Skip to main content
SpringerLink
Log in

Dimensions of service quality and satisfaction in healthcare: a patient’s satisfaction index

  • Original paper
  • Published:
Service Business Aims and scope Submit manuscript

Abstract

The assessment of patients’ satisfaction levels, and the knowledge of what factors influence satisfaction are very important for healthcare managers as it influences healthcare results and healthcare institutions financial results. The objective of this research is to analyse patients’ satisfaction levels in a set of four Portuguese primary Healthcare Centres, through the estimation of a satisfaction index, which simultaneously explains which dimensions of healthcare quality influence that satisfaction the most. For that, a conceptual model of patients’ satisfaction in primary healthcare was tested using data from a sample of 414 patients. Partial Least Squares path modelling (PLS) was the technique chosen to evaluate the proposed model. The results show that patients’ satisfaction is 60.887 in a scale from 1 to 100, revealing only a medium level of satisfaction. It is also possible to conclude that the most important positive effects on satisfaction are the ones linked to the patient/doctor relationship, the quality of facilities and the interaction with administrative staff, by this order.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Ahorony I, Strasser S (1993) Patient satisfaction: what we know about and what we still need to explore. Med Care Rev 50:49–79

    Article  Google Scholar 

  • Alford BL (1998) Affect, attribution, and disconfirmation: their impact on health care service evaluation. Health Mark Q 15:55

    Article  Google Scholar 

  • Amyx D, Mowen JC, Hamm R (2000) Patient satisfaction: a matter of choice. J Serv Mark 14:557–572

    Article  Google Scholar 

  • Anderson, EW (1993) Firm, industry and national indices of customer satisfaction: implications for services in advances In: Swartz T, Bowen D, Brown S (eds) Services marketing and management, 1993, vol 2. JAI Press, Hampton Hill, pp 87–108

  • Anderson E, Fornell C (2000a) Foundations of the American customer satisfaction index. Total Qual Manag 11:S869–S882

    Article  Google Scholar 

  • Anderson E, Fornell C (2000b) The customer satisfaction index as a leading indicator. In: Swartz T, Iacobucci D (eds) Handbook of service marketing and management. Sage publications, London, pp 255–267

    Google Scholar 

  • Anderson E, Fornell C, Lehmann D (1994) Customer satisfaction, market share, and profitability: findings from Sweden. J Mark 58:53–66

    Article  Google Scholar 

  • Barclay D, Ronald T, Christopher H (1995) The partial least squares (PLS) approach to causal modeling: personal computer adoption and use as an illustration. Technol Stud 2:285–309

    Google Scholar 

  • Boller C, Wyss K, Mtasiwa D, Tanner M (2003) Quality and comparison of antenatal care in public and private providers in the United Republic of Tanzania. Bull World Health Organ 81:116–122

    Google Scholar 

  • Bruhn M, Grund M (2000) Theory, development and implementation of national customer satisfaction indices: the Swiss Index of Customer Satisfaction (SWICS). Total qual Manag 11(7):S1017–S1028

    Article  Google Scholar 

  • Bryant C, Kent E, Lindenberger J, Schreiher J (1998) Increasing consumer satisfaction. Mark Health Serv 18:4–18

    Google Scholar 

  • Carr-Hill R (1992) The measurement of patient satisfaction. J Public Health Med 14:236–249

    Google Scholar 

  • Chin W (1998) The partial least squares approach to structural equation modeling. In: Marcoulides GA (ed) Modern methods for business research. Laurence Erlbaum Associates, New Jersey, pp 295–336

    Google Scholar 

  • Choi KS, Lee H, Kim C, Lee S (2005) The service quality dimensions and patient satisfaction relationships in South Korea: comparisons across gender, age and types of services. J Serv Mark 19:140–149

    Article  Google Scholar 

  • Donabedian A (1980) Explorations in quality assessment and monitoring: the definition of quality and approaches to its assessments, vol 1. Health Administration Press, Ann Arbor

