Factors Influencing Patient Satisfaction with Healthcare Services in Poland

Introduction

Patient satisfaction is currently recognized as an important and independent indicator of healthcare quality. Although it was long marginalized in healthcare evaluation, in recent decades it has gained significance as a key tool in assessing the functioning of healthcare systems [1]. It is most often defined as the degree of alignment between patients’ expectations and their perceptions of the care received [2–4], as well as a subjective evaluation of satisfaction with the overall treatment process [5,6]. Despite the availability of measurement tools and numerous studies worldwide, a comprehensive review of the determinants of patient satisfaction in the context of the Polish healthcare system remains lacking.

The concept of patient satisfaction is often confused with patient experience, although these are two distinct but related aspects. While experience refers to specific events and the course of care, satisfaction concerns the subjective evaluation of those events. Both dimensions coexist and influence health outcomes and the perceived quality of care [7–9].

Analyzing the determinants of patient satisfaction plays a vital role in healthcare quality research. It allows the identification of areas requiring improvement and highlights the aspects of care that matter most to patients [10]. Satisfaction arises from subjective assessments of the services provided and the conditions in which they are delivered [11]. Despite its subjective nature, patient satisfaction is a practical tool for identifying gaps in care delivery. Due to its strong link with perceived service quality, a high level of satisfaction and positive treatment experiences are now considered essential quality indicators in well-developed healthcare systems [12,13]. Measuring satisfaction allows providers to determine the extent to which healthcare services meet patient expectations and contributes to quality improvement and institutional competitiveness [14].

Patient satisfaction is not a static value; it is shaped by changing system-level factors and reflects the responsiveness of the healthcare system [15,16]. Its level is influenced by patients’ expectations, communication quality, staff behavior, and the overall conditions of care [17]. Both technical aspects of care and interpersonal competencies such as clear communication, empathy, courtesy, ease of access, and minimal waiting times play a role in shaping patient satisfaction [18]. As shown in Table 1, the key factors influencing patient satisfaction with healthcare services include quality of medical care, accessibility and organization, patient-related factors, cost-related factors, healthcare digitalization, and health outcomes.

Although numerous studies have explored the determinants of patient satisfaction, their findings remain inconsistent and are often contradictory. A major challenge is the lack of a universally accepted definition and a standardized measurement system, which hinders comparative research across settings [19].

The healthcare system in Poland is based on the principle of universal access to medical services, as guaranteed by the constitution [20]. Public healthcare is primarily funded by the National Health Fund (NFZ), and compulsory health insurance covers all employed individuals. Free healthcare is also provided to children, pregnant women, people with disabilities, and older adults. Alongside the public system, private medical services are also widely available [21].

As in many other European countries, primary healthcare plays a key role in the Polish system as the first point of contact for patients. With growing societal expectations and the increasing burden of chronic disease, evaluating healthcare quality from the patient’s perspective has become increasingly important. Aligning patient values and expectations with their actual care experiences allows for more accurate quality assessment [22]. In some countries, patient satisfaction surveys are mandatory within national quality frameworks, where hospitals are required to implement standardized tools, and “patient-centered care” forms the foundation of national strategy [23]. In Poland, a similar role is played by the PASAT system, coordinated by the National Center for Quality Monitoring in Healthcare, which enables assessment of patient experiences across various care settings and facilitates inter-facility comparison [24,25].

Patient satisfaction assessment in Poland is one of the key indicators of healthcare quality. Tools such as PASAT and the national accreditation program enable systematic monitoring of patient opinions and benchmarking between healthcare institutions. Although patient satisfaction surveys are subjective in nature, they provide valuable insights into service quality, hospitalization conditions, and communication between patients and healthcare professionals. These data are used to enhance the quality of care and support the development and optimization of the national health system [24,25].

The literature for this publication was collected by searching the databases PubMed, Google Scholar, and Science Direct. Keywords used in the searches included patient satisfaction and healthcare, quality of services and accessibility, care organization, costs, digitalization, and health outcomes. The analysis included reports from Polish public health institutions, including the Center for Quality Monitoring in Healthcare. National regulations on the healthcare quality were also examined. This article reviews the evaluation and determinants of patient satisfaction with healthcare services in Poland.

