• Tasnim Murad Mamun Economics Discipline, Khulna University, Khulna-9208, Bangladesh
  • Sajib Chowdhury Economics Discipline, Khulna University, Khulna-9208, Bangladesh
  • Nazia Sultana Sumi Economics Discipline, Khulna University, Khulna-9208, Bangladesh



Public health care services, determinants, ordered logistic regression, Bangladesh


Quality of public health care services is a necessary step in the process of improving health care services. It plays an important role for preventing the overuse, underuse and misuse of health care services and ensuring patient safety. Thus, the study aims to investigate the determinants of satisfactory public health care services in rural Bangladesh. Data are collected from 150 respondents of six upazilas in Khulna and Bagerhat districts who spend at least one day in the upazila health complex for receiving treatment. Quantitative analysis is performed through factor analysis and ordered logistic regression. This study demonstrates that almost three-fourth of the respondents visit hospitals at least 3-4 times in a year, also exerts that almost 70% of the respondents earn/month on an average between BDT 5,001-10,000, whereas nearly 40% of the respondents are compelled to spend almost about BDT 2,001-4,000 for availing medical facilities. Ordered logistic regression demonstrates that, educational status of the respondents, financial & physical access to care and health personnel conduct have positively associated with the respondent level of satisfaction on health care services rendered by public health complexes. Therefore, it is vital to improve the related facilities to increase the satisfaction level. Thus, authors suggest improving the overall structure of rural health complex, ensure availability of essential drugs, increase the financial support to government or initiate community-based health insurance to reduce the out of pocket health expenditure to increase the patient satisfaction level.


Aldana, J. M., Piechulek, H., & Al-Sabir, A. (2001). Client satisfaction and quality of health care in rural Bangladesh. Bulletin of the World Health Organization, 79(6), 512-517.

Andaleeb, S. S., Siddiqui, N., &Khandakar, S. (2007). Patient satisfaction with health services in Bangladesh. Health policy and planning, 22(4), 263-273.

Ashrafun, L., & Uddin, M. J. (2011). Factors determining inpatient satisfaction with hospital care in Bangladesh. Asian social science, 7(6), 15.

Beyene, A., Muhiye, A., Getachew, Y., Hiruye, A., Mariam, D. H., Derbew, M., ... & Enquselassie, F. (2015). Assessment of the magnitude of teenage pregnancy and its associated factors among teenage females visiting Assosa General Hospital. EMJ, 25-37.

Bhat, S., Gijo, E. V., & Jnanesh, N. A. (2016). Productivity and performance improvement in the medical records department of a hospital: an application of Lean Six Sigma. International Journal of Productivity and Performance Management.

Callander, E. J., Topp, S., Fox, H., & Corscadden, L. (2020). Out‐of‐pocket expenditure on health care by Australian mothers: Lessons for maternal universal health coverage from a long‐established system. Birth, 47(1), 49-56.

Chassin, M. R., & Loeb, J. M. (2011). The ongoing quality improvement journey: next stop, high reliability. Health Affairs, 30(4), 559-568.

Fatima, T., Malik, S. A., & Shabbir, A. (2018). Hospital healthcare service quality, patient satisfaction and loyalty: An investigation in context of private healthcare systems. International Journal of Quality & Reliability Management.

Findik, U. Y., Unsar, S., & Sut, N. (2010). Patient satisfaction with nursing care and its relationship with patient characteristics. Nursing & health sciences, 12(2), 162-169.

Hamid, S. A., Ahsan, S. M., & Begum, A. (2014). Disease-specific impoverishment impact of out-of-pocket payments for health care: evidence from rural Bangladesh. Applied health economics and health policy, 12(4), 421-433.

Hossen, A., &Westhues, A. (2011). Improving access to government health care in rural Bangladesh: the voice of older adult women. Health care for women international, 32(12), 1088-1110.

