In a questionnaire study of 700 patients from a large UK National Health Service general hospital, proximal and organizational aspects of patient satisfaction were studied. Factor analysis revealed three components of proximal patient satisfaction: overallprocess of carein the hospital;improvement in and understanding of health; andpsychological well‐being. Eleven scales measuring relevant aspects of hospital care and environment were derived. In a second study, involving 483 patients from a different general hospital, confirmatory factor analyses confirmed the robustness of the factor structure derived in the first study. Finally, aspects of care that best predicted satisfaction were identified. These included nursing and medical information practices, socialization procedures and patient participation. The implications of these findings are explored in the context of organizational theories of participation and the potential applications of the findings are considere