Spatial Design Determinants of Patient Satisfaction in Private Hospital Facilities in South West Nigeria

Patient satisfaction in healthcare settings is influenced by a complex interplay of clinical quality and environmental design factors, yet the contribution of spatial design to patient experience outcomes in Nigerian private hospitals remains empirically underexplored. This study investigates the spatial design determinants of patient satisfaction in twelve private hospital facilities across Lagos, Ogun, and Oyo states, South West Nigeria. A mixed-methods research design combines structured patient satisfaction surveys administered to six hundred and forty inpatients and outpatients, expert spatial quality assessments of all twelve facilities using a validated Environmental Assessment Tool, and semi-structured interviews with twenty-eight patients selected for deeper experience narratives. Multilevel regression analysis examines the relationship between spatial design quality scores across seven dimensions, including wayfinding clarity, natural light access, acoustic comfort, privacy provision, and spatial cleanliness maintenance, and standardised patient satisfaction scores. Findings reveal that wayfinding clarity and privacy provision are the strongest spatial predictors of overall patient satisfaction, together explaining thirty-eight percent of satisfaction variance after controlling for clinical quality variables. Natural light access is found to significantly moderate the relationship between waiting time and patient anxiety. Facilities scoring in the top quartile on spatial quality assessments record patient satisfaction scores twenty-two percent higher than bottom-quartile facilities. The study develops a Spatial Design Quality Index for Nigerian Private Hospitals and recommends its adoption by the National Health Insurance Authority as a licensing quality indicator. Keywords: spatial design, patient satisfaction, private hospitals, South West Nigeria, healthcare environment.