Impact of structural and interpersonal components of health care on user satisfaction with services of an outpatient clinic of a Nigerian tertiary hospital

Background: Patient satisfaction plays a key role in health-care reforms and service delivery. It is determined by patient's perception of the structural, interpersonal, and technical components of care. With current efforts toward universal coverage, government-owned National Health Insurance Scheme (NHIS)-accredited health facilities may need to improve the structural and interpersonal aspects of patients' care to survive in the emerging competitive health-care industry in Nigeria. Materials and Methods: A cross-sectional study of 220 NHIS enrollees randomly selected from patients attending the Staff Clinic of Aminu Kano Teaching Hospital Kano assessed patients' satisfaction with the structural (service-window-locations, cleanliness, adequacy of seats and toilets, and staff sufficiency) and interpersonal (staff friendliness, communication, respectfulness, response-to-requests, and efficiency) components of care as well as overall clinic satisfaction using a modified general practice assessment questionnaire. Results: Most of the respondents (65.9%) were satisfied with the clinic services. Respondents' satisfaction with the clinic's cleanliness, ease in locating medical records' unit and retrieving laboratory results, adequacy of doctors, friendly/respectful and responsive cashiers and clinical assistants (CAs), receiving satisfactory explanation on how to use prescribed drugs and unavailable drugs were all associated with the overall clinic satisfaction. However, cashiers' efficiency (odds ratio [OR] = 6.5, P = 0.006) and CAs' responsiveness (OR = 5.0, P = 0.03) were the predictors of overall satisfaction. Conclusion: Improvements in patients' overall satisfaction with the clinic services may require increasing the proportion of patients satisfied with the cashiers' efficiency and CAs' responsiveness (or those with similar roles) in service delivery.