Introduction: The Icelandic health care system ranks favourably in international comparison but patients' experience of interaction with the health service has not been well studied. The goal of this study was to examine the satisfaction of patients admitted to the Acute Cardiac Unit (ACU) at Landspitali – The National University Hospital of Iceland.

Methods: A questionnaire based on the Patient Satisfaction Questionnaire III was mailed to patients admitted to the ACU between 1 January and 29 February 2012. Questions were presented as statements and participants asked to respond how strongly on a scale from 1 to 5 they agreed or disagreed with each statement. Data analysis was performed using descriptive statistics, Cronbach´s alpha for internal consistency of scales and principal components analysis, Wilcoxon-Mann-Whitney and Kruskal-Wallis tests for comparison of groups and Pearson and Spearman correlation coefficients for correlation between variables.

Results: The questionnaire was mailed to 485 individuals of whom 275 (57%) responded. The median age of the participants was 62 (range, 19-95) years and 132 (48%) were women. Internal consistency of the scales was mostly high (Cronbach's alpha 0.62-0.91) and principal components analysis revealed one main factor. The mean score of the questionnaire was 6.8 ±1.0 and 91%, and 86% of the participants were pleased with their interaction with physicians and nurses, respectively. Similarly, 88% were pleased with the care they recieved but 25% felt they received insufficient explanations of their symptoms or that follow-up care was lacking.

Conclusion: Patients of the ACU generally appear to be satisfied with their care. However, our results suggest that improvement is needed in several areas, including information provided at discharge and follow-up care.

Figure 1. Answers to the Patient Satisfaction Questionaire III subscales assessing general satisfaction (gray bars) and interpersonal aspects (black bars). Each bar represents the mean porportion of patients that provided answers from 1 to 5. Response options: 1 = very unsatisfied, 2 = unsatisfied, 3 = neither unsatisfied nor satisfied, 4 = satisfied and 5 = very satisfied.

Figure 2. Scores (scale 1-10) for the Patient Satisfaction Questionaire III subscale general satisfaction according to prior experience of hospital encounters. The boxes represent patients who reported prior experience classified as follows: 1 = very  bad, 2 = bad, 3 = neither bad nor good, 4 = good and 5 = very good. N indicates the number of patients in each group. There was a strong relationship between prior experience and satisfaction with the care at the Acute Cardiology Unit (p<0.001).