title: Determinants of patient satisfaction: a systematic review.
abstract: OBJECTIVE
  A large number of studies have addressed the detection of patient satisfaction determinants, and the results are still inconclusive. Furthermore, it is known that contradicting evidence exists across patient satisfaction studies. This article is the second part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction for further operationalisation procedures. The aim of this work was to systematically identify and review evidence regarding determinants of patient satisfaction between 1980 and 2014, and to seek the reasons for contradicting results in relationships between determinants and patient satisfaction in the literature to design a further robust measurement system for patient satisfaction.
  
  
  METHODS
  This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search was conducted in PubMed, CINAHL, and Scopus in October 2014. Studies published in full in peer reviewed journals between January 1980 and August 2014 and in the English language were included. We included 109 articles for the synthesis.
  
  
  RESULTS
  We found several number of determinants of patient satisfaction investigated in a wide diversity of studies. However, study results were varied due to no globally accepted formulation of patient satisfaction and measurement system.
  
  
  CONCLUSIONS
  Health care service quality indicators were the most influential determinants of patient satisfaction across the studies. Among them, health providers' interpersonal care quality was the essential determinant of patient satisfaction. Sociodemographic characteristics were the most varied in the review. The strength and directions of associations with patient satisfaction were found inconsistent. Therefore, person-related characteristics should be considered to be the potential determinants and confounders simultaneously. The selected studies were not able to show all potential characteristics which may have had effects on satisfaction. There is a need for more studies on how cultural, behavioural, and socio-demographic differences affect patient satisfaction, using a standardised questionnaire.
authors.affiliation: Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; Faculty of Economy and Business Sciences, University of Sannio, Benevento, Italy.
authors.forename: Enkhjargal
authors.initials: E
authors.lastname: Batbaatar
authors.affiliation: Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; The Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Javkhlanbayar
authors.initials: J
authors.lastname: Dorjdagva
authors.affiliation: Department of Business Management, Ulaanbaatar University, Ulaanbaatar, Mongolia.
authors.forename: Ariunbat
authors.initials: A
authors.lastname: Luvsannyam
authors.affiliation: Department of Engineering, University of Sannio, Benevento, Italy.
authors.forename: Matteo Mario
authors.initials: MM
authors.lastname: Savino
authors.affiliation: Faculty of Economy and Business Sciences, University of Sannio, Benevento, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Amenta
mesh_terms: D002983:Clinical Competence; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: PRISMA; determinants; patient satisfaction; predictors; systematic review