Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Academic Level (Author 3)
Medical Student
Academic Level (Author 4)
Medical Student
Presentation Type
Poster
Discipline Track
Patient Care
Abstract Type
Research/Clinical
Abstract
Background: Patient-reported outcomes (PROs) are essential for tracking patient progress, but lengthy surveys, such as the 40 question Knee Injury and Osteoarthritis Outcome Score (KOOS), create time and cost challenges for private practice. Starting July 2024, the Centers for Medicare and Medicaid (CMS) now require hospitals to collect pre surgery and one year post surgery (9-15 months) HOOS JR and KOOS JR scores for total replacement surgeries, with public reporting set for 2027. Non-reporting carries financial penalties, underscoring the need for streamlined solutions. As value-based care becomes a priority, practical strategies are needed to reduce the burden on providers and patients. The Three C’s framework—Comfort (pain), Capability (functionality), and Calm (stress)—offers a functional approach. This study evaluates the implementation and effectiveness of a shorter, targeted survey based on the Three C’s, aiming to capture meaningful outcomes efficiently without sacrificing quality or increasing burden.
Methods: This study evaluated PROs using customized surveys from a healthcare company offering bundled surgeries at outpatient centers. Surveys administered preoperatively and at 120 days postoperatively employed a 10-point Likert scale to measure pain (No pain- Worst pain), functional status in activities of daily living (No Difficulty-Extreme difficulty), and disruptive stress level (No Disruption- Extreme Disruption). De-identified responses from 439 patients (2021-2023) were analyzed, focusing on high-volume procedures; carpal tunnel release (CTR) (n = 20), knee meniscectomy (n = 23), total knee arthroplasty (n = 14), and hernia surgeries (n = 36). Statistical analysis in R included box plots for visualizing distributions, descriptive statistics for summarization, and paired t-tests to evaluate pre- and post-surgical changes.
Results: Across all surgery types, mean and median scores for pain, functionality, and stress showed reductions in scores between pre surgery to post surgery responses. For example, among CTR patients, the mean pain score decreased from 7.1 (median = 8.0) to 3.7 (median = 3.0). Similar results were observed for functionality (mean: 7.2 to 3.0) and stress (mean: 5.6 to 2.2). Paired t-tests were used to evaluate the statistical significance of these reductions for each surgery and outcomes metric. CTR results demonstrated significant improvements post-surgery: CTR pain (t = 4.04, p < 0.001), functionality (t = 5.25, p < 0.001), and stress (t = 5.13, p < 0.001). These findings indicate statistically significant improvements in outcomes for many of the surgery types analyzed.
Conclusion: While the surveys used in this study were not nationally recognized, they provide a promising first step toward more efficient tools for measuring outcomes. Significant improvements in pain, functionality, and stress were documented, suggesting these shorter surveys may serve as a useful tool for tracking recovery. To further validate their effectiveness, future studies should compare the short survey results with established PROs, assess test-retest reliability, and measure responsiveness to clinical changes. Patient and provider feedback will also ensure these tools are practical and meaningful in real-world settings. Mandatory reporting and financial penalties for non-compliance by the CMS will have significant implications for the future of healthcare in the United States.
Recommended Citation
Bonilla, Paul; Murambadoro, Anesu Karen; Elizondo, Victoria; and Flanagan, Juan Pablo, "Shorter Surveys, Better Insights: The Role of Patient Reported Outcome Surveys in Value-Based Care" (2025). Research Symposium. 130.
https://scholarworks.utrgv.edu/somrs/2025/posters/130
Included in
Shorter Surveys, Better Insights: The Role of Patient Reported Outcome Surveys in Value-Based Care
Background: Patient-reported outcomes (PROs) are essential for tracking patient progress, but lengthy surveys, such as the 40 question Knee Injury and Osteoarthritis Outcome Score (KOOS), create time and cost challenges for private practice. Starting July 2024, the Centers for Medicare and Medicaid (CMS) now require hospitals to collect pre surgery and one year post surgery (9-15 months) HOOS JR and KOOS JR scores for total replacement surgeries, with public reporting set for 2027. Non-reporting carries financial penalties, underscoring the need for streamlined solutions. As value-based care becomes a priority, practical strategies are needed to reduce the burden on providers and patients. The Three C’s framework—Comfort (pain), Capability (functionality), and Calm (stress)—offers a functional approach. This study evaluates the implementation and effectiveness of a shorter, targeted survey based on the Three C’s, aiming to capture meaningful outcomes efficiently without sacrificing quality or increasing burden.
Methods: This study evaluated PROs using customized surveys from a healthcare company offering bundled surgeries at outpatient centers. Surveys administered preoperatively and at 120 days postoperatively employed a 10-point Likert scale to measure pain (No pain- Worst pain), functional status in activities of daily living (No Difficulty-Extreme difficulty), and disruptive stress level (No Disruption- Extreme Disruption). De-identified responses from 439 patients (2021-2023) were analyzed, focusing on high-volume procedures; carpal tunnel release (CTR) (n = 20), knee meniscectomy (n = 23), total knee arthroplasty (n = 14), and hernia surgeries (n = 36). Statistical analysis in R included box plots for visualizing distributions, descriptive statistics for summarization, and paired t-tests to evaluate pre- and post-surgical changes.
Results: Across all surgery types, mean and median scores for pain, functionality, and stress showed reductions in scores between pre surgery to post surgery responses. For example, among CTR patients, the mean pain score decreased from 7.1 (median = 8.0) to 3.7 (median = 3.0). Similar results were observed for functionality (mean: 7.2 to 3.0) and stress (mean: 5.6 to 2.2). Paired t-tests were used to evaluate the statistical significance of these reductions for each surgery and outcomes metric. CTR results demonstrated significant improvements post-surgery: CTR pain (t = 4.04, p < 0.001), functionality (t = 5.25, p < 0.001), and stress (t = 5.13, p < 0.001). These findings indicate statistically significant improvements in outcomes for many of the surgery types analyzed.
Conclusion: While the surveys used in this study were not nationally recognized, they provide a promising first step toward more efficient tools for measuring outcomes. Significant improvements in pain, functionality, and stress were documented, suggesting these shorter surveys may serve as a useful tool for tracking recovery. To further validate their effectiveness, future studies should compare the short survey results with established PROs, assess test-retest reliability, and measure responsiveness to clinical changes. Patient and provider feedback will also ensure these tools are practical and meaningful in real-world settings. Mandatory reporting and financial penalties for non-compliance by the CMS will have significant implications for the future of healthcare in the United States.