Determinants Influencing Patient Satisfaction

DETERMINANTS OF MEDICAL CARE QUALITY: MEDICAL STAFF COMPETENCE, PATIENT COMMUNICATION, EMPATHY, AND RESPECT:

Patient satisfaction is strongly influenced by the quality of communication and the relationship with healthcare personnel [26–28]. A key component of effective communication is the clear and understandable explanation of medical terminology, along with opportunities for patients to ask questions [29]. Familiarity with a patient’s medical history also plays an important role, fostering trust and a sense of security [30]. Diagnoses should be communicated clearly, and test results and the nature of the health condition should be explained in detail and in accessible language [28,31,32]. Communication becomes particularly critical in the context of complex medical procedures [33].

In addition, building a strong physician–patient relationship and the “soft” skills of medical staff significantly contribute to increased patient satisfaction [26,32,34]. This relationship is reinforced by addressing patients’ questions, concerns, and opinions [30,31,35,36]. Patients place high value on the empathetic attitude of physicians and their attention to the patient’s well-being [33,37–40]. The perceived emotional support from healthcare providers is equally important [33]. Respecting patient dignity, recognizing their autonomy, and treating them as individuals are factors that significantly enhance satisfaction [30,41,42]. Research indicates that the nurse–patient relationship may have an even greater impact on satisfaction than the physician–patient relationship [31,43,44]. Furthermore, active patient involvement in the treatment process and shared decision-making while considering patient preferences are associated with improved satisfaction levels [32,45,46]. Overall, effective communication, empathy, and individualized care substantially improve patient satisfaction and their sense of security within the healthcare system.

DETERMINANTS OF HEALTHCARE ACCESSIBILITY AND ORGANIZATION: WAIT TIMES, SPECIALIST AVAILABILITY, PROCEDURE ACCESSIBILITY, CARE COORDINATION, AND HOSPITAL CONDITIONS:

Healthcare accessibility and organization have been identified as key factors influencing patient satisfaction levels [43,44,47]. One of the most important elements is waiting time at various stages of care delivery. In outpatient care, delays caused by staff and lack of punctuality during appointments significantly reduce patient satisfaction [28]. In contrast, longer consultation times are associated with increased satisfaction, as patients have more time to discuss their concerns [30]. Short visits, on the other hand, often lead to dissatisfaction due to insufficient time for communication and problem resolution [46]. Effective discharge planning, clear recommendations, summaries of key information, and a smooth transition to continued care are also essential for achieving higher patient satisfaction [43].

Accessibility of healthcare services is another important predictor of satisfaction, encompassing access to laboratory, pharmaceutical, and radiological services, as well as hospital equipment and diagnostic devices [26,28,48]. The size of the facility also plays a role smaller hospitals are more frequently rated favorably [31,47].

In emergency departments, waiting time for triage, consultation, or treatment is a critical factor influencing patient satisfaction [49–51]. The mode of hospital admission (scheduled vs emergency) and the organization of the discharge process also contribute to the overall experience [37,46,51,52]. Length of hospitalization has a considerable impact on patient satisfaction [45,47,52,53,55]. In addition, the type of hospital ward may influence satisfaction levels, although this relationship is not consistently confirmed across sources [48].

Other relevant factors include the helpfulness of reception staff and clear signage directing patients within the hospital. The overall atmosphere of the facility, including accommodation conditions and food quality, also plays a role in shaping patient perceptions [31,33]. Important aspects include cleanliness [28,31,43,51,55,68], protection of privacy [33,48,52], confidentiality of medical information [50], availability of private rooms, and low noise levels [33,43,48,51,52]. The quality of meals affects not only satisfaction but also patient health and overall well-being [48,50,57].

