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Patient attitudes regarding pca and associated costs

  • Neal H. Badner
  • Wendy E. Komar
  • Rosemary A. Craen
Reports of Investigation

Abstract

Purpose

To determine patients’ knowledge and attitudes towards patient-controlled analgesia (PCA) costs through the use of our acute pain service quality assurance (QA) programme.

Methods

Quality Assurance questionnaires were distributed to all patients receiving PCA opioids for > 12 hr. Patients were asked to note the presence of side effects (nausea/vomiting, pruritus, urinary retention), to indicate their satisfaction with regard to their pain relief, follow-up assessments, treatment of side effects, and to recall the previous method of pain relief and their satisfaction with it. Patients were also asked to estimate the total cost of PCA (0-$50. $50–100, $100–200, > $200), and what amount if any they would be willing to pay (0–$50. $50–100, $ 100–200. > $200). Results obtained over a recent four month period were reviewed.

Results

One hundred and thirty-three questionnaires were distributed and 103 (77%) were returned. The percentage of patients rating their satisfaction as very good or excellent was 86% for pain relief. 96% for follow-up. 71 % for side effect treatment, but only 43% for their previous surgical pain relief (P < 0.001). The distribution of cost estimates was 10% $50–100, 37% $100–200 and 53% > $200 with 60% willing to pay a portion of this cost. Those willing to pay were more likely to have had very good or excellent pain relief (94% vs 71%.P < 0.05) and treatment of side effects (71 %vs 48%.P < 0.05) than those not willing to pay.

Conclusions

Patients continue to be highly satisfied with PCA therapy and are aware of the costs involved. A majority of patients were willing to pay to obtain this service if necessary. Patients who had poorer pain relief and less efficacious treatment of their side effects were less willing to pay.

Keywords

Pain Relief Epidural Analgesia Side Effect Treatment Good Pain Relief Acute Pain Service 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Préciser les connaissances et les attitudes du patient à l’égard des coûts de l’auto-analgésie (PCA) procurée par un service de gestion de la douleur aiguë en fonction du programme d’assurance-qualité.

Méthodes

Des questionnaires pertinents à l’assurance-qualité ont été distnbués à tous les patients recevant un morphinique en PCA pour plus de 12 h. Les patients devaient y noter l’existence d’effets secondaires (nausées, vomissements, prurit, rétention unnaire), le degré de satisfaction quant au soulagement, au suivi, au traitement des effets secondaires et comparer la méthode antérieure de traitement de la douleur et le degré de satisfaction obtenu avec celle-ci. On leur demandait aussi d’évaluer le coût total de la PCA (0–50$. 50–100$, 100–200$. > 200$) et le montant qu’ils seraient prêts à payer (0–50$, 50–100$, 100–200$. > 200$) éventuellement pour ce service. Cette étude visait une période récente de quatre mois.

Résultats

Cent trente-trois questionnaires ont été distribués dont 103 (77%) sont revenus complétés Le pourcentage de patients dont le degré de satisfaction était jugé de très grand à excellent était de 86% pour lesoulagement de la douleur, 96% pour le suivi, 71% pour le traitement des effets secondaires, mais seulement 43% pour la méthode utilisée pour soulager la douleur dans le passé (P < 0.001). La distribution de l’appréciation du coût était de l0%,50–100$. 37%. 100–200 et 53%. 200$ et plus. Le degré de soulagement de la douleur de très bon à excellent (94% vs 71%,P < 0,05) et le traitement des effets seconadres (71% vs 48%.P < 0.05) déterminaient ceux qui étaient les plus susceptibles d’accepter de payer.

Conclusions

Les patients continuent d’être très satisfaits de la PCA et en connaissent le prix. Si nécessaire, la majorité d’entre sont prêts à en défrayer les coûts. Les patients dont le soulagement de la douleur et le traite ment des effets secondaires avaient été jugés moins efficaces étaient les moins disposés à payer.

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Copyright information

© Canadian Anesthesiologists 1997

Authors and Affiliations

  • Neal H. Badner
    • 1
  • Wendy E. Komar
    • 1
  • Rosemary A. Craen
    • 1
  1. 1.Department of Anaesthesia, London Health Sciences CentreUniversity of Western OntarioLondon

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