EAHM ASSIGNMENT:

FACTORS AFFECTING
PATIENT SATISFACTION
IN A HOSPITAL

SUBMITTED BY- GROUP 4

 Bhumika Gupta
 Kripa Mehta
 Kriti Dubey
 Laxman Kavitkar
 Tanvi Chauhan
INTRODUCTION-
Patient satisfaction is a pivotal metric in the realm of healthcare, reflecting the culmination of a patient's
experience with medical services. Understanding the factors that influence patient satisfaction is crucial
for healthcare providers, as it not only contributes to enhanced healthcare quality but also holds
implications for public health, economic advantages, and patient empowerment. This project seeks to
delve into the multifaceted aspects that contribute to or diminish patient satisfaction, employing rigorous
statistical analysis to discern the relationships between various independent variables and the dependent
variable – patient satisfaction.
The independent variables taken into account were-
1. Wait Time in Minutes: Wait time directly influences patient satisfaction. Prolonged waits can lead to
dissatisfaction, while efficient service positively impacts the overall experience.
2. Number of Beds: The number of beds reflects a hospital's capacity, influencing accessibility and
service efficiency. Exploring its correlation with patient satisfaction provides insights into optimal facility
size.
3. Time Spent by Doctors: The duration of doctor-patient consultations shapes the patient-provider
relationship. Longer consultation times contribute to better communication and empathy, impacting trust
and overall satisfaction.
4. Cost of Treatment: Treatment cost affects affordability and perceived value. Examining its
relationship with patient satisfaction informs strategies for balancing financial sustainability with patient-
centred care.
5. Length of Stay: The duration of a patient's hospital stay is linked to comfort and care quality.
Investigating the connection between length of stay and patient satisfaction informs hospital process
optimization.
6. Number of Specialties: The variety of medical specialties influences patient satisfaction, signifying
capabilities and convenience. Exploring this relationship provides insights into perceived service quality.
SIGNIFICANCE OF THE PROJECT
The study on patient satisfaction reveals critical factors influencing healthcare outcomes. Enhanced
patient experiences, driven by improved communication and reduced wait times, yield positive results.
Increased patient loyalty, tied to return visits and treatment adherence, contributes to cost reduction.
Public health benefits include early disease detection and heightened healthcare utilization. Economic
advantages involve attracting professionals, enhancing organizational reputation, and achieving cost
savings. The research empowers patients and informs policy decisions by promoting awareness, patient-
centered care, and strategic resource allocation.
IDENTIFICATION DEPENDENT VARIABLE:
Patient Satisfaction:
Patient satisfaction is a dependent variable often used in healthcare research to measure the overall
contentment and fulfillment reported by individuals receiving medical care. It reflects the subjective
assessment of patients regarding various aspects of their healthcare experience, including the quality of
medical services, communication with healthcare providers, wait times, and the overall atmosphere of the
healthcare facility. High levels of patient satisfaction are typically associated with positive healthcare
outcomes, adherence to treatment plans, and a positive perception of the healthcare provider and
institution. Monitoring and understanding patient satisfaction contributes to improving the quality of
healthcare delivery and patient-centered care.
IDENTIFICATION INDEPENDENT VARIABLE:
 Wait Time in Minutes (x1):
o Definition: The amount of time a patient waits before receiving medical attention or
service in minutes.
 Unit: Minutes
 Number of Beds (x2):
o Definition: The total count of beds available in the hospital.
 Unit: Count (Number of Beds)
 Time Spent by Doctors (x3):
o Definition: The duration of time doctors spend with a patient during a consultation in
minutes.
 Unit: Minutes
 Cost of Treatment (x4):
o Definition: The financial cost associated with the patient's treatment, measured in 100
INR units.
 Unit: 100 INR
 Length of Stay (x5):
o Definition: The total duration of a patient's stay in the hospital measured in days.
 Unit: Days
 Number of Specialties (x6):
o Definition: The count of different medical specialties available in the hospital.
 Unit: Count (Number of Specialties)

As we could see that there is one dependent variable and multiple independent variables we could go for
the “Multiple Linear Regression Test” for the above variables.

Steps to test the multiple regression model of the coefficients.

