Patient Satisfaction Toward Medical Ward Services In Hospital
\nUniversiti Sains Malaysia (HUSM) AND Hospital Kota Bharu (HKB)

There are several definitions of patient satisfaction given hy different authors. For
\ninstance, Steiber defined satisfaction as a subjective perception of the customer who
\nreceives a service (Steiber,1990). Pascoe defined patient satisfaction as a health care
\nrecipient's reaction to salient aspects of (his or her) service experience. In Pascoe's
\ndefinition, he assumed that patient satisfaction has a cognitive evaluation and an
\nemotional reaction to the structure, process and outcome of care (Pascoe,1983). Pascoe
\nfurther defined patient satisfaction into two-parts, firstly; the 'contrast · model which
\nstated that whenever the service experience is greater than the patient's expectations, he
\nor she is satisfied. On the other hand, the 'assimilation' model stated that when the
\npatient does not fully understand the service experience (due to inadequacy of clinical
\nknowledge), he or she may adjust their expectations downward if the sen ice experience
\nfalls below expectations. This assimilation model may explain about the higher
\nsatisfaction rating of health personnel compared to lower non-clinical experience such as
\nsatisfaction rating for hospital food or parking facility (Pascoe, 1983 ). Linder-Pelz
\ndefined patient satisfaction as positive evaluations of distinct dimensions of health care
\nbnsed on pnticnt expectations nnd provider performnncc:. Exmnplcs of hcnlth cnrc include
\nthe treatment received by patients during their illness episode, a clinic visit, a healthcare
\nsetting or the whole health system itself. Patient satisfaction must be understood within a
\ncontext that contained multiple construct (elements) likely to satisfy the patient (LinderPelz
\nS, 1982b).
\nImportance of Patient Satisfaction
\nMeasurement of patient satisfaction can fulfil several functions such as description of
\nhealth care services from the patient's point of view, a measure of the proc1ess of care and
\nevaluation of health care (Sitzia and Wood,1997). If health manager can identify source
\nof patient dissatisfaction, the health organization can address system weakness and
\nimprove their service to patients (Strasser and Davis, 1991 ). Satisfied patients are less
\nlikely to disenroll from health plans and more likely to return to a physician or hospital
\nand less likely to bring a malpractice suit (Steiber and Krowinski, 1990). Satisfied
\npatients are more likely to maintain consistent relationship with their healthcare provider
\n(Wartman, 1983 ).
\nPredictors of patient satisfaction
\nFactors as~umed to be related to patient satisfaction include physical and psychological
\nstatus, attitudes and expectations toward medical care also the structure, process and
\noutcome of care, patient sociodemographic characteristics (Cleary and Mcneil, 1988).Structure of care
\na. The organization and financing of care
\nThe way in Which medical care is organized and financed may be related to patient
\nsatisfaction. This means that the provider and organizational characteristics which result
\nin more personal care and better communication with their patient are associated with
\nhigher levels of satisfaction (Cleary and McNeil, 1988).
\nProcess of care
\na. Technical Quality of Care
\nSatisfaction with the ambulatory care mostly is associated with satisfaction toward the
\ntreating physician while the inpatient experience is more associated with the quality of
\nstaff. With the physician, patient satisfaction breaks down into two aspects (i) satisfaction
\nwith perceived technical competence and (b) satisfaction with interpersonal skills (Hall
\nand Doman, 1988). On the other hand, nurses, midwives and physician assistants tend to
\nbe scored highly on interaction with patients because patients often emphasized on the
\ninterpersonal aspect, rather than on perceived technical competence (Hall et al., 1990).
\nb. Interpersonal Aspects of Care
\nPeople like to have doctors talk to them in an egalitarian way, listen, ask a lot of
\nquestions, answer a lot of questions, explain their health condition in a simple way that
\nthe patient can understand, and allow patients to make decisions about their care ( Hall et
\nat., 1988).
\nOutcome of care
\nA sntisfnction study townrd three typeg or hospitnl services (tncdicn • nursing nnd
\nsupportive) using structured interview method (n=476) found when patients perceived
\nthat their health improved, patient satisfaction increased (Carmel, 1985).
\nSociodemographic characteristics
\nIn her meta-analysis on patient satisfaction studies, average magnitudes of relationship
\nbetween sociodemographics characteristics with patient satisfaction were very small.
\nOlder age was the strongest correlate of satisfaction (mean r=O.l3). <:Jreater patient
\nsatisfaction was significantly associated with greater age and less (:ducation, and
\nmarginally associated with having higher social status and being married. l~o relationship
\nbetween satisfaction and gender, ethnicity, income or family size (Hall & I>oman, 1990).
\nLiterature review
\nSeveral patient satisfaction studies have been conducted in various diffen~nt setting and
\nmedical specialities to address dillerent issues. For instance, n descriptive correlation
\nstudy in a Emergency department found that 28 patients generally satisfied with the four
\nareas of Emergency department being examined i.e. nursing care, information received,
\nancillary services, and environment (Bruce et al, 1998). In a client satisfaction study
\n(n=1913). toward health care provided in government health facilities of rural
\nBangladesh, the important predictors for client satisfaction was healthcare provider
\ninterpersonal behaviour (especially respect and politeness) and a reduction in waiting
\ntime (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
\nin coronary care unit of Ontario hospitals in Canada.

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