Definition of healthcare outcomes has been given as “measures of the result of what happens to patients as a consequence of their encounters with the healthcare system” [
9]. In clinical research, three types of outcomes are measured: (a) clinical outcomes which are consequences of a medical treatment (e.g., laboratory values); (b) humanistic outcomes which are end results of a disease or a treatment on the patient’s ability to perform normal daily activities and quality of life, including patient-reported outcomes (PROs) (e.g., satisfaction of patients with healthcare services); and (c) economic outcomes which are direct, indirect, and intangible costs of treatment in relation with the results of therapy options.
Traditional medical models of care had concentrated on clinical outcomes only, whereas more recent medical models of care integrate clinical outcomes as well as economic and humanistic outcomes. This new approach, the Economic, Clinical and Humanistic Outcomes is termed the ECHO model of care. The ECHO model builds on the traditional model but broadens its scope by incorporating the humanistic and economic outcomes and thus provides a more comprehensive measurement of health care value [
10].
Patient satisfaction, a humanistic outcome, has been studied as a crucial element when assessing health outcomes and standard of care [
11]. Often, quantitative surveys such as questionnaires have been used to document patient interactions with the healthcare system, such as their satisfaction with health services in hospitals and clinics. Qualitative designs such as interviews and focus group discussions are less often used, but can gain a more comprehensive and thorough view of patients’ experiences. A study conducted in Nigeria [
11] recorded high level of satisfaction of HIV patients with pharmaceutical services using a Patient Satisfaction with Pharmaceutical Service (PSPS) questionnaire [
12]. However, in the study, the patients indicated low satisfaction with the item that examined the supply of penned information by pharmacists. Using a standardized structured interviewed questionnaire, Karunamoorthi et al. [
13] also demonstrated that most of the respondents were satisfied with the pharmaceutical service. 82.5% of the participants in the study, however, indicated long waiting hours to finally receive their medication as a major problem that is responsible for their dissatisfaction. The research on the satisfaction of patients with health services is not only important in chronic diseases such as HIV/AIDS, but, in fact, in all areas of health service delivery. For instance, a study done in the south-west region of Nigeria on the satisfaction with primary health services also indicated waiting time and availability of drugs as the main interests of the participants [
14]. It is worthwhile to note that respondents under NHIS as well as non-NHIS respondents were highly satisfied with the health services they had received from their healthcare providers at their healthcare facilities [
15‐
19]. Contrary to the studies discussed above, Abebe et al. recorded low levels of satisfaction by the respondents with pharmaceutical services [
20]. Thus, evaluation of patients’ satisfaction with health services is important and crucial to pinpoint certain areas of service and practice which need to be improved. A systematic analysis of these relevant studies can also help to identify relevant approaches in evaluating patient satisfaction and to establish different appraisal instruments based on the patients’ most important considerations.
A review focusing on the measurement of patient satisfaction in clinics specialized in the field of sexually transmitted diseases (STDs) has already been published [
21]. Some of such reviews included studies which had been carried out in LMICs such as Nigeria [
22,
23]. Another review examined the satisfaction measurement instruments for healthcare service users in Brazil [
24]. In the latter review, the researchers concluded, based on their findings, that there was no gold standard method for assessing patient satisfaction. A review of patients’ views on the quality of primary health care in sub-Saharan Africa was published in 2015. This review included six studies from Nigeria, but did not make country-specific conclusions [
25]. Even though studies from Nigeria were included in systematic reviews before, none has been conducted focusing on Nigerian patients and their satisfaction with local health services. The study therefore intends to address the following questions:
1.
How has patient satisfaction with health services in Nigerian hospitals been previously described and assessed?
2.
Is there any existence of a gold standard method?
3.
Is it possible to identify issues/topics considered by patients as most important in delivering a high-quality service?
4.
Are there any areas of dissatisfaction and if so, what are they?