Beyond clinical care: how the hospital environment shapes patient perception and satisfaction

PURPOSE: This study investigated how hospital infrastructure and environmental cleanliness influence patient satisfaction through the mediating pathway of patient perception in tertiary healthcare institutions. Drawing upon the Donabedian structure-process-outcome framework, the study examined the structural healthcare quality factors that shape patient perceptions and service evaluations. DESIGN/METHODOLOGY/APPROACH: The data were gathered using cross-sectional survey and by deploying non-probability purpose sampling using a structured questionnaire assessing hospital infrastructure, environmental cleanliness, patient perception and patient satisfaction. A total of 578 valid responses were subjected to exploratory, confirmatory factor analysis to test the structural relationships among the constructs and structural equation modeling (SEM) was used to test the hypotheses. FINDINGS: The findings reveal that hospital infrastructure and environmental cleanliness significantly influence patient perceptions of healthcare service quality. Patient perception in turn positively and significantly predict patient satisfaction. The mediating results reveal that patient perception positively and significantly mediates the relationship between structural service factors and patient outcomes. The findings underscore the fact that physical healthcare environments play a critical role in shaping patient experiences and satisfaction levels. RESEARCH LIMITATIONS/IMPLICATIONS: The study is limited to a single tertiary healthcare institution and cross-sectional survey data. Future research could employ longitudinal designs and multisource data samples to improve generalizability. PRACTICAL IMPLICATIONS: Healthcare administrators should prioritize investments in hospital infrastructure and environmental hygiene as strategic predictors of patient perceptions. Improving structural service quality can strengthen patient trust, enhance satisfaction and contribute to better healthcare service outcomes. SOCIAL IMPLICATIONS: Healthcare policymakers should invest more in hospital infrastructure and environmental hygiene as these ae strategic predictors of patient perceptions. Improving structural service quality can strengthen patient trust, enhance satisfaction and contribute to better healthcare service outcomes. ORIGINALITY/VALUE: The study advances the healthcare quality literature quality literature by empirically integrating environmental healthcare factors with the Donabedian quality framework and demonstrating the mediating role of patient perception in shaping satisfaction outcomes within hospital service environments.