The Impact of Patient Satisfaction on Patient Loyalty with the Mediating Effect of Patient Trust

Assessing Patient Satisfaction with Hospital Services: Perspectives from Bihor County Emergency Hospital, Romania

BACKGROUND/OBJECTIVES

The objective of this study is to assess overall patient satisfaction with hospital services, including cleanliness, ward conditions, and food quality. Another key goal is to determine patient willingness to return for future medical services and identify the factors influencing this decision. Moreover, the study explores the relationship between patient satisfaction and continuity of care, as indicated by previous hospitalizations.

METHODS

We conducted a retrospective cohort study to evaluate patient satisfaction at the Bihor County Emergency Clinical Hospital in Oradea, Romania. A standardized 40-item questionnaire was developed in accordance with the Framework Agreement on the provision of medical assistance within the Romanian healthcare system. The survey, which was administered over a four-year period (2019-2022), covered seven domains: demographic data, accessibility, hotel conditions, quality of care, patient safety and rights, overall satisfaction, and feedback. A total of 12,802 patients completed the questionnaire, and all statistical analyses were performed using R Studio.

RESULTS

This study analyzes patient-reported satisfaction and experiences in a large healthcare facility, based on data from 12,802 participants. Overall, 91% of respondents rated the hospital positively, with 62% giving an excellent score. Spiritual assistance was well received (71%), and 70% of patients expressed willingness to return for future medical needs. Hospital cleanliness and ward conditions were rated highly, with 71% of respondents reporting excellent experiences. Food quality was positively reviewed by 66% of participants. Most patients (95%) confirmed proper hygiene practices by medical staff, and 95% were informed about their diagnosis. However, only 67% were aware of the complaint submission process. The dataset spans 2019-2022, with the highest hospitalizations in 2020 (36%) and obstetrics, cardiology, and general surgery being the most common specialties.

CONCLUSIONS

This dataset reflects a high level of patient satisfaction across multiple dimensions of hospital services, including cleanliness, quality of care, and patient information. However, areas such as complaint handling and transparency in medication handling require further attention to improve the overall patient experience. The findings underscore the hospital's strong performance in meeting patient expectations while identifying key areas for continued improvement.

Correlation Between Social Support, Patient Satisfaction, and Associated Factors in Patients with Schizophrenia

Objective Schizophrenia is a chronic psychiatric disorder comprising cognitive, behavioral, and often emotional dysfunction. It is often accompanied by limited social support, which plays a crucial role in not only enhancing treatment adherence and resilience but also overall patient satisfaction. Given the growing recognition of perceived social support as a key factor in improving patient satisfaction, this study aims to find the correlation between perceived social support and patient satisfaction among patients diagnosed with schizophrenia who are admitted to the inpatient (wards) as well as attending the OPDs at the Department of Psychiatry, Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan. The study also aims to capture associated factors that may influence both of these variables. Materials and methods A cross-sectional study was conducted at JPMC on 151 patients with schizophrenia using convenience sampling. The data were collected using a structured questionnaire including three parts: a socio-demographic form, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Patient Satisfaction Questionnaire Short Form (PSQ-18). IBM SPSS Statistics software version 20 (IBM Corp., Armonk, NY) was used for analysis. Non-parametric tests were used, including Mann-Whitney U and Kruskal-Wallis for associations and Spearman's rho to analyze the correlation between perceived support and patient satisfaction. Results The sample (N = 151) comprised 62 (41.1%) females and 89 (58.9%) males. Among the study group, 53.6% (N = 81) of the patients were 18-30 years old, 64.9% (N = 98) were single, and 60.9% (N = 92) had an education level of primary or lower; 51.6% (N = 78) of patients had been diagnosed for over six years, and 71.4% (N = 108) had regular family contact. The MSPSS scores indicated moderate perceived support (39.28 ± 17.74), highest from family (3.88 ± 1.87) and lowest from friends (2.11 ± 1.68). The PSQ-18 scores were highest for interpersonal manner (3.70 ± 1.21) and lowest for general satisfaction (3.17 ± 1.09). The department of concern (ward/OPD) had significant associations with MSPSS and PSQ-18 scores, whereas gender was only found to have associations with PSQ-18 scores. Frequency of visits from family and friends was greatly associated with both MSPSS and PSQ-18 scores. Spearman's rho showed significant positive correlations (indicated by p-value ≤ 0.05) between MSPSS (total, family, and significant others) and all PSQ-18 subsections (ρ = 0.334-0.591), while support from friends correlated only with interpersonal manner (ρ = 0.272). Conclusion This study highlights the impact of social support on patient satisfaction in schizophrenia. Family and significant others played a key role, while support from friends was limited but associated with interpersonal communication. Despite low or moderate perceived support among the majority of the patients, satisfaction levels remained moderate overall, suggesting other contributing factors. That being said, greater family involvement and social participation were strongly associated with both perceived support and patient satisfaction. Also, perceived support overall as well as perceived support specifically from family and significant others was found to have positive correlations with all aspects of patient satisfaction. These findings emphasize that strengthening social networks and support systems may further enhance patient experiences and care outcomes.

