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Published in: BMC Health Services Research 1/2007

Open Access 01-12-2007 | Research article

Hospital outpatient perceptions of the physical environment of waiting areas: the role of patient characteristics on atmospherics in one academic medical center

Authors: Chun-Yen Tsai, Mu-Chia Wang, Wei-Tsen Liao, Jui-Heng Lu, Pi-hung Sun, Blossom Yen-Ju Lin, Gerald-Mark Breen

Published in: BMC Health Services Research | Issue 1/2007

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Abstract

Background

This study examines hospital outpatient perceptions of the physical environment of the outpatient waiting areas in one medical center. The relationship of patient characteristics and their perceptions and needs for the outpatient waiting areas are also examined.

Method

The examined medical center consists of five main buildings which house seventeen primary waiting areas for the outpatient clinics of nine medical specialties: 1) Internal Medicine; 2) Surgery; 3) Ophthalmology; 4) Obstetrics-Gynecology and Pediatrics; 5) Chinese Medicine; 6) Otolaryngology; 7) Orthopedics; 8) Family Medicine; and 9) Dermatology. A 15-item structured questionnaire was developed to rate patient satisfaction covering the four dimensions of the physical environments of the outpatient waiting areas: 1) visual environment; 2) hearing environment; 3) body contact environment; and 4) cleanliness. The survey was conducted between November 28, 2005 and December 8, 2005. A total of 680 outpatients responded. Descriptive, univariate, and multiple regression analyses were applied in this study.

Results

All of the 15 items were ranked as relatively high with a range from 3.362 to 4.010, with a neutral score of 3. Using a principal component analysis' summated scores of four constructed dimensions of patient satisfaction with the physical environments (i.e. visual environment, hearing environment, body contact environment, and cleanliness), multiple regression analyses revealed that patient satisfaction with the physical environment of outpatient waiting areas was associated with gender, age, visiting frequency, and visiting time.

