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Year : 1995  |  Volume : 2  |  Issue : 2  |  Page : 7-8  

Patient Satisfaction - A valid tool of quality assurance (C. Q. I)

Professor of Surgery, King Faisal University, College of Medicine & Medical Sciences Dammam, Consultant Surgeon, King Fahd Hospital AI-Khobar: P O. Box 40015, AI-Khobar 31952, Saudi Arabia

Date of Web Publication31-Jul-2012

Correspondence Address:
Shyam Parashar
Professor of Surgery, King Faisal University, College of Medicine & Medical Sciences Dammam, Consultant Surgeon, King Fahd Hospital AI-Khobar: P O. Box 40015, AI-Khobar 31952
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

PMID: 23012218

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How to cite this article:
Parashar S. Patient Satisfaction - A valid tool of quality assurance (C. Q. I). J Fam Community Med 1995;2:7-8

How to cite this URL:
Parashar S. Patient Satisfaction - A valid tool of quality assurance (C. Q. I). J Fam Community Med [serial online] 1995 [cited 2022 Jan 19];2:7-8. Available from:

Quality assurance has, through quantifiable parameters, been in vogue as an essential routine in almost all profit making organisations, in business and in industry: Its emergence on the scene of Medical Care system is relatively recent; commercialisation of health and medical care, sensitivity to cost effectiveness and economic factors must have played their own roles in this awareness towards quality assurance. Quality Assurance now finds its place in accreditation requirements, residency training programs and even in postgraduate licensing examinations.

Why it took so long to appreciate the value of Quality Assurance in medical care! Perhaps it is because of inherent difficulties to quantify the quality of medical and health care.

By definition, quality assurance in medical and health care aims at prolonging life, relieving distress, restoring function and preventing disability. The fundamental objectives of medical and health care are - Reduction of (1) Death, (2) Disease, (3) Disability, (4) Distress, (5) Discomfort and (6) Dissatisfaction. The first three of these can be assessed objectively, the last three, however, being subjective parameters, are not so easy to assess.

It is said that medicine is an art and therefore cannot be quantified. Others believe that medicine is a science and hence it should not be difficult to quantify the outcome. Between these two extreme views one thing is certain - quality assurance is in the interest of all, the health providers as well as health consumers. Consumer satisfaction, appropriately termed 'Patient satisfaction' in the context of medical and health care, should be the ultimate goal of every health and medical care delivery system. The question is; how to measure 'Patient Satisfaction'!

Haya R. Rubin in 1990 published an extensive review on patient satisfaction under the title "Can patients evaluate the quality of hospital care!"' After reviewing the Pros and Cons of all the available methods to measure patient satisfaction, he finally came to the conclusion that "No comprehensive instrument or survey method in the published literature has been tested enough to be recommended" and that "A few do however appear worthy of further testing." Search for an ideal format therefore continues.

In medical and health care delivery system, it is not just enough to evaluate "What" is being delivered; it is equally important to evaluate as to "How" it is delivered. It is the sum total of these two, the what and the how, that leads to patient satisfaction, or otherwise. It is necessary to include not only the physical and mental well being of the patients, but also the emotional and sentimental aspects while assessing patient satisfaction. It is here that many variables may defy measurement.

Patients' concepts of their own values and standards, their expectations of courtesy and comforts, are likely to affect their assessment. Patients may be guided by their own feelings of obligation to express gratitude, irrespective of the level of their satisfaction, and hence give more favourable response. On the other hand patients may be guided by their self perceived severity of illness, which may be unnecessarily exaggerated; the responses therefore may not be so favourable.

Environmental factors which may be beyond control of administration may affect patients' response. For example, during lean admissions period a solitary patient in a multi-bed ward may feel more satisfied than the one in a normally fully occupied ward with seriously sick patients around him during busy sessions. Similarly; patients in different services, units, divisions may have different responses in the same hospital and at different times.

Personalities of patients differ, so do their attitudes, level of tolerance and the severity of reactions. These factors can create a conflict between the outcome of treatment and the degree of satisfaction. For example a completely cured patient may leave the hospital with total dissatisfaction vowing never to return. On the other hand a patient with as incurable disease as advanced cancer may be totally satisfied and may like to return again and again for continued management. Then there are patients who do not like to respond at all or decide to remain indifferent. This bias in non-responsiveness can influence the statistics.

The difficulties to quantitatively assess "Patient satisfaction" are many. Most investigators use graded scales with varying number of points spread. A lot really depends on the construction and contents of the questionnaire, the sequencing of questions, the methodology of administration to patients and finally on the interpretation of results.

An accurate quality assessment leads to effective quality achievement, for the mutual benefit of health providers as well as health consumers.

Evaluation of evaluation techniques for Patient Satisfaction will remain a continuing process. The search for an ideal response format must continue. Patient satisfaction must remain the ultimate goal and an essential tool of quality assurance, of every medical care and health delivery system.[1]

   References Top

1.Rubin I IR. Can Patients evaluate the quality of hospital care. Medical Care Review 1900; 47 (3): 276-326.  Back to cited text no. 1


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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010