Buy this Article for $10.95

Have a coupon or promotional code? Enter it here:

When you buy this you'll get access to the ePub version, a downloadable PDF, and the ability to print the full article.


hospital care, noncompensatory model, patient satisfaction, race



  1. Otani, Koichiro
  2. Herrmann, Patrick A.
  3. Kurz, Richard S.


Background: Patient satisfaction studies have received strong attention from both health care managers and researchers. Many of them investigate how patients combine their health care attribute reactions to arrive at their overall satisfaction. These studies, however, did not specifically investigate a possible different combining process among different racial groups. Thus, these minority populations were statistically marginalized in the outcomes of the analyses. It means that parameter estimates of the attributes were assumed to be the same for all racial groups.


Purpose: This study investigated a possible different combining process between Caucasian and African American patients. The objective of this study was to discover how differently Caucasian and African American patients combine their attribute reactions to arrive at their overall satisfaction.


Methodology/Approach: Data used for this analysis were collected from 32 hospitals by using a patient satisfaction questionnaire, the Consumer Assessment of Healthcare Providers and Systems, Hospital version. There were 29,684 cases. A multiple linear regression analysis with a scatter term was conducted while controlling for age, gender, perceived health, and educational attainment.


Findings: Caucasian and African American patients recognize the same four attribute reactions (nursing care, staff care, physician care, and environment). However, when paying attention to the sizes of the parameter estimates (weights), these two groups show a clear difference. It is also found that Caucasian patients are risk averse. On the other hand, African American patients are likely to average out their attributes reactions proportionately.


Practice Implications: The critical differences found in this study provide a very important implication for health care managers developing an intervention program to improve patient satisfaction. A one-size-fits-all strategy would not work for all patients. Caucasian and African American patients are different, and each requires a different intervention program to improve their overall evaluation of their hospital stay.