Patient satisfaction is a widely accepted indicator of healthcare quality and hospital performance. It represents patients’ overall evaluation of the care they receive, including clinical treatment, nursing attention, interpersonal communication, physical environment, administrative efficiency, and cost of services. As healthcare systems evolve toward patient-centered models, satisfaction has become as important as clinical outcomes in assessing service excellence and institutional accountability.1,2 A high level of satisfaction is associated with better treatment adherence, reduced readmission rates, and stronger patient–provider relationships. Conversely, dissatisfaction can lead to non-compliance, negative perceptions, and poor utilization of healthcare services. Patient satisfaction is, therefore, not only a measure of service quality but also a determinant of public trust and organizational sustainability. Its assessment provides actionable feedback for managers and policymakers to identify service gaps and implement targeted improvements.3-5 Multiple factors influence satisfaction levels, including demographic variables such as age, gender, education, and income, as well as institutional aspects like staff behavior, communication, cleanliness, waiting time, food quality, and hospital infrastructure. In low- and middle-income settings, affordability and accessibility add further complexity. Hence, periodic evaluation of patient satisfaction offers a realistic understanding of healthcare delivery performance within local contexts.6-8 In-patients are particularly valuable respondents for such assessments, as they experience the full continuum of hospital care—from admission and treatment to discharge and follow-up. Their feedback provides comprehensive insight into the effectiveness, empathy, and responsiveness of hospital services. Despite extensive global research, limited data exist from tertiary-care teaching hospitals located in semi-urban or rural regions of India, where service delivery patterns and patient expectations differ from metropolitan settings. Against this background, the present study aims to assess the satisfaction level among in-patients at Adesh Hospital, Bathinda, and to identify determinants of dissatisfaction. The findings are intended to guide administrators in strengthening patient-centered practices and improving the overall quality of healthcare services. Aims & Objectives The study aims to evaluate the overall satisfaction levels of in-patients admitted to a tertiary care hospital in Bathinda, identify the key factors contributing to dissatisfaction, and suggest practical measures to enhance the quality of hospital services and patient experience.

Study Design and Setting A descriptive cross-sectional study was carried out at Adesh Hospital, Bathinda, a tertiary care super-specialty teaching hospital situated in the rural area of Bathinda district, Punjab. The hospital caters to both rural and urban populations and provides a wide range of specialty and super-specialty healthcare services. Study Population The study population consisted of in-patients admitted to various wards of the hospital who had completed at least 24 hours of stay. Patients aged 18 years and above of either gender were included. Patients admitted in intensive care, emergency, psychiatric, pediatric, or special wards and those unwilling to participate were excluded from the study. Sample Size and Sampling Technique The sample size was determined using Daniel’s formula: n = Z²pq/d². Taking an expected satisfaction proportion of 92% from a previous study by Saravanakumari et al9, with Z = 1.96, q = 8, and an allowable error of 5%, the calculated sample size was 118. Considering possible non-response, the final sample size was increased to 130. Participants were selected using a convenience sampling technique based on their availability and consent. Data Collection Tool and Procedure Data were collected using a pre-designed, pilot-tested, and validated semi-structured questionnaire consisting of two sections. Section A recorded socio-demographic details such as age, gender, residence, education, occupation, and income, while Section B assessed satisfaction levels regarding various hospital services. The data were collected through face-to-face interviews conducted in a private setting after explaining the purpose of the study. Written informed consent was obtained from all participants, and confidentiality was assured. Data Analysis The data were compiled and analyzed using Microsoft Excel. Results were summarized in the form of frequencies, percentages, and proportions, and presented through tables and charts. Ethical Considerations Ethical clearance was obtained from the Institutional Ethics Committee for Biomedical and Health Research, Adesh University, Bathinda, Punjab. Informed written consent was obtained from each participant before data collection, and confidentiality of information was strictly maintained.