Conclusion

Patients' socio-demographics and context backgrounds demonstrated to have effects on their satisfaction with the physical environment of outpatient waiting areas. In addition to noticing the overall rankings for less satisfactory items, what should receive further attention is the consideration of the patients' personal characteristics when redesigning more comfortable and customized physical environments of waiting areas.
Literature
1.
go back to reference Kotler P: Atmospherics as a marketing tool. J Retail. 1973, 49 (4): 48-64. Kotler P: Atmospherics as a marketing tool. J Retail. 1973, 49 (4): 48-64.
2.
go back to reference Bitner MJ: Evaluating service encounters: the effects of physical surroundings and employee responses. J Mark. 1990, 54: 69-82. 10.2307/1251871.CrossRef Bitner MJ: Evaluating service encounters: the effects of physical surroundings and employee responses. J Mark. 1990, 54: 69-82. 10.2307/1251871.CrossRef
3.
go back to reference Bitner MJ, Booms BH, Tetreault MS: The service encounter: diagnosing favorable and unfavorable incidents. J Mark. 1990, 54: 71-84. 10.2307/1252174.CrossRef Bitner MJ, Booms BH, Tetreault MS: The service encounter: diagnosing favorable and unfavorable incidents. J Mark. 1990, 54: 71-84. 10.2307/1252174.CrossRef
4.
go back to reference Grossbart S, Hampton R, Rammohan B, Lapidus RS: Environmental dispositions and customer response to store atmospherics. J Bus Res. 1990, 21: 225-241. 10.1016/0148-2963(90)90030-H.CrossRef Grossbart S, Hampton R, Rammohan B, Lapidus RS: Environmental dispositions and customer response to store atmospherics. J Bus Res. 1990, 21: 225-241. 10.1016/0148-2963(90)90030-H.CrossRef
5.
go back to reference McElroy JC, Morrow PC, Eroglu S: The atmospherics of personal selling. J Pers Sell Sales Manage. 1990, 31-41. McElroy JC, Morrow PC, Eroglu S: The atmospherics of personal selling. J Pers Sell Sales Manage. 1990, 31-41.
6.
go back to reference Bitner MJ: Servicescapes: the impact of physical surroundings on customers and employees. J Mark. 1992, 56: 57-71. 10.2307/1252042.CrossRef Bitner MJ: Servicescapes: the impact of physical surroundings on customers and employees. J Mark. 1992, 56: 57-71. 10.2307/1252042.CrossRef
7.
go back to reference Ward JC, Bitner MJ, Barnes J: Measuring the prototypicality and meaning of retail environments. J Retail. 1992, 68 (2): 194-220. Ward JC, Bitner MJ, Barnes J: Measuring the prototypicality and meaning of retail environments. J Retail. 1992, 68 (2): 194-220.
8.
go back to reference Hutton JD, Richardson LD: Healthscapes: the role of the facility and physical environment on consumer attitudes, satisfaction, quality assessments, and behaviors. Health Care Manage Rev. 1995, 20 (2): 48-61.PubMed Hutton JD, Richardson LD: Healthscapes: the role of the facility and physical environment on consumer attitudes, satisfaction, quality assessments, and behaviors. Health Care Manage Rev. 1995, 20 (2): 48-61.PubMed
9.
go back to reference Woodside AG, Nielsen RL, Walters F, Muller GD: Preference segmentation of health care services: the old-fashioned, value conscious, affluent and professional want-it-alls. J Health Care Mark. 1988, 8 (2): 14-24.PubMed Woodside AG, Nielsen RL, Walters F, Muller GD: Preference segmentation of health care services: the old-fashioned, value conscious, affluent and professional want-it-alls. J Health Care Mark. 1988, 8 (2): 14-24.PubMed
10.
go back to reference Andrus D, Buchheister J: Major factors affecting dental consumer satisfaction. Health Mark Q. 1985, 3 (1): 57-68. 10.1300/J026v03n01_08.PubMedCrossRef Andrus D, Buchheister J: Major factors affecting dental consumer satisfaction. Health Mark Q. 1985, 3 (1): 57-68. 10.1300/J026v03n01_08.PubMedCrossRef
11.
go back to reference Chakraborty G, Gaeth GJ, Cunningham M: Understanding consumers' preferences for dental service. J Health Care Mark. 1993, 13 (3): 48-58.PubMed Chakraborty G, Gaeth GJ, Cunningham M: Understanding consumers' preferences for dental service. J Health Care Mark. 1993, 13 (3): 48-58.PubMed
12.
go back to reference Gotlieb JB: Understanding the effects of nurses, patients' hospital rooms, and patients' perception of control on the perceived quality of a hospital. Health Mark Q. 2000, 18 (1–2): 1-14. 10.1300/J026v18n01_01.PubMedCrossRef Gotlieb JB: Understanding the effects of nurses, patients' hospital rooms, and patients' perception of control on the perceived quality of a hospital. Health Mark Q. 2000, 18 (1–2): 1-14. 10.1300/J026v18n01_01.PubMedCrossRef
