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The Relationship Between Patient Satisfaction and Healthcare Expenditures in Adults with Spine Related Disorders: An Analysis of the 2008 to 2015 Medical Expenditures Panel Survey (MEPS). Spine (Phila Pa 1976) 2021 Oct 15;46(20):1409-1417

Date

04/08/2021

Pubmed ID

33826590

Pubmed Central ID

PMC8463412

DOI

10.1097/BRS.0000000000004047

Scopus ID

2-s2.0-85117534187

Abstract

STUDY DESIGN: Cross-sectional study.

OBJECTIVE: The aim of this study was to investigate the relationship between patient satisfaction (PS) and healthcare expenditures (HCE) in adults with spine related disorders (SRDs).

SUMMARY OF BACKGROUND DATA: SRDs are widespread and pose a high cost to society. PS and HCE have yet to be studied in this population.

METHODS: Fifteen thousand eight hundred fifty adults with SRDs from the Medical Expenditures Panel Survey (MEPS) (2008-2015) were analyzed. The MEPS medical conditions files were used to identify SRDs based on International Classification of Diseases-9 codes. Frequencies and percentages of sample demographics were calculated. HCE was measured as total direct payments for care provided during the survey year. A composite PS score was constructed using a 0 to 10 rating of their healthcare providers combined with the frequency in which patients felt they were listened to, were given understandable explanations, were respected, and were given enough time. Mean unadjusted HCE were calculated for each year and by quartile of PS. A two-part model consisting of a probit model and subsequent generalized linear model with gamma distribution was performed, adjusting for relevant covariates. Margins command was used to calculate incremental estimates of HCE.

RESULTS: Mean unadjusted HCE increased annually from $7057 (95% confidence interval [CI], $6516, $7597) in 2008 to $9820 (95% CI, $8811, $10,830) in 2015 for adults with SRDs. Adjusting for predisposing factors, individuals in second, third, and fourth quartiles of PS were significantly different from the first quartile. Adjusting for predisposing and enabling factors, only fourth quartile was significantly different from first quartile. After adjusting for predisposing, enabling and need factors, second, third, and fourth quartiles were no longer significantly different from the first quartile.

CONCLUSION: Expenditures have increased over time in adults with SRDs. PS is significantly associated with expenditures after controlling for predisposing and enabling factors, but not significant after controlling for need factors. Need factors appear to explain the relationship between lower levels of PS and higher HCE in adults with SRDs.Level of Evidence: 2.

Author List

Gliedt JA, Walker RJ, Lu K, Dawson AZ, Egede LE

Authors

Aprill Z. Dawson PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Jordan Gliedt DC Assistant Professor in the Neurosurgery department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin




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

Adult
Cross-Sectional Studies
Health Expenditures
Humans
Patient Satisfaction
Spinal Diseases
Surveys and Questionnaires
United States