Patients' loyalty to primary care institutions and associated factors in China: a cross-sectional study

OBJECTIVES

This study aimed to examine patients' loyalty and explore some associated factors among PCIs in this country.

METHODS

A multistage stratified random sampling method was employed to collect data for this study. A structured self-administered questionnaire was distributed to 2,697 patients who had ever involved in seeking healthcare from PCIs across China between July and September in 2021. The Patients' Loyalty Scale (PLS) was measured with a 7-item scale. Group differences of PLS scores were estimated by the t-tests or ANOVA analysis. Stepwise regression analysis was used to identify the factors associated with patients' loyalty to PCIs.

RESULTS

Based on the PLS with a total score of 35, the average score of patients' loyalty was 23.81 (SD = 5.42). Multiple linear regression analysis indicated that respondents who were female (β = 0.502), older (β = 0.040), married (β = 0.568), with bachelor degree (β = 0.481), with more than three family members (β = 0.510), employees of enterprises and institutions (β = 1.079), with better self-reported health status (β = 1.938), or a moderate level of self-reported health status (β = 1.510), without a family doctor contract (β = 0.625), with willingness for medical treatment from PCIs (β = 1.172), with higher patients' trust (β = 0.311) or with higher patients' satisfaction (β = 0.368) reported a higher level of loyalty.

CONCLUSION

Patients' loyalty among PCIs was found to be above average in China. Gender, age, marital status, education level, occupation, health status, number of family members, family doctor contract, patients' trust, patients' satisfaction, and willingness to obtain medical treatment from PCIs were significant predictors of patients' loyalty.

Public awareness, attitudes, behavior and norms building green hospitals' power

Hospitals function to provide health services to the community, but they have the potential to be contributors to hazardous waste, climate change, and global warming. The concept of green hospitals is now necessary for changing hospital functions developed by various hospitals worldwide. The success of the green hospital concept requires support from the perspective of the surrounding society. The research aims to analyze public awareness, attitudes, behavior, and norms to build the power of green hospitals. This research method is simple linear regression. The research instrument used a questionnaire. The respondents of this research were 400 green hospital users from Indonesia and Taiwan. The data analysis method includes tests for normality, linearity, and heteroscedasticity. Once these three tests are met, a linear regression analysis is conducted to understand the influence and prediction of public awareness, attitudes, behavior, and norms on building the power of green hospitals. The research results show that each aspect of public awareness, attitudes, behavior, and norms significantly positively influence the building of the power of green hospitals. Each additional value of public awareness, attitudes, behavior, and norms is expected to strengthen the image of a green hospital. Maintaining the sustainability of green hospital programs worldwide not only focuses on implementing the green concept but also needs to pay attention to public perception when choosing a hospital. The research contribution is significant to developing more sustainable green hospitals, increasing knowledge about green hospitals, and increasing public interest and perception of green hospitals.

Hospital Patient Satisfaction With Nursing Care in Saudi Arabia

Introduction Patient satisfaction is a critical indicator of health care quality, yet research exploring patient satisfaction with nursing care in Saudi Arabia (SA) remains limited. This study investigated patients' satisfaction with nursing care quality during their hospitalization in SA. Material and methods A cross-sectional study was conducted using a convenience sample of 746 patients from five hospitals in five different regions of SA. Data were collected using the Newcastle Satisfaction With Nursing Scale (NSMS), which has been shown to be valid and reliable. Results The average overall patient satisfaction with nursing care was 71.16 ± 13.51 out of 95 (75.96%), indicating a high level of satisfaction with the nursing care the patients received. The highest-scoring items of patient satisfaction were the nurses' manners when carrying out their duties, the amount of privacy the nurses provided and their capability to perform their jobs. However, the level of satisfaction regarding the frequency of nurse check-ins, time spent with patients, and support provided to patients' relatives indicated areas for potential improvement. Also, patients with primary education who were divorced or married and those admitted to the gynecology ward were more satisfied with nursing care. Conclusion This study's findings indicate that the patients were highly satisfied with the care their nurses provided, although opportunities for improvement in some areas of nursing care were identified. These findings may encourage nurses to be more attentive in meeting their patients' needs according to best nursing practices. It is recommended that hospital administrators prioritize initiatives to enhance the quality of nursing care, thereby improving overall patient satisfaction.