A total of 130 in-patients participated in the study. The majority (40.8%) were in the age group of 31–40 years, followed by 26.9% aged 41–50 years, while 16.9% were between 18–30 years and 15.4% were above 50 years of age. Males comprised two-thirds (66.9%) of the respondents, and 33.1% were females. Most participants had completed secondary (28.5%) or graduate (32.3%) education, while a smaller proportion were postgraduates (7.7%) or had only primary schooling (6.2%). Nearly 60% of respondents resided in rural areas, and 83.8% were married. Occupationally, farmers (26.9%) formed the largest group, followed by housewives (19.2%), daily laborers (13.8%), and those in private business or service (13.1%). In terms of income, almost half (48.5%) reported annual earnings below ₹1 lakh, while 37.7% earned between ₹1–5 lakh. Regarding payment methods, cash (36.9%) and UPI (34.6%) were the most common, with smaller proportions using government (17.7%) or private (10.8%) insurance. About 62.3% were re-admissions, and 37.7% were new admissions. The majority (36.2%) had a hospital stay of 2–7 days, and only 11.5% stayed for more than 28 days (Table 1). Table 1: Socio-Demographic, Economic, and Admission Characteristics (N=130) Characteristic Category Frequency (n) Percentage (%) Age Group (Years) 18-30 22 16.9 31-40 53 40.8 41-50 35 26.9 >50 20 15.4 Gender Male 87 66.9 Female 43 33.1 Highest Educational Qualification Primary Education 8 6.2 High School 33 25.4 Secondary School 37 28.5 Graduate 42 32.3 Post Graduate 10 7.7 Residential Area Rural 78 60.0 Urban 52 40.0 Marital Status Married 109 83.8 Single 21 16.2 Primary Occupation Farmer 35 26.9 Housewife 25 19.2 Daily Labor 18 13.8 Private Service/Business 17 13.1 Student 15 11.5 Government Service 15 11.5 Others 5 3.8 Annual Income (INR) < 1 Lakh 63 48.5 1 - 5 Lakhs 49 37.7 > 5 Lakhs 18 13.8 Payment Method Cash 48 36.9 UPI 45 34.6 Government Insurance 23 17.7 Private Insurance 14 10.8 Admission Type Re-admission 81 62.3 New Admission 49 37.7 Duration of Hospital Stay 2-7 days 47 36.2 8-14 days 29 22.3 15-21 days 21 16.2 22-28 days 18 13.8 >28 days 15 11.5 The participants were drawn from various hospital wards, ensuring wide departmental representation. The medical ward had the highest number of respondents (24.6%), followed by surgical (20.8%), gynecology (16.9%), and orthopedics (14.6%). Smaller proportions were from respiratory (6.9%), ophthalmology (6.2%), otorhinolaryngology (6.2%), and dermatology/venereology/leprosy wards (3.8%). This distribution reflects the hospital’s general admission pattern, with internal medicine and surgical units accommodating the largest inpatient loads (Table 2). Table 2: Distribution of Study Participants by Clinical Ward Ward Frequency (n) Percentage (%) Medical 32 24.6 Surgical 27 20.8 Gynecology 22 16.9 Orthopedics 19 14.6 Respiratory 9 6.9 Ophthalmology 8 6.2 Otorhinolaryngology 8 6.2 Dermatology / Venereology / Leprosy 5 3.8 Total 130 100.0 High levels of satisfaction were recorded across interpersonal and clinical domains. Nearly all respondents were satisfied with payment services (96.2%) and security arrangements (95.4%). Cleanliness was rated positively by 93.1% of patients, with only one respondent (0.8%) expressing dissatisfaction. Satisfaction with drinking water (90.0%) and housekeeping services (90.8%) was also high. Clinical care received from consultants and doctors was rated as good by 83.8% of participants, while 16.2% rated it as average. Waiting time during admission or registration was considered good by 86.2% and average by 13.8%. Nursing care received the lowest satisfaction in this group, with 81.5% rating it good and 18.5% average, indicating a minor gap in interpersonal or response-related aspects (Table 3). Table 3: In-patient Satisfaction with Interpersonal, Clinical, and Administrative Services Service Domain Level of Satisfaction Frequency (n) Percentage (%) Payment Services Good 125 96.2 Average 5 3.8 Security Service Good 124 95.4 Average 6 4.6 Cleanliness Good 121 93.1 Average 8 6.2 Poor 1 0.8 Drinking Water Facility Good 117 90.0 Average 13 10.0 Housekeeping Services Good 118 90.8 Average 12 9.2 Consultants/Doctors Care Good 109 83.8 Average 21 16.2 Waiting Time (Admission/Registration) Good 112 86.2 Average 18 13.8 Nursing Services Good 106 81.5 Average 24 18.5 Evaluation of infrastructural amenities revealed that lighting facilities were well appreciated by most patients (89.2%), and only a small fraction (3.1%) found them poor. Toilet and washroom facilities were satisfactory for 70.8%, though 22.3% rated them average and 6.9% poor. Linen services received mixed responses, with 64.6% expressing satisfaction and 28.5% reporting average quality, suggesting potential scope for improvement