Are Favorable Hospital Outpatient Environmental Assessment Results Associated with Higher Patient Satisfaction? A Patient-Centred Analysis of Physical, Perceptual, and Social Pathways

Hospital outpatient environmental assessments have traditionally focused on technical compliance. However, favorable objective assessment results do not necessarily mean that patients perceive or evaluate the environment positively. This cross-sectional observational study examines the association between objectively assessed physical environmental quality and patient satisfaction, as well as the potential mediating roles of perceived environment and social support in this relationship. Physical environmental quality was assessed in ten hospitals in Harbin, China, across patient-relevant functional spaces identified through interviews with 25 outpatients. A questionnaire survey yielded 294 valid responses, capturing patients’ satisfaction, social support, perceived environment, and mental status. Statistical analyses were the conducted to examine the relationships among these variables. The findings indicate that physical environmental quality was positively associated with patient satisfaction (β = 0.406, p < 0.001). In a parallel mediation model, the specific indirect associations through perceived environment and social support were 0.068 and 0.165, respectively, yielding a total indirect association of 0.233. Mental status moderated the association between social support and patient satisfaction, such that the indirect association was weaker among patients with poorer mental status, as indicated by higher scores, and stronger among those with better mental status, as indicated by lower scores. The findings suggest that technical compliance provides a useful baseline for environmental assessment, while patient-reported evidence offers complementary insights into the effectiveness of the physical environment from the patient’s perspective.