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MUSCULOSKELETAL SURGERY
Published in: MUSCULOSKELETAL SURGERY 3/2018

Open Access 01-12-2018 | Original Article

Meeting patient expectations: patient expectations and recovery after hip or knee surgery

Authors: B. Wiering, D. de Boer, D. Delnoij

Published in: MUSCULOSKELETAL SURGERY | Issue 3/2018

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Abstract

Background

Although patient-centred care could help increase the value of healthcare, practice variations in hip and knee surgery suggest that physicians guide clinical decisions more than patients do. This raises the question whether treatment outcomes still meet patients’ expectations. This study investigated whether treatment outcomes measured by patient-reported outcome measures fulfil patients’ main expectations (i.e. decreased pain or improved functioning).

Methods

Patients who underwent hip or knee surgery in 20 Dutch hospitals in 2014 were invited to a survey consisting of the KOOS Physical Function Short Form or the HOOS Physical Function Short Form, the NRS pain and the EQ-5D. Patients were asked their main reason for surgery and whether the expectations regarding this reason were fulfilled.

Results

A total of 2776 patients completed the survey. The most common reason for surgery was improved functioning (43.7%). Patients who were unable to choose between pain relief and improved functioning and patients who aimed for pain relief experienced more problems before surgery. However, patients who were unable to choose improved more than patients who wanted to improve their functioning on the NRS pain during use and the EQ-5D. More patients who aimed for pain relief felt that their expectations were fulfilled compared to other patients.

Conclusions

Although an expectation for an outcome was not related to a greater improvement on that outcome, patient expectations were an indication of patients’ improvement due to surgery. Differences in expectation fulfilment may be due to unrealistic expectations. To achieve optimal value, tailoring treatment using patient preferences and managing patient expectations is vital.
Footnotes
1
A series of multilevel models confirmed that the hospital variance of PROM change scores was virtually negligible in the context of the current analyses; Hospital level variance was significant for two PROM items only. Accordingly, single-level regression models are reported in the present paper for ease of presentation.
 
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Metadata
Title
Meeting patient expectations: patient expectations and recovery after hip or knee surgery
Authors
B. Wiering
D. de Boer
D. Delnoij
Publication date
01-12-2018
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue 3/2018
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-017-0523-7

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