Impact of health policy implementation on service quality and patient satisfaction in primary care settings: A cross-sectional study
DOI:
https://doi.org/10.35816/jiksh.v15i2.338Keywords:
health policy, Patient satisfaction, Health PolicyPrimary Health Care, quality of health care, health services accessibilityAbstract
Introduction: Effective implementation of health policy at the primary care level remains uneven, often limiting its impact on service quality and patient satisfaction. This study aimed to examine the effect of health policy implementation on service quality and patient satisfaction in primary care settings.
Research Methodology: An analytical cross-sectional study was conducted among 145 patients attending primary healthcare facilities. Participants were selected using systematic random sampling. Health policy implementation was assessed across three domains: policy adherence, resource availability, and provider compliance. Service quality was measured using a modified SERVQUAL instrument, while patient satisfaction was assessed using a standardized Likert-scale questionnaire. Data were analyzed using descriptive statistics, bivariate analysis, and multiple linear regression. Statistical significance was set at p < 0.05.
Results: Health policy implementation showed a significant positive association with service quality (β = 0.52; 95% CI: 0.34–0.70; p < 0.001) and patient satisfaction (β = 0.47; 95% CI: 0.29–0.65; p < 0.001). Multivariate analysis revealed that policy adherence was the strongest predictor of service quality (β = 0.31; 95% CI: 0.18–0.44; p < 0.001) and patient satisfaction (β = 0.29; 95% CI: 0.16–0.42; p < 0.001), followed by resource availability and provider compliance, all of which remained statistically significant.
Conclusion: The findings indicate that strengthening health policy implementation, particularly adherence and resource support, is essential to improve service quality and patient satisfaction. Policy efforts should prioritize implementation fidelity, workforce capacity, and equitable resource allocation to enhance patient-centered outcomes in primary healthcare.
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Abdelwahed, N. A. A., & Zehri, A. W. (2025). Health service quality and patients’ satisfaction among hospitals: the cohesive care of human beings and accomplishment of human rights. International Journal of Human Rights in Healthcare, 18(2), 164–184. https://doi.org/10.1108/IJHRH-03-2024-0019
Alboksmaty, A., Aldakhil, R., Hayhoe, B. W. J., Ashrafian, H., Darzi, A., & Neves, A.-L. (2025). The impact of using AI-powered voice-to-text technology for clinical documentation on quality of care in primary care and outpatient settings: a systematic review. EBioMedicine, 118, 105861. https://doi.org/10.1016/j.ebiom.2025.105861
Alshaeri, T., Belton, P., Gebhard, R. E., & Dutton, R. P. (2025). Implementation of an Acute Pain Management Service in Private Practice. Advances in Anesthesia, 43(1), 61–73. https://doi.org/10.1016/j.aan.2025.07.005
Blofield, M., Danforth, K., Mathews, S., Acuña, D., Armocida, B., Bevilacqua, P. D., Delany, A., Bhate-Deosthali, P., Formenti, B., González, M. A., Madera, N., Malta, D., Mugerwa, D. K., Pieper, J., Pinto, I. V., Moreno, C. G., Ellsberg, M., Bustreo, F., & Knaul, F. (2026). Gaps in government recognition of the service needs of women who experience intimate partner violence: a comparative case study analysis of policies and implementation across eight countries. The Lancet Global Health, 14(3), e466–e474. https://doi.org/10.1016/S2214-109X(25)00487-5
