ICTMT 2025 | International Journal of Research and Innovation in Social Science (IJRISS)
ISSN: 2454-6186 | DOI: 10.47772/IJRISS
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Patient Experience as Multidimensional Construct Evidence from
Literature
Tiara Turay
1*
, Ezizwita
2
1
Fakulti Pengurusan Teknologi dan Teknousahawanan, Universiti Teknikal Malaysia Melaka, Fakultas
Ekonomi Dan Bisnis Universitas Dharma Andalas
2
Fakultas Ekonomi Dan Bisnis Universitas Dharma Andalas
*
Corresponding Author
DOI: https://dx.doi.org/10.47772/IJRISS.2025.92800017
Received: 08 November 2025; Accepted: 14 November 2025; Published: 18 December 2025
ABSTRACT
Patient experience is closely linked to perceptions of healthcare quality, reflecting how patients evaluate the
services they receive. Measuring patient experience as a multidimensional construct facilitates both the
conceptualization and operationalization of the term. Accordingly, this paper conceptualizes patient experience
and its constituent dimensions. Drawing on an extensive review of the literature, the study synthesizes previous
definitions and measurement approaches, grouping similar themes to identify key dimensions and indicators of
patient experience. Patient experience is inherently multifaceted, encompassing elements such as interaction,
communication, responsiveness, reliability, empathy, relationships, behavior, perception, and the hospital
environment. Empirical evidence indicates that patient experience not only predicts satisfaction and willingness
to recommend healthcare services but also influences patient well-being, quality of life, and long-term healthcare
decisions. Therefore, patient experience should be recognized as a multidimensional construct and positioned as
a core indicator of healthcare quality. As this study represents a literature review, it is strongly recommended
that the identified dimensions and indicators be subjected to empirical validation, and that future research expand
the scope of investigation to enhance the robustness and applicability of the conceptual framework.
Keywords: Patient experience, Interaction, Responsiveness, Patient’s Perception
INTRODUCTION
As patients become more aware of the quality of medical and non-medical services, they increasingly evaluate
hospitals not only based on clinical outcomes but also on their overall service experience (Doyle et al., 2020).
Patient experience serves as a strategic tool for hospitals to differentiate their services from competitors
(Brandao, Lizarelli, & Roschani 2023). Therefore, patient experience represents a critical aspect of healthcare
quality and is highly valued by patients when making decisions about where to seek and receive care.
The key elements of a patient’s experience include timely appointments, easy access to information, and effective
communication with clinicians and staff. Prior studies have shown that the quality of patient experience is a
strong predictor of satisfaction, loyalty, clinical effectiveness, well-being, quality of life (Ponsignon et al., 2015),
and automatically increases healthcare provider performance (Avidic et al., 2019). Recognizing the benefit that
patient experience could give to healthcare providers, healthcare providers worldwide put the patient experience
at the core of healthcare services.
Avidic et al. (2019) stated that patient experience determines satisfaction and future choices. Accordingly,
medical outcomes and the nonmedical experience perceived by patients are important in shaping perceptions of
service quality (Tiara & Elsandra, 2025). Understanding patients' needs enables hospitals to deliver services that
meet expectations and ensure a positive experience. Therefore, providing a positive patient experience is a
priority for healthcare providers (Pekovic & Rolland, 2020). Positive patient experience not only contributes to
greater trust in healthcare providers but also encourages active patient engagement, adherence to medical advice,
and improved health outcome. Conversely, negative experiences can lead to dissatisfaction, reduced compliance
ICTMT 2025 | International Journal of Research and Innovation in Social Science (IJRISS)
ISSN: 2454-6186 | DOI: 10.47772/IJRISS
Special Issue | Volume IX Issue XXVIII November 2025
Page 171
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with treatment, and a reluctance to seek care in the future.
