title: Public satisfaction with the healthcare system performance in South Korea: Universal healthcare system.
abstract: BACKGROUND
  An awareness of the public's level of satisfaction with health professionals is becoming more important as steps are being taken to improve quality, reduce costs, and implement reform. The purpose of this study is to assess public satisfaction with the healthcare system and to examine the relationship between satisfaction and socio-demographic factors in the context of the health care environment in the Republic of Korea.
  
  
  METHODS
  The data were obtained from 1573 adults aged 20-69 in three major areas - Seoul, Gyeonggi, and Busan - by the Ministry of Health and Welfare during June and July 2011 in South Korea. Satisfaction with the healthcare system was evaluated by using 13 items in three sections: access to care, cost of care, and quality of care. A confirmatory factor analysis (CFA) was conducted to examine the validity of satisfaction with a healthcare system performance questionnaire. A structural equation model (SEM) was estimated to assess the relative impact of demographic and socio-economic variables on satisfaction.
  
  
  RESULTS
  The study proposed a comprehensive three-factor model of healthcare system performance satisfaction. Among the three factors, the quality of care had the largest impact on satisfaction with the healthcare system, suggesting that is the most important determinant of consumers' satisfaction with their healthcare system. Regarding the relationships between public satisfaction and demographic and socio-economic variables, residence and marital status were significant predictors of the satisfaction level.
  
  
  CONCLUSIONS
  It is important to be aware of the potential significance of background variables in determining satisfaction with the healthcare system. An understanding of the characteristics of the sample enables healthcare managers and/or policymakers to inform targeted follow-up actions.
authors.affiliation: Department of Healthcare Management, University of Korea, Seoul, South Korea.
authors.forename: Kisoo
authors.initials: K
authors.lastname: Park
authors.affiliation: National Institutes of Health Clinical Center, Bethesda, MD, USA.
authors.forename: Jumin
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, the Catholic University of Korea, Seoul, South Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kwon
authors.affiliation: American Institutes for Research, Washington, DC, USA.
authors.forename: Yoonjeong
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Healthcare Management and Institute of Global Healthcare Research, Eulji University, Seongnam, South Korea. Electronic address: jinwon.noh@gmail.com.
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Noh
mesh_terms: D000328:Adult; D000368:Aged; D003695:Delivery of Health Care; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011787:Quality of Health Care; D056910:Republic of Korea; D012959:Socioeconomic Factors; D019472:Universal Health Insurance
keywords: Healthcare system; Satisfaction; South Korea; Universal healthcare system