Assessment of patient satisfaction with oral healthcare in two District Hospitals

 Corresponding author: Michael Fonyuy Wolani Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Assessment of patient satisfaction with oral healthcare in two District Hospitals Michael Fonyuy Wolani 1, 2, *, Marie-José Essi 1, Rose Mbede Nga Mvondo 1 and Esther Marguerite Chase Djanga 1 1 Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I. 2 Research Department Eden Global Missions. World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 Publication history: Received on 17 September 2025; revised on 28 October 2025; accepted on 31 October 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.28.2.3632 Abstract Objectives: This study aimed to assess patient satisfaction with oral healthcare based on accessibility, care environment and care quality. Methods: To meet the above objective, a descriptive cross-sectional study was conducted among patients visiting the Biyem-Assi (BA) and Cité Verte District Hospitals in Yaoundé, Cameroon, from 2021 to 2022. Satisfaction levels were assessed using an administered questionnaire derived from the Dental Satisfaction questionnaire (DSQ) and the Service Quality Questionnaire (SERVQUAL). Data were analysed using the Statistical Package for Social Sciences (SPSS) version 25. The mean was used for quantitative data, and the Likert scale was used to assess qualitative data. Results with pvalues less than 5 were considered statistically significant. Results: Two hundred participants were included in this study. The age range from 29 to 39 years was the most represented (40%), and most participants were from the grassfields (41.5%). The literacy rate was high, 73.1% of participants had a tertiary level of education. Satisfaction with access to oral health in the study hospitals was 67.5%. Fifty-seven per cent of participants reported satisfaction with the hospital environment. Almost all participants (98%) were satisfied with the quality of care received. A global satisfaction of 71% was recorded. The reasons for patient dissatisfaction included high treatment costs (41%), lack of patient intimacy (60%), and long waiting hours (60-300 minutes). Conclusion: Patient satisfaction with oral healthcare was high. Major complaints included the non-respect of patient privacy, long waiting hours and high cost of treatment. Keywords: Patient Satisfaction; Oral Healthcare; Environment; Care Quality; Access 1. Introduction Patients for one reason or the other are prompted to meet a dentist or a dental health assistant due to the high prevalence of dental pathologies. Depending on patient expectations, the interaction between patients and dental health personnel can either be satisfying or not. Patient satisfaction with healthcare has in the recent years gained widespread recognition as the measure of quality, due to the need to involve patients in decisions concerning healthcare. There is a direct link between patient satisfaction and compliance in areas such as appointment keeping, intentions to comply with recommended treatment, and medication use (1). This study aimed at providing evidence on patient satisfaction with accessibility, hospital environment and quality of administered care in two hospitals. World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 153 2. Materials and methods A cross-sectional descriptive study was carried out at the Biyem-Assi and Cite Verte District Hospitals for a period of nine months going from September 2021 to May 2022. Consenting patients aged 18 years and above were included. Patients visiting for the first time, as well as patients with uncompleted questionnaires were excluded. The data collection tool employed was a pretested administered questionnaire assessing socio-demographic data, accessibility of oral healthcare, hospital environment, and service quality. Before the study, ethical clearance was obtained from the Institutional Ethical Review Board of the Faculty of Medicine and Biomedical Sciences, and from the Yaoundé Regional Delegation of Public Health. Data was analyzed and restituted as frequencies, means, and standard deviations. The Likert scale was used to assess subjective data; Chi-square test was used with a confidence interval level of 95% and a p-value of 0.05. 