Determinants of Patient Satisfaction in a Public University Hospital in Ghana: A Structural Equation Modelling Approach

Background Despite the recognised importance of communication in healthcare delivery, limited research has examined how communication interacts with other service quality (SERVQUAL) dimensions to shape patient satisfaction in Ghanaian hospital settings. This study aimed to assess communication and SERVQUAL dimensions as determinants of satisfaction among patients accessing outpatient services at a university hospital in Ghana. Methods This cross-sectional study collected data from 366 patients who accessed outpatient services from November 1, 2025, to December 20, 2025. A structured questionnaire incorporating socio-demographic characteristics, communication, SERVQUAL model, and satisfaction was used to collect study data. Structural equation modelling was used to examine the relationship between the SERVQUAL dimensions, communication, and satisfaction. A mediation analysis was conducted to test whether communication mediated the relationship between the SERVQUAL dimensions and satisfaction. Results The median satisfaction and communication scores were 75.0 [58.3–91.7] and 75.0 [50.0–90.0], respectively. Among the SERVQUAL domains, tangibility (median: 75.0 [62.5–87.5]) was the highest-rated, whereas reliability (median: 68.8 [50.0–81.2]) was the lowest-rated. Communication (β = 0.400, p = 0.002) and empathy (β = 0.434, p = 0.043) were identified as determinants of patient satisfaction. Communication did not significantly mediate the association between the SERVQUAL dimensions and patient satisfaction. Conclusion This study highlights the critical role of communication and empathy in shaping patient satisfaction in outpatient services at the university hospital. Prioritising patient-centred communication and compassionate care should therefore be an integral part of healthcare quality improvement strategies aimed at strengthening health systems and advancing progress towards universal health coverage.