The credence‐based nature of healthcare services makes it difficult to standardize the measurement of healthcare
quality (Anabila, Kumi, & Anome, 2020). Additionally, the heterogeneous nature of healthcare services further
complicates standardization efforts. The diverse backgrounds of medical staff also make it challenging to
establish consistent standards of healthcare quality (Mosadeghrad, 2013). These service characteristics
collectively pose challenges to creating a positive patient experience. Studies have shown that improving patient
experience increases patients’ willingness to seek care in hospitals (Zao et al., 2024). Holt (2018) likewise
indicates that patient experience functions as an indicator of high-quality healthcare performance. Consequently,
it is recommended that healthcare providers prioritize enhancing patient experience, as it substantially influences
patients’ willingness to visit or revisit the provider. It is further recommended that healthcare providers focus on
strategic initiatives that strengthen patient experience as part of broader efforts to improve service quality.
LITERATURE REVIEW
The shift in hospital orientation from medical oriented to patient oriented has led to a change in the focus of
patient care (Avlijaz et al., 2023). Therefore, it is crucial to design patient experience and identify its supporting
factor that shape patients' memories of their experiences of hospital services. This is particularly important for
understanding the factors that shape patients’ memories of their hospital service experience. Since customers or
the patients will transact with businesses that can provide their needs (Pekovic & Rolland, 2020). In the context
of hospital services, patient experience, according to the Agency for Healthcare Research and Quality (AHRQ):
“The range of interactions that patients have with the healthcare system … including aspects such as timely
appointments, easy access to information, and good communication with clinicians and staff” (AHRQ, 2021).
The concept of customer experience has become a crucial aspect in business today, as creating positive
experiences leads to satisfaction and loyalty, as well as competitive advantage for the provider (Silva et al.,2021).
However, the multifaceted nature of the patient’s experience concept makes patient’s experience difficult to
define. It is highly suggested to understand the patient experience through its attributes and dimensions (Rapport
et al., 2019).
Patient Experience
The importance of patients' experience is that it reflects the quality of the hospital's services (Bernardo et
al.,2022). The patient's experience goes beyond satisfaction (Wolf and Janson, 2014). Gualandi et al. (2021) state
that the first step to better understanding the patient's experience is to understand the patient's journey. The term
'patient journey' is derived from 'customer journey', which refers to the process of experiencing a service from
the customer's perspective at every touchpoint. Such as the administration process, waiting time until treatment
by a doctor, interaction with doctors and nurses, access to information, and medical outcome. Daleske (2024)
considers family and social context of people with illnesses as indicators of patients’ experience. Therefore, in
healthcare services, the outcome of medical treatment is not only concern, but also non-medical considerations.
Table 1 below captures the definition of patient’s experience from different perspectives.
Table 1. Definition and Indicator of Patient’s Experience
Author
Definition
Indicator
Jain and Aagja (2017)
Feelings, perceptions, and attitudes built up throughout the
decision-making process and consumption chain involve an
integrated series of interactions with people, objects, processes,
and the environment, leading to cognitive, emotional, sensory, and
behavioral responses.
1. Emotion
2. Interaction
3. Cognition
4. Perceptions
The Beryl Institute
(2020)
The sum of all interactions, shaped by an organization’s culture,
that influence patient perceptions, across the continuum of care
1. Family Perception
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2. Personal Interactions
3. Organization culture
4. Continuum care
Agency for Healthcare
Research and Quality,
Rockville, MD (2025)
Patient experience” refers to the full range of interactions that
patients have with the healthcare system. This covers not only the
medical or clinical aspects but also how patients perceive things
like communication, respect, access, environment, and how well
the system meets their preferences and needs.
1. Medical care
2. Communication
3. Respect
4. Access
5. system
Larson,E., Sharma, J.,
Bohren, M. A., &
Tunçalp, Ö. (2019).
Patient experience is a process indicator and reflects the
interpersonal aspects of quality of care received. It’s composed of
effective communication; respect and dignity; and emotional
support.
