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Long‐term satisfaction after neurological second opinions and tertiary referrals
Author(s) -
Wieske L.,
Richard E.,
Wijers D.,
Stam J.,
Smets E. M. A.,
Vergouwen M. D. I.
Publication year - 2011
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2011.03394.x
Subject(s) - medicine , patient satisfaction , tertiary care , neurology , visual analogue scale , family medicine , medical diagnosis , pediatrics , physical therapy , psychiatry , nursing , pathology
Background and purpose: The number of second opinions (SO) and tertiary referrals (TR) in neurology is increasing. Previously, we showed that a day‐care admission for neurological SO’s and TR’s often results in a new diagnosis and/or treatment advice and increases patient satisfaction. However, long‐term satisfaction for these consultations has never been studied. The main purpose of this study was to investigate long‐term satisfaction in these groups of patients. Methods: A 2‐year follow‐up study in 300 patients who had attended a day‐care clinic for SO and TR. Long‐term satisfaction was assessed with a questionnaire using four Visual Analogue Scale (VAS) satisfaction items (ranging 0–10). Patients were asked if they had sought further consultations for the same problem after they had consulted the day‐care clinic. A model was constructed to assess predictors for seeking new consultations. Results: Overall satisfaction decreased 2.4 (SD 2.4) points during follow‐up to the same level as before the consultation. The decrease was similar in SO and TR patients. Twenty‐eight per cent of the patients consulted other health‐care workers. Greater satisfaction immediately after the consultation was the only predictor for not seeking additional consultations (OR 0.78, 95% CI 0.61–0.99 for every point increase on VAS). Conclusion: Despite a high rate of new diagnoses and advised treatments, long‐term satisfaction decreased after 2 years to baseline levels. These results question the long‐term efficacy of a day‐care clinic to evaluate neurological second opinions and tertiary referrals.