Keeping the customer satisfied: Issues in the interpretation and use of patient satisfaction surveys

Patient satisfaction and customer focus are increasingly important objectives set for health services. The patient satisfaction survey is be-coming the main method of iKSf ̂ sing this aspect of health care. In competitive environments, those institutions that show that they respond to consumers ' needs are in a better position to attract funding. The use of patient satisfaction surveys in quality assurance-type activities is also increasing. In these contexts, however, the way in which patient satisfaction surveys should be interpreted and used to maximise the satisfac-tion of patients has received little critical atten-tion. Problems in interpreting the results of satisfaction surveys arise from the weak concep-tual foundation of patient satisfaction, which has been well documented in the literature. The objective of this paper is to show that using current formulations of patient satisfaction sur-veys in quality assurance-type activities and competitive environments may not lead to the maximisation of patients ' satisfaction with health services. If the satisfaction of patients is to be maximised then it is necessary to extend the current conceptual basis of patient satisfaction to recognise explicitly the decision-making con-texts in which the results will be used. This paper identifies the manner by which this extension should occur by considering some of the prob