Perceived Importance vs Performance in Dental Care: Exploring Patient Satisfaction Across Age, Gender, and Purchasing Power.

Introduction: Patient satisfaction is a key indicator of healthcare quality, particularly in dental services, where both clinical and non-clinical factors shape perceptions of care. This study aims to investigate the impact of demographic variables-specifically age, gender, and purchasing power-on patient satisfaction with dental services in Quito, Ecuador. Methods: A sample of 485 patients was surveyed using a modified SERVPERF model combined with an attribute matrix. The instrument captured the perceived importance and satisfaction associated with 14 service attributes. Stratified random sampling was applied based on age, gender, and purchasing power. Satisfaction indices were calculated, and differences among groups were analyzed using the chi-square test. Results: Age was the only variable with a statistically significant impact on patient satisfaction (p < 0.05), whereas gender and purchasing power showed no significant differences. Professionalism, quality, and empathy were rated as the most essential attributes across all groups. Interestingly, attributes considered less important-such as waiting time and payment methods-received higher satisfaction scores. The attribute matrix revealed that critical attributes (important but underperforming) differed mainly by age group. The highest satisfaction scores were observed among patients under 25, while the lowest were reported among those aged 40 to 60 and in lower-income groups. Discussion: Findings highlight the relevance of age-sensitive strategies in dental care and underscore a potential misalignment between what patients value most and what they rate most positively. The combined SERVPERF and attribute matrix approach proved effective for generating actionable insights. Further research in diverse contexts is needed to validate these findings.