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The meaning of patient satisfaction: An explanation of high reported levels


  • Williams, Brian
  • Coyle, Joanne
  • Healy, David


The social policy background to the proliferation of patient satisfaction surveys is a desire for increased patient representation and participation. Within this context, it is assumed that satisfaction surveys embody patients' evaluations of services. However, as most surveys report high satisfaction levels, the interpretation of satisfaction as the outcome of an active evaluation has been called into question. The aim of this study is to identify whether and how service users evaluate services. This was made possible through unstructured in-depth interviews with users of mental health services and through more structured discussion around their responses on a patient satisfaction questionnaire (CSQ 18B) whose psychometric properties has been well documented. Twenty-nine people with current or recent contact with mental health services within the British National Health Service were interviewed. The data revealed that service users frequently described their experiences in positive or negative terms. However, the process by which these experiences were transformed into "evaluations" of the service was complex. Consequently, many expressions of "satisfaction" on the CSQ 18B hid a variety of reported negative experiences. An explanation for this lack of correspondence is outlined.

Suggested Citation

  • Williams, Brian & Coyle, Joanne & Healy, David, 1998. "The meaning of patient satisfaction: An explanation of high reported levels," Social Science & Medicine, Elsevier, vol. 47(9), pages 1351-1359, November.
  • Handle: RePEc:eee:socmed:v:47:y:1998:i:9:p:1351-1359

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    Cited by:

    1. Jackie Cumming, 2000. "Management of Key Purchaser Risks in Devolved Purchase Arrangements in Health Care," Treasury Working Paper Series 00/17, New Zealand Treasury.
    2. Bikker, Annemieke P. & Thompson, Andrew G.H., 2006. "Predicting and comparing patient satisfaction in four different modes of health care across a nation," Social Science & Medicine, Elsevier, vol. 63(6), pages 1671-1683, September.
    3. Ryan, Mandy & Kinghorn, Philip & Entwistle, Vikki A. & Francis, Jill J., 2014. "Valuing patients' experiences of healthcare processes: Towards broader applications of existing methods," Social Science & Medicine, Elsevier, vol. 106(C), pages 194-203.
    4. Callaghan, Gillian & Wistow, Gerald, 2006. "Governance and public involvement in the British National Health Service: Understanding difficulties and developments," Social Science & Medicine, Elsevier, vol. 63(9), pages 2289-2300, November.
    5. Davidson, Joyce, 2007. "Caring and daring to complain: An examination of UK national phobics society members' perception of primary care," Social Science & Medicine, Elsevier, vol. 65(3), pages 560-571, August.
    6. Magnus Lindelow, 2003. "Understanding spatial variation in the utilization of health services: does quality matter?," Economics Series Working Papers WPS/2004-12, University of Oxford, Department of Economics.
    7. Hekkert, Karin Dorieke & Cihangir, Sezgin & Kleefstra, Sophia Martine & van den Berg, Bernard & Kool, Rudolf Bertijn, 2009. "Patient satisfaction revisited: A multilevel approach," Social Science & Medicine, Elsevier, vol. 69(1), pages 68-75, July.
    8. Atkinson, Sarah & Medeiros, Regianne L., 2009. "Explanatory models of influences on the construction and expression of user satisfaction," Social Science & Medicine, Elsevier, vol. 68(11), pages 2089-2096, June.
    9. Mundy, Crystal L. & Neufeld, Amanda N. & Wells, Susan J., 2016. "A culturally relevant measure of client satisfaction in child welfare services," Children and Youth Services Review, Elsevier, vol. 70(C), pages 177-189.
    10. repec:spr:patien:v:11:y:2018:i:2:d:10.1007_s40271-017-0274-4 is not listed on IDEAS
    11. Magnus Lindelow, 2004. "Understanding spatial variation in the utilization of health," Development and Comp Systems 0409058, University Library of Munich, Germany.
    12. Richard Eckersley, 2000. "The Mixed Blessings of Material Progress: Diminishing Returns in the Pursuit of Happiness," Journal of Happiness Studies, Springer, vol. 1(3), pages 267-292, September.
    13. Bomhoff, Manja & Friele, Roland, 2017. "Complaints in long-term care facilities for older persons: Why residents do not give ‘free advice’," Health Policy, Elsevier, vol. 121(1), pages 75-81.


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