Characterizing patient care experience among adults with lower extremity trauma.

Abstract

The subjective experience of receiving surgical care is an important aspect of health care delivery. We aimed to characterize the care experience following traumatic lower extremity injury using patient-reported experience measures validated for this population. In this cross-sectional study, patients with lower extremity trauma completed the LIMB-Q Satisfaction with Decision, Satisfaction with Information, and Satisfaction with Health Care Professional scales (scored 0-100, greater is better). We collected demographic, clinical, and patient-reported outcome data. Multivariable linear regression was used to identify independent predictors of LIMB-Q scores. We collected data from 645 patients. Their mean age was 42 years (SD 17 years), and 62% were cisgender men. Patients reported high satisfaction with their surgeon (Mean=91 [SD 14]) but less satisfaction with how decisions were made regarding their care (Mean=74 [SD 26]) and the information they received about their care (Mean=70 [SD 21]). Each decade after injury was associated with a mean 4.8-point reduction in Satisfaction with Decision score (95% CI -0.74,-0.22). Education level was inversely associated with Satisfaction with Information (p=0.03). Compared to cisgender men, transgender and nonbinary patients reported less satisfaction with treatment decisions (mean difference [MD]=-27; 95% CI -46,-7.5) and health care professionals (MD=-30; 95% CI -55,-5.1). Compared to White patients, Asian or Pacific Islander patients reported lower satisfaction with health care professionals (MD=-19; 95% CI -36,-1.8) and treatment decisions (MD=-17; 95% CI -29,-3.7). Patients with lower extremity trauma reported high levels of satisfaction with surgeons, but less satisfaction with treatment decisions and information. Satisfaction varied with demographic factors.