Association of one-stop administrative and logistics services with patient satisfaction in smart hospitals

Abstract

This study aims to examine whether the quality of one-stop administrative and logistics services is associated with patient satisfaction in smart hospitals and identify indicators that may merit attention in service redesign. This multicenter cross-sectional study included 837 service users at 4 sites in 3 public hospitals in Dongguan, China (January 2023–December 2025). A 27-item questionnaire covered 9 service-experience domains. Overall satisfaction (0–10) was the primary outcome; high satisfaction (score ≥ 8) was a secondary outcome. Eight operational indicators were extracted from work-order systems. Analyses included confirmatory factor analysis, hierarchical linear and logistic regression with site fixed effects, structural equation modeling, and an exploratory gradient-boosting analysis. Mean age was 47.2 years; 57.1% were women. Cronbach α ranged from 0.72 to 0.79. The prespecified 9-domain structure showed satisfactory fit in this sample; independent psychometric validation is needed. In the fully adjusted linear model (n = 774), first-contact resolution (β = 0.31; 95% confidence interval [CI], 0.23–0.38) and problem closure (β = 0.29; 95% CI, 0.25–0.33) were positively associated with satisfaction. Convenience, reliability, responsiveness, transparency, and digital access were also positively associated (β, 0.12–0.19). Longer response time (β = −0.26), complaint or second feedback (β = −0.20), and repeated visits (β = −0.16) were negatively associated. Problem closure showed the strongest association with high satisfaction (odds ratio, 2.87; 95% CI, 2.18–3.82). In structural equation modeling, the standardized direct association between digital access and satisfaction was 0.08 ( P = .052), and the summed standardized indirect associations through convenience, responsiveness, and problem closure were 0.35. The exploratory, unvalidated ranking placed problem closure, convenience, responsiveness, reliability, and digital access highest. Service-process quality was associated with patient satisfaction. First-contact resolution, problem closure, and related indicators are candidate targets for prospective evaluation. The cross-sectional design precludes causal interpretation, and the instrument requires independent validation.