Dr. Bekele, DessalegnDr. Yitbarek, Henok Yitbarek2018-10-232023-11-052018-10-232023-11-052017-12http://etd.aau.edu.et/handle/123456789/13094Consumer satisfaction is playing an increasingly important role in quality of care reforms and health-care delivery more generally in United States of America and Europe. However, consumer satisfaction studies are challenged by the lack of a universally accepted definition or measure [1–6] and by a dual focus: while some researchers focus on patient satisfaction with the quality and type of health-care services received [7–10]. Others focus on people’s satisfaction with the health system more generally [11–14]. The importance of both perspectives has been demonstrated in the literature. For example, satisfied patients are more likely to complete treatment regimens and to be compliant and cooperative [14, 15]. Research on health system satisfaction, which is largely comparative, has identified ways to improve health, reduce costs and implement reform. Even though it is difficult to find an agreed-upon definition, patient satisfaction is “health care recipient’s reaction to salient aspects of his or her experience, expectation and preference of a service met by health care service and provider [17] and is one desired outcome of mental health care service and core parameter for the positive evaluation of a mental health care system [18-20]. For consumers of mental health services, satisfaction has become a significant contributing outcome in the assessment and improvement of quality of care, including adherence to treatment, intent to return for care and follow-up and continuity of outpatient care [21]. The absence of a solid conceptual basis and consistent measurement tool for consumer satisfaction has led, over the past 10 years, to a proliferation of surveys that focus exclusively on patient experience, i.e. aspects of the care experience such as waiting times, the quality of basic amenities, and communication with health-care providers, all of which help identify tangible priorities for quality improvement. The increasing importance of patient experience and the sustained interest in comparing people’s satisfaction with the health system across different countries and time 2 periods suggests the need to characterize the relationship between them. Research relating global satisfaction ratings with patient experience has revealed strong associations between the two [23]. Yet to what extent patient experience explains satisfaction with the health-care system remains unclear. The literature suggests that much of the remaining variation in health system satisfaction after adjusting for factors commonly used to measure the concept is a reflection of patient experience [24, 25]. Different studies showed that the global level of patient satisfaction to psychiatric services ranges from 39.3% to 91.9%. A range of factors can affect patient satisfaction, including unpleasantly built environments, staff being too busy, failure to obtain prescribed medications from the hospital pharmacies, the stigma of a psychiatric treatment service, long waiting hours, results, and payment for psychiatric services. Consequently, a dissatisfied patient is not psychologically and socially well becoming evident of lack of goal attainment by the service provider or the clinician.[31–33] Different studies also indicated that, other than the quality of service delivery, satisfaction is also affected by many factors such as patients’ demographics [34,35] diagnosis and duration of disease, [36,37] treatment program, [38] and patients’ expectation of service [39] Studies on 21 European countries showed that patient experience accounts for only a small fraction of the unexplained variation in health system satisfaction, even after adjustments for the demographic, health and institutional factors with which such satisfaction is commonly associated. [21–23, 26–30]. In this study, most of the variation in satisfaction with the health-care system was explained by factors above and beyond patient experience. Reliance on psychiatric symptoms alone as a measure of service satisfaction is somehow a narrow concept; it is rather important to see how satisfied the patients are by the service they received [42]. Despite psychiatric outpatient service being given in most of referral hospitals in Ethiopia, there had been few evidences that examined patients’ 3 satisfaction with the quality of psychiatric care based on sound theoretical frameworks and this study also probably contributes pattern of satisfaction of psychiatric patients in Ethiopia. However the scales used to measure satisfaction level was based on scales validated and used in other countries. Hence a need to understand more patients experience based on a mental health service scale (MHSSS) scale, validated and tested in Ethiopia makes this study sound helpful [45].Patient’s responses to their experiences of using services are under-researched in the context of mental healthcare in low income countries. Therefore, the purpose of this study is to explore the factors underlying psychiatric patients’ satisfaction with the health-care system and the extent to which satisfaction reflects their experience of care with the validated MHSSS (mental health service satisfaction scale) tool in Ethiopia, written in Amharic and English version as a measure of satisfaction among consumers of mental healthcare.en-UShealth service satisfaction,PsychiatryThesis