This study aims to investigate the antecedents of patient satisfaction in healthcare organizations, particularly in the context of a developing nation, India. A conceptual model is developed to test the relationship between five types of healthcare services—doctor, nurse, supportive, auxiliary, and technical—on patient satisfaction. The moderating effect of administrative services in influencing patient satisfaction is also examined. In this cross-sectional research, a survey instrument was developed, and data were collected from 628 patients from super-specialty hospitals in Tiruchirappalli (from the southern state of Tamil Nadu, India). First, we checked the measurement properties of the survey instrument by using structural equation modeling with Lisrel software. We performed hierarchical regression to test the hypothesized relationships. The findings indicate that (a) doctor services, (b) nurse services, (c) supportive services, and (d) technical services are significantly and positively associated with patient satisfaction. The results also showed that administrative services moderate the relationship between (a) doctor services, (b) auxiliary services, and (c) technical services and patient satisfaction. This research underscores the importance of administrative services and provides valuable insights to administrators and policymakers about the antecedents to patient satisfaction. The conceptual model significantly contributes to advancing theory in the healthcare industry.
AagjaJ. P., & GargR. (2010). Measuring perceived service quality for public hospitals (PubHosqual) in the Indian context. International Journal of Pharmaceutical and Healthcare Marketing, 4(1), 60–83. https://doi.org/10.1108/17506121011036033
2.
Abbasi-MoghaddamM. A., ZareiE., BagherzadehR., DargahiH., & FarrokhiP. (2019). Evaluation of service quality from patients’ viewpoint. BMC Health Services Research, 19(1), 1–7. https://doi.org/10.1186/s12913-019-3998-0
3.
AlibrandiA., GittoL., LimosaniM., MusticaP. F. (2023). Patient satisfaction and quality of hospital care. Evaluation and Program Planning, 97, 102251. https://doi.org/10.1016/j.evalprogplan.2023.102251
4.
Al-NeyadiH. S., AbdallahS., & MalikM. (2016). Measuring patient’s satisfaction of healthcare services in the UAE hospitals: Using SERVQUAL. International Journal of Healthcare Management, 11(2), 96–105. https://doi.org/10.1080/20479700.2016.1266804
5.
AndaleebS. S. (2001). Service quality perceptions and patient satisfaction: A study of hospitals in a developing country. Social Science & Medicine, 52(9), 1359–1370.
6.
AminM., & NasharuddinS. Z. (2013). Hospital service quality and its effects on patient satisfaction and behavioural intention. Clinical Governance: An International Journal, 18(3), 238–254. https://doi.org/10.1108/CGIJ-05-2012-0016
7.
AndersonJ. C., & GerbingD. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103(3), 411–423. https://doi.org/10.1037/0033-2909.103.3.411
8.
ArthurE., & OaikhenanH. E. (2017). The effects of health expenditure on health outcomes in Sub-Saharan Africa (SSA). African Development Review, 29(3), 524–536. https://doi.org/10.1111/1467-8268.12287
9.
AsifM., JameelA., SahitoN., HwangJ., HussainA., & ManzoorF. (2019). Can leadership enhance patient satisfaction? Assessing the role of administrative and medical quality. International Journal of Environmental Research and Public Health, 16, 3212.
10.
BadriM. A., AttiaS., & UstadiA. M. (2009). Healthcare quality and moderators of patient satisfaction: Testing for causality. International Journal of Health Care Quality Assurance, 22, 382–410.
11.
BarneyJ. B. (1991). Firm resources and sustained competitive advantage. Journal of Management, 17, 99–120. https://doi.org/10.1177/014920639101700108
12.
BBC. (2021). COVID-19: India outrage over ‘no oxygen shortage death data’ claim. https://www.bbc.com/news/world-asia-india-57911638
13.
BhojakN. P., ModiA., PatelJ. D., & PatelM. (2022). Measuring patient satisfaction in emergency department: An empirical test using structural equation modeling. International Journal of Healthcare Management, https://doi.org/10.1080/20479700.2022.2112440
14.
Blanco-ToppingR. (2021). The impact of Maryland all-payer model on patient satisfaction of care: A one-way analysis of variance (ANOVA). International Journal of Healthcare Management, 14(4), 1397–1404. https://doi.org/10.1080/20479700.2020.1762055
15.