DEMOGRAPHIC AND SOCIOECONOMIC DETERMINANTS OF PATIENT HEALTH:

Patient satisfaction is influenced not only by factors directly related to the quality of medical care but also by variables independent of healthcare personnel [47,49,53,58–61]. Among these, key determinants include age, gender, race/ethnicity, education level, marital status, and socioeconomic status. These factors significantly affect the quality of communication, shaping patients’ expectations toward medical staff and their satisfaction with interactions particularly in terms of communication style, staff courtesy, and access to information. Individuals in these demographic groups often demonstrate greater sensitivity to communication quality and report lower satisfaction with healthcare staff interactions [49,58,62].

Age has been identified as a significant predictor of patient satisfaction [50,51,58,61]. Older patients are more likely to report higher satisfaction with healthcare services [51,53,61], especially regarding respect, politeness, dignity, and pain management [50]. In contrast, younger patients tend to rate the availability and quality of outpatient services more favorably [50].

Gender also plays a role in the perception of care, particularly in areas such as comfort, privacy, and visitation policies. Women tend to place greater emphasis on communication with healthcare staff and are more likely to report higher overall satisfaction with healthcare services [59]. Racial or ethnic minority status is associated with lower levels of satisfaction, as these groups more frequently report less positive experiences [47,49,55].

Educational attainment has been shown to influence satisfaction levels. Patients with lower levels of education often report higher satisfaction and demonstrate increased sensitivity to the communication style of healthcare providers. Education level also affects perceptions of comfort and cleanliness in healthcare settings [53,59].

Marital status is another relevant predictor. Unmarried individuals more frequently report higher satisfaction with healthcare services. It also affects perceptions of information delivery, privacy, cleanliness, and the overall quality of care [49]. Socioeconomic status significantly influences satisfaction levels. Patients employed full-time particularly those commuting long distances report lower satisfaction with healthcare services. In contrast, higher satisfaction levels have been observed among unemployed individuals and students [49].

COST-RELATED DETERMINANTS IN HEALTHCARE:

High costs of treatment and hospitalization can significantly impact patient satisfaction. Financial burden related to medical care is frequently identified as a major source of dissatisfaction in both outpatient and inpatient settings. Hospitalization fees and the overall cost of treatment represent important determinants of patient satisfaction in public and private healthcare facilities alike [53].

In public healthcare institutions, additional expenses related to diagnostic tests and the need to purchase medications essential for treatment are often cited as further sources of dissatisfaction [53, 63]. The financial accessibility of healthcare services remains one of the key factors influencing patient satisfaction [37].

Among hospitalized patients in public facilities, health insurance status has been shown to be a significant factor affecting satisfaction levels [29,49]. Insured individuals more frequently report higher levels of satisfaction with the care received. Furthermore, patients with private health insurance more often indicate a high level of satisfaction with healthcare services [29].

DETERMINANTS OF HEALTHCARE DIGITALIZATION:

Telemedicine provides patients with safe, cost-effective, and convenient access to healthcare without compromising satisfaction levels. Although not a new solution, its use has significantly increased since the COVID-19 pandemic. Patient satisfaction with telemedicine services is comparable to that of traditional in-person visits [64].

Digitalization significantly enhances patient satisfaction by improving the organization of healthcare facilities and enabling more effective visit planning through access to real-time information on delays. Technologies that improve the waiting experience, such as television and Wi-Fi, help reduce stress and positively influence patient perceptions. Improved quality of teleconsultations increases the professionalism of care, thereby building trust and enhancing patient satisfaction [65].

Telemedicine visits offer numerous patient benefits, including greater convenience, easier access to services, shorter wait times, and reduced transportation costs [66]. Another key aspect of healthcare system digitalization is the implementation of electronic prescriptions, which streamline the prescribing process, enhance communication between medical institutions, and improve patient safety and satisfaction [67].

DETERMINANTS OF ACHIEVED HEALTH OUTCOMES:

Health outcomes, such as effective symptom control, are key determinants of patient satisfaction [34]. Among these, pain management is considered one of the most critical aspects. Patients experiencing chronic pain report lower levels of satisfaction with medical care [68]. Pain control has been identified as a major prognostic factor influencing overall assessments of healthcare quality [33,47,50,68]. Effective pain management is associated not only with higher satisfaction but also with more favorable evaluations of other aspects of care [47].

