====== Patient satisfaction ======

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Patient [[satisfaction]] ratings are increasingly used for hospital [[ranking]]s, referral base, and physician [[reimbursement]]. As such, online physician rating websites (PRWs) are quickly becoming a topic of interest.

Patient-reported experience is often used as a measure for [[quality of care]].

[[Depression]] has been associated with poor [[outcome]]s in neurosurgical [[patient]]s, including increased pain, poorer functional recovery, delayed return to work, and decreased patient [[satisfaction]]. 

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The satisfaction of a group of 205 patients with regard to [[anesthesia]] used and their future preferences were evaluated [[prospective]]ly through a [[questionnaire]]. The reasons for dissatisfaction were assessed.

CEA was performed under general anesthesia (GA) in 159 cases (77.6%) and under local anesthesia (LA) in 46 cases (22.4%). In the GA group, 148 patients (93.1%) were satisfied; 30 patients (65.2%) in the LA group were satisfied (p < 0.0001). The reason for dissatisfaction with GA were postoperative [[nausea]] and [[vomiting]] (7 patients), postoperative psychological alteration (3), and fear of GA (1). The reasons for dissatisfaction with LA were intraoperative pain (9 patients), intraoperative discomfort and [[stress]] (5), and intraoperative breathing problems (2). Of the GA group, 154 (96.9%) patients would prefer GA again, and of the LA group, 28 (60.9%) patients would prefer LA if operated on again (p < 0.0001). Overall, 172 patients (83.9%) would prefer GA in the future, and 33 patients (16.1%) would prefer LA.

Overall patient [[satisfaction]] with CEA performed under both GA and LA is high. Nevertheless, in the GA group, patient satisfaction and future preference were significantly higher. Both GA and LA have advantages and [[disadvantage]]s for CEA. An optimal approach is to make use of both anesthetic techniques based on their individual indications and patient preference
((Mracek J, Kletecka J, Holeckova I, Dostal J, Mrackova J, Mork J, Priban V.
Patient Satisfaction with General versus Local Anesthesia during Carotid
Endarterectomy. J Neurol Surg A Cent Eur Neurosurg. 2019 Apr 29. doi:
10.1055/s-0039-1688692. [Epub ahead of print] PubMed PMID: 31035296.
)).
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Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery
((Reponen E, Tuominen H, Hernesniemi J, Korja M. Patient Satisfaction and
Short-Term Outcome in Elective Cranial Neurosurgery. Neurosurgery. 2015 Aug 4.
[Epub ahead of print] PubMed PMID: 26244270.
)).

===== Patient satisfaction metrics =====

[[Patient satisfaction metrics]].