Determining factors affecting healthcare service satisfaction utilizing fuzzy rule-based systems

Abstract

Health communication, which is a multi-attribute concept, is a generic title describing clinical practice. The literature shows that the relation between health communication and healthcare service satisfaction (HSS) has been found to be significant. The main objective of pursuing better health communication is to achieve the best outcome and patient satisfaction where healthcare systems are supposed to deliver. However, the health communication is a complex process. Also, measuring patients' satisfaction is not an easy task since satisfaction is a complex notion with several factors. In this study, questions in the questionnaire directed to patients are factor-analyzed in order to obtain components which are used as independent attributes that will be modeled by fuzzy rule-based systems (FRBS) in order to explain HSS. Utilizing FRBS brings two different advantages, one of which is to use mathematical functions called membership functions for linguistically expressed responses. The second one is to observe the transition among the linguistic values expressed by patients. The four independent variables, namely, doctor-patient communication (DPC), information seeking behavior (ISB), equal behavior and tolerance to cultural differences (TCD) and the dependent variable HSS are employed in the modeling. Although both DPC and ISB have positive effects on HSS, TCD has none. One interesting finding about DPC is that if DPC scores below the average value tend to lower, it does not have a decreasing effect on HSS, which means that if a patient does expect to have average DPC, his or her evaluation on HSS does not lower, which says that if a patient knows that the doctor has a poor communication skill, the patient does not pay attention to this attribute.