Patient and Attendant Satisfaction With Services at Medical College Hospital in Bangladesh: A Cross-Sectional Survey.

BACKGROUND: Patient satisfaction is a key indicator of healthcare quality, particularly in resource-constrained public health systems. Despite growing evidence on healthcare service quality in Bangladesh, comprehensive assessments incorporating both patients and attendants remain limited. This study evaluated satisfaction with healthcare services at Sylhet MAG Osmani Medical College Hospital using the SERVQUAL framework. METHODS: A cross-sectional survey was conducted among 400 respondents, including 167 patients and 233 attendants, selected through multi-stage cluster sampling. Data were collected using a structured questionnaire measuring five SERVQUAL dimensions: tangibility, reliability, responsiveness, assurance, and empathy. Descriptive statistics, independent-samples t-tests, chi-square tests, and binary logistic regression were employed for data analysis. RESULTS: Reliability and assurance received the highest ratings, particularly accurate diagnosis (mean = 3.96), reliable test results (mean = 3.99), and confidence in specialist doctors (mean = 4.07). In contrast, tangibility recorded the lowest ratings, with 74.6% dissatisfied with bed availability and 70.3% dissatisfied with seating arrangements. Empathy scores revealed concerns regarding equitable care, especially for poor patients (mean = 2.22). Independent-samples t-tests showed no significant differences between patients' and attendants' perceptions across SERVQUAL dimensions or overall satisfaction. Logistic regression identified assurance (OR = 6.86), empathy (OR = 4.64), tangibility (OR = 2.47), and responsiveness (OR = 2.08) as significant predictors of overall satisfaction, whereas reliability was not significant. Age, education, profession, and frequency of hospital visits were associated with satisfaction, while gender and income were not. CONCLUSIONS: Interpersonal aspects of care, particularly assurance and empathy, are the strongest determinants of satisfaction in a public medical college hospital in Bangladesh. Although respondents expressed confidence in healthcare providers, substantial deficiencies in infrastructure and perceived inequities in care for vulnerable populations remain. Addressing these gaps is essential for improving patient-centered service delivery and healthcare quality in public hospitals.