Patient Satisfaction after Lung Cancer Surgery: Do Clinical Outcomes affect HCAHPS Scores?

Abstract Background Little is known about patients’ hospital experience and satisfaction following lung cancer surgery. We sought to determine how length of hospital stay (LOS) and postoperative complications affect hospital consumer assessment of health care providers and systems (HCAHPS) scores. Methods Patients undergoing lung resection for cancer at a single academic cancer center between years 2014-2018 were analyzed. Clinical data were derived from the institutional Society of Thoracic Surgeons (STS) database and supplemented with HCAHPS survey data. Endpoints were top-box satisfaction scores, and domain-specific scores for physicians and nurses communication. Results In total, 181 out of 478 (38%) patients who underwent pulmonary resection for lung cancer completed HCAHPS surveys. Median age was 65 years, and most underwent lobectomy (94%). The top-box rating for the overall hospital experience, physician communication, and nurse communication were 92%, 84%, and 69%, respectively. Overall and major complication rates were 43% and 3%, and not associated with top-box HCAHPS scores. Increasing LOS was associated with worse satisfaction with provider communication. Adjusted for patient factors, increasing LOS was associated with worse patient satisfaction in the domains of communication with physicians and nurses. Patients with LOS >6 days were less likely to endorse that doctors gave understandable explanations (OR 0.15, 95%CI 0.04-0.56) and nurses listened carefully (OR 0.11, 95%CI 0.06-0.69). Conclusions Overall HCAHPS satisfaction scores following lung resection for cancer were high and negatively associated with increasing length of stay. Patient satisfaction may be impacted more by the perception of effective communication during prolonged hospitalizations than by complications.