Understanding patient satisfaction and dissatisfaction with health care.

Patient satisfaction or dissatisfaction is a complicated phenomenon that is linked to patients' expectations, health status, and personal characteristics, as well as health system characteristics. This article presents a cross-sectional study of the relationship among these factors using data collected from a large sample of university employees. The primary hypothesis, that patients' expectations would be the best predictor of satisfaction, was supported by the data. Health status, personal characteristics, and health system characteristics were not strong predictors. The findings suggest that patients may base their evaluations on sophisticated expectations and that those expectations vary from one sociodemographic group to another. Implications for social work practice in health care are highlighted.