in linen cleanliness or availability. The lift facility emerged as the most concerning area, with just 56.9% rating it good, 28.5% average, and 14.6% poor, indicating reliability or accessibility issues that warrant administrative attention (Table 4). Table 4: In-patient Satisfaction with Core Facility Amenities Service Domain Level of Satisfaction Frequency (n) Percentage (%) Lighting Facility Good 116 89.2 Average 10 7.7 Poor 4 3.1 Toilet/Washroom Facility Good 92 70.8 Average 29 22.3 Poor 9 6.9 Linen Facility Good 84 64.6 Average 37 28.5 Poor 9 6.9 Lift Facility Good 74 56.9 Average 37 28.5 Poor 19 14.6 Satisfaction with dietary and catering facilities was moderate compared to other service domains. About two-thirds of patients were satisfied with dietary services (67.7%) and canteen facilities (66.9%), while approximately one-third rated them average or poor. Among those who used mobility assistance services, 84.7% of stretcher or wheelchair users and 73.2% of ambulance service users reported good experiences, although some cited delays or limited availability. These findings highlight that while core clinical care was satisfactory, auxiliary and hospitality services remain relatively weaker areas requiring focused improvement (Table 5). Table 5: In-patient Satisfaction with Hospitality and Auxiliary Services Service Domain Level of Satisfaction Frequency (n) Percentage (%) Dietary Services Good 88 67.7 Average 37 28.5 Poor 5 3.8 Catering/Canteen Facility Good 87 66.9 Average 35 26.9 Poor 8 6.2 Stretcher/Wheelchair Facility (n=59) Good 50 84.7 Average 9 15.3 Ambulance/Transport Services (n=41) Good 30 73.2 Average 11 26.8 Ancillary services, including pharmacy, laboratory, and radiology, demonstrated consistently high satisfaction levels, with 90.8%, 90.0%, and 87.7% of respondents rating them good, respectively. These results reflect efficient diagnostic and medication support within the hospital. Parking facilities were rated good by 72.3% but average or poor by 17.6%, indicating space or congestion challenges. Seating arrangements within hospital waiting areas were satisfactory for 82.3% of patients. Among additional amenities, bathing facilities, available to a subset of 52 patients, were considered good by 23.1%, average by 15.4%, and poor by 1.5%, reflecting lower utilization and quality concerns. Night-stay arrangements for attendants were perceived as satisfactory by only half (50%), while 34.6% rated them poor, highlighting a critical area for infrastructural and comfort enhancement (Table 6). Table 6: In-patient Satisfaction with Additional Services Service Domain Level of Satisfaction Frequency (n) Percentage (%) Pharmacy Services Good 118 90.8 Average 12 9.2 Laboratory Services Good 117 90.0 Average 13 10.0 Radiology Services Good 114 87.7 Average 16 12.3 Parking Facility Good 94 72.3 Average 18 13.8 Poor 5 3.8 Seating Arrangements Good 107 82.3 Average 18 13.8 Poor 5 3.8 Bathing Facility (n=52) Good 30 23.1 Average 20 15.4 Poor 2 1.5 Night Stay Facility (for Attendants) Good 65 50.0 Average 20 15.4 Poor 45 34.6

The present cross-sectional study assessed the level of satisfaction among in-patients admitted to Adesh Hospital, Bathinda, and identified key areas influencing their perceptions of hospital care. Patient satisfaction, a vital component of healthcare quality assessment, reflects both technical performance and interpersonal aspects of service delivery. The findings of this study are compared with results from similar studies conducted in India and other developing nations to contextualize the observations and identify converging and diverging trends. In the present study, the largest proportion of patients belonged to the 31–40-year age group (40.8%), followed by those aged 41–50 years (26.9%). This is comparable to the findings of Raju et al10, who observed that 42.1% of respondents were between 31–40 years and 21.2% between 41–50 years in their study conducted in a multispecialty public hospital in Mysuru, Karnataka. The predominance of middle-aged patients in both studies suggests that this age group forms the bulk of hospital admissions due to active workforce participation and associated lifestyle or occupational health issues. Gender distribution in the current study showed that 66.9% were males and 33.1% were females, a trend opposite to that reported by Subedi et al11 in Nepal, where 62% of patients were female. This discrepancy can be attributed to cultural and healthcare-seeking behavior differences between India and Nepal, with males in rural India more likely to seek hospital-based care due to their role as economic providers. Regarding educational background, 32.3% of respondents were graduates, while 28.5% had completed secondary education. In contrast, Subedi