Dalton, K., Lyall-Watson, S., Young, A., Bade, S., & Simons, M. (2026). Therapy-led model of care for simple, diagnostic-defined pediatric hand fractures can maximize service access and improve consumer outcomes: An implementation study of value-based healthcare using mixed-method design. Journal of Hand Therapy, 39(1), 224–235. https://doi.org/10.1016/j.jht.2025.05.006
Dimitropoulos, G., Lindenbach, D., Potestio, M., Mogan, T., Richardson, A., Anderson, A., Heintz, M., Moskovic, K., Gondziola, J., Bradley, J., LaMonica, H. M., Iorfino, F., Hickie, I., Patten, S. B., & Arnold, P. D. (2024). Using a Rapid Learning Health System for Stratified Care in Emerging Adult Mental Health Services: Protocol for the Implementation of Patient-Reported Outcome Measures. JMIR Research Protocols, 13, e51667. https://doi.org/10.2196/51667
Feely, K., Matthews, S., Quilas, E., McGain, F., Kwek, E., & Wynne, R. (2025). Implementation of reusable linen in the intensive care unit: Impact on pressure injury, staff satisfaction, and environmental sustainability. Australian Critical Care, 38(6), 101311. https://doi.org/10.1016/j.aucc.2025.101311
Karamagi, H., Mamo, A., Droti, B., Tsofa, B., Sy, S., Kidane, S., Cabral, N., Nabyonga, J., & Tumusiime, P. (2026). Organisation of health services for the delivery of primary health care in the WHO African region: a future perspective. The Lancet Primary Care, 100122. https://doi.org/10.1016/j.lanprc.2026.100122
Kovacevic, L., Forbes, L., Ashrafian, H., Mayer, E., Mossialos, E., & Lugo-Palacios, D. (2026). The impact of primary care networks on emergency hospitalisations in the English NHS: An interrupted time series analysis. Health Policy, 165, 105524. https://doi.org/10.1016/j.healthpol.2025.105524
Litchfield, I., Harper, L., Syed, M., Dutton, F., Melyda, M., Wolhuter, C., & Bird, C. (2025). Understanding the influence of leadership, organisation, and policy on delivering an integrated child health and social care service in community settings: A qualitative exploration using the SELFIE framework. Health Policy, 160, 105335. https://doi.org/10.1016/j.healthpol.2025.105335
Manzanera, R., Iruela, A., Moral, I., Armengol, R., Gálvez, G., & Lourdes Jiménez, M. (2026). Assessing the impact of socioeconomic determinants and management models on primary health care in Catalonia. Atención Primaria, 58(4), 103452. https://doi.org/10.1016/j.aprim.2026.103452
Miller, J., Donnelly, C., McClintock, C., Varette, K., Camargo, Y., Marsh, J., Taljaard, M., Mamun, M. S. Al, Bacchus, G., Barber, D., Cooper, L., French, S., Hill, J., Green, M., MacDermid, J., Norman, K., Richardson, J., Tranmer, J., & Wideman, T. (2026). Determining the Impact of a Physiotherapist-Led Primary Care Model for Low Back Pain: Protocol and Analysis Plan for a Cluster Randomized Controlled Trial and Embedded Process Evaluation. JMIR Research Protocols, 15, e89004. https://doi.org/10.2196/89004
Molle, J., Agnel, J., Colson, S., & Chays-Amania, A. (2025). Using implementation science to promote evidence-based nutritional care in healthcare settings: A mixed-methods systematic review. International Journal of Nursing Studies Advances, 9, 100414. https://doi.org/10.1016/j.ijnsa.2025.100414
Montagna Barbosa Gouvêa, A., Paes, J. P. R. S., Hannesch, A., Pasa, M. E., & Rodrigues, R. R. D. (2026). Minor procedures in primary health care: A rapid review. Public Health, 255, 106277. https://doi.org/10.1016/j.puhe.2026.106277
Nakase-Richardson, R., Haun, J. N., Moore, M., Bogner, J., Hoffman, J. M., Dams-O’Connor, K., Coulter, J., Kretzmer, T., Martin, A. M., & Silva, M. A. (2026). Using Implementation Science to Improve Health Care Access and Quality for People With Traumatic Brain Injury–Related Morbidity (I-HEAL): Protocol for a Translational Multiproject Program Award. JMIR Research Protocols, 15, e79738–e79738. https://doi.org/10.2196/79738
