Factors Affecting Patient Satisfaction in the Emergency Department: A Systematic Review

Abstract

Patient satisfaction is widely recognized as a key indicator of healthcare quality and an essential measure of performance in emergency departments. As the emergency department represents the first point of contact for many patients, understanding the factors that influence satisfaction is crucial for improving care delivery. This systematic review aimed to assess patient satisfaction and identify the factors associated with satisfaction in the emergency department. A systematic search of PubMed and Google Scholar was conducted to identify relevant studies published between 2019 and 2022 using combinations of the keywords "Factors," "Affecting," "Patient," "Satisfaction," "Emergency," and "Department." Only original, full-text research articles addressing patient satisfaction in the emergency department were included. Of the 100 records initially identified, seven studies met the eligibility criteria and were included in the final analysis. The included studies consisted of three cross-sectional studies, two retrospective studies, one case study, and one randomized controlled trial, conducted across Saudi Arabia, Portugal, Italy, Rotterdam, and Iran, with a total sample exceeding 3,491 emergency department patients. Overall patient satisfaction across the included studies ranged from relatively satisfied to completely satisfied. Key predictors of patient satisfaction included overall doctor satisfaction, perceived waiting time for triage, and meeting patient expectations. Additional influential factors included tangibles, assurance, reliability, responsiveness, and empathy. Shorter emergency department length of stay and the provision of general, medical, and practical information were associated with higher satisfaction, with oral communication and written leaflets being the preferred methods of information delivery. Studies conducted in Saudi Arabia reported moderate levels of satisfaction with physician and nursing care, high preference for waiting time estimation, and relatively lower satisfaction with translation services, drug information, and pain management. These findings indicate that patient satisfaction in emergency departments is influenced by a combination of communication quality, service organization, and patient-provider interaction. Targeted interventions focusing on improving communication, managing waiting time expectations, and enhancing information delivery may contribute to improved patient satisfaction in emergency care settings.