State the Hypotheses:
 Null Hypothesis (H0): There is no relationship between the independent variables and the
dependent variable (all coefficients are zero).
 Alternative Hypothesis (H1): There is a relationship between at least one independent variable
and the dependent variable (at least one coefficient is not zero).
Set Significance Level (α):
 Choose a significance level (commonly 0.05) to determine whether to reject the null hypothesis.
Make Decision:
 If the p-value for a coefficient is less than the chosen significance level, reject the null hypothesis
for that coefficient.
 If the p-value is greater than the significance level, fail to reject the null hypothesis for that
coefficient.
Interpret Results:
 For coefficients with a significant result, interpret the coefficient as having a statistically
significant effect on the dependent variable.
 For coefficients without significance, interpret cautiously, as there is not enough evidence to
conclude a significant effect.
Consider Practical Significance:
  Even if a coefficient is statistically significant, consider its practical significance in the context of
your problem. A small p-value doesn't always imply a large practical impact.
Check Assumptions:
 Ensure that the assumptions of linear regression (such as normality of residuals and
homoscedasticity) are met, as violations can affect the validity of statistical tests.

Let's Start with simple linear regression with each independent variable for the same. This is to
understand the relationship between each independent variable and the dependent variable individually.
The general equation for simple linear regression is expressed as:
y=β0 +β *x + ε
Where:
 y is the dependent variable (the variable we are trying to predict), - patient satisfaction in this case
 x is the independent variable (the variable used to make predictions), listed above
 β0 is the intercept, representing the predicted value of y when x is zero,
 β1 is the slope, representing the change in y for a one-unit change in x,
 ε is the error term, accounting for unobserved factors influencing y that are not captured by the
linear relationship.
All the models are assumed at a significance value of 0.05

MODEL 1

The independent variable taken into consideration is “Waiting Time”.

Null Hypothesis (H0): There is no significant linear relationship between wait time (in minutes) and
patient satisfaction (β1 =0).
Alternative Hypothesis (H1): There is a significant linear relationship between wait time (in minutes) and
patient satisfaction (β1 not equal to 0).
Patient Satisfaction = β0 - β1* (Wait Time) + ε
In this equation:
 Patient Satisfaction is the dependent variable (output),
 Wait Time in Minutes is the independent variable (input),
 β0 is the intercept, representing the baseline level of patient satisfaction when wait time is zero
minutes,
 β1 is the slope, indicating the change in patient satisfaction for a one-minute increase in wait time,
 ε is the error term, representing unobserved factors influencing patient satisfaction that are not
captured by the linear relationship.
Now, interpreting the coefficient β1:
"On average, patient satisfaction decreases by β1 units when the wait time increases by 1 minute."
So, the negative sign of β1 aligns with the statement that there is a negative link between wait times and
patient satisfaction, indicating that as wait times increase, patient satisfaction tends to decrease.
This is mainly taken from the article “Association of waiting and consultation time with patient
satisfaction: secondary-data analysis of a national survey in Peruvian ambulatory care facilities, BMC
Health Services Research, 2019”.

MODEL 2

The independent variable taken into consideration is “Number of Beds”.

Null Hypothesis (H0): There is no significant linear relationship between Number of Beds and patient
satisfaction (β1 =0).
Alternative Hypothesis (H1): There is a significant linear relationship between Number of Beds and
patient satisfaction (β1 not equal to 0).
Patient Satisfaction = β0 - β1 *(Number of Beds) + ε
In this equation:
 Patient Satisfaction is the dependent variable (output),
 Number of Beds is the independent variable (input),
 β0 is the intercept, representing the baseline level of patient satisfaction when the number of beds
is zero,
 β1 is the slope, indicating the change in patient satisfaction for a one-unit increase in the number
of beds,
 ε is the error term, representing unobserved factors influencing patient satisfaction that are not
captured by the linear relationship.
Now, interpreting the coefficient β1:
"On average, patient satisfaction decreases by β1 units when the number of beds increases by 1."
This is mainly taken from the article "Does Hospital Size Affect Patient Satisfaction? (Qual Manag
Health Care. 2017.)

