Faculty Collaboration Database

Satisfaction and emergency department revisits in patients with possible acute coronary syndrome. J Emerg Med 2013 Dec;45(6):947-57

Date

08/14/2013

Pubmed ID

23937807

DOI

10.1016/j.jemermed.2013.05.029

Scopus ID

2-s2.0-84888641580 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

BACKGROUND: Patients with possible acute coronary syndrome (ACS) are typically instructed to return to the emergency department (ED) if their condition worsens. Little is known about the relationship between patient satisfaction in the ED and subsequent return visits.

OBJECTIVE: Our aim was to determine the association between satisfaction with ED care and subsequent ED return visits.

METHODS: One thousand and five consecutive ED patients with symptoms of possible ACS who participated in a prospective guideline implementation trial at two university hospitals completed a telephone survey at 30-day follow-up. Satisfaction with care at the initial ED visit was measured using items from the Press Ganey satisfaction questionnaire. Logistic regression was used to determine the association between individual satisfaction items and the occurrence of any ED revisits, and the association between satisfaction items and return visits to the same ED.

RESULTS: Patients who reported superior ratings of person-centered care ("staff cared about you as a person") were significantly less likely to return to any ED during 30-day follow-up: 59 vs. 71%, adjusted odds ratio = 0.57 (95% confidence interval 0.37-0.87). Among those with ED revisits, superior ratings of personal care and perceived waiting time for emergency physician evaluation were significantly associated with return to the same ED.

CONCLUSIONS: Although diagnostic workup and risk stratification are the primary focus in evaluating patients with possible ACS, greater attention to the patient's experience of care may have the positive impact of reducing ED return visits and increasing the likelihood that patients will return to the same ED for re-evaluation.

Author List

Katz DA, Aufderheide TP, Gaeth G, Rahko PS, Hillis SL, Selker HP

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Coronary Syndrome
Adult
Aged
Emergency Service, Hospital
Female
Humans
Male
Middle Aged
Odds Ratio
Patient Acceptance of Health Care
Patient Readmission
Patient Satisfaction
Patient-Centered Care
Surveys and Questionnaires
Wisconsin