BleusteinC., RothschildD. B., ValenA., ValatisE., SchweitzerL., & JonesR. (2014). Wait times, patient satisfaction scores, and the perception of care. American Journal of Managed Care, 20, 393–400.
16.
CaponeV., DonizzettiA. R., & ParkM. S.-A. (2021). Validation and psychometric evaluation of the COVID‑19 risk perception scale (CoRP): A new brief scale to measure individuals’ risk perception. International Journal of Mental Health and Addiction, 21, 1320–1333. https://doi.org/10.1007/s11469-021-00660-6
17.
ChahalH., & MehtaS. (2013). Modeling patient satisfaction construct in the Indian health care context. International Journal of Pharmaceutical and Healthcare Marketing, 7(1), 75–92. https://doi.org/10.1108/17506121311315445
18.
ChenX., ZhaoW., YuanJ., QinW., ZhangY., & ZhangY. (2022). The relationships between patient experience with nursing care, patient satisfaction and patient loyalty: A structural equation modeling. Patient Preference and Adherence, 16, 3173–3183. https://doi.org/10.2147/PPA.S386294
19.
CosmaS. A., BotaM., FleseriuC., MorgovanC., ValeanuM., & CosmaD. (2020). Measuring patients’ perception and satisfaction with the Romanian healthcare system. Sustainability, 12, 1612, https://doi.org/10.3390/su12041612
20.
CoulterA., & JenkinsonC. (2005). European patients’ views on the responsiveness of health systems and healthcare providers. European Journal of Public Health, 15, 355–360.
21.
Dawood-KhanH. K., NainaS. K., & ParayitamS. (2024). The antecedents of patient satisfaction: Evidence from super-specialty hospitals in Tiruchirappalli in India. International Journal of Healthcare Management, 17(2), 305–317. https://doi.org/10.1080/20479700.2023.2182491
22.
DayL. A. (1976). Client behavior in the health marketplace: Emphasis on access to care. Published in Client Behavior in Health Marketplace: A symposium proceedings. NewmanIan M. (Ed). Nebraska Center for Health Education & University of Nebraska-Lincoln.
23.
DiMatteoR. M., PrinceL. M., & TarantaA. (1979). Patients’ perceptions of physicians’ behavior. Journal of Community Health, 4, 280–290.
24.
DufreneR. L. (2000). An evaluation of a patient satisfaction survey: Validity and reliability. Evaluation and Program Planning, 23(3), 293–300. https://doi.org/10.1016/S0149-7189(00)00015-X
25.
Economic Times (2024). Doctor-population ratio in country stands at 1:834, Mansukh Mandaviya tells Lok Sabha, https://economictimes.indiatimes.com/news/india/doctor-population-ratio-in-country-stands-at-1834-mansukh-mandaviya-tells-lok-sabha/articleshow/107561323.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst
26.
FornellC., & LarckerD.. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50.
27.
FreedmanD. B. (2006). Involvement of patients in clinical governance. Clinical Chemistry Laboratory Medicine, 44, 699–703.
28.
GeorgeM. (2011). The role of basic laboratory services in strengthening primary health centres. Indian Journal of Medical Ethics, 8, 161–163.
29.
GopalanH.S., & MisraA. (2020). COVID-19 pandemic and challenges for socio-economic issues, healthcare and National Health Programs in India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14, 757–759. https://doi.org/10.1016/j.dsx.2020.05.041
30.
HairJ. F.Jr., HultG. T. M., RingleC., & SarstedtM. (2016). A primer on partial least squares structural equation modeling (PLS-SEM). Sage Publications.
31.
HowardJ. (1999). Hospital customer service in a changing healthcare world: Does it matter?Journal of Health Care Management, 44(4), 312–325.
32.
ItumallaR., AcharyuluG. V. R. K., & ShekharB. R. (2014). Development of hospitalqual: A service quality scale for measuring in-patient services in hospital. Operations and Supply Chain Management: An International Journal, 7(2), 54–63. https://doi.org/10.31387/oscm0170108
33.
