Response to: Patients’ Perception of Patient-Centered Care and Associated Factors Among Patients Admitted in Private and Public Hospitals [Letter]

Dear editor

We have carefully reviewed articles that discuss patient perception of “patient-centered care”, which were influenced by 4 factors, namely length of stay, intimacy with provider, privacy and access to service. Meanwhile, 3 factors were significant only in private hospitals, namely awareness of disease, involvement in decisions, and information on plan; 3 factors were significant only in public hospitals namely residence, information on medication and hospital attractiveness; and 2 factors did not affect perception, namely presence of reception and presence of disturbing sounds.¹

This is a very valuable finding for related hospitals, but further questions arise: 1) Is it true that the presence of reception and presence of disturbing sounds does not affect perception? 2) Is it possible that these two factors influence the perception indirectly?

The use of logistic regression test, shows that researchers analyzed the direct effect of 12 factors simultaneously on the perception.¹ Logically, there may be several factors that influence the perception indirectly through intermediate factors. For example, the possibility of the presence of disturbing sounds affects privacy, then privacy affects perception. Referring to a similar problem,^2,3 we propose a framework that shows the paths between factors, involving intermediate factors, which are open to further review (Figure 1). With the existence of intermediate factors, we suggest that further analysis be carried out using “path-analysis”, so that the influence of each factor, both directly and indirectly,⁴ on perception can be explained. For categorical data, a good program to use is Smart-PLS.⁴

Figure 1 The framework of the influence of 12 factors on perception.

It is hoped that with this further analysis, each factor can know its influence on the perception of patient-centered care, even though it is through an intermediate factor. Thus, the new information obtained can be recommended for related hospitals in order to improve the quality of service.