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This research models the impact of patient perceptions of care quality on overall patient satisfaction in a rural healthcare organization over a three-year time period. The purpose of this paper is to determine if the factors that influence perceptions of service quality change over time and if the change affects overall patient satisfaction.

Data were collected for three fiscal years (2012-2014) using a 36-question, Likert-scaled attitudinal survey. Multiple regression analysis was performed to identify which constructs of five different service quality dimensions were statistically significant in predicting overall patient satisfaction. Paired comparison of means and ANOVA F-tests highlighted significant differences across years and demographics.

Multiple regression models of overall patient satisfaction over a three-year time period had significant repeat variables, indicating salience of the dimensions and constructs of service quality that predict patient satisfaction. However, some dimensions of service quality did not remain significant from one year to another, indicating there may be a gap in the patient service cycle over an extended time frame.

This paper explored the sequential relationship between patient satisfaction survey data and perceptions of service quality over a multi-year time frame. The research focussed on outpatient medical clinics, while the majority of previous studies have focussed on acute care or inpatient stays. A longitudinal study is especially relevant for outpatient clinics where continuity of care is important.

Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act requires healthcare organizations to collect certain metrics, including patient assessments of quality, in order to monitor and improve the quality of healthcare. These metrics are used as a basis for graduated insurance reimbursements, and are available to consumers as an aid in selecting healthcare providers and insurance plans. The purpose of this paper is to provide healthcare providers with the analytic capabilities to better understand quality of care from the patient’s point of view.

This research examines patient satisfaction data from a multi-specialty Medical Practice Group, and uses regression analysis and paired comparisons to provide insight into patient perceptions of care quality.

Results show that variables related to Access, Moving Through the Visit, Nurse/Assistant, Care Provider and Personal Issues significantly impact overall assessments of care quality. In addition, while gender and type of care provider do not appear to have an impact on overall patient satisfaction, significant differences do exist based on age group, specialty of the physician and clinic type.

This study differs from most academic research as it focusses on medical practices, rather than hospitals, and includes multiple clinic types, medical specialties and physician types in the analysis. The study demonstrates how analytics and patient perceptions of quality can inform policy decisions.

The most challenging aspect of hospital design is the creation of an environment that heals rather than the one acting as a barrier to healing. Much has not been done in the aspect of ascertaining the level of impact “indoor environmental quality (IEQ)” has on building occupants in healthcare facilities. Therefore, this study aims to investigate the impact of IEQ on patients' health and well-being.

The study investigates the hypothesis that four IEQ parameters (thermal quality, acoustic quality, lighting quality and indoor air quality [IAQ]) influence patients' overall satisfaction with the performance of hospital wards. Questionnaire responses were sought from the patients as the main occupants of hospital ward buildings. A proposed weighted structural model for IEQ establishing the relationship between IEQ parameters, patients' overall satisfaction and patients' health outcome was analyzed using structural equation modeling (SEM).

The most influential IEQ parameters on patients' overall satisfaction with IEQ in hospital wards are thermal quality, IAQ and lighting quality. The findings from this study revealed that the parameters of influence on patients' overall satisfaction and health outcomes vary with hospital ward orientation and design configuration.

This study has explored the need for the integration of all factors of IEQ at the building design stage towards providing a hospital environmental setting that reflects occupants' requirements and expectations and also promotes patient healing processes. This should be the focus of architects and healthcare managers and providers.

Pressure from competition; inflexible third-party reimbursements; greater demand from government, regulatory and certifying agencies; discerning patients; and the quest of healthcare entities for greater profitably place demands and high expectations for service quality impacting overall patient experience. Extending a prior multivariate, single-period model of varied medical practices predicting patient experience to a three-year time period to understand whether there was a change in overall assessment using data analytics. The paper aims to discuss these issues.

SEM was employed on a per year and aggregated, three-year basis to gain insights into qualitative psychometric constructs predicting overall patient experience and strength of the relationships.

Statistically significant differences were uncovered between years indicating the strength of the relationships of latent variables on overall performance.

Study focused on data gathered from a questionnaire mailed to patients who visited various outpatient medical clinics in a rural community with over 4,000 responses during the three-year study period. A higher percentage of female respondents over the age of 45 may limit the generalizability of the findings.

Practitioners can gain a broader understanding of different factors influencing overall patient experience. Administrative processes associated with the primary care provider are inconsequential. Patients are not as concerned with patient flow as they are with patient safety and health.

This research informs healthcare quality management of psychometrics and analytics to improve the overall patient experience in outpatient medical clinics.

The purpose of this research is to develop an alternative method of measuring out‐patient satisfaction where satisfaction is the central construct. The Gap Model operationalized by SERVQUAL is widely used to measure service quality. However, the SERVQUAL instrument only measures expectations (resulting from the pre‐process segment of the service experience) and perceptions (resulting from the post‐process segment). All three segments should be measured. The lack of proper segmentation and methodological criticisms in the literature motivated this study.

A partial least squares (PLS) approach, a form of structural equation modeling, is used to develop a framework to evaluate patient satisfaction in three service process segments: pre‐process, process, and post‐process service experiences.

Results indicate that each process stage mediates subsequent stages, that the process segment is the most important to the patient and that the antecedents have differing impacts on patient satisfaction depending where in the process the antecedent is evaluated.

Only one out‐patient surgery center was evaluated. Patient satisfaction criteria specific to hospital selection are not included in this study.

Results indicate what is important to patients in each service process segment that focus where ambulatory surgery centers should allocate resources.

This study is the first to evaluate patient satisfaction with all three process segments.

Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the relationship between the eight dimensions of responsiveness and overall patient satisfaction in public and private hospitals in Tehran, Iran.