Another important determinant of patient satisfaction is the extent to which treatment outcomes meet patient expectations, which is recognized as a primary predictor of satisfaction [27,34,69,70]. Unmet expectations may significantly reduce satisfaction with medical services [70] and contribute to poor adherence to therapeutic recommendations [27]. Considering patient preferences during the treatment process may enhance satisfaction with care and increase engagement in recovery [69].

Patient Satisfaction with the Polish Healthcare System

In Poland, one of the standard systems for assessing patient and medical staff satisfaction is PASAT, implemented by the Center for Quality Monitoring in Healthcare. This system is based on the analysis of standardized data collected through surveys conducted in all medical facilities participating in the study. The results are then compared with those obtained by other institutions of the same type, allowing for benchmarking and evaluation of the quality of provided services [24,25].

The currently functioning solution relies on the use of surveys as a research tool, as well as a database application, MS ACCESS, for entering survey results into a computer system. Additionally, it includes a tool for data analysis and visualization of results. This system can be applied in three areas of medical care: pediatrics, hospitalization, and primary healthcare [24,25].

The results of a study conducted by the Center for Quality Monitoring in Healthcare, based on an analysis of 90 000 anonymous surveys from over 170 hospitals, both public and private, including provincial, district, municipal, and clinical facilities, provide valuable insights into patient experiences. The vast majority of respondents, as much as 90%, reported feeling safe during their hospital stay. Over 80% noticed an improvement in their health condition due to hospitalization, and 89% positively assessed the way medical staff communicated information about their health status [71].

The quality of medical care was also rated highly, with 86% of patients expressing satisfaction with medical care, 88% giving positive feedback on nursing care, and 87% appreciating physiotherapy services. More than 75% of respondents had no complaints about the general conditions of their hospital stay, although the quality of hospital meals received a slightly lower rating, with 68% of patients assessing them positively. On the other hand, 25% of participants reported experiencing feelings of distress related to hospitalization. Despite these experiences, as many as 84% of patients stated they would recommend the hospital they stayed in to others, indicating an overall high level of satisfaction with the provided care [71].

However, detailed findings from a study conducted by the Patient Rights Ombudsman, which included over 7000 patients, revealed not only positive aspects of care but also areas that require improvement. Respondents rated the kindness and professionalism of medical staff the highest – 90% of participants reported positive experiences in this area. Patients also appreciated the cleanliness of hospitals and the sense of safety during treatment [72].

Despite many positive opinions, the study also identified challenges that affect patient satisfaction. One of the most frequently reported issues was the waiting time for consultations and the limited availability of information about their health condition. These factors lowered the overall assessment of care quality and point to the need for further improvements to better meet patient expectations. Treatment effectiveness, including effective pain management, also significantly impacts patient satisfaction. Numerous studies, including those conducted in Poland, emphasize that appropriate pain relief and psychological support greatly enhance patients’ positive perception of hospital care. Taking into account individual patient needs, particularly in terms of communication and access to information, may contribute to further increasing satisfaction and building trust in the Polish healthcare system. The results of both studies provide essential data for analysis and highlight the need to balance high-quality medical care with improvements in service organization and accessibility. Despite many positive aspects, the Polish healthcare system requires continuous improvement to fully meet patient expectations [71,72].

A study conducted by the Public Opinion Research Center found that only 27% of respondents were satisfied with the functioning of the Polish healthcare system. Compared to previous years, there has been a noticeable decline in satisfaction levels, particularly after the COVID-19 pandemic, during which a temporary increase in positive evaluations was observed. The highest levels of satisfaction were reported by older adults, rural residents, and pensioners, while the most critical opinions were expressed by younger individuals, residents of medium-sized cities, and those with higher education and incomes above 3000 PLN per capita [73].

