Causal relationships between background characteristics, service utilization, satisfaction, and service outcomes (school performance): A path analysis

This study develops a causal model to examine the relationships between service outcome (school performance) and consumer satisfaction, service utilization, and demographic characteristics of the youth receiving mental health services. Data for 281 children, aged 12-18. served from April 2003 to December 2004 were used for the analyses. Causal relationships among variables of the proposed model were tested by using AMOS, and the respecified model was accepted as the final model with good fit to the data (*2 = 5.099, df=8, NFI=.951, CFI=.998, RMSEA=.001). Results of the model test point to the importance of the children's age, service intensity, and consumer satisfaction as determinants of school performance outcome. In particular, increased worker satisfaction and overall satisfaction lead to increases in the perceived success satisfaction and this satisfaction, in turn, leads improvement in grades. Efforts to improve service satisfaction are emphasized and studies based on a more dynamic perspective are needed. (C) 2009 Elsevier Ltd. All rights reserved.