3. Results A total of 200 patients were recruited in this study as shown in figure 1 below. Figure 1 Participant recruitment A sex ratio of 1:2 was recorded in this study with a mean age of 27 + 9 years as shown in table I below. World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 154 Table 1 Socio-demographic data Variable Modality Biyem-Assi n (%) Cite Verte n (%) Total n (%) Age (years) 18-28 36 (36) 19 (19) 55 (27.5) 29-39 33 (33) 47 (47) 80 (40) 40-50 22 (22) 28 (28) 50 (25) 51-61 0 6 (6) 6 (3) >62 9 (9) 0 (0) 9 (4.5) Cultural area Coast 9 (9) 8 (8) 17 (8.5) Forest 28 (28) 42 (42) 70 (35) Grass fields 52 (52) 31 (31) 83 (41.5) Sahel 6 (6) 11 (11) 17 (8.5) Savannah 5 (5) 8 (5) 13 (6.5) Education Illiterate 0 3 (3) 3 (1.5) Primary 1 (1) 0 1 (0.5) Secondary 9 (9) 6 (6) 15 (7.5) High school 17 (17) 17 (17) 34 (17) Tertiary 73 (73) 74 (74) 147 (73.5) Profession Jobless 1 (1) 8 (8) 9 (4.5) Private 30 (30) 33 (33) 63 (31.5) Public 20 (20) 27 (27) 47 (23.5) Retired 6 (6) 3 (3) 9 (4.5) Student 43 (43) 29 (29) 72 (36) Most participants were less than 40 years. Four percent of those working in the public sector were from the medical field, implying an easy access to oral healthcare services as shown below. World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 155 Table 2 Oral Healthcare Access Variable Modality Biyem-Assi n (%) Cite Verte n (%) Total n (%) Transport means Taxi 52 (52) 56 (56) 108 (54) Bike 24 (24) 25 (25) 49 (24.5) Personal vehicle 13 (13) 16 (16) 29 (14.5) On foot 11 (11) 3 (3) 14 (7) Transport time (minutes) < 15 12 (12) 3 (3) 15 (7.5) 15-30 66 (66) 55 (55) 121 (60.5) 31-45 8 (8) 14 (14) 22 (11) 47-60 6 (6) 17 (17) 23 (11.5) >60 7 (7) 3 (3) 10 (5) I don’t know 1 (1) 8 (8) 9 (4.5) Consultation cost Low 0 3 (3) 3 (1.5) Moderate 63 (63) 61 (61) 124 (62) High 26 (26) 22 (22) 48 (24) Too high 4 (4) 8 (8) 12 (6) I don’t know 7 (7) 6 (6) 13 (6.5) Treatment cost Moderate 41 (41) 50 (50) 91 (45.5) High 48 (48) 34 (34) 82 (41) Too high 4 (4) 8 (8) 12 (6) I don’t know 7 (7) 8 (8) 15 (7.5) Medication cost Low 2 (2) 0 2 (1) Moderate 71 (71) 66 (66) 137 (68.5) High 11 (11) 6 (6) 17 (8.5) Too high 1 (1) 0 1 (0.5) I don’t know 15 (15) 28 (28) 43 (21.5) Most participants (71%) spent 46 minutes of transport time to access these hospitals. Equitable treatment of patients was reported in both hospitals (93% and 100% for Biyem-Assi and Cité Verte respectively). Discrepancies between perceive and estimated satisfaction ratings are shown in figure 5 below. World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 156 Figure 2 Accessibility ratings The different domains assessed in the hospital environment are shown in table III below. Table 3 Environment setting Variable Modality Biyem-Assi n (%) Cite Verte n (%) Total n (%) Accessible reception Yes 95 (95) 97 (97) 192 (96) Waiting room Comfortable 85 (85) 61 (61) 146 (73) Tidiness Not tidy 5 (5) 6 (6) 11 (5.5) Tidy 84 (84) 91 (91) 175 (87.5) Very Tidy 9 (9) 3 (3) 12 (6) I don’t know 2 (2) 0 2 (1) Convenience Yes 79 (79) 69 (69) 148 (74) Explanation if no Too crowded 7 (7) 8 (8) 15 (7.5) No chair 2 (2) 0 2 (1) Too noisy 1 (1) 0 1 (0.5) Lack of sufficient shelter 2 (2) 0 2 (1) Patient intimacy not respected 8 (8) 22 (22) 30 (15) Waiting time (minutes) < 15 4 (4) 3 (3) 7 (3.5) 16-30 30 (30) 17 (17) 47 (23.5) 31 – 45 31 (31) 22 (22) 53 (26.5) >60 33 (33) 55 (55) 88 (44) World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 157 I don’t know 2 (2) 3 (3) 5 (2.5) Data entry speed Slow 6 (6) 8 (8) 14 (7) Average 41 (41) 22 (22) 63 (31.5) Fast 44 (44) 36 (36) 80 (40) I don’t know 9 (9) 33 (33) 132 (66) The reception area is one of the most important compartments for both the patients and the hospital. Majority of participants (86%) reported that the reception area was easily identifiable, waiting times ranging from 60 minutes to 300 minutes were reported by 44% of patients. Few participants (27%) thought of the waiting room as being uncomfortable and another 26% were inconvenienced by the environment. Global satisfaction ratings are presented in figure 3 below. Figure 3 Patient satisfaction ratings with hospital environment Data on patient satisfaction is shown in table IV below. Table 4 Patient satisfaction with care quality Variable Modality Biyem-Assi n (%) Cite Verte n (%) Total n (%) Service in line with needs Yes 96 (96) 83 (83) 179 (89.5) Dependable staff Undecided 5 (5) 11 (11) 16 (8) Agree 7 (7) 6 (6) 13 (6.5) Strongly agree 81 (81) 83 (83) 164 (82) Effectiveness of treatment Disagree 0 8 (8) 8 (4) Undecided 5 (5) 6 (6) 11 (5.5) World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 158 Agree 14 (14) 17 (17) 31 (15.5) Strongly agree 81 (81) 69 (69) 150 (75) Error-free record Disagree 5 (5) 11 (11) 16 (8) Undecided 2 (2) 8 (8) 10 (5) Agree 21 (21) 12 (12) 33 (16.5) Strongly agree 72 (72) 69 (69) 141 (70.5) Time of service provision Short 24 (24) 28 (28) 52 (26) Average 45 (45) 53 (53) 98 (49) Long 23 (23) 19 (19) 42 (21) I don’t know 8 (8) 0 8 (4) Treatment information Always 83 (83) 80 (80) 163 (81.5) Often 5 (5) 8 (8) 13 (6.5) Sometimes 5 (5) 3 (3) 8 (4) Never 6 (6) 6 (6) 12 (6) I don’t know 1 (1) 3 (3) 4 (2) Willingness to help Always 77 (77) 64 (64) 141 (70.5) Often 5 (5) 3 (3) 8 (4) Sometimes 6 (6) 8 (8) 14 (7) Never 2 (2) 0 2 (1) I don’t know 10 (10) 25 (25) 35 (17.5) Most participants (90.5%) either agreed or strongly agreed that treatment received relieved their symptoms. The remaining data is shown in figure 4 below. Figure 4 Care quality World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 159 A majority of participants (78%) were of the opinion that working hours were convenient and 55% thought that facilities were appealing. Estimated satisfaction ratings varied from perceived satisfaction ratings as shown below. Figure 5 Perceived and estimated satisfaction ratings Most participants perceived the quality of care received as satisfying and where estimated care quality ratings of 98% and 92% were observed in Biyem-Assi and Cite Verte respectively. All the above data was analyzed for global satisfaction ratings. The link between satisfaction ratings and socio-demographic data are shown in table v below. Table 5 Link between patient satisfaction and socio-demographic data Variable Modality SS Global satisfaction n (%) S NSND P-value Age (years) 18-28 4 (2) 28 (14) 0 0.854 29-39 3 (1.5) 30 (15) 2 (1) 40-50 4 (2) 16 (8) 3 (1.5) 51-61 0 2 (1) 0 >62 2 (1) 6 (3) 0 Cultural area Coast 2 (1) 6 (3) 0 0.903 Forest 2 (1) 27 (23.5) 2 (1) Grassfields 6 (3) 40 (20) 1 (0.5) Sahel 1 (0.5) 7 (3.5) 1 (0.5) Savannah 2 (2) 3 (1.5) 0 Education Illiterate 0 0 1 (0.5) 0.000 Primary 0 1 (0.5) 0 Secondary 1 (0.5) 7 (3.5) 0 High school 2 (1) 13 (6.5) 1 (0.5) Tertiary 10 (5) 61 (30.5) 3 (1.5) Profession Jobless 0 2 (1) 0 0.378 Public 4 (2) 16 (8) 3 (1.5) Private 2 (1) 27 (23.5) 2 (1) Retired 0 3 (1.5) 0 World Journal of Advanced Research and Reviews, 2025, 28(02), 152–162 160 Student 8 (4) 41 (20.5) 0 Sex Male 6 (3) 20 (10) 3 (1.5) 0.39 Female 6 (3) 63 (31.5) 2 (1) *SS= strongly satisfied, S= satisfied, NSND= neither satisfied nor dissatisfied All the above data was analyzed for global satisfaction ratings. The results are shown the figure below. Figure 6 Global satisfaction ratings per study site Ninety five percent of patients were satisfied in both hospitals of study. 4. Discussion This study was limited for the following reasons: • Data collection was based on patient declarations. • The study was carried out in two District hospitals in Yaoundé. The results obtained are not generalizable to the entire population of Yaoundé. • Patients visiting for the first time, as well as patients under the age of 18 years were not involved in this study. • The sample size was not attained for this study. Unsurprisingly, most participants were women. It is known that women are more conscious of their health, appearance and esthetics than men, who are always busy with their activities. In Cameroon, men wait for the last moment, when dental pain is unbearable and non-responsive to self-medication to seek help (2). Women are generally more satisfied with oral healthcare services than men (3), and this might explain the high satisfaction ratings recorded in this study. The high participation rate of students and private sector workers in this study demonstrated a good oral health promotion among these groups of participants. The fact that most participants could access these hospitals using the most common transportation means, demonstrate a good overall access to oral healthcare in these hospitals. This is further reinforced by the fact transport times ranging from 15 minutes to 30 minutes and just few participants recording transport times above 30 minutes. Consultation and treatment costs were considered either moderate or high. This is intriguing, as costs in public hospitals are often considered less costly, and makes Cameroon comparable to Tanzania, Burkina Faso and Nigeria (4). Dental treatment often warrants the use of costly dental materials and consumables. The perceived high treatment costs might have resulted from participants’ lack of knowledge on the stakes held by dental treatment. In fact, dental treatment is considered the “fourth most expensive treatment in most industrialized countries” (5). While treatment was considered costly, drug costs were considered moderate. Patients in these hospitals were not obliged to purchase their medication from these hospitals’ pharmacies. As a result they cannot directly link medication cost to the hospital. Furthermore, drugs frequently prescribed in dentistry involve antibiotics, anti-