Patient Satisfaction in the Spanish National Health Service: Partial Least Squares Structural Equation Modeling.

María Del Carmen Valls Martínez,Alicia Ramírez-Orellana

doi:10.3390/ijerph16244886

Abstract

The aim of this article was to determine which key indicators influence patient satisfaction with the Spanish NHS to provide useful information for policy decision-making. A total of 33 variables for each of the 17 Spanish autonomous communities were collected from the statistical portal of the Spanish Ministry of Health, Social Services, and Equality between 2005 and 2016. A cross-sectional study was applied using Partial Least Squares to a Structural Equation Model (PLS-SEM). The influence of expenditures, resource allocation, and safety were hypothesized about patient satisfaction. Gross Domestic Product (GDP) and life expectancy were used as control variables. Moreover, the influence of resource allocation on use was tested. The model explained 57.1% of patient satisfaction with the Spanish NHS. It was positively influenced mainly by resource allocation and expenditures, followed by safety and life expectancy. Additionally, resources directly influenced the level of use. The number of hospital beds, hemodialysis equipment, rate of adverse drug reactions, and expenditure positively influenced patient satisfaction. In contrast, the number of posts in day hospitals, the hospital infection rate, and the percentage of pharmacy spending negatively influenced patient satisfaction.

Highlights

An excellent healthcare service contributes to improving the health of population in a specific country by increasing the expectancy of life of its citizens, promoting its social equity, and enhancing the efficiency of its economy [1]
The territorialized public health expenditure per protected inhabitant exerted a direct influence on satisfaction, which is in line with the results reported by Pérez-Romero et al [15]
We found that Gross Domestic Product (GDP) per capita did not exert any influence on patient satisfaction, which is in line with recent research performed in the Spanish context [1]

Summary

Introduction

An excellent healthcare service contributes to improving the health of population in a specific country by increasing the expectancy of life of its citizens, promoting its social equity, and enhancing the efficiency of its economy [1]. The main aim of National Health Service (NHS) is to achieve a healthier population, that is, to improve citizens’ quality of daily life and health. This implies an essential challenge to the health managers, who have to face an increasingly demanding population and the rising cost of medical technology and resources that are limited and scarce, and reduced as a consequence of the economic crisis. The decrease of the budget in the provision of certain services can affect citizen satisfaction with the NHS [3]

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Methods

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Discussion

Conclusion