Patient satisfaction: Insights from the regional referral hospitals in Bhutan

Patient satisfaction is crucial for evaluating healthcare quality and guiding continuous quality improvement. Globally, patient satisfaction has been extensively studied; however, there is limited research on this topic in Bhutan, where the healthcare system is in the early stages of developing a quality-oriented culture. To address this gap, we aimed to evaluate patient satisfaction levels among different socio-demographic and clinical groups and identify the predictors of patient satisfaction in Bhutan.

We retrospectively analysed archived patient satisfaction data from two tertiary healthcare centres in Bhutan: Mongar Eastern Regional Referral Hospital and Gelephu Central Regional Referral Hospital. The routine survey was conducted throughout April 2024 using a modified version of the Patient Satisfaction Questionnaire 18. The data were analysed using descriptive statistics, one-way ANOVA, and binary logistic regression.

Our study revealed significant variations in patient satisfaction across socio-demographic and clinical groups. Ethnicity, occupation, and education level emerged as significant predictors of satisfaction. Sharchop and other ethnic groups; farmers, religious personnel, and other occupational groups; and illiterate individuals exhibited significantly higher satisfaction levels. While patient type, age, and marital status influenced satisfaction levels, they did not emerge as significant predictors when considering other variables. Overall, patient satisfaction in Bhutan was high, particularly in the financial domain; however, accessibility and convenience scored the lowest.

Our findings underscore the importance of addressing socio-demographic disparities in patient satisfaction. With anticipated changes in the socio-demographic characteristics of the Bhutanese population, satisfaction levels may decline. Therefore, healthcare policy and decision-makers should implement targeted interventions to address these shifts. To enhance overall satisfaction, healthcare policymakers should focus on improving accessibility and convenience. Strategies such as establishing dynamic limits on free services, exploring private sector engagement in high-end services, and strengthening the healthcare workforce are essential for sustainable and quality healthcare service delivery.