13.
go back to reference Sofaer S, Crofton C, Goldstein E, Hoy E, Crabb J: What do consumers want to know about the quality of care in hospitals?. Health Serv Res. 2005, 40 (6 Pt 2): 2018-36. 10.1111/j.1475-6773.2005.00473.x.PubMedPubMedCentralCrossRef Sofaer S, Crofton C, Goldstein E, Hoy E, Crabb J: What do consumers want to know about the quality of care in hospitals?. Health Serv Res. 2005, 40 (6 Pt 2): 2018-36. 10.1111/j.1475-6773.2005.00473.x.PubMedPubMedCentralCrossRef
14.
go back to reference Akinci F, Esatoglu AE, Tengilimoglu D, Parsons A: Hospital choice factors: a case study in Turkey. Health Mark Q. 2004, 22 (1): 3-19. 10.1300/J026v22n01_02.PubMedCrossRef Akinci F, Esatoglu AE, Tengilimoglu D, Parsons A: Hospital choice factors: a case study in Turkey. Health Mark Q. 2004, 22 (1): 3-19. 10.1300/J026v22n01_02.PubMedCrossRef
15.
go back to reference Douglas CH, Douglas MR: Patient-centered improvements in health-care built environments: perspectives and design indicators. Health Expect. 2005, 8 (3): 264-76. 10.1111/j.1369-7625.2005.00336.x.PubMedPubMedCentralCrossRef Douglas CH, Douglas MR: Patient-centered improvements in health-care built environments: perspectives and design indicators. Health Expect. 2005, 8 (3): 264-76. 10.1111/j.1369-7625.2005.00336.x.PubMedPubMedCentralCrossRef
16.
go back to reference Hiidenhovi H, Nojonen K, Laippala P: Measurement of outpatients' views of service quality in a Finnish university hospital. J Adv Nurs. 2002, 38 (1): 59-67. 10.1046/j.1365-2648.2002.02146.x.PubMedCrossRef Hiidenhovi H, Nojonen K, Laippala P: Measurement of outpatients' views of service quality in a Finnish university hospital. J Adv Nurs. 2002, 38 (1): 59-67. 10.1046/j.1365-2648.2002.02146.x.PubMedCrossRef
17.
go back to reference Mitike G, Mekonnen A, Osman M: Satisfaction on outpatient services in hospitals of the Amhara Region. Ethiop Med J. 2002, 40 (4): 387-96.PubMed Mitike G, Mekonnen A, Osman M: Satisfaction on outpatient services in hospitals of the Amhara Region. Ethiop Med J. 2002, 40 (4): 387-96.PubMed
18.
go back to reference Gouveia GC, Souza WV, Luna CF, Souza-Junior PR, Szwarcwald CL: Health care users' satisfaction in Brazil, 2003. Cad Saude Publica. 2005, 21 (Suppl): 109-18.PubMedCrossRef Gouveia GC, Souza WV, Luna CF, Souza-Junior PR, Szwarcwald CL: Health care users' satisfaction in Brazil, 2003. Cad Saude Publica. 2005, 21 (Suppl): 109-18.PubMedCrossRef
19.
go back to reference Martin K, Balding C, Sohal A: Stakeholder perspectives on outpatient services performance: what patients, clinicians and managers want to know. Aust Health Rev. 2003, 26 (2): 63-72.PubMedCrossRef Martin K, Balding C, Sohal A: Stakeholder perspectives on outpatient services performance: what patients, clinicians and managers want to know. Aust Health Rev. 2003, 26 (2): 63-72.PubMedCrossRef
20.
go back to reference Dunnill MG, Pounder RE: Medical outpatients: changes that can benefit patients. Clin Med. 2004, 4 (1): 45-9.CrossRef Dunnill MG, Pounder RE: Medical outpatients: changes that can benefit patients. Clin Med. 2004, 4 (1): 45-9.CrossRef
21.
go back to reference Bergenmar M, Nylen U, Lidbrink E, Bergh J, Brandberg Y: Improvements in patient satisfaction at an outpatient clinic for patients with breast cancer. Acta Oncol. 2006, 45 (5): 550-8. 10.1080/02841860500511239.PubMedCrossRef Bergenmar M, Nylen U, Lidbrink E, Bergh J, Brandberg Y: Improvements in patient satisfaction at an outpatient clinic for patients with breast cancer. Acta Oncol. 2006, 45 (5): 550-8. 10.1080/02841860500511239.PubMedCrossRef
22.
go back to reference Pothier DD, Frosh A: Do information sheets improve patient satisfaction in the out-patient department?. Ann R Coll Surg Engl. 2006, 88 (6): 557-61. 10.1308/003588406X117061.PubMedPubMedCentralCrossRef Pothier DD, Frosh A: Do information sheets improve patient satisfaction in the out-patient department?. Ann R Coll Surg Engl. 2006, 88 (6): 557-61. 10.1308/003588406X117061.PubMedPubMedCentralCrossRef
23.
go back to reference Chandra A, Finlay JB, Paul DP: Overall outpatient satisfaction and its components: perceived changes at the Huntington VA Medical Center over five years. Hosp Top. 2006, 84 (4): 33-6. 10.3200/HTPS.84.4.33-36.PubMedCrossRef Chandra A, Finlay JB, Paul DP: Overall outpatient satisfaction and its components: perceived changes at the Huntington VA Medical Center over five years. Hosp Top. 2006, 84 (4): 33-6. 10.3200/HTPS.84.4.33-36.PubMedCrossRef
