Patient satisfaction informs programmatic decision-making and policy development as an integral component of contemporary evaluation approaches to the quality of healthcare. In Armenia, surveys –including those conducted by the AUA School of Public Health – consistently reveal high patient satisfaction ratings of healthcare services despite documented poor-quality care. The manuscript explored this inconsistency through qualitative content analysis of interviews with 25 women who had recently used reproductive healthcare services. The analysis revealed that cultural and socioeconomic characteristics largely explain the contradiction between high satisfaction and poor-quality.
• Although women shared an understanding of what quality care should be many were satisfied because their low expectations were met.
• Patients avoided critiquing healthcare services because of personal relationships with and respect for their providers and fear of losing services, especially given the small communities where they live and their tight social networks.
• They also reported that it was not culturally acceptable to criticize healthcare services.
These findings may be relevant and valuable to other countries with similar levels of economic development and cultural considerations and with similar contradictions between high satisfaction and poor healthcare services. Given this insight, patient satisfaction measures for health programs need careful, contextual interpretation and should not be relied on as a primary variable for decision making.
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The AUA School of Public Health works actively to improve the health of the populace and health services in Armenia and the region through interdisciplinary education and development of public health professionals and others to be leaders in public health, health services research and evaluation, and health care delivery and management.