    Google Scholar 

  • ECSI Technical Committee (1998) European Customer Satisfaction Index: Foundation and Structure for Harmonized National Pilot Projects. Report prepared for the ECSI Steering Committee, October

  • Falk RF, Miller NB (1992) A primer for soft modeling. The University of Akron Press, Ohio

    Google Scholar 

  • Fitzpatrick R, Hopkins A (1983) Problem in the conceptual framework of patient satisfaction research: an empirical exploration. Social Health Illn 5:297–311

    Article  Google Scholar 

  • Fornell C (1992) A national customer satisfaction barometer: the Swedish experience. J Mark 56:6–21

    Article  Google Scholar 

  • Fornell C, Larcker D (1981) Evaluating structural equation models with unobservable variables and measurement error. J Mark Res 118:39–50

    Article  Google Scholar 

  • Fornell C, Johnson M, Anderson E, Cha J, Bryant B (1996) The American customer satisfaction index: nature, purpose, and findings. J Mar 60:7–18

    Article  Google Scholar 

  • Foundation of the American College of Healthcare Executives (2006) Patient satisfaction: understanding and managing the experience of care, 2nd edn. Irwin Press

  • Garland B, Westbrook R (1989) An exploration of client satisfaction in a nonprofit context. J Acad Mar Sci 17(4):297–303

    Article  Google Scholar 

  • Geisser S (1975) The predictive sample reuse method with applications. J Am Stat Assoc 70:320–328

    Article  Google Scholar 

  • Hair JF Jr, Anderson ER, Tatham RL, Black WC (1998) Multivariate data analysis, 5th edn. Prentice Hall International, London

    Google Scholar 

  • Hayes B (1998) Measuring customer satisfaction: survey design, use, and statistical analysis methods, 2nd edn. ASQ Quality Press, Milwaukee

    Google Scholar 

  • Headley D, Miller S (1993) Measuring service quality and its relationship to future consumer behavior. J Health Care Mark 13:32–41

    Google Scholar 

  • John J (1991) Improving quality through patient-provider information. J Health Care Mark 12:56–64

    Google Scholar 

  • Johnson M (1995) The four faces of aggregation in customer satisfaction research. Adv Consumer Res 22:89–93

    Google Scholar 

  • Johnson M, Anderson E, Fornell C (1995) Rational and adaptive performance expectations in a customer satisfaction framework. J Consumer Res 21:695–707

    Article  Google Scholar 

  • Jöreskog KG, Wold H (1982) The ML and PLS techniques for modeling with latent variables: historical and comparative aspects. In: Wold H, Jöreskog K (eds) Systems under indirect observation: causality, structure, prediction, vol I. North-Holland, Amsterdam, pp 263–270

    Google Scholar 

  • Kara A, Lonial S, Tarim M, Zaim S (2005) A paradox of service quality in Turkey—the seemingly contradictory relative importance of tangible and intangible determinants of service quality. Eur Bus Rev 17:2–20

    Google Scholar 

  • Larrabee JH, Ostrow L, Withrow Mary L, Janney MA, Hobbs RG Jr, Burant C (2004) Predictors of patient satisfaction with inpatient hospital nursing care. Res Nurs Health 27:254–268

    Article  Google Scholar 

  • MacStravic R (1991) Beyond patient satisfaction: building patient loyalty. Health Administration Press, Ann Arbor

    Google Scholar 

  • Mowen J, Licata J, Mcphail J (1993) Waiting in the emergency room: how to improve patient satisfaction. J Health Care Mark 13:26–33

    Google Scholar 

  • Nunnaly Jum C, Bernstein IH (1994) Psychometric theory, 3rd edn. McGraw-Hill, New York

    Google Scholar 

  • Oliver RA (1977) Theoretical reinterpretation of expectation and disconfirmation effects on posterior product evaluation: experience in the field. In: Day R (ed) Consumer satisfaction dissatisfaction and complaining behavior. School of Business, Indiana University, Bloomington, pp 2–9

    Google Scholar 

  • Oliver R (1980) A cognitive model of the antecedents and consequences of satisfaction decisions. J Mark Res 17:460–469

