Evaluating factors affecting patient satisfaction using the Kano model

Tejaswi Materla, Elizabeth A. Cudney, Deborah Hopen

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Purpose: Healthcare providers are increasing their focus on patient satisfaction and patient-oriented services as they play a significant role in managing rising costs, elevating service quality and establishing sustainable quality improvement strategies. In recent years, the Kano model has gained popularity in the healthcare industry and has been employed to improve patient satisfaction. The purpose of this paper is to illustrate how the Kano model can be deployed to identify a wide range of complex patient needs and convey its potential usefulness in the continuous improvement of the healthcare sector. Design/methodology/approach: This paper provides a case study of implementing the Kano model to identify diverse patient needs and aims to eliminate the gaps identified in prior research, which include generically applying the Kano model to all service units of the healthcare system and using a predetermined service quality scale. This study emphasizes the importance of scale development and individual attention to each healthcare service unit in determining intricate patient needs. A cross-sectional study was conducted at the Student Health Services (SHS) of Missouri University of Science and Technology where the data were collected using the Kano survey. The respondents included undergraduate and graduate students that have utilized the healthcare services offered. A total of 138 patients were surveyed using a Kano model-based questionnaire that included demographics and treatment as well as service expectations. Findings: Of the 21 quality attributes evaluated by the patients, 16 were categorized as one-dimensional, 3 as indifferent, and 2 as attractive attributes using the Kano model. None of the quality attributes showed a dominant must-be feature. The students considered the availability of appropriately qualified medical staff within 10 minutes of the check-in process and provision of after-hours care as attractive attributes that create greater satisfaction. Research limitations/implications: The research was conducted at a university SHS center. Therefore, respondents in the survey are in a younger age group, which may affect patient expectations. In addition, expectations of an SHS center may be different than expectations of visiting a primary care physician and other healthcare units. Originality/value: This study contributes to a better understanding of the identification of healthcare needs using the Kano model and advocates focusing on shifts in the categories over time and changes in the demographic environment.

Original languageEnglish (US)
Pages (from-to)137-151
Number of pages15
JournalInternational Journal of Health Care Quality Assurance
Issue number1
StatePublished - Feb 11 2019

All Science Journal Classification (ASJC) codes

  • Health Policy


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