الفهرس 
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Abstract
Measurement of patient satisfaction plays an increasingly important role in the growing push toward accountability among health care providers. Overshadowed by measures in the quality of care equation, patient satisfaction measurement has traditionally been related to service improvement efforts by hospitals and physician, and to fulfill accreditation requirements of health plans, while some plans the satisfaction scores to financial incentives as a portion of their calculation of payment bonus to primary care physicians with capitation contracts.
Variation in measurement tools, however, is an obstacle to make patient satisfaction a reliable part of the quality equation. Data on patient satisfaction is currently collected by various entities, for different purposes. Health care system-including health plans, hospitals and physician practices. Only recently have efforts begun to bring uniformity to patient satisfaction measurement for hospitals, as part of a hospital report card initiative launched by the Department of Health and Human Services.
The aim of the work is measuring healthcare satisfaction among the in-patients in both surgical and medical wards in the Medical Research Institute (MRI) hospital
Design and population: Cross sectional assessment of healthcare satisfaction of in-patients in both medical and surgical wards in the free and private sectors in the Medical Research Institute (MRI), Alexandria, Egypt.
Inclusion Criteria: Adults 18 years and older of in-patients free and private sectors with length of stay of at least one overnight.
Questionnaire: Various sources and methods were used to determine the questions to be included in the questionnaire. First, a literature search using MEDLINE database, that aimed to analyze the instruments that had been devised so far to evaluate inpatient satisfaction at the national and international levels.
This study reports on the development and validation of questionnaire to assess patients’ experience in health in a low-income country, Egypt. The questionnaire includes 25 questions that comprise 4 constructs. The questionnaire was adopted from Ethiopia, very similar conditions. The results indicate that the scales in questionnaire have good to excellent reliability, and good validity. Reliability and validity are again measured after adaptation to the Egyptian culture. Again good to excellent reliability, and good construct validity are assured.
Ethics: All study participants are informed and declared their approval in the participation of the survey as they can’t sign a confirmed consent due to high percentage of illiteracy.
Observation checklist was prepared from the Egyptian standards in healthcare of the ministry of health, the general quality department to compare patients resposnse with it.
Majority of patients at the cross sectional study are females (54%),Age 50 years old or more (52%),illiterate(59%),( 61%) mentioned that it was their first visit, and (54%) stated that they are in good condition.
Most of patients(93%) are satisfied with the healthcare service, while satisfaction inside the wards are surprising, (100%)of medical or internal medicine department are satisfied, while (84.8%)of patients only are satisfied in surgery ward.
It is true that unwillingness of some of patients to express dissatisfaction with their providers or care to a third party, even in conditions of complete anonymity. Patients may be reluctant to hold providers accountable to quality standards that are unrealistic given the broader socioeconomic realities that make attaining such standards impossible. This reluctance might be further enhanced by misconceptions that poor assessments would lead to punitive measures directed at the providers.
In this framework, less educated people have little knowledge of what ideal care should look like and are also less likely to have had the experience for an informed comparison. The findings here are reminiscent of perceptions of poverty described in some research on poverty and happiness, where people with higher income sometimes identify themselves as poor while those below the objective poverty line may not. This disconnect between satisfaction and objective measures is explained by different expectations in these populations. An alternate explanation is that less educated clients are unable to judge the technical quality of the services they received. Patients may never know for sure whether the service was performed correctly or if it was needed in the first place. Some authors have noted that, the greater the perceived technical nature of treatment, the more likely a patient will not feel competent to judge its quality.
Quantitative assessment tools for quality and patient satisfaction need further refinement to ensure that they provide the robust measures needed by policy-makers.
Qualitative research that would explore how people assess quality, and how they would like to report on it, would be appropriate. It could help to calibrate and integrate subjective and objective measures of quality. Until then, patient satisfaction surveys should be interpreted with caution.