Policy Effects on the Quality of Public Health Care: Evaluating Portuguese Public Hospitals’ Quality through Customers’ Views

Jaime R. S. Fonseca, Rosária M. P. Ramos, Ana M. P. Santos, Ana P. S. S. Fonseca


In this paper, public health care administration issues are reviewed and public hospital patients’ views on quality of health care are empirically tested. The purpose is to support the recommendation of new public policies that lead to better performance, if necessary. Hospital patients’ views on service quality were assessed through a questionnaire to estimate a global customer satisfaction measure. We argue that customer satisfaction should be measured through multiple indicators, as a latent variable. Thus, we considered the latent segment models (LSM) approach to assess customer service satisfaction. We found a two-segment latent structure: segment 1, the satisfied, with 48 percent of patients, mostly male and middle-aged patients; and segment 2, the unsatisfied, with 52 percent of patients, mostly female and youngest/oldest patients.


public administration; public policies; health care evaluation; patients’ views; latent segment models; customer satisfaction; Portugal

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ISSN 1802-4866 | Charles University in Prague, Faculty of Social Sciences | Creative Commons Attribution 3.0.