title: Patient satisfaction in Japan.
abstract: OBJECTIVE
  To extend existing knowledge about health care quality and patient satisfaction by exploring Japanese context having a different health care system and a different culture from the USA and Europe.
  
  
  METHODS
  A structural equation model is used to explore links between quality perception and patient satisfaction as well as between patient satisfaction and intentional behavior relying on 159 Japanese outpatient replies.
  
  
  RESULTS
  Japanese healthcare service quality is evaluated using its process characteristics (patient-provider interaction) and physical attributes (settings and appearance). Process quality attributes were found to be patient satisfaction antecedents. Satisfaction in turn predicts patient intentional behavior (to return and to recommend). Japanese society cultural specificity seems to be an interesting background to understand Japanese evaluation when patients assess health service quality.
  
  
  CONCLUSIONS
  The sample investigated is relatively small. The study relied on a linear approach to assess patient satisfaction and intentional behavior. However, the non-linear model should yield a better reality fit.
  
  
  CONCLUSIONS
  To improve Japanese patient satisfaction, cultural values such as courtesy, empathy and harmony should be emphasized when delivering medical services. Satisfied consumers are an important asset for the healthcare provider as they intend to reuse the service and to recommend it to their families and friends. Both foreign and Japanese providers should adopt a consumer perspective to enhance the service quality and then to maintain long-term relationships with their customers.
  
  
  CONCLUSIONS
  The study used structural equation analysis to assess patient satisfaction in a scarcely investigated context. Moreover, the study relies on Japanese society's cultural characteristics to explain and understand results.
authors.affiliation: Osaka University of Economics, Osaka, Japan. G069201ea@osaka-ue.ac.jp
authors.forename: Amira
authors.initials: A
authors.lastname: Elleuch
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D015285:Hospital-Patient Relations; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires