Client satisfaction and associated factors with the health care services in Central Ethiopia, 2025: facility-based comparative cross-sectional study

Abstract

Client satisfaction is a key indicator of healthcare quality and the extent to which patient expectations are met. Despite efforts to improve healthcare quality, evidence on client satisfaction in public and private hospitals, particularly in Central Ethiopia, remains limited. To assess the level of client satisfaction and associated factors in public and private facilities, Central Ethiopia, 2025. Facility-based comparative cross-sectional study was conducted at public and private hospitals of Central Ethiopia from April to July 2025. A systematic random sampling method was employed to select 436 participants from both institutions. A modified Client Satisfaction Assessment Tool was used to measure the level of client satisfaction. A binary logistic regression model was applied, and variables with a p-value < 0.05 with a 95% CI in the multivariable analysis were considered significant. A total of 262 public and 174 private hospital clients participated. Overall satisfaction was 45%, with lower in public (39.3%) than the private (53.4%). In public hospitals, satisfaction was significantly associated with rural residence (AOR = 1.92; 95% CI: 1.09–3.37), longer duration of stay (AOR = 2.33; 95% CI: 1.15–4.72), daytime admission (AOR = 2.12; 95% CI: 1.18–3.78), and insurance payment type (AOR = 1.81; 95% CI: 1.04–3.14). In private hospitals, repeated visits (AOR = 2.44; 95% CI: 1.15–5.14), chronic illness (AOR = 2.18; 95% CI: 1.05–4.51), shorter hospital stays (AOR = 2.60; 95% CI: 1.01–6.67), and shorter waiting times (AOR = 3.43; 95% CI: 1.36–8.64) were associated. Across both facilities, attending private facilities (AOR = 1.79; 95% CI: 1.16–2.75), outpatient service use (AOR = 2.12; 95% CI: 1.15–3.93), daytime admission (AOR = 2.30; 95% CI: 1.48–3.55), and shorter hospital stays (AOR = 2.24; 95% CI: 1.33–3.79) were associated. Overall client satisfaction was lower in public hospitals. Satisfaction was associated with residence, admission time, duration of stay, and payment type in public hospitals, with visit type, chronic illness, hospital stay, and waiting time in private hospitals, and with type of facility, visiting units, admission time, and duration of stay across both facilities. Improving waiting times, stay management, and payment processes is essential.