Does Hospital Consumer Assessment of Healthcare Providers and Systems survey correlate with traditional metrics of patient satisfaction? The challenge of measuring patient pain control and satisfaction in total joint replacement

BACKGROUND: Medicare reimbursements have been tied to patient satisfaction measures. Despite these measures' influence on reimbursements, the relationship between pain management and patient satisfaction remains unclear. This study aims to evaluate the relationship between traditional patient perception of pain control and their overall satisfaction after joint replacement. METHODS: This study is a retrospective review of consecutive primary total hip and total knee replacements. A total of 286 patients who underwent primary total hip (N = 106) and total knee (N = 196) replacements with completed Hospital Consumer Assessment of Healthcare Providers and Systems surveys were evaluated. Pain control, communication, and hospital satisfaction were stratified into satisfactory or unsatisfactory groups. These 2 groups were compared in terms of visual analog scale (VAS), opioid use in morphine equivalents, length of hospital stay, anesthesia type, and demographics. RESULTS: Average VAS and opioid use did not differ between patient groups for any of the questions evaluated. Those who responded “always” to pain domain questions had a statistically shorter length of stay compared to patients with other response. On average, those who endorsed “always” on communication question were younger. CONCLUSIONS: Patients who endorsed satisfactory pain control and communication with staff had shorter lengths of stay. There was no relationship between survey scores and traditional pain control measures such as VAS and opioid use. This questions the relevance of our primary pain measures in assessing patient perception of pain control. Length of stay may be a better surrogate marker for patient satisfaction of pain control.