Bridging the gap between healthcare providers and patient expectations.

Are We Missing the Mark? Bridging the Gap Between Healthcare Providers and Patient Expectations

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Lena Kashyap in Health & Wellness October 2026 • 4 min read.

"Uncover hidden gaps in public health clinics and what they mean for quality care. A must-read for healthcare professionals and patients alike."


In developing countries, the efficient delivery of public healthcare services faces constant challenges due to increasing demands and limited resources. Evaluating these services is crucial for ensuring quality and optimizing available resources. A key aspect of this evaluation involves understanding the perceptions of both users (patients) and providers (healthcare professionals) regarding service quality.

Service quality, from a patient's perspective, is closely linked to how promptly their needs are addressed and whether the benefits of receiving care outweigh any potential risks. Factors like infrastructure and the quality of health professionals play vital roles in shaping these perceptions.

Despite ongoing efforts to improve public healthcare in Brazil, quality remains a persistent concern. The Unified Public Health System (SUS), established in 1988, aims to provide universal access to healthcare. However, effectively planning, prioritizing, and allocating resources within primary healthcare centers requires a deep understanding of both provider expertise and patient perceptions of service quality. This article explores these perceptions, aiming to identify gaps and inform strategies for enhancing healthcare delivery.

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Measuring Patient-Centered Quality

Patient satisfaction and the factors influencing it have become major subjects of scientific study. Measuring patient satisfaction and health-related quality of life reflects patients’ growing involvement in evaluating healthcare. However, a 2025 narrative review reported significant gaps between patient expectations and actual service delivery, particularly in functional and emotional quality dimensions, while also noting limitations involving contextual generalizability and bias.

The Perception Problem: Are Providers Aware of Patient Needs?

Bridging the gap between healthcare providers and patient expectations.

A study was conducted across three public health centers in Natal, Brazil, involving 1,200 patients and 265 healthcare providers (doctors, nutritionists, psychologists, pharmacists, and managers). The research aimed to pinpoint the service attributes patients consider most important and compare these with providers' perceptions.

The findings revealed a significant disconnect. While patients highly valued attributes such as safety, comfort, and easily accessible information, providers often underestimated their importance. This suggests that healthcare professionals may not always be fully aware of patients' actual needs and priorities.

  • Safety and Comfort: Patients ranked these attributes as high priorities, while providers placed them lower, indicating a potential blind spot.
  • Clear Communication: Knowledge, attention, and clear explanations from healthcare professionals were valued by both groups, highlighting the importance of the doctor-patient relationship.
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Emerging Evidence on Experience

A literature review found that consumer psychology, consumer experience, consumer satisfaction, and organizational performance have remained active research topics over approximately the last five years. The reviewed work has generally appeared in leading journals in business management, marketing, and management. The review suggests that studies connecting these areas can produce research suitable for prestigious journals.

Patient-Provider Perception Gaps

The Crossref-indexed study found significant differences between patients and providers on 18 of the 22 items in its quality-of-care scale. This result indicates that patients and providers may evaluate important aspects of care differently. Such differences are directly relevant when assessing gaps between healthcare delivery and patient expectations.

These discrepancies highlight the need for healthcare providers to actively seek and understand patient perspectives to deliver truly patient-centered care. When comparing the overall responses, the Spearman test indicated a low match between the priorities of patients and providers' perception of their priorities.

Closing the Gap: A Path to Improved Healthcare

The study's findings underscore the importance of aligning healthcare delivery with patient expectations. By understanding what patients truly value, healthcare providers and managers can make informed decisions about resource allocation and service improvement.

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Understanding Expectations

A 2022 conceptual review examined healthcare expectations through business, management, social psychology, and sociology literature. It proposed an integrative analytical framework for understanding individuals’ expectations in healthcare. Related research emphasizes that measuring patient expectations is central to improving satisfaction and delivering patient-centered care, although most empirical studies have focused on expectations associated with specific diseases.

A Data-Driven Future

Oracle describes the future of healthcare as data-driven, AI-enabled, and fundamentally patient-centered. It identifies AI, cloud computing, genomics, and virtual care as converging technologies that could support earlier intervention, personalized treatment, and risk prediction. The stated goal includes preventing costly hospitalizations through a smarter health system.

One of the key takeaways from the study is that the patients perceived the public clinics to have negative quality. In all attributes, the degree of expectation was higher than the performance of the services offered. To bridge the gaps, the authors recommend the following:

Prioritize the attributes of security and comfort in order to meet the patients needs. Focus on improvments for safety and comfort at the health clinics. The gaps in the quality of 'availability of a sector of complaints or suggestions', should be addressed with a demand for an ombudsman who can attend to patients' complaints.

