Patient satisfaction with inpatient services in a public tertiary hospital in Trinidad and Tobago: associated factors and predictors


  • Mandreker Bahall School of Medicine and Arthur Lok Jack Graduate School of Business, University of the West Indies, St. Augustine, Trinidad and Tobago
  • George Legall Department of Food Production and Agriculture, University of the West Indies, St. Augustine, Trinidad and Tobago



Basic health services, Health outcomes, Health reform, Patient satisfaction


Background: Patient experience is an important factor in assessing the quality of healthcare. Numerous reports highlight the continued inconsistencies in healthcare and poor patient satisfaction affecting outcomes. This study aimed to assess patient satisfaction in a teaching hospital in Trinidad and Tobago.

Methods: A cohort study was conducted among recently discharged patients from the largest teaching hospital in Trinidad and Tobago. The survey instrument was an adaptation of the Picker Patient Experience Questionnaire. Data were collected from January 1, 2017 to March 2017, using face-to-face interviews. SPSS version 21 was used for descriptive and inferential analysis of data.

Results: The majority of the 300 participants was female (n=157; 53.3%), aged over 35 years (n=202; 67.3%) with secondary school education (n=137; 45.7%). Satisfaction levels ranged from 50% and 70% for management issues, treatment-related communication issues, environmental issues, and deportment of medical staff. Patient satisfaction with treatment-related support and hotel services was less than 50%. All satisfaction domains were inter-dependent with the highest correlation between treatment-related communication and management issues (r=0.691; p≤0.001) and the lowest between support services and hotel services (r=0.311; p≤0.001). Education was the only factor that was both associated with, and a predictor of, patient satisfaction. Satisfaction level decreased with increased education level.

Conclusions: Low satisfaction was found with treatment-related support and hotel services with education level as the only predictor. Steps are needed to ensure periodical satisfaction monitoring and continuous improvement of services such as support and hotel services.


Health Boards Executive. Measurement of patient satisfaction guidelines: Health strategy implementation project 2003. [Internet]. Clonminch: Health Boards Executive. 2003, 1573. Available at: Accessed 13 August 2018.

Lohr KN, Schroeder SA. A strategy for quality assurance in Medicare. N Engl J Med. 1990;322:707–12.

Grimes F. The measurement of patient satisfaction with acute services in Ireland: Irish patient satisfaction literature review and scoping exercise. Health Services National Partnership Forum. 2003. Available at: /10147/43467/3418.pdf?sequence=1&isAllowed=y. Accessed 13 August 2018.

Al-Abri R, Al-Balushi A. Patient satisfaction survey as a tool towards quality improvement. Oman Med J. 2014;29(1):3–7.

O’Connor SJ, Shewchuk RM, Carney LW. The great gap: Physicians’ perceptions of patient service quality expectations fall short of reality. J Health Care Mark. 1994;14:32–9.

Pomey MP, Hihat H, Khalifa M, Lebel P, Néron A. Patient partnership in quality improvement of healthcare services: Patients’ inputs and challenges faced. Patient Experience Journal. 2015;2(1). Available at: .cgi?article=1064&context=journal;Patient. Accessed 10 July 2018.

Campbell J. Exemplary practices for measuring consumer satisfaction: a review of the literature. (Unpublished report for the Center for Mental Health Services), Rockville, MD; 1999.

Aiken LH, Sermeus W, Van Den Heede K, Sloane DM, Busse R, McKee M, et al. Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ. 2012;344:e1717.

Fakhoury W, McCarthy M, Addington-Hall J. Determinants of informal caregivers’ satisfaction with services for dying cancer patients. Soc Sci Med. 1996;42:721–31.

JCAHO Joint Commission on the Accreditation of Healthcare Organisations, 1994 Manual for the Accreditation of Hospitals, Illinois, Oak Brooks; 1993.

Donabedian A. The Definition of Quality and Approaches to its Assessment. Ann Arbor, MI: Health Administration Press; 1980.

García-Lacalle J, Bachiller P. Dissecting hospital quality. Antecedents of clinical and perceived quality in hospitals. Int J Health Plan Manage. 2011;26(3):264–81.

Kavitha R. A comparative study on patients’ satisfaction in health care service. European Journal of Business and Management. 2012;4(13).

Burroughs TE, Waterman BM, Cira JC, Desikan R, Claiborne Dunagan W. Patient satisfaction measurement strategies: A comparison of phone and mail methods. Jt Comm J Qual Improv. 2001;27:349–61.

Strauss AL, Corbin JM. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks CA: Sage Publications Inc.; 1998.

