Patient satisfaction with surgical informed consent and associated factors: A comparative cross-sectional study of public and private hospitals in Addis Ababa, Ethiopia, 2024

ABSTRACT Background Assessing patient satisfaction with surgical informed consent is essential for evaluating clinical quality and patient-centered care. This study compared adult patient satisfaction with surgical informed consent and its determinants across selected public and private hospitals in Addis Ababa, Ethiopia. Methods We conducted an institution-based comparative cross-sectional study from 15 April to 7 June 2024 in four public and four private hospitals. Adult patients who underwent surgery were selected using systematic random sampling. Interviewers administered a pretested questionnaire was used developed based on previously pushed literature. A pretested, interviewer-administered questionnaire adapted from published scales was used. Data were entered in EpiData v4.6 and analyzed in SPSS v27 using descriptive statistics and multivariable logistic regression; significance was set at P < 0.05. Results Of 298 eligible patients, 56.0% were satisfied with the surgical informed consent process (95% CI 50.4–61.5). Satisfaction was higher in private than public hospitals (72.1% vs 43.8%). In multivariable logistic regression, higher patient satisfaction was independently associated with receiving care in a private hospital (AOR = 2.83; P = 0.001), undergoing elective surgery (AOR = 2.06; P = 0.002), having a prior surgical history (AOR = 2.88; P = 0.001), providing informed consent before the day of surgery (AOR = 5.59; P < 0.001), and receiving consent in the patient’s primary language (AOR = 2.60; P = 0.002). Conclusion Overall satisfaction with the surgical informed consent process was suboptimal and markedly lower in public hospitals. Hospital type, surgical type, prior surgical history, timing of informed consent, and language concordance were key determinants of satisfaction. Strengthening preoperative communication through standardized counseling protocols, ensuring consent in the patient’s primary language (including use of professional interpreters), and providing targeted staff training in consent practices are warranted to promote equitable, patient-centered perioperative care.