How the reported expectation gap was tested

  • 5 percent significance levelThe study compared mean quality shortcomings reported independently by users and providers. The authors reported that the gaps were statistically the same at a 5 percent significance level; this describes the comparison between groups, not whether services met expectations.[1]Caveat: The gaps were statistically the same

What this snapshot cannot settle

  • The analysis did not examine whether views differed across income, gender, or age groups.[1]
  • The authors noted that interviews or other qualitative work could clarify why patient and provider views diverged or aligned.[1]

A survey of patients and clinic providers in Natal

PopulationPatients who used public health services and health clinic providers[1]
Sample size1,200 patients and 265 providers[1]
SettingThree health clinics in Natal, Brazil[1]
ComparisonPatients and healthcare service providers[1]
Main outcomeExpectations and quality gaps in services provided at city public health clinics[1]
p-valueSignificance level of 5 percent[1]
Times cited21[1]

A later study of Brazilian public clinics described the service quality perceived by patients in the Natal study as low, placing the reported shortcomings in a broader discussion of perceived quality in healthcare organizations.[2]

Questions the clinic survey leaves open

  • Would the mismatch between providers’ estimates and users’ expectations look different across social or demographic groups?[1]
  • What experiences or assumptions account for the differences and areas of agreement between patients and providers?[1]
  • Would repeated measurement show that the reported shortcomings and expectations persist or shift over time?[1]

Terms used to describe the study

Service attribute
A feature of a health service assessed in the study.[1]

Sources

  1. Service quality in public health clinics: perceptions of users and health professionals (Emerald, 2017)
  2. INVESTIGATING SERVICE QUALITY IN GREEK CITIZENS SERVICE CENTERS (2019)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1108/ijhcqa-09-2016-0140, Alternate LINK

Title: Service Quality In Public Health Clinics: Perceptions Of Users And Health Professionals

Subject: Health Policy

Journal: International Journal of Health Care Quality Assurance

Publisher: Emerald

Authors: Domingos Fernandes Campos, Rinaldo Bezerra Negromonte Filho, Felipe Nalon Castro

Published: 2017-10-09

Everything You Need To Know

1

How is 'service quality' defined from a patient's point of view, and what are its key components?

Service quality, from a patient's perspective, is closely tied to how quickly their needs are met and whether the advantages of receiving care outweigh any possible risks. Factors such as infrastructure and the quality of health professionals are vital in shaping these perceptions. A key aspect of this evaluation involves understanding the perceptions of both users (patients) and providers (healthcare professionals) regarding service quality. This involves aspects such as the timeliness of care, the expertise and communication skills of healthcare professionals, and the overall environment of the healthcare setting.

2

What was the methodology used in the study conducted in Natal, Brazil, and what were the key findings regarding patient and provider perceptions?

The study conducted across three public health centers in Natal, Brazil, involved 1,200 patients and 265 healthcare providers (doctors, nutritionists, psychologists, pharmacists, and managers). The research aimed to pinpoint the service attributes patients consider most important and compare these with providers' perceptions. The study revealed a significant disconnect between what patients prioritize and what healthcare providers believe patients value, particularly in areas like safety, comfort, and easily accessible information. This discrepancy highlights the need for healthcare providers to actively seek and understand patient perspectives.

3

Why is bridging the gap between healthcare providers and patient expectations so important in the context of healthcare?

In the context of healthcare, bridging the gap between healthcare providers and patient expectations is important because it directly impacts patient satisfaction, healthcare outcomes, and the effective use of resources. When providers are unaware of patient needs, they may allocate resources inefficiently or offer services that do not meet patients' priorities. This can lead to dissatisfaction, reduced adherence to treatment plans, and ultimately, poorer health outcomes. Improving this alignment helps to ensure that care is patient-centered, improving both patient and provider experience.

4

What are some of the specific examples of discrepancies between patient and provider perceptions found in the study, and what are the implications?

The findings reveal that healthcare professionals may not always be fully aware of patients' actual needs and priorities, leading to a mismatch in service delivery. For instance, patients in the study highly valued safety, comfort, and accessible information, while providers often underestimated their importance. This disconnect can lead to patient dissatisfaction, decreased trust in the healthcare system, and potentially, poorer health outcomes.

5

What is the significance of the Unified Public Health System (SUS) in the context of this discussion?

The Unified Public Health System (SUS), established in 1988, aims to provide universal access to healthcare in Brazil. Effectively planning, prioritizing, and allocating resources within primary healthcare centers requires a deep understanding of both provider expertise and patient perceptions of service quality. The SUS faces the challenge of efficiently delivering public healthcare services due to increasing demands and limited resources. Understanding patient perceptions helps in improving the quality of services and optimizing the allocation of these resources.

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