Scale library · Service quality

Patient satisfaction (PSQ-18): Marshall & Hays (1994)

The PSQ-18 was shortened by Marshall and Hays (1994) at RAND from the 50-item PSQ-III to measure patient satisfaction with medical care. Its 18 items cover seven dimensions: general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with the doctor, and accessibility and convenience. It takes about 3–4 minutes to complete and suits theses on outpatient satisfaction and the service quality of public and private hospitals and clinics.

Cite the original, not the blog.

Original English items

Items marked (R) are reverse-coded: recode them before computing reliability or scale scores. Replace bracketed placeholders such as [system] with the name of the system, brand or organization you study.

General Satisfaction (GS, 2 items)

Code Item wording Reverse-coded
PSQ3 The medical care I have been receiving is just about perfect. No
PSQ17 (R) I am dissatisfied with some things about the medical care I receive. Yes

Technical Quality (TQ, 4 items)

Code Item wording Reverse-coded
PSQ2 I think my doctor's office has everything needed to provide complete medical care. No
PSQ4 (R) Sometimes doctors make me wonder if their diagnosis is correct. Yes
PSQ6 When I go for medical care, they are careful to check everything when treating and examining me. No
PSQ14 (R) I have some doubts about the ability of the doctors who treat me. Yes

Interpersonal Manner (IM, 2 items)

Code Item wording Reverse-coded
PSQ10 (R) Doctors act too businesslike and impersonal toward me. Yes
PSQ11 My doctors treat me in a very friendly and courteous manner. No

Communication (COM, 2 items)

Code Item wording Reverse-coded
PSQ1 Doctors are good about explaining the reason for medical tests. No
PSQ13 (R) Doctors sometimes ignore what I tell them. Yes

Financial Aspects (FA, 2 items)

Code Item wording Reverse-coded
PSQ5 I feel confident that I can get the medical care I need without being set back financially. No
PSQ7 (R) I have to pay for more of my medical care than I can afford. Yes

Time Spent with Doctor (TS, 2 items)

Code Item wording Reverse-coded
PSQ12 (R) Those who provide my medical care sometimes hurry too much when they treat me. Yes
PSQ15 Doctors usually spend plenty of time with me. No

Accessibility and Convenience (AC, 4 items)

Code Item wording Reverse-coded
PSQ8 I have easy access to the medical specialists I need. No
PSQ9 (R) Where I get medical care, people have to wait too long for emergency treatment. Yes
PSQ16 (R) I find it hard to get an appointment for medical care right away. Yes
PSQ18 I am able to get medical care whenever I need it. No

Response scale

5-point agreement scale. The original RAND version numbers it in reverse: 1 = Strongly agree, 2 = Agree, 3 = Uncertain, 4 = Disagree, 5 = Strongly disagree; the scoring instructions recode it so that high scores always mean high satisfaction. If you switch to 1 = Strongly disagree … 5 = Strongly agree, only the items flagged as reverse-coded need reverse scoring.

Recoding reverse-coded items: 1–5 scale: new score = 1 + 5 − score = 6 − score. If you keep RAND's numbering (1 = Strongly agree), follow the original scoring key instead of this formula.

Licence and permission

According to RAND Health, surveys developed by RAND Health are public documents; RAND charges no fee and requires no permission for non-commercial use, only appropriate citation. Translation also requires no permission.

Sources (APA 7)

Vietnamese translation

A Vietnamese translation of every item, with sample-size advice and studies that used the scale, is on the Vietnamese page for this scale.

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