ASSESSMENT OF PATIENT SATISFACTION AMONG INPATIENTS IN INTENSIVE AND STEP-DOWN CARE UNITS OF A TERTIARY CARE TEACHING HOSPITAL IN JHARKHAND: A CROSS-SECTIONAL STUDY

Abstract

Background: Patient satisfaction is an important patient-reported indicator of healthcare quality, particularly in   intensive care units (ICUs) and step-down care units (SDUs), where severe illness, restricted communication and reliance on family attendants influence the care experience. Despite the growing emphasis on patient-centred care, comparative evidence on patient satisfaction across ICU and SDU settings in public tertiary-care hospitals of eastern India remains limited. Objective: To measure overall and domain-specific satisfaction among eligible patients and primary attendants, compare ICU and SDU experiences, and identify independent predictors of overall patient satisfaction. Methods: A hospital-based observational cross-sectional study was conducted in a public tertiary care teaching hospital in Ranchi, Jharkhand. Four hundred consecutive participants who had received at least 48 hours of ICU or SDU care were enrolled. A structured bilingual questionnaire comprising 34 satisfaction items distributed across eight service domains was used to assess patient satisfaction using a five-point Likert scale. The questionnaire demonstrated excellent internal consistency (Cronbach’s α = 0.948). Descriptive statistics, chi-square tests, independent-samples t tests, analysis of variance, correlation analysis and multivariable binary logistic regression were applied. Statistical significance was defined as P<0.05. Results: The mean composite satisfaction score was 96.25 (SD 13.72) out of a maximum possible score of 170, equivalent to a mean item score of 2.83 (SD 0.40). Overall, 41.5% of respondents were satisfied, 38.0% reported neutral satisfaction, and 20.5% were dissatisfied or very dissatisfied. Financial, grievance and patient-support services recorded the highest mean domain score (2.96), whereas support to attendants had the lowest score (2.58). Overall composite satisfaction did not differ significantly between ICU and SDU participants (2.82 vs. 2.84; p = 0.741), although significant differences were observed in admission support, hospital environment, supportive services, financial and grievance services, and attendant support. Rural residence was independently associated with higher odds of satisfaction (adjusted odds ratio 6.88, 95% CI 4.01–11.81; p < 0.001). Conclusion: Satisfaction was moderate and varied substantially by service component. Clinical care and communication were perceived more favourably than attendant amenities, privacy, medicine availability and diagnostic timeliness. Structured family communication, improved attendant facilities, and routine domain-specific monitoring should be prioritised to strengthen patient-centred critical-care services. These findings provide actionable evidence to support targeted quality-improvement initiatives in critical- care services.