Polish patients recognize positive aspects of the system, such as the competence of doctors (70%), their commitment (63%), and the use of modern technologies and medical equipment (69%). Respondents also appreciate the availability of primary care physicians (59%) and the diagnostic skills of specialists. In recent years, there has also been an increasing perception that patients are treated with care, kindness, and equal respect, regardless of their health status [73]. However, negative opinions dominate in areas such as access to specialist doctors, which was critically assessed by as many as 84% of respondents. Concerns were also raised about staffing shortages in hospitals, limited availability of diagnostic tests, and difficulties in scheduling appointments at convenient times and locations. Moreover, 74% of respondents believe that healthcare in Poland is not free, with only 21% convinced of the actual free-of-charge nature of medical services [73]. Modern solutions, such as e-prescriptions, e-referrals, and the Internet Patient Account, have been met with widespread approval – 81% of respondents rated them positively. These tools are particularly appreciated by younger individuals, residents of larger cities, and those with higher education and wealthier backgrounds [73].

The growing importance of patient-centered care and digitalization in healthcare makes monitoring patient satisfaction even more urgent. As Poland continues to integrate digital tools like telemedicine and e-prescriptions, understanding patient perceptions is crucial to ensuring that technological advancements effectively enhance access, efficiency, and overall satisfaction with healthcare services. Limited digital skills and a negative attitude toward technology still hinder the adoption of e-health applications. Despite increased internet access in Poland, poor connection quality in remote areas and lower engagement of medical institutions in digitalization remain significant barriers. The main factors encouraging the use of e-health solutions are time savings and reduced costs of traditional healthcare services. Users also appreciate specific features, such as the ability to view and share medical records through the Internet Patient Account. Acceptance of e-health increases when patients recognize the benefits of sharing personal data to improve healthcare quality and support other patients [74].

It has been shown that innovations in healthcare require a longer adaptation period. The main concerns regarding telemedicine include the risk of delayed diagnosis and limited effectiveness of teleconsultations. Telemedicine received better evaluations from patients who used it more frequently. Patient satisfaction remains a key indicator of healthcare quality and should be a priority in the development of telemedicine services [75].

Despite the positive opinions on the availability of primary healthcare physicians, a decline in satisfaction has been observed over the past two decades. In 2007, 85% of respondents believed that access to a general practitioner was easy, whereas today this percentage has dropped to just 59%. Simultaneously, the number of people who believe in the free-of-charge nature of healthcare has decreased – from 52% in 2012 to only 21% today. These trends indicate changing healthcare utilization patterns, with an increasing number of patients combining public and private healthcare services [73].

Patient satisfaction with the Polish healthcare system remains the subject of ongoing research and analysis. According to a report by Termedia, the overall satisfaction level is low only 30% of patients positively assess access to healthcare, placing Poland among the lowest-ranked countries within the Organisation for Economic Co-operation and Development (OECD). Key challenges include long waiting times, a shortage of medical personnel, and limited access to specialist services, which negatively impact the perceived quality of care [76].

Conclusions

Patient satisfaction remains a key indicator of healthcare quality. In Poland, despite positive evaluations of medical staff competence and reported safety during hospital stays, satisfaction is lowered by long waiting times, limited access to specialists, and insufficient use of digital health services.

Although a system for assessing patient satisfaction exists, its implementation is not yet fully integrated at the national level. Regular and widely adopted monitoring of patient feedback could provide valuable data to improve service organization and better align care with patient needs. Strengthening the role of systematic evaluation tools may contribute to building a more responsive and patient-centered healthcare system.

Future Directions

Future research should explore the effectiveness and integration of existing patient satisfaction assessment tools, such as PASAT, within the national healthcare system. Special attention should be given to how digital health solutions including e-services and telemedicine impact satisfaction, particularly in terms of accessibility, ease of use, and patient engagement. Further studies are also needed to examine how systemic issues such as waiting times, access to specialists, and regional inequalities affect patient satisfaction across various population groups. Ongoing, standardized measurement of patient satisfaction is essential for identifying service gaps and guiding patient-centered improvements in the Polish healthcare system.