1. Effective communication
2. Respect and dignity
3. Emotional support
Zao et al. (2024)
Patient experience refers to patients' actual experiences and
feelings after receiving medical services from institutions,
including subjective evaluations and objective descriptions of
hospitals.
Gualandi, Masella,
Piredda,
Ercoli, & Tartaglini,
2021; Y. Lin et al.,
2020)
The patient experience is defined by interactions and perceptions
1. Interaction
2. Perceived service
Rodrigues (2019)
Easy access to information, the way to respond to requests,
respectful treatment, listening to the patient's needs and the
compliance with individual values
1. Easy accesss to information
2. Responsiveness
3. Respectfull treatment
4. Listening
5. Compliance with individual values
WHO
Patient experience encompasses the range of interactions that
patients have with the healthcare system, including care from
doctors, nurses and hospital staff. As an integral component of
healthcare quality, patient experience includes aspects of
healthcare delivery that patients value highly, such as timely
appointments, easy access to information and effective
communication with clinicians and staff
1. The importance of care
2. Emotional
3. Social
Cultural factor
AHRQ (2025).
"Patient experience is all about how patients interact with the
healthcare system, including care from doctors, nurses and staff in
hospitals. It's a key part of healthcare quality and includes things
patients value highly, such as getting appointments on time, easy
access to information, and good communication with clinicians
and staff."
1. Patients’ interaction with
healthcare providers
2. Easy appointment
3. Easy access to information
Good
4. Communication with clinicians and
staff
Coulter et al.,2009
1. choice of provider
ICTMT 2025 | International Journal of Research and Innovation in Social Science (IJRISS)
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2. Access
3. Waiting time
4. Confidence
5. Trust in health professionals
6. Information and communication
7. Involvement in treatment decisions
8. Availability of staff when needed
9. Hygiene, cleanliness and
handwashing
10. Food and physical environment
11. Access to records and medical
communications
12. Being treated with dignity and
respect
13. Overall satisfaction
www.gallup.com
1. Confidence,
2. Integrity,
3. Pride and Passion,
Engaging patients
Sharma et al.,2015
Patient experience is a process indicator and reflects the
interpersonal aspects of quality of care received.:
1. Effective communication.
2. Respect and dignity
3. emotional support
1. subjective experiences (eg,
controlled pain),
2. objective experiences (eg, waiting
time for appointments),
3.perceptions about the behavior of
doctors, nurses, technicians,
assistants, and other professionals
(eg, whether the doctor provided all
the necessary information).
References: Previous Research
METHOD
This study conducts an extensive review of the literature on patient experience. A systematic search was carried
out to identify studies examining patient experience. The search included online databases and institutional
websites such as WHO, AHRQ, the Beryl Institute, and peer-reviewed journals. Keywords and combinations of
terms used included: patient experience, healthcare services, perceived quality, customer satisfaction, structural
equation modeling, patient experience model, patient conceptual model, patient applications, and dimensions of
patient experience.
The selected articles, covering the period from 2009 to 2025, were analyzed using a narrative synthesis approach.
ICTMT 2025 | International Journal of Research and Innovation in Social Science (IJRISS)
ISSN: 2454-6186 | DOI: 10.47772/IJRISS
Special Issue | Volume IX Issue XXVIII November 2025
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The extracted information included study objectives, research designs, target populations, measurement
instruments, and key findings related to patient experience. Emerging patterns and themes across the studies
were examined to consolidate the conceptual frameworks, measurement methodologies, and core dimensions of
patient experience. This approach enabled a systematic comparison of the studies and facilitated the
identification of gaps within the existing literature, thereby informing directions for future research. Table 2
provides a summary of the reviewed articles.
Table 2 Authors and Journal
Authors and Title
Journal
Avlijas, R. N., Squires, R. N., Janet, E., Lalonde, R. N., & Backman, R. N. (2023).
Title: A concept analysis of the patient experience
Patient Experience Journal, 10(1), 15-63.
Avdic, D., Moscelli, G., Pilny, A., Sriubaite, I., 2019b.
