Factors Associated with Patient Satisfaction during Labor: A Quality Improvement Study [28E]

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Abstract

INTRODUCTION:

It is known that a positive birth experience is associated with an increased mother-child bond and maternal self-esteem. Thus, it is important to identify those factors playing a role with a positive birth experience. Our goal was to evaluate the association between patient satisfaction and maternal characteristics, management of labor and neonatal outcome using a patient satisfaction survey as a tool of health care quality.

METHODS:

A validated Labor and Delivery Satisfaction Index (LADSI) survey was administered to puerperal women on the first day post-partum, from November 2016 to January 2017. The primary outcome was patient satisfaction, defined as the total LADSI score. Maternal demographics, obstetrics characteristics and neonatal outcomes, relevant to maternal satisfaction, were collected. Univariate analysis, followed by a multivariate quantile regression analysis, were performed to examine the association between the study variables and LADSI score.

RESULTS:

Of the 312 women that participated in the study, 93% completed the survey. Our findings show that women managed by private providers are more satisfied than those managed by university providers (220, 201-226 vs 212, 196-223), p=0.017. Vaginal delivery is associated with a better birthing experience compared to cesarean section (220, 205-228 vs 210.5, 200-227, p=0.001). Patient satisfaction score is not associated with other demographics/obstetrics variables and neonatal outcomes. Multivariate quantile regression confirmed that private provider (βcoefficient=7.79, p=0.04) and vaginal delivery (βcoefficient=8.97, p=0.02) were significantly associated with a higher LADSI score.

CONCLUSION:

This study showed that women undergoing labor have a better birth experience when managed by a private provider and delivered vaginally.

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