24.
go back to reference Rao KD, Peters DH, Bandeen-Roche K: Towards patient-centered health services in India – a scale to measure patient perceptions of quality. Int J Qual Health Care. 2006, 18 (6): 414-21. 10.1093/intqhc/mzl049.PubMedCrossRef Rao KD, Peters DH, Bandeen-Roche K: Towards patient-centered health services in India – a scale to measure patient perceptions of quality. Int J Qual Health Care. 2006, 18 (6): 414-21. 10.1093/intqhc/mzl049.PubMedCrossRef
25.
go back to reference Aletras VH, Papadopoulos EA, Niakas DA: Development and preliminary validation of a Greek-language outpatient satisfaction questionnaire with principal components and multi-trait analyses. BMC Health Serv Res. 2006, 6 (6): 66-10.1186/1472-6963-6-66.PubMedPubMedCentralCrossRef Aletras VH, Papadopoulos EA, Niakas DA: Development and preliminary validation of a Greek-language outpatient satisfaction questionnaire with principal components and multi-trait analyses. BMC Health Serv Res. 2006, 6 (6): 66-10.1186/1472-6963-6-66.PubMedPubMedCentralCrossRef
26.
go back to reference Labarere J, Francois P, Bertrand D, Peyrin JC, Robert C, Fourny M: Outpatient satisfaction: validation of a French-language questionnaire: data quality and identification of associated factors. Clin Perform Qual Health Care. 1999, 7 (2): 63-9.PubMed Labarere J, Francois P, Bertrand D, Peyrin JC, Robert C, Fourny M: Outpatient satisfaction: validation of a French-language questionnaire: data quality and identification of associated factors. Clin Perform Qual Health Care. 1999, 7 (2): 63-9.PubMed
27.
go back to reference Cho WH, Lee H, Kim C, Lee S, Choi KS: The impact of visit frequency on the relationship between service quality and outpatient satisfaction: a South Korean study. Health Serv Res. 2004, 39 (1): 13-33. 10.1111/j.1475-6773.2004.00213.x.PubMedPubMedCentralCrossRef Cho WH, Lee H, Kim C, Lee S, Choi KS: The impact of visit frequency on the relationship between service quality and outpatient satisfaction: a South Korean study. Health Serv Res. 2004, 39 (1): 13-33. 10.1111/j.1475-6773.2004.00213.x.PubMedPubMedCentralCrossRef
28.
go back to reference Rahman MM, Shahidullah M, Shahiduzzaman M, Rashid HA: Quality of health care from patient perspectives. Bangladesh Med Res Counc Bull. 2002, 28 (3): 87-96.PubMed Rahman MM, Shahidullah M, Shahiduzzaman M, Rashid HA: Quality of health care from patient perspectives. Bangladesh Med Res Counc Bull. 2002, 28 (3): 87-96.PubMed
29.
go back to reference Jackson JL, Chamberlin J, Kroenke K: Predictors of patient satisfaction. Soc Sci Med. 2001, 52 (4): 609-20. 10.1016/S0277-9536(00)00164-7.PubMedCrossRef Jackson JL, Chamberlin J, Kroenke K: Predictors of patient satisfaction. Soc Sci Med. 2001, 52 (4): 609-20. 10.1016/S0277-9536(00)00164-7.PubMedCrossRef
30.
go back to reference Crow R, Gage H, Hampsom S, Hart J, Kimber A, Storey L, Thomas H: The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess. 2002, 6 (32). Crow R, Gage H, Hampsom S, Hart J, Kimber A, Storey L, Thomas H: The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess. 2002, 6 (32).
31.
go back to reference Rahmquist M: Patient satisfaction in relation to age, health status and other background factors: a model for comparison of care units. Int J Qual Health Care. 2001, 13: 385-390. 10.1093/intqhc/13.5.385.CrossRef Rahmquist M: Patient satisfaction in relation to age, health status and other background factors: a model for comparison of care units. Int J Qual Health Care. 2001, 13: 385-390. 10.1093/intqhc/13.5.385.CrossRef
32.
go back to reference Danielsen K, Garratt AM, Andresen Bjertnæs ØA, Petersen KI: Patient experiences in relation to health care process and provider characteristics. Scand J Public Health. 2007, 35: 70-77. 10.1080/14034940600858615.PubMedCrossRef Danielsen K, Garratt AM, Andresen Bjertnæs ØA, Petersen KI: Patient experiences in relation to health care process and provider characteristics. Scand J Public Health. 2007, 35: 70-77. 10.1080/14034940600858615.PubMedCrossRef
34.
go back to reference Huelat BJ: Healing Environments: Design for the Body, Mind, & Spirit. Medezyn. 2003 Huelat BJ: Healing Environments: Design for the Body, Mind, & Spirit. Medezyn. 2003
35.
go back to reference McLver JP, Carmines EG: Unidimensional scaling. 1981, Thousand Oaks, CA: SageCrossRef McLver JP, Carmines EG: Unidimensional scaling. 1981, Thousand Oaks, CA: SageCrossRef