Title: Subjective and objective quality and choice of hospital: Evidence from
maternal care services in Germany.
Journal of Health Economics Volume 68,
Bernardo, J. M. S., Mendes, G. H. S., Lizarelli, F. L., & Roscani, M. G. (2022).
Title: Instruments to measure patient experience in hospitals: a scoping review.
Gestão & Produção, 29, e0821. https://doi.org/10.1590/1806-9649-
2022v29e0821
Gestão & Produção, 29, e0821.
https://doi.org/10.1590/1806-9649-
2022v29e0821
Doyle, C., Lennox, L., & Bell, D. (2020).
Title: Patient experience: An analysis of the concept and its measurement.
Patient Experience Journal, 7(3), 12–20.
https://doi.org/10.35680/2372-0247.1427
Daleske, C. B. (2024).
Title:The Five-Dimension Patient Experience Model and Its Applications in
Healthcare Using the Example of Spinal Cord Injury and COPD. .
Journal of Patient Experience, 11,
23743735241293965
Coulter, A., Fitzpatrick, R., & Cornwell, J. (2009). Measures of patients'
experience in hospital: purpose, methods and uses (pp. 7-9).
London: King's Fund
Gualandi, R., Masella, C., Piredda, M., Ercoli, M., & Tartaglini, D. (2021).
Title: What does the patient have to say? Valuing the patient experience to
improve the patient journey.
BMC health services research, 21(1), 347.
Ponsignon, F., Smart, A., & Phillips, L. (2018).
Title:A customer journey perspective on service delivery system design:
insights from healthcare. International Journal of Quality & Reliability
Management, 35(10), 2328-2347.
International Journal of Quality & Reliability
Management, 35(10), 2328-2347.
Rapport, F., Hibbert, P., Baysari, M., Long, J. C., Seah, R., Zheng, W. Y.,
Jones, C., Preece, K., & Braithwaite, J. (2019).
Title: What do patients really want? An in-depth examination of patient
experience in four Australian hospitals.
BMC Health Services Research, 19(1), 38.
http://dx.doi.org/10.1186/s12913-019-3881-z
PMid:30646962.
» http://dx.doi.org/10.1186/s12913-019-3881-z
Tunçalp Ö, Were WM, MacLennan C, Oladapo OT, Gülmezoglu AM, Bahl R,
et al. (2015)
Title: Quality of care for pregnant women and newborns – the WHO vision
BJOG. 2015 Jul;122(8):1045–9. doi:
http://dx.doi.org/10.1111/1471- 0528.13451
PMID: 25929823
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RESULTS AND DISCUSSION
Table 2 presents the definitions and indicators of patient experience identified in prior scholarly work.
To enhance clarity and analytical coherence, the author consolidated the fifty-one (51) indicators extracted from
more than ten (10) sources by categorizing them based on their conceptual similarities.
The resulting thematic groupings are presented in Table 3.
Table 3 Patient’s Experience Dimensions
Variable
Indicators
Patient’s Experience
1. Patient’s interaction with healthcare
provider
2. Doctor-patients interaction
3. Nurses-patient interaction
1. Good communication between patients and
healthcare providers
2. Good communication with doctor
3. Listening
1. Access to medical record
2. Easy access to information
3. Easy access to appointment
4. Continuum Care
1. Patient engagement
2. Patient’s involvement
3. Respect and dignity
4. Emotion
5. Confidence
6. Trust
7. Compliance with individual values
1.Availability of staff when needed
2. Responsiveness of the healthcare
provider
1. System
1. hygiene, cleanliness, handwashing
2. food and physical environment
1. Doctor behavior
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2. Nurses’ behavior
3. Staff behavior
1. Subjective perception
2. Family perception
Reference: Analysis by the Author
As shown in Table 1, definitions of patient experience exhibit minor variations, reflecting differences in authors’
conceptualizations of the construct. Such diversity in conceptualization can present challenges for its
operationalization and measurement (Wolf & Jason, 2014; Rapport et al., 2019). Following an extensive review
of the literature, the author identified that the measurement of patient experience encompasses nine (9)
dimensions comprising twenty-seven (27) specific indicators.