JandavathR. K. N., & ByramA. (2016). Healthcare service quality effect on patient satisfaction and behavioural intentions in corporate hospitals in India. International Journal of Pharmaceutical and Healthcare Marketing, 10(1), 48–74. https://doi.org/10.1108/IJPHM-07-2014-0043
34.
KamraV., SinghH., & Kumar DeK. (2015). Factors affecting patient satisfaction: An exploratory study for quality management in the health-care sector. Total Quality Management & Business Excellence, 27(9–10), 1013–1027. https://doi.org/10.1080/14783363.2015.1057488
35.
KumahE. (2019). Patient experience and satisfaction with a healthcare system: Connecting the dots. International Journal of Healthcare Management, 12(3), 173–179. https://doi.org/10.1080/20479700.2017.1353776
36.
KumarA. (2023). The transformation of The Indian Healthcare System. Cureus, 15(5), e39079. https://doi.org/10.7759/cureus.39079
37.
KwatengK. O., LumorR., & AcheampongF. O. (2019). Service quality in public and private hospitals: A comparative study on patient satisfaction. International Journal of Healthcare Management, 12(4), 251–258. https://doi.org/10.1080/20479700.2017.1390183
38.
LeeJ. Y., McFaddenK. L., LeeM. K., & GowenC. R. (2021). U.S. hospital culture profiles for better performance in patient safety, patient satisfaction, Six Sigma, and lean implementation. International Journal Production Economics, 234, Article 108047.
39.
LescherM., & SirvenN. (2019). Healthcare quality, patients’ satisfaction, and hospital incentives in France. Revue d′´economie politique, Dalloz, 129, 525–551.
40.
LiangL., & WuG. (2022). Effects of COVID-19 on customer service experience: Can employees wearing facemasks enhance customer-perceived service quality?Journal of Hospitality and Tourism Management, 50, 10–20. https://doi.org/10.1016/j.jhtm.2021.12.004
41.
LiuS., LiG., LiuN., & HongweiW. (2021). The impact of patient satisfaction on patient loyalty with the mediating effect of patient trust. Inquiry, 58, 469580211007221. https://doi.org/10.1177/00469580211007221
42.
LeeM. A., & YomY.-H. (2007). A comparative study of patients’ and nurses’ perceptions of the quality of nursing services, satisfaction and intent to revisit the hospital: A questionnaire survey. International Journal of Nursing Studies, 44(4), 545–555.
43.
MakaremS. C., & Al-AminM. (2014). Beyond the service process: The effects of organizational and market factors on customer perceptions of health care services. Journal of Service Research, 17(4), 399–414. https://doi.org/10.1177/1094670514541965
44.
Manoliu-HamwiE. M., DascăluC. G., ZeganG., CărăușuE. M., GhiciucC. M., IvănescuM. C., & StanC. D. (2024). Patient’s satisfaction level with community pharmacies services in Romania: A questionnaire-based study. Journal of Pharmaceutical Policy and Practice, 17(1), https://doi.org/10.1080/20523211.2024.2381104
45.
ManzoorF., WeiL., HussainA., AsifM., ShahS. I. A. (2019). Patient satisfaction with health care services: An application of physician’s behavior as a moderator. International Journal of Environmental Research and Public Health, 16(18), 3318. https://doi.org/10.3390/ijerph16183318
46.
MatisG. K., BirbilisT. A., & ChrysouO. I. (2009). Patient satisfaction questionnaire and quality achievement in hospital care: The case of a Greek public university hospital. Health Service Management Research, 22(4), 191–196. https://doi.org/10.1258/
47.
MosadeghradA. M. (2014). Factors influencing healthcare service quality. International Journal of Health Policy and Management, 3(2), 77–89. https://doi.org/10.15171/ijhpm.2014.65
48.
NetemeyerR. G., JohnstonM. W., & BurtonS. (1990). Analysis of role conflict and role ambiguity in a structural equations framework. Journal of Applied Psychology, 75(2), 148–157.
49.
OtaniK., HarrisL. E., & TierneyW. M. (2003). A paradigm shift in patient satisfaction assessment. Medical Care Research Review, 60, 347–365.
50.
PadmaP., RajendranC., & LokachariP. S. (2010). Service quality and its impact on customer satisfaction in Indian hospitals. Benchmarking: An International Journal, 17(6), 807–841. https://doi.org/10.1108/14635771011089746
51.
