Health Services Research
Factors Affecting Outpatients' Satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC)
Last reviewed: March 2026
Key Findings
- Patient satisfaction at UKMMC outpatient clinics was influenced by multiple factors including waiting time, staff communication quality, and the physical environment of the facility.
- Longer waiting times were consistently associated with lower patient satisfaction, identifying appointment scheduling and patient flow management as key areas for improvement.
- The quality of interpersonal interaction between healthcare providers and patients — including courtesy, explanations of conditions and treatments, and perceived attentiveness — was a major determinant of satisfaction.
- The study provided actionable evidence for quality improvement initiatives at UKMMC and contributed to the growing literature on patient satisfaction in Malaysian public teaching hospitals.
Background and Context
Patient satisfaction has emerged as a critical quality indicator in healthcare systems worldwide. Measuring and understanding patient satisfaction provides valuable feedback for healthcare organisations seeking to improve service delivery, enhance patient experience, and achieve better health outcomes. In the context of Malaysia’s public healthcare system, where government hospitals provide the majority of specialist outpatient services, patient satisfaction assessment is essential for identifying areas where service quality can be strengthened and where patients’ expectations are not being met.
The Universiti Kebangsaan Malaysia Medical Centre (UKMMC) is one of Malaysia’s premier teaching hospitals, providing tertiary-level care to populations in the southern districts of the Federal Territory of Kuala Lumpur and surrounding areas. As a teaching institution, UKMMC serves the dual functions of patient care and clinical education, which can create unique dynamics in the patient experience — including longer consultation times due to teaching activities, exposure to multiple providers, and varying levels of experience among clinicians-in-training.
This study, published in the Malaysian Journal of Public Health Medicine in 2014, examined the factors affecting outpatients’ satisfaction at UKMMC, with the goal of identifying modifiable factors that could be targeted through quality improvement initiatives.
Study Design and Methods
The study employed a cross-sectional design to assess satisfaction levels and identify associated factors among outpatients attending various specialist clinics at UKMMC. Data were collected using structured questionnaires that assessed multiple dimensions of the outpatient experience, including registration and appointment processes, waiting time, physical environment, staff attitudes and communication, clinical care quality, and overall satisfaction.
The questionnaire incorporated validated satisfaction measures adapted for the Malaysian healthcare context, with items rated on Likert scales. Sociodemographic data including age, gender, ethnicity, educational level, and employment status were collected to assess their relationship with satisfaction levels. Statistical analyses included descriptive statistics, bivariate analyses (chi-square tests and t-tests), and multivariate regression to identify independent predictors of satisfaction.
Waiting Time and Patient Flow
Waiting time emerged as one of the most significant factors affecting outpatient satisfaction. Patients who experienced longer waits between arrival and consultation reported lower satisfaction levels across multiple dimensions of care. This finding was consistent with the broader healthcare quality literature, which consistently identifies waiting time as a primary determinant of patient satisfaction in outpatient settings.
In the context of a busy teaching hospital like UKMMC, long waiting times may result from high patient volumes, complex scheduling requirements for multiple specialist clinics, the additional time required for teaching activities during consultations, and occasional disruptions due to emergency cases. Strategies to reduce waiting times might include optimising appointment scheduling systems, implementing real-time patient tracking and queue management technologies, and improving clinic workflow efficiency.
Interpersonal Quality of Care
The quality of interpersonal interactions between healthcare providers and patients was identified as another major determinant of satisfaction. Patients who perceived their healthcare providers as courteous, attentive, and communicative reported significantly higher satisfaction levels. The provision of clear explanations about medical conditions, treatment plans, and follow-up requirements was particularly valued by patients, reflecting the importance of health literacy and shared decision-making in the patient experience.
In a teaching hospital environment, where patients may interact with medical students, resident doctors, and consultant physicians during a single visit, the consistency and quality of communication across all levels of the care team is particularly important. Ensuring that teaching activities do not compromise the patient’s sense of being the focus of care requires deliberate attention and institutional commitment.
Physical Environment and Facilities
The physical environment of the outpatient clinics — including cleanliness, comfort, signage, and accessibility — also contributed to patient satisfaction. Well-maintained, clean, and navigable clinic spaces conveyed professionalism and respect for patients, while deficiencies in these areas could contribute to negative perceptions regardless of the quality of clinical care provided.
Implications for Quality Improvement
The study’s findings provided a roadmap for targeted quality improvement at UKMMC and similar institutions. Key recommendations included implementing systematic waiting time reduction strategies, investing in communication skills training for all clinical staff (including students and trainees), maintaining high standards of facility cleanliness and comfort, and establishing regular patient satisfaction monitoring through standardised surveys and feedback mechanisms.
The integration of patient satisfaction measurement into institutional quality dashboards and performance review processes was recommended to ensure sustained attention to patient experience as a strategic priority.
Limitations
The study was conducted at a single institution, limiting generalisability to other settings. Patient satisfaction surveys are subject to response bias, with more satisfied or more dissatisfied patients potentially overrepresented among respondents. The cross-sectional design provided a snapshot at one point in time and did not capture temporal changes. Additionally, patient satisfaction may be influenced by clinical outcomes — which were not assessed in this study — making it difficult to isolate the specific contributions of service process factors.
Significance for Malaysian Healthcare
This research contributed to the evidence base on outpatient satisfaction in Malaysian public hospitals and provided practical insights for quality improvement. As Malaysia’s healthcare system continues to evolve toward greater patient-centredness and accountability, studies such as this play an important role in ensuring that the voices and experiences of patients inform service design and delivery improvements.
Factors affecting outpatients' satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC). Malaysian Journal of Public Health Medicine. 2014;14(2).