Analysis of the indicators reveals that, among the fifty-one (51) identified items, only one pertains explicitly to
medical care, whereas the remaining fifty focus on interactions among patients, physicians, nurses, and hospital
staff, as well as effective communication, organizational systems, patient engagement, and psychological and
emotional aspects. Accordingly, patient experience can be conceptualized as a journey or process that patients
undergo while receiving healthcare services, highlighting the multidimensional and interactional nature of the
experience within the hospital setting
DISCUSSION
In this study, nine (9) dimensions and twenty-seven (27) indicators are proposed to describe patient experience,
based on prior research. The first dimension identified is the interaction between patients and healthcare
providers, including physicians and nurses. This interaction is widely recognized as a critical factor in the
healthcare context, as it reflects the efforts of medical service organizations to cultivate long-term patient
relationships (An, Lee, & Shin, 2023). Thom et al. (2004) emphasized the centrality of patient–provider
interaction in evaluating the quality of care, finding that higher levels of patient trust in medical staff are
associated with stronger intentions to revisit the healthcare provider.
Several studies have further investigated patient satisfaction by analyzing interactions with medical staff through
dimensions such as communication, responsiveness, and staff behavior (An et al., 2023). Evidence indicates that
effective patient–provider interactions foster greater trust in healthcare professionals, which, in turn, enhances
organizational performance. Nevertheless, the overall quality of care remains predominantly determined by the
professional competence of healthcare providers (Wolf et al., 2014). Therefore, optimizing the quality of patient–
provider interactions is essential to achieving high standards in healthcare service delivery
Effective communication is a fundamental component of high-quality healthcare. Interactions between
physicians and patients play a critical role in facilitating informed decision-making, exchanging information,
building trust, reducing patient uncertainty, addressing emotional concerns, and promoting self-management
(Sharkiya, 2023). In this study, effective communication is conceptualized not only as clear and accurate
exchanges between patients, healthcare providers, and physicians but also as the ability to actively listen and
respond to patients’ needs.
In addition to communication, empathy constitutes a pivotal element in the delivery of effective healthcare, often
exerting a greater influence than is widely recognized. A deep understanding of patients’ experiences enables
providers to deliver more personalized care and achieve improved health outcomes. By prioritizing empathy,
demonstrating compassionate behavior, and integrating empathetic practices into healthcare system design,
organizations can cultivate a more humane and patient-centered environment, ultimately evolving into
institutions that genuinely value patient well-being. Within healthcare services, empathy is reflected in practices
such as providing easy access to medical records, ensuring straightforward appointment scheduling, and offering
continuous and coordinated care
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The relational dimension is a fundamental aspect of patient experience, encompassing active participation in
treatment decisions, patient engagement, respect and dignity, continuity of care, emotional support, trust,
confidence, and alignment with personal values. Interactions between patients and healthcare providers are
central to understanding patients’ needs and preferences, thereby enabling patient-centered care (Malenfant et
al., 2022).
Building on this, relational experiences are shaped by genuine interactions among patients, their families, and
healthcare professionals, fostering trust, collaboration, and empowerment. Research has linked relational
practices to improved clinical outcomes, emphasizing their critical role in high-quality healthcare delivery
(Emmamaly et al., 2022). Key features of relational practice include purposeful connections between individuals,
authentic and transparent expression of emotions, attentiveness to patient needs while respecting differences,
and mutual trust and respect, all of which contribute to patient empowerment (Fletcher, 1988).
