Predictors of Patient Satisfaction and the Perceived Quality of Healthcare in an Emergency Department in Portugal

Abstract

Introduction: The predictors of patient satisfaction in emergency medicine (EM) have been widely studied and discussed in the scientific literature; the results vary depending on the specific EM attributes, cultural aspects, researchers’ preferences, and approaches. However, it is not clear whether the same predictors of patient satisfaction can contribute to a better-perceived quality of healthcare or whether patients’ perceptions form a different attitude toward satisfaction and perceived quality of healthcare. The goal of this study was to identify the key predictors of patient satisfaction and perceived quality of healthcare in the framework of an emergency department (ED). Methods: We conducted a retrospective study of patients seen at an ED between January -December 2016. Data collection took place in the public hospital in Lisbon, Portugal, between May - November 2017. The total sample size included 382 patients. The sample distribution had a 5% margin of error and a 95% confidence interval. Data for this research, using a questionnaire, was collected by mail or e-mail according to the respondent’s preference. Results: A detailed analysis showed that three out of the 18 predictors had a statistically significant relationship with satisfaction: overall satisfaction with doctors, with a positive correlation (r = 0.14, p ≤ 0.01); qualitative perceived waiting time for triage, with a positive correlation (r = 0.08, p ≤ 0.05); and meeting expectations, with a positive correlation (r = 0.53, p ≤ 0.01). Furthermore, a detailed analysis showed that only two out of the 18 predictors had a statistically significant relationship with the perceived quality of healthcare (PQHC): overall satisfaction with doctors, with a positive correlation (r = 0.43, p ≤ 0.01) and meeting expectations, with a positive correlation (r = 0.26, p ≤ 0.01). Conclusion: The main predictors of satisfaction and perceived quality of healthcare were overall satisfaction with doctors and meeting expectations. We should note that “meeting expectations” plays the most important role in terms of satisfaction; however, in terms of PQHC the predictor “overall satisfaction with doctors” plays the most important role due to its stronger correlation. In addition, the qualitative perceived waiting time for triage could be considered as another predictor, influencing satisfaction only, thus emphasizing similarities and differences between satisfaction and the PQHC in an ED context.

What can COVID‐19 teach us about patient satisfaction in the emergency department? A mixed‐methods approach

“…1,3 Factors associated with patient satisfaction in the ED have been relatively consistent during the past 2 decades, falling into the following broad categories: (1) interpersonal skills and attitude of staff (eg, courtesy, caring, concern, respect), (2) communication or providing explanations and information to patients (eg, providing instructions at discharge or explaining test results or the cause of a patients symptoms), (3) wait times, and (4) perceived standards of care. 4,5 Other studies have had similar findings 6,7 and have added factors related to the environment of the ED (eg, cleanliness, privacy). 8,9 King et al recently linked overcrowding in the ED to lower patient satisfaction.…”

Overuse of Health Care in the Emergency Services in Chile

“…Of course, this situation negatively impacts both the internal user (health personnel) and the external user’s (the patient) perception of satisfaction [ 39 ]; in addition to hindering the normal flow in clinical care, which is less fluid and develops a tendency to less protection of privacy in care. Finally, sometimes these shortcomings cause a delay in the care and/or the resolution of the cases, directly affecting the health of people who must tolerate the suffering of their ailments without an early clinical solution, some palliative measure, or a worsening of their symptoms during the waiting time.…”

Big data simulations for capacity improvement in a general ophthalmology clinic

“…Waiting times have been shown to be a major cause for patient satisfaction in multiple clinical studies [5][6][7][8]. The reported correlation between waiting time and patients' satisfaction directly influences the perceived quality of healthcare [9]. Quality management without waiting time optimisation is therefore inconceivable.…”