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147 Patient Perceptions About Quality of Care in Spinal Disorders.

Neurosurgery 2016 August
INTRODUCTION: Reimbursements are increasingly reliant upon value-based purchasing/pay for performance rather than fee-for-service. However, value is difficult to define. Therefore, we surveyed patients in a general neurosurgery spine clinic to determine patients' perceptions regarding the quality/value of spine care.

METHODS: We administered questionnaires to patients at 2 tertiary care institutions who presented to a spine clinic for evaluation. Questions assessed patient perceptions regarding quality of spine care as impacted by provider/institution-specific factors (8 choices including US News & World Report rankings, consumer website survey results, medical website survey results, etc) and by patient-specific factors (7 choices including convenience of access, distance, prior experience, etc). Standard statistical methods were used. The Institutional Review Boards approved the study.

RESULTS: Two hundred thirty-three surveys from consenting adults were included. Of all choices, patients reported that of most importance were credentials of the health care provider and US News & World Report rankings of the institution. Of slightly less importance in the provider-institution factors was word-of-mouth reputation. Significant patient-specific factors included professionalism, timing of access from referral, and accommodation of requests and choice of provider. Of least importance were prior experience with the provider/institution, distance to clinic, and consumer website (eg, Angie's List) and medical website ratings.

CONCLUSION: Patients perceived that the most important contributors to quality in health care are the reputations of the provider and institution. Additionally, the personalization of the provider-patient relationship also contributed to the perception of quality. Interestingly, out-of-pocket costs and prior experience with provider/institution were noted to be less important. Further investigation would explore the correlation of these patient perceptions to payer perceptions of the factors most important to quality in spine care.

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