[Determinants of patient satisfaction and intention to continue service utilization: analysis of a survey of outpatients at general hospital].

The patient-perceived quality of hospital ambulatory service and its relationship to patient satisfaction and intention to continue utilization of the service were assessed using a questionnaire which was mailed to 1,695 outpatients of a general hospital in Tokyo (response rate, 77.2%). Patient satisfaction and satisfaction and intention of continuing service utilization were each assessed and both for physicians and for the hospital. The quality of hospital outpatient service was evaluated for 36 items, and 9 patient evaluation scales were extracted by factor analysis: i.e., "treatment results", "physician competence and explanation", "physician warmth and commitment", "reputation of hospital and physician", "services by nurses and non-clerical staff", "services by clerical staff", "medical costs and barriers", "hospital environment" and "accessibility to medical care". These scales, with the exception of "accessibility of medical care", had high internal consistency. Accessibility was then decomposed into 4 independent scales-"waiting time", "outpatient clinic hours", "availability of services when needed" and "transportation convenience". The effects of a total of 23 variables, consisting of 12 patient evaluation scales, sex, age, education, income, clinical departments (4 dummy variables), "frequency of service utilization", "perceived severity of disease" and perceived necessity for medical care intervention" on patient satisfaction and patient intention to continue utilization of services were assessed by multiple regression analysis (forced entry method). The results indicated that patient assessment of "treatment results", "physician competence and explanation", "physician warmth and commitment" and "reputation of hospital and physician are important determinants of patients satisfaction and intention to continue using hospital outpatient service.