Defense Date


Document Type


Degree Name

Doctor of Philosophy


Public Policy & Administration

First Advisor

Dr. Janet R. Hutchinson


The objectives of this study were to measure and describe the overall satisfaction of Hispanics/Latinos with services they receive from Chesterfield County's Health Department and compare it to that of African Americans and Caucasians. Also, the objectives were to analyze reasons for different levels of satisfaction, assess the nature and degree of satisfaction with particular services, and suggest implications of the Hispanic/Latino opinions for public policy. While the empirical literature revealed that Hispanics/Latinos experience lower levels of satisfaction with health care services, this study did not provide evidence to support this theory.This is a multi-method non-experimental research design combining a cross-sectional design and qualitative interviews. Quantitative data was collected through a patient satisfaction survey, in both English and Spanish, incorporating both closed and open-ended questions. Qualitative data was collected through taped in-depth interviews conducted with each subject to obtain their perspective on the services provided by the Health Department.The Spanish and English research instrument (Appendix C and D) was a self-designed survey to provide a more comprehensive approach to assess customer satisfaction of health services, collect demographic information, and determine how to better deliver these services. The survey consisted of 46 questions (and several follow-up questions) with 23 questions pertaining to the six satisfaction dimensions. These dimensions were measured by a Likert-type response scale ranging from strongly agrees to strongly disagree.Item identification was based on suggestions offered by staff of Chesterfield County's Health Department, theoretical concepts introduced in the literature review and miscellaneous information adapted from the following surveys: The Connecticut Surgical Group - Patient Satisfaction Survey (2004); SERVQUAL--an instrument for measuring quality service (1990); and The Patient's View on Health Care by RAND and UMQC (1994). Authors of these surveys suggest satisfaction be assessed across the following dimensions: reliability, responsiveness, competence, access, courtesy, communication, credibility, security, understanding/knowledge of the customer, and tangibles (appearance of physical facilities). Data were collected from 166 non-Hispanic/Latino and 90 Hispanic/Latino patients that were 18 years of age or older and receive services, at Chesterfield County, Virginia's Health Department. The independent variables were sex, age, level of school completed, income, marital status, children, ethnic background, ability to speak English, modes of transportation, and length of residency in Chesterfield County, Virginia. Dependent variables in the analyses included the six dimensions of satisfaction--staff reliability, staff responsiveness, staff courtesy, staff communication, access to Health Department services, and Health Department Facilities. The data were analyzed through several inferential statistical techniques--univariate, bivariate, multivariate, and nonparametric.Results of the tests indicated that overall, ethnic background only influenced satisfaction with services across two dimensions--staff responsiveness and staff courtesy. However, there were noted differences in the measured levels of satisfaction across the racial/ethnic groups. This study also found that valid comparisons can be made among Hispanics/Latinos, African Americans, and Caucasians on their levels of satisfaction using the 23 measures. Population characteristics had no influence on the differences in satisfaction among the racial ethnic/groups. Results of the in-depth interview revealed that respondents were satisfied with the services as well as the quality of the services provided by the Health Department.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

June 2008