MODEL 3

The independent variable taken into consideration is “Time Spent by Doctors”

Null Hypothesis (H0): There is no significant linear relationship between Time Spent by Doctorand
patient satisfaction (β1 =0).
Alternative Hypothesis (H1): There is a significant linear relationship between Time Spent by Doctorand
patient satisfaction (β1 not equal to 0).
Patient Satisfaction = β0 +β1 *(Time Spent by Doctors) + ε
In this equation:
 Patient Satisfaction is the dependent variable (output),
 Time Spent by Doctors is the independent variable (input),
 β0 is the intercept, representing the baseline level of patient satisfaction when the time spent by
doctors is zero,
 β1 is the slope, indicating the change in patient satisfaction for a one-minute increase in the time
spent by doctors,
 ε is the error term, representing unobserved factors influencing patient satisfaction that are not
captured by the linear relationship.
Now, interpreting the coefficient β1:
"On average, patient satisfaction increases by β1 units when the time spent by doctors increases by
1 minute."
This is mainly taken from the article “Association of waiting and consultation time with patient
satisfaction: secondary-data analysis of a national survey in Peruvian ambulatory care facilities,
BMC Health Services Research, 2019”.

MODEL 4
The independent variable taken into consideration is “Cost of Treatment”.
Null Hypothesis (H0): There is no significant linear relationship between Cost of Treatment and patient
satisfaction (β1 =0).
Alternative Hypothesis (H1): There is a significant linear relationship between Cost of Treatment and
patient satisfaction (β1 not equal to 0).
Here, the data can show significant variability from mean distribution as cost can have high deviations
making the distribution longer.Hence, to secure normality, logarithmic value of cost can be utilized.

Patient Satisfaction = β0 -β1* ln (Cost of Treatment) + ε

In this equation:
 Patient Satisfaction is the dependent variable (output),
 Cost of Treatment is the independent variable (input),
 β0 is the intercept, representing the baseline level of patient satisfaction when the cost of
treatment is zero,
 β1 is the slope, indicating the change in patient satisfaction for a one-unit increase in the cost of
treatment,
 ε is the error term, representing unobserved factors influencing patient satisfaction that are not
captured by the linear relationship.
Now, interpreting the coefficient β1:
"On average, patient satisfaction decreases by β1/100 units when the cost of treatment increases by
1%"
This is mainly taken from the article "Patient satisfaction with the healthcare system: Assessing the
impact of socio-economic and healthcare provision factors " (BMC health services research, 2016).

MODEL 5
The independent variable taken into consideration is “Length of Stay”.
Null Hypothesis (H0): There is no significant linear relationship between Length of Stay and patient
satisfaction (β1 =0).
Alternative Hypothesis (H1): There is a significant linear relationship between Length of Stay and patient
satisfaction (β1 not equal to 0).
Patient Satisfaction = β0 -β1 *(Length of Stay) + ε
In this equation:
 Satisfaction is the dependent variable (output),
 Length of Stay is the independent variable (input),
 β0 is the intercept, representing the baseline level of patient satisfaction when the length of stay is
zero,
 β1 is the slope, indicating the change in patient satisfaction for a one-unit increase in the length of
stay,
 ε is the error term, representing unobserved factors influencing patient satisfaction that are not
captured by the linear relationship.
Now, interpreting the coefficient β1 based on the study's "The Relationship Between Length of Stay and
Patient Satisfaction in Hospitalized Patients" (Journal of Nursing Research, 2015) suggestion of a negative
relationship:
“On average, patient satisfaction decreases by β1 units when the length of stay increases by 1 day."

MODEL 6:
The independent variable taken into consideration is "Number of Specialties”
The independent variable taken into consideration is “Number of Specialties”.
Null Hypothesis (H0): There is no significant linear relationship between Number of Specialties and
patient satisfaction (β1 =0).
Alternative Hypothesis (H1): There is a significant linear relationship between Number of Specialties and
patient satisfaction (β1 not equal to 0).

Patient Satisfaction = β0 +β1 *(Number of Specialties) + ε

In this equation:
 Patient Satisfaction is the dependent variable (output),
 Number of Specialties is the independent variable (input),
 β0 is the intercept, representing the baseline level of patient satisfaction when the number of
specialties is zero,
 β1 is the slope, indicating the change in patient satisfaction for a one-unit increase in the number
of specialties,
 ε is the error term, representing unobserved factors influencing patient satisfaction that are not
captured by the linear relationship.
Now, interpreting the coefficient β1 based on the study's suggestion of a positive relationship:
"On average, patient satisfaction increases by β1 units when the number of specialties increases by
1 Day." This is mainly taken from the article " A Study on Patient Satisfaction at a Multi Super Specialty
Hospital in Delhi ".

