Lutfi Cagatay ONAR
The Medical Bulletin of Haseki - 2026;64(3):213-219
Aim: Public-private partnership (PPP) hospitals have been increasingly implemented in Türkiye to improve healthcare infrastructure and patient comfort. Coronary artery bypass grafting (CABG) is a high-risk surgical procedure frequently associated with significant preoperative anxiety, which may influence perioperative outcomes. This study aimed to compare preoperative anxiety levels and patient satisfaction among CABG patients treated at both a public hospital and a PPP-operated hospital with similar clinical capacity. Methods: A total of 2,201 patients who underwent isolated CABG between April 2016 and July 2024 were included in a retrospective analysis. Patients were divided into two groups: alethe [public hospital group (PHG), n=1.110] and the [PPP hospital group (PPPHG), n=1.091]. Patients using antidepressant or anxiolytic medications or whith known psychiatric disorders were excluded. Preoperative anxiety was assessed using the Beck Anxiety Inventory (BAI), and patient satisfaction was evaluated using the Patient Satisfaction Questionnaire Short Form (PSQ-18) and patient satisfaction were assessed using the BAI and the PSQ-18, respectively. Continuous and categorical variables were compared using Student's t-test and chi² test, respectively. Results: Overall patient satisfaction scores did not differ significantly between the two groups. However, preoperative anxiety levels were significantly lower in the PPPHG compared with the PHG (BAI: 9.3+/-4.1 vs. 17.8+/-6.4; p<0.001). Higher anxiety levels were associated with previous percutaneous coronary intervention, chronic obstructive pulmonary disease, divorced or widowed marital status, and lower socioeconomic status. Conclusion: While patient satisfaction with medical care was similar in both hospital models, CABG patients treated in the PPP hospital experienced significantly lower preoperative anxiety. Hospital environment and organizational characteristics may influence psychological well-being independently of clinical care quality.