    Article  Google Scholar 

  • Oliver R (1997) Satisfaction—a behavioral perspective on the consumer. McGraw-Hill/Irwin, New York

    Google Scholar 

  • Oliver R, Bearden W (1983) The role of involvement in satisfaction processes. Adv Consumer Res 10:250–255

    Google Scholar 

  • Otani K, Kurz R (2004) The impact of nursing care and other health care attributes on hospitalized patient satisfaction and behavioral intentions. J Healthc Manag 49:181–197

    Google Scholar 

  • Otani K, Kurz R, Harris L, Byrne F (2005) Managing primary care using patient satisfaction measures. J Healthc Manag 50:311–325

    Google Scholar 

  • Parasuraman A, Zeithaml V, Berry L (1985) A conceptual model of service quality and its implications for future research. J Mark 49:41–50

    Article  Google Scholar 

  • Parasuraman A, Zeithaml V, Berry L (1988) SERVQUAL: a multiple-item scale for measuring consumer perceptions of service quality. J Retail 64(1):12–40

    Google Scholar 

  • Peyrot M, Cooper P, Schnapt D (1993) Consumer satisfaction and perceived quality of outpatient health services. J Health Care Mark 13:24–33

    Google Scholar 

  • Rao K, Peters D, Bandeen-Roche K (2006) Towards patient-centered health services in India—a scale to measure patient perceptions of quality. Int J Qual Health Care 18:414–421

    Article  Google Scholar 

  • Ryan M, Buzas T, Ramaswamy V (1995) Making CSM a power tool: composite indices boost the value of satisfaction measures for decision making. Mark Res 7:11–16

    Google Scholar 

  • Singh JA (1990) Multifacet typology of patient satisfaction with a hospital. J Health Care Mark 10:8–21

    Google Scholar 

  • Stone M (1974) Cross-validatory choice and assessment of statistical predictions. J R Stat Soc: Ser B (Methodological) 36:111–147

    Google Scholar 

  • Taylor SA, Cronin JJ Jr (1994) Modeling patient satisfaction and service quality. J Health Care Mark 14:34

    Google Scholar 

  • Trumble SC, O’Brien ML, O’Brien M, Hartwig B (2006) Communication skills training for doctors increases patient satisfaction. Clinical Gov Int J 11:299–307

    Article  Google Scholar 

  • Venkatapparao M, Gopalakrishna P (1995) Mediators vs moderators of patient satisfaction. J Health Care Mark 15:16–21

    Google Scholar 

  • Westbrook R, Oliver R (1981) Developing better measures of consumer satisfaction: some preliminary results. Adv Consumer Res 8:94–99

    Google Scholar 

  • Wilton P, Nicosia F (1986) Emerging paradigms for the study of consumer satisfaction. Eur Res 14(1):4–11

    Google Scholar 

  • Woodside A, Frey L, Daly R (1989) Linking service quality, customer satisfaction and behavioral intention. J Health Care Mark 9:5–17

    Google Scholar 

  • Yarnold PR, Michelson EA, Thompson DA, Adams SL (1998) Predicting patient satisfaction: a study of two emergency departments. J Behav Med 21:545–563

    Article  Google Scholar 

Download references

Acknowledgement

The authors would like to thank to Dr. Manuel Nunes and Dr. Ana Correia, manager of the Castelo Branco Regional Health Administration, for the authorization given for this study.

Author information

Authors and Affiliations

  1. Business and Economics Department, University of Beira Interior, Estrada do Sineiro, Covilha, 6200-209, Portugal

    Mário Lino Raposo, Helena Maria Alves & Paulo Alexandre Duarte

Authors
  1. Mário Lino Raposo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Helena Maria Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paulo Alexandre Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mário Lino Raposo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Raposo, M.L., Alves, H.M. & Duarte, P.A. Dimensions of service quality and satisfaction in healthcare: a patient’s satisfaction index. Serv Bus 3, 85–100 (2009). https://doi.org/10.1007/s11628-008-0055-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11628-008-0055-1

Keywords

Search

Navigation