Perceived Competence and Quality of Care in Health Centers Versus Hospitals: A Systematic Review of Patient Experience in Developing Countries
Abstract:
Patient perception of healthcare quality and provider competence is a vital dimension of service evaluation, particularly in developing countries where resource disparities between health centers and hospitals remain prominent. This systematic review critically examines how patients in these settings experience and compare perceived competence and care quality across facility types. Drawing on 60 empirical studies published between 2015 and 2024, the review synthesizes findings on four thematic areas: technical competence, interpersonal care, accessibility and responsiveness, and patient satisfaction and trust. The analysis reveals that hospitals are generally perceived as technically superior due to their infrastructure, specialized staff, and advanced diagnos tics. However, they often fall short in delivering relational care, with patients reporting rushed interactions and impersonal treatment. In contrast, health centers are widely appreciated for their interpersonal warmth, com munity proximity, and responsiveness, despite limitations in medical capacity. These divergent strengths suggest that patients in low-resource settings navigate complex trade-offs between clinical expertise and emotional en gagement when choosing where to seek care. The findings underscore the need for integrated policy approaches that simultaneously strengthen the technical capacity of primary care and promote person-centered practices in hospital settings. This review contributes to global health discourse by framing healthcare quality as a multidi mensional construct shaped not only by biomedical inputs but also by cultural, emotional, and systemic factors. The study offers actionable insights for health policymakers, facility managers, and practitioners committed to building equitable, responsive, and trust-driven health systems in developing countries.
