Winn, Than and Baba, Abdul Aziz
(2004)
Patient Satisfaction Toward Medical Ward Services In Hospital
Universiti Sains Malaysia (HUSM) AND Hospital Kota Bharu (HKB).
Patient Satisfaction Toward Medical Ward Services In Hospital Universiti Sains Malaysia (HUSM) AND Hospital Kota Bharu (HKB).
(Submitted)
Abstract
There are several definitions of patient satisfaction given hy different authors. For
instance, Steiber defined satisfaction as a subjective perception of the customer who
receives a service (Steiber,1990). Pascoe defined patient satisfaction as a health care
recipient's reaction to salient aspects of (his or her) service experience. In Pascoe's
definition, he assumed that patient satisfaction has a cognitive evaluation and an
emotional reaction to the structure, process and outcome of care (Pascoe,1983). Pascoe
further defined patient satisfaction into two-parts, firstly; the 'contrast · model which
stated that whenever the service experience is greater than the patient's expectations, he
or she is satisfied. On the other hand, the 'assimilation' model stated that when the
patient does not fully understand the service experience (due to inadequacy of clinical
knowledge), he or she may adjust their expectations downward if the sen ice experience
falls below expectations. This assimilation model may explain about the higher
satisfaction rating of health personnel compared to lower non-clinical experience such as
satisfaction rating for hospital food or parking facility (Pascoe, 1983 ). Linder-Pelz
defined patient satisfaction as positive evaluations of distinct dimensions of health care
bnsed on pnticnt expectations nnd provider performnncc:. Exmnplcs of hcnlth cnrc include
the treatment received by patients during their illness episode, a clinic visit, a healthcare
setting or the whole health system itself. Patient satisfaction must be understood within a
context that contained multiple construct (elements) likely to satisfy the patient (LinderPelz
S, 1982b).
Importance of Patient Satisfaction
Measurement of patient satisfaction can fulfil several functions such as description of
health care services from the patient's point of view, a measure of the proc1ess of care and
evaluation of health care (Sitzia and Wood,1997). If health manager can identify source
of patient dissatisfaction, the health organization can address system weakness and
improve their service to patients (Strasser and Davis, 1991 ). Satisfied patients are less
likely to disenroll from health plans and more likely to return to a physician or hospital
and less likely to bring a malpractice suit (Steiber and Krowinski, 1990). Satisfied
patients are more likely to maintain consistent relationship with their healthcare provider
(Wartman, 1983 ).
Predictors of patient satisfaction
Factors as~umed to be related to patient satisfaction include physical and psychological
status, attitudes and expectations toward medical care also the structure, process and
outcome of care, patient sociodemographic characteristics (Cleary and Mcneil, 1988).Structure of care
a. The organization and financing of care
The way in Which medical care is organized and financed may be related to patient
satisfaction. This means that the provider and organizational characteristics which result
in more personal care and better communication with their patient are associated with
higher levels of satisfaction (Cleary and McNeil, 1988).
Process of care
a. Technical Quality of Care
Satisfaction with the ambulatory care mostly is associated with satisfaction toward the
treating physician while the inpatient experience is more associated with the quality of
staff. With the physician, patient satisfaction breaks down into two aspects (i) satisfaction
with perceived technical competence and (b) satisfaction with interpersonal skills (Hall
and Doman, 1988). On the other hand, nurses, midwives and physician assistants tend to
be scored highly on interaction with patients because patients often emphasized on the
interpersonal aspect, rather than on perceived technical competence (Hall et al., 1990).
b. Interpersonal Aspects of Care
People like to have doctors talk to them in an egalitarian way, listen, ask a lot of
questions, answer a lot of questions, explain their health condition in a simple way that
the patient can understand, and allow patients to make decisions about their care ( Hall et
at., 1988).
Outcome of care
A sntisfnction study townrd three typeg or hospitnl services (tncdicn • nursing nnd
supportive) using structured interview method (n=476) found when patients perceived
that their health improved, patient satisfaction increased (Carmel, 1985).
Sociodemographic characteristics
In her meta-analysis on patient satisfaction studies, average magnitudes of relationship
between sociodemographics characteristics with patient satisfaction were very small.
Older age was the strongest correlate of satisfaction (mean r=O.l3). <:Jreater patient
satisfaction was significantly associated with greater age and less (:ducation, and
marginally associated with having higher social status and being married. l~o relationship
between satisfaction and gender, ethnicity, income or family size (Hall & I>oman, 1990).
Literature review
Several patient satisfaction studies have been conducted in various diffen~nt setting and
medical specialities to address dillerent issues. For instance, n descriptive correlation
study in a Emergency department found that 28 patients generally satisfied with the four
areas of Emergency department being examined i.e. nursing care, information received,
ancillary services, and environment (Bruce et al, 1998). In a client satisfaction study
(n=1913). toward health care provided in government health facilities of rural
Bangladesh, the important predictors for client satisfaction was healthcare provider
interpersonal behaviour (especially respect and politeness) and a reduction in waiting
time (on average to 30 min) (Aldana et al., 2001 ). An example of satisfaction studiesfocusing on specialty services was a satisfaction study toward cardiac speciality services
in coronary care unit of Ontario hospitals in Canada.
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