IDEAS home Printed from
   My bibliography  Save this article

Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union


  • Footman, Katharine
  • Roberts, Bayard
  • Mills, Anne
  • Richardson, Erica
  • McKee, Martin


Measurement of health system performance increasingly includes the views of healthcare users, yet little research has focussed on general population satisfaction with health systems. This study is the first to examine public satisfaction with health systems in the former Soviet Union (fSU). Data were derived from two related studies conducted in 2001 and 2010 in nine fSU countries, using nationally representative cross-sectional surveys. The prevalence of health system satisfaction in each country was compared for 2001 and 2010. Patterns of satisfaction were further examined by comparing satisfaction with the health system and other parts of the public sector, and the views of health care users and non-users. Potential determinants of population satisfaction were explored using logistic regression. For all countries combined, the level of satisfaction with health systems increased from 19.4% in 2001 to 40.6% in 2010, but varied considerably by country. Changes in satisfaction with the health system were similar to changes with the public sector, and non-users of healthcare were slightly more likely to report satisfaction than users. Characteristics associated with higher satisfaction include younger age, lower education, higher economic status, rural residency, better health status, and higher levels of political trust. Our results suggest that satisfaction can provide useful insight into public opinion on health system performance, particularly when used in conjunction with other subjective measures of satisfaction with government performance.

Suggested Citation

  • Footman, Katharine & Roberts, Bayard & Mills, Anne & Richardson, Erica & McKee, Martin, 2013. "Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union," Health Policy, Elsevier, vol. 112(1), pages 62-69.
  • Handle: RePEc:eee:hepoli:v:112:y:2013:i:1:p:62-69
    DOI: 10.1016/j.healthpol.2013.03.004

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Ensor, Tim & Thompson, Robin, 1998. "Health insurance as a catalyst to change in former communist countries?," Health Policy, Elsevier, vol. 43(3), pages 203-218, March.
    2. Calnan, Michael & Almond, Stephen & Smith, Nick, 2003. "Ageing and public satisfaction with the health service: an analysis of recent trends," Social Science & Medicine, Elsevier, vol. 57(4), pages 757-762, August.
    3. Hassan Danaee Fard & Ali Anvary Rostamy, 2007. "Promoting Public Trust in Public Organizations: Explaining the Role of Public Accountability," Public Organization Review, Springer, vol. 7(4), pages 331-344, December.
    4. Elias Mossialos, 1997. "Citizens' Views on Health Care Systems in the 15 Member States of The European Union," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 109-116.
    5. repec:aph:ajpbhl:10.2105/ajph.2011.300547_5 is not listed on IDEAS
    6. Cockerham, William C. & Hinote, Brian P. & Abbott, Pamela, 2006. "Psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine," Social Science & Medicine, Elsevier, vol. 63(9), pages 2381-2394, November.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Joan Costa-i-Font & Gilberto Turati, 2016. "Regional Health Care Decentralization in Unitary States: Equal Spending, Equal Satisfaction?," CESifo Working Paper Series 5973, CESifo Group Munich.
    2. repec:eee:socmed:v:189:y:2017:i:c:p:25-34 is not listed on IDEAS
    3. Luck, J. & Peabody, J.W. & DeMaria, L.M. & Alvarado, C.S. & Menon, R., 2014. "Patient and provider perspectives on quality and health system effectiveness in a transition economy: Evidence from Ukraine," Social Science & Medicine, Elsevier, vol. 114(C), pages 57-65.
    4. Park, Kisoo & Park, Jumin & Kwon, Young Dae & Kang, Yoonjeong & Noh, Jin-Won, 2016. "Public satisfaction with the healthcare system performance in South Korea: Universal healthcare system," Health Policy, Elsevier, vol. 120(6), pages 621-629.
    5. repec:eee:hepoli:v:122:y:2018:i:3:p:269-278 is not listed on IDEAS


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:112:y:2013:i:1:p:62-69. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu) or (). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.