Symmetric and asymmetric effects of primary healthcare attributes on patient satisfaction: Do they vary across patients?

Perceived quality of primary healthcare services and patient satisfaction are concepts that are increasingly important because of their impact on healthcare results and providers operational expenses' management. Though there is growing evidence that the relationship between service performance and satisfaction is asymmetric, there are no studies investigating the nature of this relationship in the context of primary healthcare services and how this is affected by patients' characteristics. The purpose of this study is to exploit the framework of the three-factor theory to distinguish between different types of quality attributes, and then to explore possible deviations from the aggregated quality attributes' classification pattern for patients with different demographic characteristics. The results of an empirical study, concerning 407 service users, confirmed the asymmetric relationship between identified attributes' performance and patient satisfaction and revealed three attributes' classification patterns for different patient characteristics. Implications for practice and directions for future research are then discussed.