Many patient satisfaction studies consider patient satisfaction and intention to recommend as the same constructs. However, we propose to investigate the two constructs separately. This study has utilized patient satisfaction data with 32 hospitals in different locations to investigate how hospital discharged patients combine their attribute reactions to arrive at their evaluation of hospital care and their intention to recommend to others. A multiple linear regression analysis with a scatter term was conducted while controlling for age, gender, perceived health, educational attainment and race. The interpretation of the scatter term is presented with a story. There were 31,471 cases for the analysis, and the results show some similarities and critical differences between the two models. In conclusion, hospital managers are well advised to focus on improving nursing care first, and then staff care and environment in order to increase patient evaluation of hospital care and intention to recommend.
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