Influences on Health Delivery System Satisfaction: A Partial Test of the Ecological Model

Abstract

This study uses structural equation modeling to investigate several predictors of hospital system satisfaction. Drawing on Street's ecological perspective, the researchers explore several individual, provider-patient interaction, and system perceptions and expectations, test a model of hospital system satisfaction, and discuss the implications of the structural equation modeling analysis. Specifically, it was hypothesized that individuals who rated themselves as having high self-efficacy would report higher levels of patient satisfaction than individuals who reported lower self-efficacy scores. In addition, it was hypothesized that patient perceptions of physician affirming nonverbal behavior and patient expectations, as well as the amount of time the patient must wait, will likely affect physician credibility. Last, patient perceptions of physician credibility and patient satisfaction were hypothesized to ultimately affect overall patient satisfaction with the health system. The results indicate partial support for the model. The implications of the findings for Street's model and the limitations of this study are discussed.

Visualising Conversation Structure across Time: Insights into Effective Doctor-Patient Consultations

“…Effective communication between health professionals and their clients is a critical part of healthcare [1], [2], [3]. Poor communication in the health context can result in adverse outcomes for patients [4].…”

The relationship between college health professionals' communicative behaviors, students' satisfaction, and students' perceived quality of healthcare

“…Additionally, previous research (Koemer & Kilbane, 2008;Moore et al, 2009;& Uitterhoeve et al, 2009) conducted in traditional healthcare settings (off-campus) found that affective behavior had a stronger association with patient satisfaction than instrumental behavior.…”

“…A large body of research has examined the influence of health provider-patient communication on patient satisfaction (Dutta-Bergman, 2005;Moore, Wright, & Bernard, 2009). Moore, Wright, and Bernard (2009) suggest that patients may not be educated enough to be able to evaluate physicians' technical or task behaviors but may be able to evaluate physicians' affective behaviors such as patience, concern, empathy, and attentiveness. Consequently, most scholarships deal with the association between influence of affective behaviors and patient satisfaction.…”

“…There appears to be a contradiction in the literature as to which health professionals' communicative behaviors are more important in predicting patient satisfaction. Some studies (Koermer & Kilbane, 2008;Moore et al, 2009) suggest affective behaviors as more important, while other studies indicate that "patients tend to be most satisfied with understanding their treatment plan, physician honesty, and being understood, and report being least satisfied with physician information concerning caring for their illness" (Sparks, Villagran, Parker-Raley, & Cunningham, 2007, p. 182). Surprisingly, most studies have focused on doctors; few studies have focused on other health professionals, particularly nurses, whom literature suggests interact more with patients than other health professionals do (Hersh et al, 2016), evidencing therefore the need for more investigation into the communication of other health professionals.…”

“…Age difference may also be a possible explanation for this contradiction since college students are relatively younger than patients in traditional health centers (American College Health Association, 2016). Notably, Moore et al (2009) suggest that patients may not be educated enough to be able to evaluate physicians' technical (instrumental) behavior, leading affective behavior to have the stronger association with patient satisfaction. But the present results imply that college students might be getting enough education to evaluate health professionals' technical behaviors since both instrumental and affective behaviors had strong associations with patient satisfaction.…”