Hussain, M. M., & Raihan, M. M. H. (2016). Patients’ satisfaction with public health care services in Bangladesh: Some critical issues. Malaysian Journal of Medical and Biological Research, 3(1), 51-62.

Islam, M. R., & Hasan, M. (2016). Climate-induced human displacement: A case study of Cyclone Aila in the south-west coastal region of Bangladesh. Natural hazards, 81(2), 1051-1071.

Jalil, A., Zakar, R., Zakar, M. Z., & Fischer, F. (2017). Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan. BMC health services research, 17(1), 1-13.

Khalid, F., Raza, W., Hotchkiss, D. R., & Soelaeman, R. H. (2021). Health services utilization and out-of-pocket (OOP) expenditures in public and private facilities in Pakistan: an empirical analysis of the 2013–14 OOP health expenditure survey. BMC health services research, 21(1), 1-14.

Khandakar, M. S. A. (2014). Rural Health Care System and Patients’ Satisfaction towards Medical Care in Bangladesh: An Empirical Study. Journal of Business, 35(2).

Lluch, M. (2011). Healthcare professionals’ organisational barriers to health information technologies A literature review. International journal of medical informatics, 80(12), 849-862.

Manzoor, F., Wei, L., Hussain, A., Asif, M., & Shah, S. I. A. (2019). Patient satisfaction with health care services; an application of physician’s behavior as a moderator. International journal of environmental research and public health, 16(18), 3318.

Molla, A. A., Chi, C., & Mondaca, A. L. N. (2017). Predictors of high out-of-pocket healthcare expenditure: an analysis using Bangladesh household income and expenditure survey, 2010. BMC Health Services Research, 17(1), 1-8.

Narang, R. (2011). Determining quality of public health care services in rural India. Clinical Governance: An International Journal, 16(1), 35-49.

Newspaper Store. (2019). Available at.

Pradhan, J., & Behera, S. (2021). Does choice of health care facility matter? Assessing out-of-pocket expenditure and catastrophic spending on emergency obstetric care in India. Journal of Biosocial Science, 53(4), 481-496.

Priporas, C. V., Laspa, C., & Kamenidou, I. (2008). Patient satisfaction measurement for in-hospital services: a pilot study in Greece. Journal of Medical Marketing, 8(4), 325-340.

Saha, S. K. (2017). Cyclone Aila, livelihood stress, and migration: empirical evidence from coastal Bangladesh. Disasters, 41(3), 505-526.

Scott, A., Sivey, P., Ouakrim, D. A., Willenberg, L., Naccarella, L., Furler, J., & Young, D. (2011). The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane database of systematic reviews, (9).

Talib, F., Azam, M., & Rahman, Z. (2015). Service quality in healthcare establishments: A literature review. International Journal of Behavioural and Healthcare Research, 5(1-2), 1-24.

Van Duong, D., Binns, C. W., Lee, A. H., & Hipgrave, D. B. (2004). Measuring client-perceived quality of maternity services in rural Vietnam. International Journal for Quality in Health Care, 16(6), 447-452.

Westaway, M. S., Rheeder, P., Van Zyl, D. G., & Seager, J. R. (2003). Interpersonal and organizational dimensions of patient satisfaction: the moderating effects of health status. International journal for quality in health care, 15(4), 337-344.

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of nursing management, 21(5), 709-724.

World Bank. (2019). Available at.

Zeng, W., Lannes, L., & Mutasa, R. (2018). Utilization of health care and burden of out-of-pocket health expenditure in Zimbabwe: results from a National Household Survey. Health systems & reform, 4(4), 300-312.




How to Cite

T. M. . Mamun, S. Chowdhury, and N. S. . Sumi, “DETERMINANTS OF SATISFACTORY PUBLIC HEALTH CARE SERVICES IN RURAL BANGLADESH”, Khulna Univ. Stud., vol. 19, no. 1, pp. 128–140, Feb. 2022.



Social Sciences