Determinants of Patient Satisfaction Across Healthcare Settings: A Systematic Review

Abstract

Background. Patient satisfaction is an important component of healthcare-quality assessment because it reflects patients’ evaluations of interpersonal care, clinical and service processes, accessibility, organizational conditions, affordability, and the broader healthcare experience. However, satisfaction is a multidimensional and context-dependent construct, and its determinants vary across healthcare systems, service settings, and patient populations.

Objective. This systematic review aimed to synthesize recent empirical evidence concerning determinants, predictors, correlates, and associated factors of patient satisfaction across diverse healthcare settings.

Methods. Primary empirical studies published between 2021 and 2025 were eligible when they examined patient satisfaction or a closely related healthcare-satisfaction outcome and evaluated at least one determinant, predictor, correlate, associated factor, or qualitative driver. Following bibliographic reconciliation, 45 primary empirical studies were included in the narrative synthesis. Five systematic reviews or meta-analyses were retained separately as contextual evidence and were not counted in the primary-study denominator. Determinants were organized into seven domains: communication, empathy, trust, and patient-centered care; service and clinical-process quality; waiting time, accessibility, and continuity; financial access, insurance, and affordability; organizational, environmental, facility, and workforce factors; demographic, clinical, and psychosocial characteristics; and digital and technology-related factors. Because of substantial heterogeneity in populations, healthcare settings, satisfaction measures, and analytical methods, the findings were synthesized narratively.

Results. The evidence consistently indicated that patient satisfaction is associated with interacting interpersonal, service, organizational, accessibility, financial, patient-level, and technological characteristics. Service and clinical-process quality represented one of the most recurrent modifiable determinant domains. Organizational and environmental conditions, waiting time and accessibility, and communication and patient-centered interaction were also repeatedly associated with satisfaction. Financial and insurance-related factors were important in several healthcare systems. Demographic, clinical, and psychosocial characteristics were frequently associated with satisfaction but showed considerable variation across settings. Digital and technology-related determinants constituted a smaller but increasingly important evidence domain.

Conclusion. Patient satisfaction is best understood as a multilevel outcome rather than as the product of a single determinant. Healthcare organizations should prioritize modifiable service-system factors, particularly service quality, communication, timely access, continuity, organizational conditions, and financial accessibility. Demographic and clinical characteristics should primarily be interpreted as contextual modifiers. Because much of the available evidence is cross-sectional, associations should not automatically be interpreted as causal effects.