Searching for the most suitable tool to measure satisfaction with healthcare: the importance of patient discontent

User´s satisfaction is an important tool to evaluate the performance of healthcare services. This paper aims to provide the most suitable measure of quality assessment that can help policy-makers in the design and implementation of programs oriented to successfully increase healthcare satisfaction. In doing so, a comparative study is proposed to simultaneously study the effects of individual and market characteristics on two alternative measures of user’s quality assessment, namely: (1) level of confidence with the service provided (5-point Likert scale response), and (2) whether or not you would recommend the service to a friend or relative (dichotomous response). Results indicate that there seems to be an invariant relationship between the two alternative variables and the latent and unobserved variable on users’ global satisfaction opinion or service quality assessment. However, when considering the different dimensions of the service provided, there is a different ranking on the relevance of these dimensions, with the relative importance for the 5 points variable being more equilibrated than the binary choice one. This observation has important implications for health policy management. It is suggested that the dichotomous response is a better tool to highlighting areas of patient discontent.