An Analysis of Inpatient Satisfaction with Trust-related Factors of Public Secondary and Tertiary Hospitals in China

BACKGROUND AND OBJECTIVES

Patient satisfaction surveys are implemented as an essential quality improvement tool in healthcare markets. This study investigates patient satisfaction in public secondary and tertiary hospitals and identifies factors contributing to inpatient satisfaction, particularly trust-related factors, to eventually improve the quality of care in the healthcare system.

METHODS

A population-based cross-sectional survey was conducted between February and April 2021 in 31 Chinese provinces. Telephone interviews with computer assistance were used to gather data. Spearman Rank Correlation was used to analyze satisfaction with hospitalization services between secondary and tertiary hospitals. Multiple Linear Regression was used to determine the influencing factors of overall patient satisfaction.

RESULTS

Inpatients reported more satisfaction with inpatient care when doctors treated them respectfully (p < 0.01). Inpatients with higher self-identified social class reported higher satisfaction (p < 0.01). Inpatients who trust in most people in society (p < 0.01) and trust in the Chinese healthcare system (p < 0.01) reported higher satisfaction. Female inpatients reported higher overall satisfaction (p < 0.01).

CONCLUSIONS

The study of Chinese inpatients in secondary and tertiary hospitals highlighted the importance of respect from doctors, their self-identified social class, and their trust in influencing satisfaction during their hospital stay and called for additional research into policy measures.

The Relationship among Patient Satisfaction, Patient Loyalty, and Compliance with Treatment

This study examined the relationship between patient loyalty and adherence to treatment and evaluated the mediating role of patient satisfaction in this relationship. This study consisted of 386 participants. Correlation and regression analyses were used. A low level of positive correlation was found between loyalty and compliance scores. It was determined that satisfaction did not mediate the relationship between loyalty and compliance. In addition, a moderately positive relationship was found between loyalty and satisfaction. It has been observed that patient loyalty can play a critical role in important health outcomes such as adherence to treatment and increasing satisfaction.

Corporate social responsibility and patient's intention to revisit: A serial mediation study witnessing the healthcare sector

The present study aims to identify the impact of corporate social responsibility on patients' intention to revisit the healthcare industry. Furthermore, mediating the role of patient satisfaction and patient loyalty along with serial mediation through corporate social responsibility =  > patient satisfaction =  > patient loyalty =  > intention to revisit was also tested. The present study is quantitative in nature, while the data for the study was collected using purposive sampling from 321 patients working in eight hospitals in Rawalpindi and Islamabad, Pakistan. For the data analysis, statistical package for the social sciences (SPSS) and structural equation modeling through the partial least square approach (smart-PLS v 3.3.9) were employed. The study results show that corporate social responsibility forms a significantly positive relationship with patient satisfaction, patient loyalty, and patient intention to revisit. Study findings confirmed the mediating role of patient satisfaction and patient loyalty. Furthermore, serial mediation through patient satisfaction and patient loyalty was also confirmed. In the current competitive environment, understanding the direct and indirect effects of CSR activities on patient satisfaction, patient loyalty, and intentions to revisit is of the utmost importance for hospitals. These activities provide hospitals with the opportunity to take certain actions to improve patient satisfaction, and these actions increase their loyalty, which in turn encourages their intention to revisit.

Patients' satisfaction with nursing care quality and associated factors: A cross-section study

AIM

This research aimed to evaluate patients' satisfaction with the nursing care quality during their hospitalization.

DESIGN

Quantitative cross-sectional descriptive design.

METHODS

A convenience sample of 238 patients were recruited from hospitals in two provinces in Saudi Arabia. Patient satisfaction was measured by the Arabic version of the Patients' Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ-Ar).

RESULTS

Significant differences were found between Saudi provinces regarding the overall quality of nursing care (M = 4.65, p < 0.001). The study revealed mean significant variations between patient satisfaction with nursing care and sociodemographic factors, including age (p = 0.002), education level (p = 0.047), marital status (p = 0.017), employment status (p = 0.038), urban vs. suburban residence (p = 0.006), length of hospitalization (p = 0.001), and accompaniment by a family member (p = 0.014). Improving patients' experience during their hospitalization requires regular examination of the quality of nursing care services.

PATIENT CONTRIBUTION

This research enhances our understanding of patients satisfaction toward the quality of nursing care received during hospitalization.

