Introduction: Hospitals commonly use Press Ganey (PG) patient satisfaction surveys forbenchmarking physician performance. PG scores range from 1 to 5, with 5 being the highest,which is known as the “topbox” score. Our objective was to identify patient and physician factorsassociated with topbox PG scores in the emergency department (ED).
Methods: We looked at PG surveys from January 2015–December 2017 at an academic, urbanhospital with 78,000 ED visits each year. Outcomes were topbox scores for the questions:“Likelihood of your recommending our ED to others”; and “Courtesy of the doctor.” We analyzedtopbox scores using generalized estimating equation models clustered by physician and adjustedfor patient and physician factors. Patient factors included age, gender, race, ethnicity, and ED areawhere patient was seen. The ED has four areas based on patient acuity: emergent; urgent; vertical(urgent but able to sit in a recliner rather than a gurney); and fast track (non-urgent). Physicianfactors included age, gender, race, ethnicity, and number of years at current institution.
Results: We analyzed a total of 3,038 surveys. For “Likelihood of your recommending our ED toothers,” topbox scores were more likely with increasing patient age (odds ratio [OR] 1.07; 95%confidence interval [CI], 1.03-1.12); less likely among female compared to male patients (OR 0.81;95% CI, 0.70-0.93); less likely among Asian compared to White patients (OR 0.71; 95% CI, 0.60-0.83); and less likely in the urgent (OR 0.71; 95% CI, 0.54-0.93) and vertical areas (OR 0.71; 95% CI0.53-0.95) compared to fast track. For “Courtesy of the doctor,” topbox scores were more likely withincreasing patient age (OR 1.1; CI, 1.06-1.14); less likely among Asian (OR 0.70; 95% CI, 0.58-0.84),Black (OR 0.66; 95% CI ,0.45-0.96), and Hispanic patients (OR 0.68; 95% CI ,0.55-0.83) compared toWhite patients; and less likely in urgent area (OR 0.69; 95% CI ,0.50-0.95) compared to fast track.
Conclusion: Increasing patient age was associated with increased likelihood of topbox scores,while Asian patients, and urgent and vertical areas had decreased likelihood of topbox scores. Weencourage hospitals that use PG topbox scores as financial incentives to understand the contributionof non-service factors to these scores.