Towards a theory of patient satisfaction: studies on the impacts of patient-technology fit and electronic patient portal use on patient satisfaction outcome

Abstract

Recent attention upon patient satisfaction within health care has increased the complexity of organizational management in hospitals. Recent regulatory changes, such as the Medicaid value based purchasing program, no longer allow leaders to focus only upon health outcomes and fiscal bottom lines; a critical concern is the perception of the health care experience from the patient perspective. This dissertation theorizes and builds a nomological network of antecedents to patient satisfaction from distinct theoretical perspectives, to move towards a theory of patient satisfaction, and to contribute to and extend existing work in health care research. To this end, this dissertation first examines patient satisfaction as an outcome variable, seeking to establish a robust and consistent outcome variable. Second, this research introduces the concept of patient technology fit, and the impacts of its antecedents, expanding previous research on task technology fit to the patient experience. Finally, a direct examination of the impact of cognitive and affective factors on patient satisfaction is studied, to explain post-adoptive use of health information technologies and their impact on patient satisfaction. Primary survey instruments were used to assess patient satisfaction scores, as well as utilization of existing and adapted scales to measure key variables. Structural equation modeling using PLS was used to test the hypothesized relationships. Findings from the dissertation confirm the dimensionality of patient satisfaction, while illustrating the importance of patient-technology fit, cognitive and affective factors in predicting patient satisfaction. These findings have research and practical implications, as healthcare organizations strive to improve their patient satisfaction through patient-centric care.