College of Medicine & Veterinary Medicine

Understanding patient satisfaction

Patient satisfaction with surgery depends on a wide range of factors, researchers say.

A study by the University’s Department of Orthopaedics and Trauma has found that patients’ satisfaction with their operation depends not only on the surgeon’s ability to treat them safely, but on the hospital environment.

More than 4,700 joint replacement surgery patients were involved in the study, which is published online in the British Medical Journal Open.


Other factors identified to influence patient experience and satisfaction includes the meeting of pre-operative expectations and good pain relief.

The five-year study is the first to measure and show how important the hospital environment and care pathway is to levels of satisfaction among patients.

The researchers also found that levels of patient satisfaction had dropped at the same time as clinical performance had improved.

Meeting expectations

Researchers say that the study highlights the complexity of meeting and measuring patients’ expectations and satisfaction with surgery.

The Edinburgh team concludes that patient satisfaction is determined by different factors to those which influence patients' overall health outcome, such as age, gender and other medical conditions.

“Patients’ satisfaction comes not just from my abilities as a surgeon but how clearly I can explain the procedure.

"Our research shows that patients’ care very much about their overall hospital experience - right down to how easy it is to find a car park space.

"For many people their experience of healthcare is as important as their actual clinical care that was delivered," said senior author Mr Colin Howie, consultant surgeon in the Orthopaedic and Trauma department.

The paper is available at:

This research draws on information collected over a long period of time. It demonstrates the value of carrying out large studies over many years to acquire the level of data to help us understand the pertinent influences on patient outcomes.

Professor Hamish SimpsonUniversity of Edinburgh Professor of Orthopaedics and Trauma