Péfoyo AJK, Wodchis WP. Organizational performance impacting patient satisfaction in Ontario hospitals: a multilevel analysis. BMC Research Notes. 2013;6:509.

Joseph C, Nichols S. Patient satisfaction and quality of life among persons attending chronic disease clinics in South Trinidad, West Indies. WIMJ. 2007;56:108–14.

World Health Organization. People-Centred Health Care: A Policy Framework. [Internet]. 2007. Available at: services/people_at_the_centre_of_care/documents/ENG-PCIPolicyFramework.pdf. Accessed 7 August 2018.

Rubio DJ. The impact of decentralization of health services on health outcomes: evidence from Canada. Applied Economics. 2010;43(26):3907–17.

‘Healthcare Crisis’. Newsday. August 7, 1999.

Wilson S. Begging for a bed. Trinidad and Tobago Guardian Newspaper. March 25, 2011. Available at: Accessed 13 August 2018.

Clyne K. Shortage of medical supplies at SWRHA. Trinidad and Tobago Guardian Newspaper. September 3, 2015. Available at: medical-supplies-swrha. Accessed 20 June 2018.

Hospitals at crisis point. Trinidad and Tobago Guardian Newspaper. July 17, 2016. Available at: tals-crisis-point. Accessed 20 June 2018.

No medicine for cancer patients. Trinidad and Tobago Guardian Newspaper. April 27, 2017. Available at: Accessed 20 June 2018.

1,200 waiting for CT, MRI scans. Trinidad and Tobago Guardian Newspaper. June 15, 2017. Available at: Accessed 20 June 2018.

Dowlat R. Nursing shortage worries TTRNA. Trinidad and Tobago Guardian Newspaper. October 21, 2017. Available at: Accessed 20 June 2018.

Çiçek A, Erkan O. Research and Sampling Methods in Agricultural Economics, GOPÜ. Ziraat Fakültesi Yayınları. No:12, Ders Kitapları Serisi, No:6, Tokat; 1996.

Bahall M. An evaluation of the effectiveness of the decentralized health system in Trinidad and Tobago. The University of the West Indies. 2010. Available at: Accessed 6 July 2018.

Raja Lexshimi RG, Zaleha MI, Shamsul AS, Suriawati G. Patient satisfaction on waiting time and duration of consultation at orthopedic clinic, Universiti Kebangsaan Malaysia Medical Centre. Medicine & Health. 2009;4(1).

Ahmed T, Assefa N, Demisie A, Kenay A. Levels of adult patients’ satisfaction with nursing care in selected public hospitals in Ethiopia. Int J Health Sci (Qassim). 2014;8(4):371–9.

Makarem J, Larijani B, Joodaki K, Ghaderi S, Nayeri F, Mohammadpoor M. Patients’ satisfaction with inpatient services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2011–2013. J Med Ethics Hist Med. 2016;9:6.

Singh S, Kaur P, Rochwani R. Patient satisfaction levels in a tertiary care medical college hospital in Punjab, North India. Int J Res Dev Health. 2013;1(4):172–82.

Christoglou K, Vassiliadis C, Sigalas I. Using SERVQUAL and Kano research techniques in a patient service quality survey. World Hosp Health Serv. 2006;42(2):21–6.

Designing for quality: hospitals look to the built environment to provide better patient care outcomes. Qual Lett Healthc Lead. 2003;15(4):2–13.

Kline TJ, Baylis BW, Chatur F, Morrison SA, White DE, Flin RH, et al. Patient satisfaction: evaluating the success of hospital ward redesign. J Health Qual. 2007;29:44-9.

Xiao H, Barber JP. The effect of perceived health status on patient satisfaction. Value Health. 2008;11(4):719–25.

Jaipaul CK, Rosenthal GE. Are older patients more satisfied with hospital care than younger patients? J Gen Intern Med. 2003;18(1):23–30.

Quintana JM, González N, Bilbao A, Aizpuru F, Escobar A, Esteban C. Predictors of patient satisfaction with hospital health care. BMC Health Serv Res. 2006;6:102.

Rahmqvist M, Bara AC. Patient characteristics and quality dimensions related to patient satisfaction. Int J Qual Health Care. 2010;22(2):86–92.

Kelarijani SEJ, Jamshidi R, Heidarian AR, Khorshidi M. Evaluation of factors influencing patient satisfaction in social security hospitals in Mazandaran province, North of Iran. Caspian J Intern Med. 2014;5(4):232-4.




How to Cite

Bahall, M., & Legall, G. (2019). Patient satisfaction with inpatient services in a public tertiary hospital in Trinidad and Tobago: associated factors and predictors. International Journal Of Community Medicine And Public Health, 6(8), 3195–3202.



Original Research Articles