PATIENT SATISFACTION FOLLOWING TOTAL HIP ARTHROPLASTY: COMPARISON OF NHS, PRIVATE AND GSUP PATIENTS

Abstract

Introduction: Increasing numbers of patients are being treated outside traditional NHS hospitals as part of GSup (General supplemental funding) projects and other initiatives to reduce waiting lists. Concerns regarding these arrangements include case mix at NHS hospitals, quality of clinical care and patient satisfaction.

Null Hypothesis: There is no difference between overall patient satisfaction following treatment within the NHS, as part of GSup or as an independent private patient.

Methods: Patients undergoing total hip arthroplasty by a single consultant were contacted 6 to 18 months postop. 3 groups were formed; those treated in the local NHS hospital, patients treated as part of GSup and private patients independently financed.

A previously validated patient satisfaction questionnaire was completed by each patient. This investigates satisfaction with admission, environment, healthcare professionals, treatment, leaving hospital and overall care. Fisher exact test used to compare groups for significant differences in responses, significance was assumed at p< 0.05 level.

Results: 144 of 202 patients responded. Though generally high overall levels of satisfaction were reported, areas of concern were identified, particularly regarding cleanliness of hospital, the availability of nursing staff, maintenance of patient confidentiality and communication with patients. In all cases the GSup patients reported significantly higher levels of satisfaction compared with the NHS patients. 12% of NHS patients felt their overall care fell below “very good” compared with 0% of the GSup patients (p< 0.05).

Discussion: Significant differences are identified between NHS and GSup patient satisfaction regarding hospital environment, healthcare professionals and overall standards of care. There were few differences between GSup and private patients treated in the same environment but where they did occur they were universally more positive for the GSup patients.

Conclusions: Concerns that GSup patients may be less satisfied with their care appear unfounded; in general they were better satisfied than NHS patients.