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A Patient Satisfaction Theory and Its Robustness Across Gender in Emergency Departments: A Multigroup Structural Equation Modeling Investigation

The School of Health Sciences, Winston-Salem State University, Winston-Salem, NC, aragons{at}wssu.edu

Sabina B. Gesell, PhD

Press Ganey Associates, Inc, South Bend, IN

This investigation tested the patient-centered Primary Provider Theory of Patient Satisfaction across gender in national random samples of emergency patients. Using multigroup structural equation modeling, the results supported the model's robustness. Physician service, waiting time, and nursing satisfaction explained 48%, 41%, and 11% of overall satisfaction plus 92% and 93% of female and male satisfaction, respectively. Unit increases in physician service satisfaction increased waiting time, nursing, and overall satisfaction by 0.991, 0.844, and 1.031 units, respectively. Unit increases in waiting time satisfaction increased nursing and overall satisfaction by 0.417 and 0.685 units, respectively. A unit increase in nursing satisfaction increased overall service satisfaction by 0.221 units. The investigation offers an alternative paradigm for measuring and achieving emergency department satisfaction, hierarchically related to patient expectations, where the primary provider has the greatest clinical utility to patients, followed by waiting for the primary provider, and then by nursing service.

Key Words: Emergency department • model • patient satisfaction measurement • primary provider theory • quality

American Journal of Medical Quality, Vol. 18, No. 6, 229-241 (2003)
DOI: 10.1177/106286060301800603


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