Determinants of Multidimensional Patient Wellbeing in Private Healthcare Institutions: Evidence From Azerbaijan

Abstract Background Patient wellbeing is increasingly recognised as a key outcome of health system performance, extending beyond traditional indicators of patient satisfaction and clinical effectiveness.In health systems with expanding private sectors, understanding how service delivery processes and institutional factors shape patient wellbeing is particularly important. However, empirical evidence from middle-income countries remains limited. This study aimed to assess multidimensional patient wellbeing in private healthcare institutions in Azerbaijan and to identify its key determinants. Methods A cross-sectional survey was conducted among 300 adult patients receiving care in private healthcare institutions in Azerbaijan. A structured questionnaire measured six wellbeing-related domains: emotional, relational, experiential, financial, informational, and institutional wellbeing, using a five-point Likert scale. An Overall Wellbeing Index (OWI) was constructed by aggregating domain scores. Descriptive statistics, subgroup analyses, Pearson correlation analysis, and multiple linear regression were used to examine determinants of patient wellbeing. Results Overall patient wellbeing was high (OWI = 4.09 on a 5-point scale). Relational and emotional wellbeing demonstrated the strongest performance, highlighting the importance of trust, empathy, and communication quality in private healthcare settings. In contrast, financial and institutional wellbeing scored comparatively lower, reflecting concerns related to pricing transparency, administrative coordination, and service consistency. Regression analysis identified service quality, communication, timeliness of care, and pricing transparency as the strongest predictors of overall wellbeing. Subgroup analyses revealed significantly higher wellbeing among urban residents, individuals with higher socioeconomic status, and patients covered by the Mandatory Health Insurance system. Conclusions Private healthcare institutions in Azerbaijan perform strongly in interpersonal and experiential aspects of care but face persistent system-level challenges related to administrative efficiency, digital readiness, and financial transparency. Strengthening service organisation, pricing transparency, and digital integration may substantially enhance multidimensional patient wellbeing and reduce socioeconomic and geographic disparities. These findings provide policy-relevant evidence for improving patient-centred performance in mixed public–private healthcare systems