Testing the Strength of Hospital Accreditation as a Signal of the Quality of Care in Romania: Do Patients' and Health Professionals' Perceptions Align?

Hospital accreditation, as a quality signal, is gaining its popularity among low- and middle-income countries, such as Romania, despite its costly nature. Nevertheless, its effectiveness as a quality signal in driving patients' choice of hospital services remains unclear. In this study, we intend to empirically explore the perceptions of both healthcare professionals and patients toward Romanian hospital accreditation and identify perception gaps between the two parties. Exploratory and confirmatory factor analyses were carried out to extract the latent constructs of health professionals' perceived effects of hospital accreditation. The Wilcoxon rank-sum test and Kruskal-Wallis test were used to identify correlations between patients' sociodemographic characteristics and their behavioral intentions when confronted with low-quality services. We found that health professionals believe that hospital accreditation plays a positive role in improving patient satisfaction, institutional reputation, and healthcare services quality. However, we found a lack of awareness of hospital accreditation status among patients, indicating the existence of the perception gap of the accreditation effectiveness as a market signal. Our results suggest that the effect of interpersonal trust in current service providers may distract patients from the accreditation status. Our study provides important practical implications for Romanian hospitals on enhancing the quality of accreditation signal and suggests practical interventions.