36.
go back to reference Spector P: Summated rating scale construction. 1992, Thousand Oaks, CA: SageCrossRef Spector P: Summated rating scale construction. 1992, Thousand Oaks, CA: SageCrossRef
37.
go back to reference Nunnally JC, Bernstein IH: Psychometric theory. 1994, New York: McGraw-Hill, 3 Nunnally JC, Bernstein IH: Psychometric theory. 1994, New York: McGraw-Hill, 3
38.
go back to reference Kressin NR, Skinner K, Sullivan L, Miller DR, Frayne S, Kazis L, Tripp T: Patient satisfaction with Department of Veterans Affairs health care: do women differ from men?. Mil Med. 1999, 164 (4): 283-8.PubMedCrossRef Kressin NR, Skinner K, Sullivan L, Miller DR, Frayne S, Kazis L, Tripp T: Patient satisfaction with Department of Veterans Affairs health care: do women differ from men?. Mil Med. 1999, 164 (4): 283-8.PubMedCrossRef
39.
go back to reference Campbell JL, Ramsay J, Green J: Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care. Qual Health Care. 2001, 10 (2): 90-5. 10.1136/qhc.10.2.90.PubMedPubMedCentralCrossRef Campbell JL, Ramsay J, Green J: Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care. Qual Health Care. 2001, 10 (2): 90-5. 10.1136/qhc.10.2.90.PubMedPubMedCentralCrossRef
40.
go back to reference Jaipaul CK, Rosenthal GE: Are older patients more satisfied with hospital care than younger patients?. J Gen Intern Med. 2003, 18 (1): 23-30. 10.1046/j.1525-1497.2003.20114.x.PubMedPubMedCentralCrossRef Jaipaul CK, Rosenthal GE: Are older patients more satisfied with hospital care than younger patients?. J Gen Intern Med. 2003, 18 (1): 23-30. 10.1046/j.1525-1497.2003.20114.x.PubMedPubMedCentralCrossRef
41.
go back to reference Quintana JM, Gonzalez N, Bilbao A, Aizpuru F, Escobar A, Esteban C, San-Sebastian JA, de-la-Sierra E, Thompson A: Predictors of patient satisfaction with hospital health care. BMC Health Serv Res. 2006, 6: 102-10.1186/1472-6963-6-102.PubMedPubMedCentralCrossRef Quintana JM, Gonzalez N, Bilbao A, Aizpuru F, Escobar A, Esteban C, San-Sebastian JA, de-la-Sierra E, Thompson A: Predictors of patient satisfaction with hospital health care. BMC Health Serv Res. 2006, 6: 102-10.1186/1472-6963-6-102.PubMedPubMedCentralCrossRef
42.
go back to reference Sahin B, Yilmaz F, Lee KH: Factors affecting inpatient satisfaction: structural equation modeling. J Med Syst. 2007, 31 (1): 9-16. 10.1007/s10916-006-9038-8.PubMedCrossRef Sahin B, Yilmaz F, Lee KH: Factors affecting inpatient satisfaction: structural equation modeling. J Med Syst. 2007, 31 (1): 9-16. 10.1007/s10916-006-9038-8.PubMedCrossRef
43.
go back to reference Young GJ, Meterko M, Desai KR: Patient satisfaction with hospital care: effects of demographic and institutional characteristics. Med Care. 2000, 38 (3): 325-3. 10.1097/00005650-200003000-00009.PubMedCrossRef Young GJ, Meterko M, Desai KR: Patient satisfaction with hospital care: effects of demographic and institutional characteristics. Med Care. 2000, 38 (3): 325-3. 10.1097/00005650-200003000-00009.PubMedCrossRef
44.
go back to reference Wright SM, Craig T, Campbell S, Schaefer J, Humble C: Patient satisfaction of female and male users of Veterans Health Administration services. J Gen Intern Med. 2006, 21 (Suppl 3): S26-32. 10.1111/j.1525-1497.2006.00371.x.PubMedPubMedCentralCrossRef Wright SM, Craig T, Campbell S, Schaefer J, Humble C: Patient satisfaction of female and male users of Veterans Health Administration services. J Gen Intern Med. 2006, 21 (Suppl 3): S26-32. 10.1111/j.1525-1497.2006.00371.x.PubMedPubMedCentralCrossRef
45.
go back to reference Hendriks AA, Smets EM, Vrielink MR, Van Es SQ, De Haes JC: Is personality a determinant of patient satisfaction with hospital care?. Int J Qual Health Care. 2006, 18 (2): 152-8. 10.1093/intqhc/mzi102.PubMedCrossRef Hendriks AA, Smets EM, Vrielink MR, Van Es SQ, De Haes JC: Is personality a determinant of patient satisfaction with hospital care?. Int J Qual Health Care. 2006, 18 (2): 152-8. 10.1093/intqhc/mzi102.PubMedCrossRef
Metadata
Title
Hospital outpatient perceptions of the physical environment of waiting areas: the role of patient characteristics on atmospherics in one academic medical center
Authors
Chun-Yen Tsai
Mu-Chia Wang
Wei-Tsen Liao
Jui-Heng Lu
Pi-hung Sun
Blossom Yen-Ju Lin
Gerald-Mark Breen
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2007
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-7-198

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