Influences on health delivery system satisfaction: a partial test of the ecological model

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.