Correlates of Adult Outpatient Dissatisfaction in Public Hospitals of Addis Ababa, Ethiopia: A Multi-Center Study.

Abstract

Introduction: Patient satisfaction and dissatisfaction are critical indicator of healthcare quality. This study assessed satisfaction levels and identified factors associated with outpatient dissatisfaction among adult outpatient attendees in public hospitals in Addis Ababa, Ethiopia.

Methods: A multicenter, institution-based cross-sectional study was conducted in August 2023 among 421 outpatients. Data were collected using a standardized questionnaire, processed in EpiData, and analyzed via SPSS version 27. Multivariable logistic regression was used to identify factors associated with patient dissatisfaction.

Results: A total of 421 patients participated, with an overall satisfaction was 67% (95% CI [62.5, 71.5%]). Patients with repeated visits for the second (adjusted odds ratio (AOR): 0.023; 95% CI [0.003, 0.192]) and third visits (AOR: 0.098; 95% CI [0.016-0.603]) were significantly less likely to be dissatisfied compared to first-time visitors. Conversely, partial (AOR: 4.126; 95% CI [1.589, 10.72]) or complete non-availability (AOR: 6.668; 95% CI [2.14, 20.753]) of ordered procedures, unclean waiting areas (AOR: 12.48; 95% CI [3.96, 39.37]) or consultation rooms (AOR: 0.168; 95% CI [0.041, 0.68]), and poor patient-provider interactions, including not feeling comfortable asking questions (AOR: 30.28; 95% CI [13.52, 67.85]), and perceived impoliteness: (AOR: 7.204; 95% CI [1.305, 39.78]) were significantly associated with higher odds of dissatisfaction.

Conclusion: Patient satisfaction was sub-optimal. Outpatient dissatisfaction was strongly associated with first-time visits, structural limitations in procedure availability, unclean waiting environments, and poor interpersonal interactions. Strengthening nurses' roles in patient communication and coordination represents a vital pathway to mitigate dissatisfaction and optimize healthcare quality.