et al11 reported 80% literacy in their study but with lower educational attainment levels. The higher education levels among patients in the present study may reflect the urbanizing and educational progress of Punjab, an economically advanced Indian state, compared to neighboring developing regions. A majority (60%) of patients in this study hailed from rural areas, consistent with Bathinda’s predominantly agrarian demographic profile. Raju et al10also reported a significant rural representation in their study, underscoring the reliance of rural populations on tertiary healthcare centers for specialized treatment. Occupationally, farmers (26.9%) and housewives (19.2%) were the largest groups, reflecting the local economy. Annual income levels showed that nearly half earned below ₹1 lakh per annum, consistent with the middle-to-lower socioeconomic profile typical of patients in public and teaching hospitals across northern India. The majority of respondents (62.3%) were re-admitted cases, suggesting strong institutional trust and continuity of care. In comparison, Saravanakumari et al9 reported an overall inpatient satisfaction rate of 92% in a tertiary hospital in Tamil Nadu, indicating that high-quality services often encourage repeat hospital use. The average duration of hospital stay in this study was relatively short, with 36% staying 2–7 days and 22% staying 8–14 days, which aligns with global trends emphasizing shorter inpatient durations to reduce healthcare costs and improve turnover efficiency. The present study found remarkably high satisfaction levels with payment services (96.2%), security arrangements (95.4%), and cleanliness (93.1%). These findings are consistent with Raju et al10, who reported that 90% of patients were satisfied with cleanliness in their Mysuru-based study. Similarly, Subedi et al11observed lower satisfaction with payment systems (only 16% rated them satisfactory), likely due to limited digitalization and insurance penetration in Nepal, highlighting India’s progress in adopting cashless healthcare payment mechanisms. Satisfaction with consultant and doctor care (83.8%) and nursing services (81.5%) in this study also mirrors findings by Raju et al10 and Mahapatra et al6, both of whom emphasized the critical role of interpersonal communication, empathy, and timely response in shaping patient perceptions of care. Although nursing care was rated slightly lower than physician care, such disparities are common in similar studies, as interpersonal attention and response time are often key determinants of satisfaction in nursing domains. Core facility amenities such as lighting (89.2%) and washroom facilities (70.8%) received favorable ratings, consistent with the findings of Verma et al12, who reported 73% satisfaction with toilet facilities in their study. Linen (64.6%) and lift (56.9%) facilities received comparatively lower satisfaction, highlighting potential gaps in maintenance and accessibility. Kumar et al5, in a study conducted in a rural public medical college, reported similar observations, with only 46% rating lift facilities as very good and 6% as average. The higher satisfaction observed in the current study can be attributed to the superior infrastructure typical of private tertiary hospitals like Adesh Hospital compared to public-sector institutions. Dietary (67.7%) and canteen (66.9%) services in the current study demonstrated moderate satisfaction, influenced by factors such as cost and taste preferences. In contrast, Subedi et al11 reported only 49% satisfaction with canteen services in Nepal, citing poor food quality and high prices. The higher ratings in the present study may be due to better quality control and oversight in a private hospital setting. Similarly, Bahall et al13 found that only 54% of respondents in a public-sector Caribbean hospital were satisfied with wheelchair and stretcher services, compared to 84.7% in the present study—again reflecting differences in resource availability and maintenance standards between private and public hospitals. Ambulance services were rated positively by 73.2% of respondents, which compares favorably with the 40% satisfaction reported by Raju et al10in Mysuru. This suggests that private tertiary care facilities may have more reliable transport systems and shorter response times. However, the night-stay facility for attendants received only 50% satisfaction, indicating the need for infrastructural and comfort improvements for caregivers—an aspect often overlooked in hospital planning in low- and middle-income settings. High satisfaction was recorded for pharmacy (90.8%), laboratory (90.0%), and radiology (87.7%) services, closely aligning with the results of Raju et al10 and Mahapatra et al6, who reported