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health care quality, hospital, patient satisfaction



  1. Swan, John E.
  2. Richardson, Lynne D.
  3. Hutton, James D.


This article investigates the effects of appealing hospital rooms on patient evaluations of hospital services. A field study contrasting appealing and typical rooms finds that appealing rooms result in more positive patient evaluations of physicians and nurses, as well as more favorable patient judgments of the service.


Customer evaluation of services is of great concern to both health care services practitioners and researchers. The physical surroundings in which services in general are delivered have been found to influence customer judgments of service performance including customer satisfaction, loyalty, favorable word-of-mouth (WOM) recommendations, and service quality perceptions.1-6 A common finding in the health care literature is that the physical facilities are a component of patient evaluations of health care services.7-16 However, some studies have questioned the importance of tangibles in health care.17,18 The impact of health care facilities on human behavior has long been a topic of interest.15,19-21


To our knowledge, the extent to which appealing hospital rooms as a type of physical facilities will positively influence hospital patient evaluations of physicians and nurses and hospital services is not known. This work is an initial investigation toward understanding the effects of part of the physical environment on patient outcomes. The impact of better physical facilities is of great practical concern as each year health care organizations spend billions of dollars on facility projects.22 However, until good evidence is found on the benefits of appealing and more costly rooms, then the business case for such rooms is not conclusive.


An important finding from controlled experiments in environmental psychology is the appealing setting effect, that is, subjects in appealing facilities judge other people more favorably than do subjects in less appealing settings.23,24 No previous study has tested the possibility that the appealing setting effect generalizes to hospital patients' evaluations of care received. The objective of the study on which this article is based was to test the hypothesis that patients in appealing hospital rooms compared to patients in typical rooms will more favorably evaluate physicians and nurses. A second hypothesis examined was that appealing facilities result in more favorable patient judgments of the service rendered including an overall evaluation, intentions to utilize the hospital in the future, and plans to give favorable word-of-mouth.


The hospital selected for study made it possible to examine evaluations of services made by similar patients in appealing and typical rooms. The appealing rooms were in an area of the hospital, the Magnolia Pavilion (pseudonym), with well-decorated and appointed hotel-like rooms with wood furniture, decorator art, carpeted floors, crown molding, and ceramic tile baths. The typical rooms were standard wardrooms with typical metal hospital beds, inexpensive family sitting chairs, and no artwork. The typical rooms were slightly smaller and noise levels were higher than in Magnolia.


In the next section we present theoretical underpinnings for a model of the effects of hospital facilities on customer evaluations. This is followed by study hypotheses, the research method, and results. The article ends with a discussion of the importance of the findings, and includes managerial implications and directions for future research.