Determinants of patient satisfaction with healthcare services among insured and uninsured patients at a public hospital in Cameroon: A comparative cross-sectional study using the modified PSQ-18 questionnaire

Abstract

Background: Regular assessment of patient satisfaction is crucial for healthcare providers to evaluate and improve the quality of services offered. However, research on patient satisfaction, particularly in Cameroon, remains limited. This study aimed to assess patient satisfaction levels with the healthcare services at the Yaoundé Central Hospital using the PSQ-18 questionnaire. Design and methods: A hospital-based cross-sectional study was conducted from September 2022 to March 2023, involving outpatients aged 18 and above who willingly consented to participate. A modified version of the PSQ-18 questionnaire was utilized to evaluate satisfaction across 10 hospital variables. Results: The study included 385 participants, with 264 uninsured and 121 insured. The overall satisfaction rate was 90.9%. Satisfaction level for insured patients was 98.3% and 87.5% for not insured patients. Variables such as diagnosis, information provided by healthcare personnel, and equipment quality received high satisfaction scores. However, both insured and uninsured patients expressed dissatisfaction with specialist waiting times. Binary logistic regression revealed significant difference, with uninsured individuals being 8.5 times more likely to be dissatisfied compared to insured counterparts (95% CI 2.0–36.0; p = 0.0006). Large family size of more than 5 persons was the only factor that significantly increased the risk of dissatisfaction with health services. Conclusions: These findings highlight a critical policy gap that needs intervention now. Targeted policy interventions are needed to help uninsured Cameroonians afford high-quality healthcare. For population-wide healthcare access, this gap must be closed. Therefore, the national universal health coverage scheme must be expanded and improved to reach all 10 Cameroon regions.