The relationship between job satisfaction of primary healthcare workers and patient satisfaction: the cross-level mediating effect of perceived quality of health care

Corresponding author: yuanbeibei, beibeiyuan@pku.edu.cn

DOI: 10.12201/bmr.202606.00082

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  Abstract: Objective: To investigate the relationship between job satisfaction of primary healthcare workers in community health service institutions and patient satisfaction, as well as the cross-level mediating effect of patients'' perceived quality of primary health care services. Methods: A cross-sectional design was adopted. Data were collected from 907 primary healthcare workers and 1 411 outpatients in 44 community health service institutions in a district of Beijing from November to December 2025. Core variables were measured using the Minnesota Satisfaction Questionnaire, a self-developed Patient Satisfaction Scale, and a self-developed Perceived Quality of Primary Health Care Services Scale. A 2-1-1 cross-level mediation model was constructed, and the mediating effect was tested using the cluster bootstrap method. Results: Job satisfaction of primary healthcare workers showed a significant positive association with patient satisfaction (γ=0.21, P<0.01). Patients'' perceived quality of primary health care services played a partial mediating role, with an indirect effect of 0.07 (95% confidence interval, CI: 0.01–0.14). Patient age was negatively correlated with patient satisfaction, while frequency of primary care visits was positively correlated with perceived quality of primary health care. Conclusions: Job satisfaction of primary healthcare workers not only has a direct positive association with patient satisfaction, but also exerts an indirect effect through patients'' perceived quality of primary health care services. It is recommended to optimize salary distribution and career development pathways to enhance job satisfaction of primary healthcare workers, and to strengthen service continuity and coordination to improve patients'' quality perception, so as to achieve simultaneous improvement of both staff and patient satisfaction in primary healthcare settings.

  Key words: Community health services; Job satisfaction; Patient satisfaction; Quality of health care

  Submit time: 30 June 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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