Abstract
BACKGROUND: Patient satisfaction constitutes one of the three dimensions of health system performance metrics, alongside health status and financial protection. However, a comprehensive understanding of the elements influencing inpatient satisfaction remains limited. METHODS: This cross-sectional study evaluated inpatient satisfaction using a two-tiered analytical approach: an exploratory assessment of sociodemographic associations followed by a focused analysis of core service dimensions. A survey was conducted among 433 patients at the Fifth Affiliated Hospital of Wenzhou Medical University, employing a stratified random sampling technique. The Kruskal-Wallis test and ordered logistic regression were utilized to examine the relationships between inpatient satisfaction and its influencing factors, adjusting for sociodemographic variables. RESULTS: The mean overall satisfaction score was 4.49. Satisfaction was highest in medical processes and technology, and lowest regarding costs. Univariate analysis identified payment method as a significant correlate. While exploratory univariate analysis of sociodemographic factors yielded limited significant associations, ordered logistic regression identified patients’ perceived quality across the five core service dimensions as the primary and significant predictors of overall inpatient satisfaction. CONCLUSIONS: Medical technology, doctor-patient communication, environmental factors, medical processes, and medical costs significantly and positively influence inpatient satisfaction. The overall satisfaction with inpatient services is affected by multiple factors, and enhancements can be achieved by optimizing doctor-patient communication, improving the hospital environment and facilities, and standardizing the medical service process. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-026-14238-2.