O’Connor, M., Fagan, M., & Ryan, M.-L. (2026). Community and residential care providers’ perspectives on the impact of mobile x-ray services in Ireland: A national study. Journal of Medical Imaging and Radiation Sciences, 57(1), 102137. https://doi.org/10.1016/j.jmir.2025.102137
Özden, A. T., & Çelik, E. (2025). A comparative analysis of e-service quality in health care: evidence from Turkey during and post-Covid-19 era. International Journal of Pharmaceutical and Healthcare Marketing, 19(4), 981–1001. https://doi.org/10.1108/IJPHM-10-2024-0108
R., S., K.R., S., Shankar S., S., & Unhelkar, B. (2026). Bridging hospitality and healthcare: A data-driven approach to leveraging service excellence for improved patient satisfaction. International Journal of Hospitality Management, 134, 104599. https://doi.org/10.1016/j.ijhm.2026.104599
Rudd, M. D., Wine, M., Pedler, R., Wright, M., Gleason, V. L., Pérez-Muñoz, A., Tuna, B., Tempchin, J., Flowers, T. A., & Bryan, C. J. (2025). Examining the efficacy of a digital therapeutic to prevent suicidal ideation and behaviors in a primary care setting: Design and methodology of a randomized controlled trial with military service members. Contemporary Clinical Trials, 158, 108107. https://doi.org/10.1016/j.cct.2025.108107
Shaw, J., Medlock, S., Singh, R. S., Piromalli, C., Trainor, J., Johnson, R., Rollolazo, S., Fieldhouse, C., Mortenson, R., & Landes, S. J. (2026). Evaluating a tailored communication tool to increase advance care planning among Alaska Native and American Indian people in primary care: A type 1 hybrid effectiveness-implementation cluster randomized trial protocol. Contemporary Clinical Trials, 108305. https://doi.org/10.1016/j.cct.2026.108305
Squires, A., Gerchow, L., Ma, C., Liang, E., & Miner, S. (2025). Testing a novel theoretical framework to study language services implementation in health care. PEC Innovation, 7, 100427. https://doi.org/10.1016/j.pecinn.2025.100427
Sun, M., Liu, J., Yi, M., Chen, S., Huang, Y., Zhao, Y. I., Leung, A. Y. M., & Wang, Z. (2026). Implementing integrated care for older adults in primary health care: A systematic scoping review. International Journal of Nursing Studies, 176, 105342. https://doi.org/10.1016/j.ijnurstu.2026.105342
Suprapto. (2026). Stunting Policy Implementation in Indonesia: A Primary Health Care Perspective. Jurnal Ilmiah Kesehatan Sandi Husada, 15(1), 347–361. https://doi.org/10.35816/jiksh.v15i1.302
Suprapto, S., Andi Latif, S., Nurhanifah, D., Yunus, M., & Ajeng Wijayanti, L. (2025). How is Quality in Homecare Services Created? A Qualitative Study of Health Professional Perspectives. Jurnal Kesehatan Masyarakat, 21(2), 485–496. https://doi.org/10.15294/kemas.v21i2.31257
Tracey, M., Schulmann, K., Tille, F., Rice, T., Mercille, J., Timans, R., Allin, S., Dottin, A., Syrjälä, S., Sotamaa, T., Keskimäki, I., & Rechel, B. (2025). What are the policy options for regulating private equity involvement in health care? A review of policies implemented or considered in seven high-income countries. Health Policy, 156, 105312. https://doi.org/10.1016/j.healthpol.2025.105312
Vianna, R. F., Bonamigo, A., Sobral, A. P. B., & Calado, R. D. (2026). Evaluation of the medium- to long-term effects of Lean Healthcare implementation in the emergency service care. International Journal of Lean Six Sigma, 17(3), 943–967. https://doi.org/10.1108/IJLSS-06-2025-0169
Zuchowski, I., Kuruvila, A., Sen Gupta, T., & Wielandt, R. (2025). Integrating social workers in Australian primary health care settings. Journal of Integrated Care, 33(5), 72–85. https://doi.org/10.1108/JICA-04-2025-0027
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