similar satisfaction trends in diagnostic and drug-dispensing departments. Conversely, Subedi et al11 observed lower satisfaction in Nepalese hospitals, where delays in reporting, unavailability of medicines, and high costs were common complaints. These contrasts underline the importance of efficient diagnostics and pharmacy systems in enhancing patient trust. Parking (72.3%) and seating arrangements (82.3%) were rated positively, though still lower than clinical services. The parking satisfaction rate aligns with findings from Subediet al11, where only 58.3% were satisfied, suggesting that urban congestion and space limitations remain universal challenges. Bathing (23.1%) and linen (64.6%) facilities emerged as weaker domains, confirming the continuing infrastructural constraints in non-clinical areas even within private hospitals. Overall, satisfaction levels in this study (≥80% in most domains) are higher than those reported in comparable studies across South Asia. This suggests that private tertiary hospitals in India, such as Adesh Hospital, have achieved substantial progress in patient-centered care, infrastructure, and digital service delivery. However, moderate satisfaction in non-clinical amenities such as linen, dietary, and attendant facilities indicates that patient comfort and hospitality remain areas requiring institutional attention. The findings echo those of Mahapatra et al6, who highlighted that continuous feedback, monitoring, and staff sensitization programs are essential for sustained quality improvement. The strong performance in clinical and administrative areas validates the hospital’s service protocols, while weaker infrastructure-related aspects point toward the need for reinvestment in supportive services. In summary, the present study demonstrates high satisfaction among in-patients at Adesh Hospital, Bathinda, particularly in areas related to medical care, security, and cleanliness. The results are consistent with Raju et al10, Saravanakumari et al9, and Mahapatra et al6, reaffirming that courteous staff behavior, effective communication, and clean surroundings are the strongest determinants of patient satisfaction. Comparisons with studies from Nepal (Subedi et al11, the Caribbean (Bahallet al13), and public-sector hospitals (Kumar et al5)underscore that infrastructural and service disparities continue to influence satisfaction outcomes. To further enhance patient experiences, targeted interventions in comfort-related amenities and hospitality services should complement existing clinical excellence Strengths and Limitations The strength of this study lies in its comprehensive evaluation of in-patient satisfaction across multiple domains—clinical, administrative, and infrastructural—within a tertiary care teaching hospital serving a largely rural population in Punjab. By including participants from different wards and using a validated, pre-tested questionnaire with face-to-face interviews, the study ensured authentic, first-hand insights into patients’ experiences and perceptions of healthcare delivery. It contributes valuable regional evidence to the limited body of research on patient satisfaction in non-corporate hospitals of northern India. However, the study was limited to a single institution and excluded outpatient and pediatric populations, which may restrict the generalizability of findings. Additionally, as respondents were interviewed during their hospital stay, a possibility of socially desirable responses cannot be ruled out. Despite these limitations, the study’s robust design and contextual relevance make it a meaningful contribution to the understanding of hospital-based patient satisfaction in low- and middle-income settings.

This study assessed the satisfaction levels of 130 in-patients at Adesh Hospital, Bathinda, and revealed an overall high degree of satisfaction with the quality of medical care, staff behavior, cleanliness, and administrative efficiency. The majority of patients expressed confidence in the doctors, nurses, and hospital staff, and appreciated the cleanliness, security, and affordability of treatment. However, moderate satisfaction with certain physical amenities such as parking, dietary services, and attendant facilities indicates the need for infrastructural and hospitality improvements. These findings highlight that patient satisfaction is a multidimensional construct influenced not only by clinical care but also by the hospital environment, interpersonal communication, and service responsiveness. Regular patient feedback and targeted interventions are essential to sustaining quality improvement, strengthening trust, and ensuring a more patient-centered healthcare experience.

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