Relating patient satisfaction to waiting time perceptions and expectations: the disconfirmation paradigm.

OBJECTIVE: To determine the association of patient satisfaction with waiting time perceptions and expectations.
METHODS: A random sample of patients seen at one community hospital ED during a one-year period was surveyed by telephone within two to four weeks of evaluation to determine perceived satisfaction and waiting time perceptions and expectations.
RESULTS: In response to 3,641 attempted phone surveys, 1,574 patients had usable interviews. Consistent with a hypothesis derived using the disconfirmation paradigm (i.e., that satisfaction is a function of the magnitude and direction of the difference between perceived service and expected service), the patients were least satisfied when waiting times were longer than expected, were relatively satisfied when waiting times were perceived as equal to expectations, and were highly satisfied when waiting times were shorter than expected (p < 0.0001). Overall, the measure of effect strength (values from 0 to 1) of perceived waiting time vs expectation on the patient satisfaction score was 0.32, indicating moderate association.
CONCLUSIONS: The current study supports the validity of the disconfirmation paradigm in relating patient satisfaction to waiting time perceptions and expectations. Furthermore, it emphasizes that achieving satisfaction in a service encounter necessitates that perceived performance meet or exceed patient expectations.