Comparison of measurement models based on expectations and perceived performance for the satisfaction study in health services

The literature on satisfaction measurement features several models for establishing the rela- tionship between expectations, service performance and satisfaction. The set of measures used includes the Importance-Performance Analysis (IPA), expectation disconfirmation and the satisfaction determinants model. This paper presents a comparison of different mea- surement models on the basis of a sample of 2900 health services users. The comparison shows that the expectations disconfirmation model allows to establish significant corre- lations between service attributes and general satisfaction, yet it warrants an adjustment of data distribution to identify the attributes where confirmation and disconfirmation are presented – when not due to chance. On the other hand, the direct effect approach allows to identify predictor attributes of satisfaction better than the other models do, whereas the importance – performance model is easier to implement but can generate erroneous conclusions about the service attributes that generate satisfaction.