MAIN MODEL OF MULTIPLE LINEAR REGRESSION MODEL:

A multiple linear regression model with all six independent variables (x1, x2, x3, x4, x5, x6) can be
expressed as:
Patient Satisfaction = β0 - β1 * x1 + β2 * x2 + β3 * x3 - β4 *ln(x4) - β5 * x5 + β6 * x6 + ε

Here, x1 represents "Wait Time "; x2 is "Number of Beds”; x3 is "Time Spent by Doctors”; x4 is "Cost of
Treatment”; x5 is "Length of Stay”, and x6 is “Number of Specialties”.

Null Hypothesis (H0): There is no relationship between any of the independent variables (wait time,
number of beds, time spent by doctors, cost of treatment, length of stay, number of specialties) and the
dependent variable (patient satisfaction). Mathematically, this is represented as
β1 =β2 =β3 =β4 =β5 =β6 =0.
Alternative Hypothesis (H1): At least one of the independent variables has a statistically significant
relationship with the dependent variable (patient satisfaction). Mathematically, this is represented as β1 ≠
0 or β2 ≠ 0 or β3 ≠ 0 or β4 ≠ 0 or β5 ≠ 0 or β6 ≠ 0.
Coefficients interpretation:

β1: "On average, patient satisfaction decreases by β1 units when the wait time increases by 1 minute."
β2: "On average, patient satisfaction increases by β2 units when the number of beds increases by 1."
β3: "On average, patient satisfaction increases by β3 units when the time spent by doctors increases by 1
minute."
β4: " On average, patient satisfaction decreases by β1/100 units when the cost of treatment increases by
1% "
β5: "On average, patient satisfaction decreases by β5 units when the length of stay increases by 1 day."
β6: "On average, patient satisfaction increases by β6 units when the number of specialties increases by 1."

Significance level is 0.05 (following best practices used in medical research for understanding patient
perceptions)
Functional Form:
Cost of Treatment (x4):
Consideration: If extremely low or high costs have a different impact on patient satisfaction, a quadratic
term (x42) might be considered. ASSUMPTION: with time costs could be increased.
So, the equation could be:
Patient Satisfaction = β0 + β1 * x1 + β2 * x2 + β3 * x3 + β4 *ln(x4) + β5 * x5 + β6 * x6 + β7 ⋅ (x4)2 + ε
Here the interpretation of β1 to β6 would be the same as mentioned above
β7: The quadratic term. It represents how the slope of the relationship between "Cost of Treatment" and
patient satisfaction changes. Cost of treatment here has a marginal effect on patient satisfaction. If β7 is
positive, it indicates that the effect of cost on satisfaction increases as the cost increases; if negative, it
indicates a decreasing effect.

Conclusion
A key finding lies in the inverse relationship between wait times and satisfaction. Each added minute in
the waiting room erodes patient satisfaction, highlighting the need for optimizing clinic flow and
prioritizing efficient service delivery. Conversely, increased consultation time with doctors acts as a balm,
fostering empathy, communication, and trust, thereby boosting patient contentment. This underscores the
value of investing in adequate physician-patient interaction time.

There is a negative relationship between the bed capacity and patient satisfaction, possibly indicating
diminishing returns or a saturation point in patient satisfaction associated with an increased number of
beds. Further investigation is warranted to comprehend the optimal balance between bed capacity and
patient satisfaction, ensuring that healthcare facilities efficiently meet patient needs while avoiding
potential diminishing returns. This underscores the significance of carefully optimizing bed capacity to
align with patient needs and maximize positive experiences.

The relationship between the cost of treatment and patient satisfaction followed a linear trend, indicating a
decrease in satisfaction as treatment costs rose. This finding highlights the need for careful consideration
in managing healthcare costs without compromising patient satisfaction.

The length of stay, often associated with prolonged illness or complex procedures, emerges as a negative
influencer of satisfaction. Prolonged hospital stays can be isolating and disrupt routines, contributing to
decreased well-being. Addressing patient anxieties and implementing measures to enhance comfort and
engagement during extended stays becomes crucial.

Our findings reveal a positive association between the number of specialties offered and patient
satisfaction. A diverse range of specialties under one roof signifies accessibility, convenience, and
potential confidence in receiving comprehensive care. This underscores the importance of strategic
hospital infrastructure development catering to varied medical needs.