likert scale ranging from ‘completely dissatisfied’ to ‘completely satisfied.’. Main Outcome Measure Patient survival was the primary end point. Results The response rate for this study was 69%. Six hundred patients were newly diagnosed, while 386 were previously treated. Four hundred sixty-nine were males, while 517 were females. 101, 59, 288 and 538 patients had stage I, II, III and IV disease, respectively. Mean age was 58.9 years. Six hundred and thirty (63.9%) patients had expired at the time of this analysis. Seven hundred and sixty-two (77.3%) patients were ‘completely satisfied’. Median overall survival was 12.1 months (95% confidence interval (CI): 10.9–13.2 months). On univariate analysis, ‘completely satisfied’ patients had a significantly lower risk of mortality compared with those not ‘completely satisfied’ [hazard ratio (HR) = 0.70; 95% CI: 0.59–0.84; P < 0.001]. On multivariate analysis controlling for stage at diagnosis, prior treatment history, age and gender, ‘completely satisfied’ patients demonstrated significantly lower mortality (HR = 0.71; 95% CI: 0.60–0.85; P < 0.001) compared with those not ‘completely satisfied’. Conclusions Self-reported experience with service quality was an independent predictor of survival in NSCLC patients undergoing oncologic treatment, a novel finding in the literature. Based on these provocative findings, further exploration of this relationship is warranted in well-designed prospective studies.

Can Patient Experience with Service Quality Predict Survival in Colorectal Cancer

&NA; Despite the recognized relevance of symptom burden in colorectal cancer, there has been limited exploration of whether an individual patients assessment of the overall quality‐of‐care received might influence outcome. We evaluated the relationship between patient‐reported experience with service quality and survival in 702 returning colorectal cancer patients treated at our institution between July 2007 and December 2010. Overall patient experience “considering everything, how satisfied are you with your overall experience?” was measured on a 7‐point Likert scale ranging from completely dissatisfied to completely satisfied. It was dichotomized into two categories: top box response (7) versus all others (1–6). Cox regression was used to evaluate the association between patient experience and survival. Of 702 patients, 506 were “completely satisfied” while 196 were not. On univariate analysis, “completely satisfied” patients had a significantly lower risk of mortality compared to those “not completely satisfied” (hazard ratio [HR] = 0.78; 95% confidence interval [CI]: 0.61–0.98; p = .04). Similarly, on multivariate analysis controlling for stage at diagnosis, treatment history, age, and gender, “completely satisfied” patients demonstrated significantly lower mortality (HR = 0.74; 95% CI: 0.58–0.95; p = .02). Patient experience with service quality was an independent predictor of survival in colorectal cancer, a novel finding in the literature.

The relationship between patient satisfaction with service quality and survival in pancreatic cancer.

Purpose Despite the recognized relevance of symptom burden in pancreatic cancer, there has been limited exploration of whether an individual patient’s satisfaction with the overall quality of care received might influence outcome. We evaluated the relationship between patient satisfaction with health service quality and survival in patients with pancreatic cancer. Patients and methods A random sample of 496 pancreatic cancer patients treated at Cancer Treatment Centers of America® (CTCA) between July 2007 and December 2010. A questionnaire that covered several dimensions of patient satisfaction was administered. Items were measured on a seven-point Likert scale ranging from “completely dissatisfied” to “completely satisfied.” Patient survival was the primary end point. Cox regression was used to evaluate the association between patient satisfaction and survival. Results The response rate for this study was 72%. Of the 496 patients, 345 (69.6%) reported being “completely satisfied” with the care provided. Median overall survival was 7.9 months. On univariate analysis, patients reporting they were “completely satisfied” experienced superior survival compared with patients stating they were “not completely satisfied” (hazard ratio = 0.62; 95% confidence interval: 0.50–0.77; P < 0.001). On multivariate analysis controlling for stage at diagnosis, treatment history, and specific CTCA treatment center, “completely satisfied” patients demonstrated significantly lower mortality (hazard ratio = 0.63; 95% confidence interval: 0.51–0.79; P < 0.001). Conclusion In this exploratory analysis, patient satisfaction with health service quality was an independent predictor of survival in pancreatic cancer. Further exploration of a possible meaningful relationship between patient satisfaction with the care they have received and outcome in this difficult malignancy is indicated.

Abstract 3849: Do cancer patients with better quality of life report higher satisfaction with the quality of care they receive

Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA Background: Patient satisfaction with quality of care is being increasingly recognized and reported as an important outcome measure in oncology. However, it has been argued by some that patients with greater satisfaction with care quality might be the ones with better self-reported quality of life (QoL). In other words, patient satisfaction has been simply purported to be a marker of underlying patient QoL. We asked the question if cancer patients who report higher satisfaction with quality of their care are indeed the ones with better QoL. Methods: 6,914 returning cancer patients treated at four Cancer Treatment Centers of America® hospitals completed a patient satisfaction survey between July 2011 and March 2013. All patients who had not responded to a service quality questionnaire within the preceding 60 days of treatment were eligible. Overall QoL (How would you rate your overall health during the last week?) was measured on a 7-point Likert scale ranging from “very poor” to “excellent”. Overall patient satisfaction (“considering everything, how satisfied are you with your overall experience?”) was also measured on a 7-point Likert scale ranging from “completely dissatisfied” to “completely satisfied”. Spearman correlation was used to investigate the association between patient satisfaction and QoL. Results: A total of 8,642 eligible cancer patients were contacted to participate in the survey. 6,914 patients responded. As a result, the response rate for this study was 80%. The median time duration between the date first seen and the date of first survey was 7.5 months. The mean age at the time of survey was 56.6 years. 4,116 patients were newly diagnosed while 2,798 had been previously treated. 2,778 were males and 4,136 were females. The most common cancer types were breast (27.6%), prostate (13.3%), lung (11.3%), colorectal (8.9%) and pancreas (5.2%). 20%, 28%, 24% and 28% patients had stage I, II, III and IV disease respectively. 1,916 (27.7%) patients reported “excellent” QoL while 5,553 (80.3%) patients were “completely satisfied” with their care. Spearman correlation coefficient between QoL and patient satisfaction for the entire patient population was 0.20 (p<0.001). These correlations in different patient subgroups were as follows: males (0.21), females (0.20), early-stage disease (0.19), late-stage disease (0.22), newly diagnosed (0.19), previously treated (0.20), breast (0.17), colorectal (0.24), lung (0.23), pancreas (0.18), prostate (0.20); with p <0.001 for all. Conclusions: Self-reported QoL has a low correlation with patient satisfaction with care quality. Contrary to what one might expect, higher levels of self-reported QoL do not translate into higher satisfaction with oncology care. This analysis shows that self-reported QoL and satisfaction with care are weakly related dimensions of the larger cancer care quality umbrella. Citation Format: Digant Gupta, James F. Grutsch, Mark Rodeghier, Christopher G. Lis. Do cancer patients with better quality of life report higher satisfaction with the quality of care they receive. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3849. doi:10.1158/1538-7445.AM2014-3849

The relationship between service quality measures and patient willingness to recommend at a national oncology provider network: The Cancer Treatment Centers of America experience.

6097 Background: While “willingness to recommend” questions are being increasingly used to measure and manage patient loyalty, there is little data in the literature correlating factors to the top ...