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The Impact of Institutional Level on Postoperative Pain Management in Surgical Patients: A Propensity Score-matched
Chamaidi Sarakatsianou1, Konstantinos Perivoliotis2, Dimitra Papaspyrou1
1Department of Anesthesiology, University Hospital of Larissa, Larissa, Greece.
Purpose:
This study evaluated the effect of the health care institution type on the postoperative pain management level of care in surgical patients.
Design:
The study was designed as a prospective comparative survey.
Methods:
This was a prospective comparative study and was conducted, in parallel, in a tertiary and a secondary center. A 1:1 propensity score matching algorithm was applied based on age, sex, body mass index, American Society of Anesthesiologists, anesthesia technique, analgesia modality, type of surgery, operative approach, and elective status. Multivariable analysis included the performance of ordinal regression. The Greek validated version of the Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire was used.
Findings:
Overall, 256 patients were, initially, included in the study. After propensity score matching, 43 cases were retained in each arm. In the matched cohort, a significant difference between centers was noted in terms of pain management (22 vs 26, P < .001), support (5 vs 9, P < .001), and total (50 vs 55, P < .001) subscales. Besides the institutional level (P = .02), patient age (P = .005) and surgical approach (P = .039) were also predictors of total subscale Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire score.
Conclusions:
Our study suggested that the institutional level, patient age, and surgical approach significantly impact the postoperative pain management level of care.
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