A Comparison of Patients' Satisfaction of Oral Squamous Cell Carcinoma Treated at Public and Private Healthcare Institutions: A Cross-Sectional Study Using the Healthqual Model

Background: Patient satisfaction is a vital indicator of healthcare quality, particularly for oral squamous cell carcinoma (OSCC) patients whose treatment demands long-term, multidisciplinary care. The HEALTHQUAL model provides a robust framework for evaluating service quality in healthcare. Objectives: To compare satisfaction levels of OSCC patients treated under the health scheme in public versus private tertiary care hospitals in Karachi, using the HEALTHQUAL model. Methods: A comparative cross-sectional study was conducted at Jinnah Postgraduate Medical Centre (public) and Darul Sehat Hospital (private) from January to June 2025. A total of 200 OSCC patients (100 from each setting) were recruited through purposive sampling. Satisfaction was measured across five HEALTHQUAL domains using a prevalidated questionnaire. Independent samples t-tests and Chi-square tests were performed in SPSS v22. Results: Private hospital patients reported significantly higher satisfaction in all domains: Environment (4.52 ± 0.44 vs. 2.74 ± 0.88, p < 0.001), Empathy (4.61 ± 0.39 vs. 3.93 ± 0.59, p = 0.008), Efficiency (4.57 ± 0.41 vs. 3.69 ± 0.63, p = 0.001), Safety (4.55 ± 0.38 vs. 3.96 ± 0.64, p = 0.015), and Improvement (4.58 ± 0.40 vs. 3.99 ± 0.65, p = 0.012). Overall satisfaction was significantly higher in private hospitals (4.57 ± 0.36) compared to public (3.54 ± 0.56, p < 0.001). Higher education and younger age were associated with greater satisfaction (p < 0.05). Conclusion: OSCC patients under the health scheme are more satisfied with private healthcare services across all HEALTHQUAL domains. Enhancing environmental quality, empathy, and efficiency in public hospitals could improve equity in cancer care delivery.