Citizen (Dis)satisfaction: An Experimental Equivalence Framing Study

Abstract This article introduces the importance of equivalence framing for understanding how satisfaction measures affect citizens’ evaluation of public services. Does a 90 percent satisfaction rate have a different effect than a logically equivalent 10 percent dissatisfaction rate? Two experiments were conducted on citizens’ evaluations of hospital services in a large, nationally representative sample of Danish citizens. Both experiments found that exposing citizens to a patient dissatisfaction measure led to more negative views of public service than exposing them to a logically equivalent satisfaction metric. There is some support for part of the shift in evaluations being caused by a negativity bias: dissatisfaction has a larger negative impact than satisfaction has a positive impact. Both professional experience at a hospital and prior exposure to satisfaction rates reduced the negative response to dissatisfaction rates. The results call for further study of equivalence framing of performance information . Practitioner Points The valence (positive/negative) of performance information can have substantial effects on citizens’ perception of public services—even if the underlying performance is exactly the same. Presenting citizens with a dissatisfaction rate of 10 percent induces a much more negative evaluation of public services than presenting them with a logically equivalent satisfaction rate of 90 percent. Policy makers must carefully consider how minor equivalent changes in the presentation of performance information can induce large shifts in citizens’ perceptions of public service performance.