<b>Determinants of Patient Satisfaction in a Bangladeshi Public Hospital Outpatient Department: A Cross-Sectional Study</b>

Background: Patient satisfaction is critical for healthcare utilization in resource-constrained settings like Bangladesh, yet evidence on outpatient satisfaction determinants remains limited. This study assessed perceived service quality and identified predictors of satisfaction in a public medical college hospital. Methods: A cross-sectional study (September–December 2023) recruited 1,089 adult outpatients via systematic random sampling. Data were collected using validated Bengali instruments measuring perceived quality (24 items) and satisfaction (14 items). Binary logistic regression identified predictors (p<0.05), with model validation (AUC, pseudo-R², classification accuracy). Results: Participants (mean age 34±15.64 years; 51.5% male; 63.0% rural) reported positive physician interactions (e.g., 56.7% felt respected). Critical deficiencies included poor toilet cleanliness (75.5%), inadequate drinking water (67.6%), and medication shortages (30.6%). Female patients reported insufficient consultation time (17.5%). Regression analysis (AUC=0.92) revealed higher satisfaction among males (AOR=1.79, 95% CI: 1.02–3.16), suburban residents (vs. rural; AOR=2.01, 1.06–3.81), businesspersons (vs. students; AOR=2.89, 1.19–7.04), and those with prior positive experiences (AOR=1.50, 1.42–1.58). Upper-middle-class patients had lower satisfaction (AOR=0.40, 0.20–0.79). Positive perceptions of management and administration independently increased satisfaction (AOR=1.14 for both). Conclusion: Gender, socioeconomic status, and prior OPD service experiences critically shape satisfaction in Bangladesh’s resource-constrained public health system. Investments in non-clinical services, particularly sanitation, gender equity, and patient feedback mechanisms, are vital to bridge the quality-satisfaction gap.