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Is quality important to our patients? The relationship between surgical outcomes and patient satisfaction
  1. Kristel Lobo Prabhu1,2,
  2. Michelle C Cleghorn2,
  3. Ahmad Elnahas2,
  4. Alvina Tse2,
  5. Azusa Maeda2,
  6. Fayez A Quereshy1,2,
  7. Allan Okrainec1,2,
  8. Timothy D Jackson1,2
  1. 1 Department of Surgery, University of Toronto, Toronto, Ontario, Canada
  2. 2 Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Dr Timothy D Jackson, Division of General Surgery, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Room 8MP-322, Toronto, Ontario, M5T 2S8, Canada; timothy.jackson{at}


Background With greater transparency in health system reporting and increased reliance on patient-centred outcomes, patient satisfaction has become a priority in delivering quality care. We sought to explore the relationship between patient satisfaction and short-term outcomes in patients undergoing general surgical procedures.

Methods Satisfaction surveys were distributed to patients following discharge from the general surgery service at an academic hospital between June 2012 and March 2015. Short-term clinical outcomes were obtained from the American College of Surgeons National Surgical Quality Improvement Program database. Patients rated their level of satisfaction on a 5-point Likert scale, and ordered logistic regression model was used to determine predictors of high patient satisfaction.

Results 757 patient satisfaction surveys were completed. The mean age of patients surveyed was 52.2 years; 60.0% of patients were female. The majority of patients underwent a laparoscopic procedure (85.9%) and were admitted as inpatients following surgery (72%). 91.5% of patients rated satisfaction of 4–5, and 95.0% said they would recommend the service. The odds of overall satisfaction were lower in patients who had complications (OR: 0.52, 95% CI 0.31 to 0.87) and 30-day readmission (OR: 0.35, 95% CI 0.17 to 0.70). Having elective surgery was associated with higher odds of satisfaction (OR: 1.62, 95% CI 1.07 to 2.47).

Conclusions We found a significant association between patient satisfaction and both 30-day readmission and the occurrence of postoperative surgical complications. Given this association, further study is warranted to evaluate patient satisfaction as a healthcare quality indicator.

  • surgery
  • patient-centred care
  • patient satisfaction
  • surveys

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  • Handling editor Kaveh G Shojania

  • Contributors KLP performed the study and wrote the manuscript. KLP, AE, AT and AM collected and analysed data. MCC and AM provided critical review and edited the manuscript. FAQ, AO and TDJ guided the concept and TDJ supervised the project. All authors reviewed and approved the manuscript.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval University Health Network Research Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.