Antecedents of Patient Satisfaction in Private Clinical Laboratories toward Patient Loyalty with Switching Cost and Location as Moderating Factors (An Empirical Study from Indonesia)

BACKGROUND: Clinical laboratory services are at the forefront to support healthcare services, particularly during the pandemic of COVID-19. The increasing number of private clinical laboratories at present days indicates the increase in patient needs, causing the healthcare service provider to face challenges as people have more options. Therefore fostering patient loyalty (PL) is a crucial success factor for the business growth of clinical laboratories as healthcare providers.   AIM: The purpose of this study is to analyse antecedents of patient satisfaction (PS) in clinical laboratories towards PL with the switching cost (SC) and location (LO) as moderating factors. METHODS: This study was done as a quantitative survey, and data were obtained by a cross-sectional approach with partial least squares structural equation modeling (PLS-SEM) for the data analysis method. There are 266 respondents eligible as samples, who undergo the phlebotomy process in a private laboratory located within a specific area. RESULTS:  This study demonstrated that all the 9 hypotheses supported with α: 0.05 and p < 0.05, include 6 independent variables named administrative process (AP), information availability (IA), the environment in the phlebotomy room (ER), phlebotomy process (PP), waiting time (WT) and result notification (RN) that influence PS. Patient satisfaction has been shown to have a direct effect on patient loyalty and also mediate the antecedents. Furthermore, SC and LO have demonstrated a significant effect to moderate this relationship. CONCLUSIONS: Patient satisfaction has been confirmed as the main construct to predict PL whereas the AP is the most important independent variable followed by IA. Clinical laboratory management should pay more attention to these antecedents in order to ensure PS and retain the clinic’s patients. The cost from the patient's perspective should be taken into account since this helps the clinical laboratory keep the patient loyal.

Impacts of service quality, brand image, and perceived value on outpatient's loyalty to China's private dental clinics with service satisfaction as a mediator

BACKGROUND

This study explores the effects and influence paths of service quality, brand image, perceived value, and service satisfaction on outpatients' loyalty to China's private dental clinics.

METHODS

A cross-sectional survey study was conducted in Dongguan City, Guangdong Province, China in January 2019. The participants were selected using the convenience sampling method. Of the 230 residents surveyed, 125 had received services in private dental clinics, being the valid sample of this study. A multiple linear regression model was used in exploring factors influencing patient loyalty. Subsequently, the path analysis was used in investigating the relationships among service quality, brand image, perceived value, patient satisfaction, and patient loyalty.

RESULTS

After the effects of demographic and socioeconomic variables were controlled, perceived value and patient satisfaction showed significant influences on patient loyalty. Path analysis indicated that perceived value, perceived quality, and expected quality have direct effects on patient satisfaction and have indirect effects on patient loyalty, and patient satisfaction is a mediator.

CONCLUSION

Perceived service quality influences patient loyalty through the effect of patient satisfaction, which plays a key role in promoting patient loyalty. This study implies that managers in private dental clinics can gain support from customers by building customer loyalty toward dental clinics.

Assessment of the satisfaction with public health insurance programs by patients with chronic diseases in China: a structural equation modeling approach

BACKGROUND

China has successfully sustained its universal health insurance coverage over the past decade. Although patient satisfaction has been recognized as an important indicator to measure the performance of insurance programs in China, there is a lack of evidence on how patients with chronic diseases are satisfied with China's public health insurance programs and whether their satisfaction differs by type of insurance. We aimed to fill the evidence gap.

METHODS

We established a hypothetical model that comprised patients' awareness of insurance policies, the fulfillment of patients' expectations of insurance benefits, patients' perceived value of health insurance coverage, patients' satisfaction with health insurance programs, patients' complaints, and trust in health insurance programs. We performed a confirmatory factor analysis by using a structural equation modeling (SEM) approach to examine the hypothesized model. A model-testing survey in 10 tertiary hospitals was conducted between June and October 2018, with a valid sample of 922 insured patients with chronic diseases.

RESULTS

The SEM model, with good fit indices, showed that patients' awareness of health insurance policies, insurance program's fulfillment of expectations, and patients' perceived value of insurance coverage, positively predicted patient satisfaction (P < 0.01). The fulfillment of patients' expectations of insurance benefits was the major predictor of satisfaction with health insurance (coefficient = 0.593, P < 0.001), while the patients' perceived value of insurance coverage had the largest impact on their trust in health insurance (coefficient = 0.409, P < 0.01). Compared to patients with Urban-Rural Resident Basic Medical Insurance, Urban Employee Basic Medical Insurance enrollees had a higher degree of satisfaction with insurance on average (P < 0.01). Despite differences in the degree of satisfaction, the main findings from the SEM were also proved by the multi-group analysis.

CONCLUSIONS

Our findings highlight the importance of incorporating patients' perceived value as part of the ongoing efforts to increase satisfaction with health insurance by patients, especially those who have chronic diseases. Policymakers are also suggested to formulate evidence-informed reimbursement policies that meet patients' expectations.