An economic analysis of service quality and patient satisfaction of greek healthcare system

Quality in healthcare has been studied largely from the clinical perspective, excluding the patient’s perception of service quality. Patient satisfaction is a topic that is important both to medical (health) providers, the patients (consumers) and other third-party stakeholders in the medical care industry. Patients’ opinions are taken as part of producing a quality management, and the users’ satisfaction is taken to determine the service quality dimension. This dissertation aims to evaluate the quality of the Health System through the revealed preferences of its users. Among other factors, we take into account various socioeconomic factors and demographic parameters and derive relevant policy implications. Chapter 1 introduces the topic of patient’s satisfaction, relates it with the quality of healthcare service. The literature review reveals its importance, the factors related to it and previous ways to quantify it and measure it. The research motivation factors along with the research problems and questions are also presented. Chapter 2 studies whether the European patients are satisfied with their country’s healthcare system quality. The results demonstrate that more than half of the European patients are in general satisfied with their healthcare system. Public health expenditures as a percentage of GDP, population aging, as well as number of doctors and number of nurses increase patient satisfaction. Chapter 3 examines the deviation documented between patients’ preferences with respect to healthcare resources allocation and actual public spending on health. There is a small deviation between citizens’ preferences with respect to health resources allocation and actual public health spending, while income, number of family members and residence seem to greatly shape these preferences. Chapter 4 explores ehealth literacy as the ability in searching, analyzing, processing and comprehending information from the Internet in order to address or solve health related issues and reveals that the ehealth literacy level of Greek citizens is fair. The degree of ehealth literacy depends positively on education level and physical exercise, and negatively on the age of the participant. Chapter 5 examines the case study of Konstantopouleio General Hospital, providing evidence for the relationship between patient’s satisfaction level and received services. The results demonstrate the important role of the attention received by the medical staff, nursing staff, and hospital’s environment for both groups of in- and out-patients, while among the demographic factors, the perceived health status and age also play a significant role for the inpatients’ satisfaction. The latter remains significant for out-patients, along with education and insurance. Overall, patient satisfaction is related to healthcare outcomes, but it is also considered to be a tool for disseminating social inequalities; therefore, lightening how several factors associate with patients’ preferences, and in consequence with patient satisfaction, taking into consideration specific characteristics of users, is extremely important. This research contributes to important discussions in the literature, for instance, the encouragement of patients’ participation by introducing policies of empowerment the knowledge dissemination along with the democratization of the decision making process.