Associação entre características estruturais, assistência e ensino, na satisfação dos usuários da HUBRASIL - Hospitais Universitários do Brasil

Abstract

Introduction: User satisfaction is an essential component in evaluating the quality of healthcare services, especially in university hospitals that integrate care, teaching, and research. Objective: To assess the extent to which structural, care-related, and academic variables are associated with user satisfaction in the university hospitals of the EBSERH Network. Materials and Methods: Data from 38 hospitals for the year 2023 were analyzed, including structural, care-related, and academic information (total expenditure, number of beds, built area, number of employees, residents, students, residency programs, outpatient visits, diagnostic exams, surgeries, and hospitalizations). Satisfaction scores were obtained from institutional surveys conducted by hospital ombudsman offices and consolidated in a Business Intelligence platform. Generalized Additive Models (GAM) were applied and selected using the Akaike Information Criterion (AIC). Results: The number of surgeries was the main predictor of overall satisfaction, showing a non-linear relationship. Structural and academic dimensions did not explain the variation in satisfaction, resulting in null models. Higher numbers of hospitalizations and employees were associated with lower satisfaction levels, while care-related variables—particularly surgical volume—showed greater predictive capacity. Conclusion: User satisfaction is more closely associated with the organization and effectiveness of care processes than with the structural size or academic activity of hospitals. The findings reinforce the importance of workflow management, care efficiency, and clinical governance in the user experience. As a technical-technological product, the findings of this study will be consolidated into a Conclusive Technical Report to be submitted to EBSERH, structured in a replicable format and intended for use by hospital managers, health planning and budgeting sectors, and internal and external control bodies, with potential for direct impact on public hospital management and evidence-based decision-making within the Brazilian Unified Health System (SUS).