ParasuramanA., ZeithamlV. A., & BerryL. (1988). SERVQUAL: A multiple-item scale for measuring consumer perception. Journal of Retailing, 64(1), 21–40.
52.
PinkG. H., BrownA. D., StuderM. L., ReiterK. L., & LeattP. (2006). Pay-for-performance in publicly financed healthcare: Some international experience and considerations. Health Papers, 6(4), 8–26.
53.
RaghupathiV., & RaghupathiW. (2020). Healthcare expenditure and economic performance: Insights from the United States data. Frontiers in Public Health, 8, 156. https://doi.org/10.3389/fpubh.2020.00156
54.
ŞeremetG. G., & KoncaM. (2024). Technical efficiency and its determinants in healthcare systems of underdeveloped countries. Evaluation and Program Planning, 107, 102473. https://doi.org/10.1016/j.evalprogplan.2024.102473.
55.
ShabbirA., MalikS. A., & MalikS. A. (2016). Measuring patients’ healthcare service quality perceptions, satisfaction, and loyalty in public and private sector hospitals in Pakistan. International Journal of Quality & Reliability Management, 33(5), 538–557. https://doi.org/10.1108/IJQRM-06-2014-0074
56.
ShamsS. A., HaleemA., & JavaidM. (2020). Analyzing COVID-19 pandemic for unequal distribution of tests, identified cases, deaths, and fatality rates in the top 18 countries. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(5), 953–961. https://doi.org/10.1016/j.dsx.2020.06.051
57.
ShoaibM., NawalA., KorsakieneR., ZámeˇcníkR., Asad Ur RehmanA. U., & RaišienA. G. (2022). ˙Performance of academic staff during COVID-19 pandemic-induced work transformations: An IPO model for stress management. Economies10(2), 51. https://doi.org/10.3390/economies10020051
58.
ShrefflerJ., PetreyJ., & HueckerM. (2020). The impact of COVID-19 on healthcare worker wellness: A scoping review. Western Journal of Emergency Medicine, 21(5), 1059–1066.
59.
SinghD., & DixitK. (2020). Measuring perceived service quality in healthcare setting in developing countries: A review for enhancing managerial decision-making. Journal of Health Management, 22(3), 472–489. https://doi.org/10.1177/0972063420963407
60.
SørupC. M., & Jacobsen. (2014). Patient safety and satisfaction drivers in emergency departments re-visited: An empirical analysis using structural equation modeling, its obtained performance levels. Health Systems, 3, 105–116.
61.
SwainS., & KarN. C. (2018). Hospital service quality as antecedent of patient satisfaction: A conceptual framework. International Journal of Pharmaceutical and Healthcare Marketing, 12(3), 251–269. https://doi.org/10.1108/IJPHM-06-2016-0028
62.
SwathiK. S., BarkurG., & SomuG. (2023). Assessment of healthcare service quality effect on patient satisfaction and care outcomes: A case study in India. Cogent Business & Management, 10(3). https://doi.org/10.1080/23311975.2023.2264579
63.
TafreshiM. Z., PazargadiM., & SaeediZ. A. (2007). Nurses’ perspectives on quality of nursing care: A qualitative study in Iran. International Journal of Health Care Quality Assurance, 20(4), 320–328.
64.
ThimblebyH. (2013). Technology and the future of healthcare. Journal of Public Health Research, 2(3), https://doi.org/10.4081/jphr.2013.e28
65.
TopM., KoncaM., & SapazB. (2020). Technical efficiency of healthcare systems in African countries: An application based on data envelopment analysis. Health Policy and Technology, 9(1), 62–68. https://doi.org/10.1016/j.hlpt.2019.11.010
66.
VermaP., KumarS., & SharmaS. K. (2022). Evaluating the total quality and its role in measuring consumer satisfaction with e-healthcare services using the 5Qs model: A structure equation modeling approach. Benchmarking, 29(1), 22–46. https://doi.org/10.1108/BIJ-09-2020-0467
67.
YorkA. S. & McCarthyK. A. (2011). Patient, staff and physician satisfaction: A new model, instrument and their implications. International Journal of Health Care Quality Assurance, 24(2), 178–191. https://doi.org/10.1108/09526861111105121
