Driving Factors of Recommending a Hand Surgery Clinic After Surgery

Jarry T. Porsius, Marloes H.P. ter Stege*, R. W. Selles, H. P. Slijper, the Hand-Wrist Study Group

*Corresponding author for this work

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Since a patient's recommendation of a clinic to others is an important indicator of patient experience, more insight is needed into the underlying factors that motivate such recommendations. This retrospective cohort study assessed the relative contribution of the following: (1) patient-related characteristics, (2) treatment outcome, (3) satisfaction with treatment outcome, and (4) patients’ experience with the process of care to patients’ recommendation of a specific clinic after elective surgery. 


Patients of specialized outpatient hand surgery clinics (N = 6,895) reported the likelihood of recommending the clinic to friends or family 3–5 months after surgery by filling in the Net Promoter Score. Potential predictors of the Net Promoter Score were preoperative patient characteristics, patient-reported treatment outcomes, satisfaction with treatment outcome, and experience with several health care delivery domains. Linear regression analyses were used to examine the contribution of the predictors. 


Mean age of the patients was 53 (SD, 14) years, 62.5% were women, and 62.5% were employed. Preoperative patient characteristics explained 1% of the variance in clinic recommendations. An additional 6% was explained by the treatment outcome, 21.6% by satisfaction with treatment outcome, and 33.8% by patients’ experience with care delivery (total explained variance was 62.3%). The strongest independent predictors of clinic recommendations were positive experiences with the quality of the facilities and the communication skills of the physician. 


Patient recommendations are more strongly driven by patients’ experience with care delivery than by treatment outcome and patient characteristics. Clinical relevance: In elective surgery, improving patient experiences is pivotal in boosting patient recommendation of the clinic.

Original languageEnglish
Pages (from-to)114-123
Number of pages10
JournalJournal of Hand Surgery
Issue number2
Publication statusE-pub ahead of print - 13 Dec 2023

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Publisher Copyright:
© 2024 American Society for Surgery of the Hand


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