This cross-sectional study was conducted in 2015. In all, 500 patients were selected by the convenient sampling method from two public and three private hospitals. All data were collected using a valid and reliable questionnaire consisted of 32 items to assess the responsiveness of hospitals across eight dimensions and four items to assess the level of overall patient satisfaction. Data analysis was performed using descriptive statistics and multivariate regression was performed by SPSS 18.

The mean score of hospital responsiveness and patient satisfaction was 3.48±0.69 and 3.54±0.97 out of 5, respectively. Based on the regression analysis, around 65 percent of the variance in overall satisfaction can be explained by dimensions of responsiveness. Seven independent variables had a positive impact on patient satisfaction; the quality of basic amenities and respect for human dignity were the most powerful factors influencing overall patient satisfaction.

Hospital responsiveness had a strong effect on overall patient satisfaction. Health care facilities should consider including efforts to responsiveness improvement in their strategic plans. It is recommended that patients should be involved in their treatment processes and have the right to choose their physician.

The purpose of this paper is to develop and test a new public healthcare patient satisfaction index (PSI) in Indonesia. More clearly, the index measures overall patient satisfaction and its determinants.

Literature review was performed to identify the determinants of patient satisfaction. Data collection was carried out by using survey with questionnaire. The survey involves 161 patients of one public healthcare service institution in Tangerang, Indonesia. The authors conducted some statistical analyses, namely exploratory factor analysis, Cronbach α analysis, and multiple regression analysis.

A new public healthcare PSI was developed and tested. The index consists of overall patient satisfaction and its determinants. The determinants include the quality of healthcare delivery, the quality of healthcare personnel, the adequacy of healthcare resources, the quality of administration process, perceived value, perceived sacrifice, and image. Furthermore, the new index was called as IPHSI-PSB.

This research was carried out only in Tangerang, Indonesia and only involved one public healthcare service. Hence, the index needs to be tested in different cities in Indonesia. Furthermore, it is also needed to involve more public healthcare service institutions in future researches.

Public healthcare service managers can use IPHSI-PSB to monitor, measure, and improve the patient satisfaction of the public healthcare service institution they manage.

This paper has developed and tested a new public healthcare patient satisfaction index.

The purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.

The case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.

The findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.

These findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.

There are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

The purpose of this paper is to examine the role of perceived service attributes in the development of overall customer satisfaction (OCS) and customer loyalty (CL) in a health-care setting. This paper also sheds light on the role of hospitalist physicians (HPs) and offers suggestions to improve patient satisfaction and loyalty.

A telephone survey was used to collect data from recently hospitalized patients with respect to their HP. Structural equations modeling (SEM) was used to confirm the overall relationships between perceived service quality (PSQ), OCS and CL. The sample was then divided into customer relationship groups (CRGs) based on satisfaction and loyalty measures. Discriminant analysis was used to determine which attributes differentiated most between high and low satisfaction and loyalty groups.

Overall relationships among PSQ, OCS and CL were in conformity with the conceptual model. Findings also revealed that service attributes played an important role in distinguishing between high and low satisfaction and loyalty groups, although some attributes were more important than others and different attributes emerged as being key influencers for satisfaction and loyalty.

The conceptual model used is a fairly straight forward model, and we have not considered the impact of individual factors such as expectations and value perceptions or involvement levels and demographic characteristics on service quality and overall satisfaction. The data for this study were provided by a major health maintenance organization (HMO), and there is room for improvement in the manner in which certain constructs were measured. For example, OCS, recommendation and retention all used single item measures, and it might have been preferable to use multiple item measures for these constructs.

The study shows that organizations can benefit by identifying and focusing on critical attributes as part of their customer relationship management program.

The SEM results provide strong support for the overall model linking service quality, OCS and CL in a health-care setting. As one would expect, PSQ has a strong impact on OCS, which, in turn, has a fairly strong impact on CL. However, there is also a significant direct linkage between PSQ and CL. This linkage shows that at least a certain portion of CL could evolve independent of the satisfaction level with the HP. This shows that, in addition to trying to improve satisfaction, organizations should also explore influencing loyalty directly, perhaps by the strategic use of service attribute perceptions.

The study shows that customer perceptions at the service attribute level can often be the key to the generation and management of customer satisfaction and loyalty. It also has significance for how satisfaction and loyalty with HPs can be improved in a hospital setting.

The purpose of this paper is to provide insight, exploratory research, and support for the strategic use of hospital secondary support functions as an initial strategy for marketing healthcare, increasing patient volume, and expanding patient satisfaction.

This research paper is based upon longitudinal patient satisfaction and perception studies following both emergency room and elective‐stay hospitalization visits in Beirut. Exploratory statistical methods are used to examine substantial data comprising over 300 patient stays. Comprehensive information is presented which illustrates patient perceptions, their inflection points, and the importance of this knowledge in the marketing of hospitals and health care systems.

This research paper presents that patient perceptions are significantly influenced by hospital support functions. Further, these perceptions determine hospital reputation, influence future patient demands, and are integral to the understanding of patients as consumers of health care systems rather than consumers of medical procedures.

This paper provides support for health care system administrators who are often at odds with health care core service administrators and personnel with respect to long‐term hospital growth strategies. It illustrates that focusing on increasing core competencies is a short‐sighted approach to developing health care systems. It provides support for growing secondary support functions as being a more efficient means to increasing long‐term core competencies.

The originality of this paper is that it illustrates the conflict between the immediate medical care that health care systems understand to be their strategy and the strategies that truly grow hospital health care systems. It illustrates the paradox that requires hospitals to focus upon secondary support functions rather than core competencies in order to market themselves using strategies consistent with long‐term growth.