Patient satisfaction remains one of the most visible indicators of healthcare performance, yet satisfaction alone cannot explain what patients experienced, what those experiences meant to them, or why apparently similar encounters generate different judgments of care quality. This conceptual article develops a psychosocial account of perceived care quality that separates care events from their interpretation. It argues that satisfaction is best understood as a downstream evaluative judgment shaped by expectations and comparison standards, whereas healthcare experience encompasses reported events, interactions, relational conditions, continuity, material environments, and opportunities for participation. Emotional meaning is treated not as an accessory to experience but as part of the interpretive process through which events acquire significance. Recognition, dignity, trust, voice, information usability, and continuity can therefore alter perceived quality without being interchangeable with satisfaction. The article further emphasizes that evaluation is temporally cumulative: earlier encounters modify expectations, trust, vigilance, and interpretation of subsequent care. Cultural conditions, illness severity, organizational arrangements, digital modalities, resource inequalities, and power asymmetries constrain these processes. The resulting theory is explicitly proposed rather than empirically validated. Its purpose is to provide a bounded conceptual architecture for distinguishing what happened during care, how patients interpreted it, and how those interpretations contribute to perceived quality. This distinction has implications for measurement and quality improvement because global satisfaction scores may conceal clinically and organizationally important differences in patient experience.