Responsiveness represents another essential dimension of patient experience. In the healthcare context, it refers
to the health system’s capacity to meet patients’ expectations during their interactions with providers (WHO,
2000). Responsiveness serves as a vital performance indicator within healthcare systems. In this study,
responsiveness is assessed through indicators such as the availability of staff when required and the promptness
with which healthcare providers address patient concerns. While patients may lack the technical knowledge to
fully evaluate diagnoses, treatment decisions, or outcomes, they can reliably assess the responsiveness of the
healthcare system based on their experiences (Mohammadi & Koorosh, 2014)
In health care service, reliability is included in one of dimensions of patient’s experience that reflects the skills,
abilities, and qualifications involved in providing adequate healthcare services. It also signifies a lower rate of
critical incidents (Pronovost et al.,2006). Reliability includes the system where the hospital system enhances
reliability by ensuring consistent procedures and processes that can lead to reliability, especially in complex
organizations such as healthcare services which involve in high-risk service, it needs a good system to carry out
daily activities and ensure reliability (Duplechan, 2024).
In hospital management, the perceptions of patients and their families are crucial to the success of the hospital.
For instance, when customers perceive the service quality positively, it offers several advantages to the provider,
such as lowering customer sensitivity to pricing (Berry, Parasuraman, & Zeithaml, 1994) and strengthening the
provider’s position in the market (Kesuma et al., 2013). Moreover, superior service quality can enhance
perceived service value (Dubey & Sahu, 2019; Gumussoy & Koseoglu, 2016; Pevec & Pisnic, 2018; Prajitmutita
et al., 2016), which ultimately leads to improved organizational performance.
It is essential for service providers to deeply understand customers’ experiences and perceptions to offer
enhanced services that promote satisfaction and loyalty (Bhattti & Hassab, 2019; Ghotbabadi et al., 2015). Given
that service quality is subjective, healthcare providers should establish suitable service standards that reflect the
nature of their services and the characteristics of the patients. This approach ensures that the services delivered
align with customer expectations and effectively meet their need.
CONCLUSION
Patient-centeredness is a concept primarily shaped by healthcare providers, aimed at enhancing patients’
competencies, attitudes, and behaviors in managing their personal healthcare. By empowering patients,
healthcare systems can foster greater involvement and active engagement in care processes. Encouraging patients
to take an active role not only cultivates a sense of ownership but also improves adherence to prescribed care
pathways. Overall, patient engagement represents a comprehensive and mature framework for transforming
patients into active partners in managing their own health.
Patients’ perceptions of their experiences are closely linked to the quality of healthcare services they receive.
Consequently, understanding patient experiences is essential for improving both clinical and non-clinical
services across the entire hospital care continuum. Patient experience can be assessed by evaluating each stage
of the healthcare journey, including admission, diagnosis, interactions with healthcare providers (physicians,
nurses, and staff), treatment, discharge, and post-treatment follow-up. Patient experiences may be positive or
ICTMT 2025 | International Journal of Research and Innovation in Social Science (IJRISS)
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negative, depending on the quality of these interactions and processes. Since patient experience reflects the
patient’s journey throughout care, it is most effectively understood through a dimensional approach, measuring
experiences at each phase of service delivery.
From a practical standpoint, these findings suggest that healthcare organizations should prioritize the
development of systematic standards of care aligned with patient needs and expectations. Strategies include
enhancing patient–provider interactions, promoting effective communication, fostering empathy, strengthening
relational practices, ensuring continuity and consistency of care, optimizing the physical environment of
healthcare facilities, and improving patients’ and families’ perceptions of service quality. Furthermore, reliable
and responsive healthcare delivery can enhance patient satisfaction, trust, and loyalty, ultimately improving
hospital performance and care quality while creating unique and memorable patient experiences.
This study has certain limitations. The identified dimensions and indicators of patient experience were derived
from a selective review of the literature, focusing on studies addressing the concept, measurement, and
dimensions of patient experience. Future research is recommended to conduct further empirical analyses,
including exploratory factor analysis (EFA), reliability testing, confirmatory factor analysis (CFA), and model
validation, to ensure the robustness and validity of the proposed framework.
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