Patient-Centered Care and Patient Satisfaction in Chronic Disease Management in Public Hospitals

Abstract

Chronic diseases rank highly among the world’s major health challenges requiring the planning of interventions that personalize health care delivery. From this perspective, Patient-Centered Care (PCC) has been recognized as an important approach to improving health and satisfaction. Nevertheless, a comprehensive and integrated assessment of PCC’s real performance with regard to the limitations of its implementation remains necessary, especially when looking at the public hospital systems of developing countries. This systematic review intends to fill this gap. It presents a detailed evaluation of the complex relationship of PCC and patient satisfaction in the context of chronic care in public hospitals. Three aims structure this analysis. First, to assess the strength of the relationship. Second, to identify the main barriers and facilitators of PCC. And finally, to focus on what the relationship and barriers indicate for the Egyptian healthcare system. This review was developed based on the stringent application of the 2020 PRISMA guidelines. Materials were gathered from four major databases (PubMed, Scopus, Web of Science, and Google Scholar) from January 2000 to December 2024. Screening and data collection were carried out independently by two reviewers, with the third acting as adjudicator for disputes. The Mixed Methods Appraisal Tool (MMAT) assessed the quality of the included studies. In the quantitative synthesis, a fixed-effects model was employed to calculate the pooled effect size. The correlation of PCC and patient satisfaction was positive and significant, with a pooled effect size of r = 0.51 (95% CI [0.44, 0.58]) across the 20 included studies. A random-effects sensitivity analysis yielded r = 0.49 (95% CI [0.41, 0.57]), confirming the robustness of this finding. The consistent barriers to PCC implementation included high clinician workloads, a lack of material and human resources, and a poor supply of specialized training. Facilitators included leadership support, clinical governance frameworks, and targeted communication training. Moderate heterogeneity was observed (I² = 45%, p < 0.01). The findings offer specific, actionable direction to policymakers and healthcare administrators, particularly in the Egyptian context undergoing Universal Health Insurance (UHI) reform.