Trends in Patient Satisfaction of Services at Imam Al-Hujjah Hospital, Holy Karbala, Iraq: A Longitudinal Comparative Study

Abstract

Background: Patient satisfaction is a key indicator of healthcare quality, particularly in patient-centered care models. Regular monitoring supports service improvement. This study compared patient satisfaction with services.

Methods: A longitudinal comparative study was conducted using standardized electronic post-discharge questionnaires. A total of 3,274 patients participated in the study in 2020 and 3,221 patients in 2024. Satisfaction was measured in 12 clinical and non-clinical service areas using a five-point Likert scale. Statistical analyses included chi-square tests, odds ratios, Cohen's h for effect size, and thematic analysis of open-ended responses.

Results: Eleven of 12 domains showed statistically significant improvement (p = 0.001). Overall satisfaction increased from 68.6% in 2020 to 78.4% in 2024, a 9.8% rise. The largest gains were noted in radiology (+15.2%), pharmacy (+14.2%), laboratories (+13.0%), nursing (+11.3%), and medical services (+10.8%). Dissatisfaction (bottom-box responses) declined by an average of 3.6%. Clinical and administrative services showed moderate effect sizes (Cohen’s h: 0.25–0.36; ORs (Odds Ratios): 1.96–2.42). Cleaning services maintained high satisfaction (93% in 2024), while food (+5.2%) and entry/account services (+3.7%) showed minimal improvement. Qualitative feedback indicated persistent concerns regarding food variety, appointment delays, and communication gaps.

Conclusions: Patient satisfaction improved substantially between the two specific years, 2020 and 2024, particularly in clinical services. Persistent gaps in some non-clinical areas highlight the need for targeted quality improvement. Longitudinal monitoring provides valuable insights to advance patient-centered care in resource-constrained settings.