A Multi-Hospital Assessment of Healthcare Service Quality and Patient Satisfaction in Ghana's Tertiary Hospitals:...

Sustainable Development Goal 3 (SDG 3) emphasizes universal access to high-quality healthcare services as a cornerstone of global health improvement. Although access to care has expanded in many low- and middle-income countries, including Ghana, healthcare service quality (HSQ) and patient satisfaction (PS) remain uneven, particularly within tertiary hospitals. This study assessed PS and determinants of HSQ in Ghanaian tertiary hospitals using the RATER model.

A multi-center cross-sectional survey was conducted among patients attending five tertiary hospitals in Ghana that were operational prior to the inception of SDG 3. PS was measured using the Client Satisfaction Questionnaire (CSQ-8), while HSQ was assessed using the RATER dimensions of SERVQUAL. Of the 354 participants targeted, 297 were enrolled with a response rate of 83.9%. Data were collected electronically using REDCap. Group differences, associations, and predictors of PS were examined using appropriate non-parametric tests and multivariable regression models. All analyses were performed using SPSS and R software.

The mean age of participants was 38.96 ± 15.19 years (range: 18-75), and 65.7% were female. Overall PS was high with a mean score of 3.56 ± 0.41. All RATER gap dimensions were strongly intercorrelated (ρ= 0.62-0.80) and demonstrated moderate-to-strong positive associations with PS (ρ=0.50-0.59). Demographic characteristics were not significantly associated with satisfaction. However, monthly income predicted satisfaction, with low-income participants reporting higher satisfaction than those with no income. Institutional differences in unadjusted satisfaction were observed, with the highest satisfaction among patients attending Tamale and Komfo Anokye Teaching Hospitals, although these differences attenuated after multivariable adjustment. Among HSQ dimensions, reliability showed the strongest association with PS.

Patient satisfaction in Ghana's tertiary hospitals is driven more by structural and socioeconomic conditions, institutional performance and perceived service reliability than by demographic characteristics. Strengthening reliability in service delivery and reducing inter-hospital disparities are critical for advancing patient-centered care and achieving SDG 3.