Executive Administrator and Vice President, Surgical Services, Emory Health Care

Dissertation Title

The relationship between patient complaints and surgical complications.

Dissertation Abstract

Background: Patient complaints are viewed as indications of dissatisfaction with the service received or experience at a health care institution. The prediction of patient complaints is not clearly understood, and to date, very little quantitative research has evaluated the relationship between patient complaints and health care quality.

Objective: The objective of this study was to examine whether (1) surgeons that operate on patients with higher perioperative surgical risk are associated with higher levels of patient complaints and (2) surgeons with higher levels of patient complaints are associated with higher levels of post-operative occurrences.

Methods: Patient complaint data from Emory Healthcare was aggregated by individual physician at the Center for Patient and Professional Advocacy at Vanderbilt University Medical Center. Patient surgical data was aggregated by individual physician at Emory Healthcare using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). Fixed effects panel regression models were used to analyze the relationship between patient complaints and surgical data from October 1, 2009 through December 31, 2013.

Results: Sixty-one surgeons generated a mean number of cases per quarter of 8.38 and performed a total of 9,351 NSQIP-abstracted procedures with 4,064 reported post-operative occurrences. There was not a significant relationship between the perioperative surgical risk profile and the number of patient complaints (β = .012, p = 0.920). The number of patient complaints was marginally significant with post-operative occurrences (β = .062, p < .10). Patient complaints were significantly associated with central nervous system (β = .181, p < .05), cardiac (β = .118, p < .05), and other (β = .079, p < .05) post-operative occurrences. The only specific types of patient complaints that were significantly associated with post-operative occurrences were accessibility related (β = .265, p < .05).

Conclusion: This study found surgeons that operate on patients with higher perioperative surgical risk were not associated with patient complaints and that surgeons that had higher levels of patient complaints were associated with higher levels of post-operative occurrences. These findings suggest that patient complaints can be viewed as indicators of quality.