The goal of this paper is to analyze changes in productivity and their relation with variations in citizens’ perceived satisfaction in the field of hospital care and specialized care in the Spanish regional health services for the period 1999-2004. To assess changes in productivity the Malmquist indices and Data Envelopment Analysis methodology are used, completing the analysis with bootstrap procedures. The average results show a rise in productivity accompanied by a drop in citizens’ satisfaction. However, the individual analysis does not allow identifying any correlation between variables. The inclusion of the hospital indicator of satisfaction in the production function improves the results, although does not change the regional administrations rankings.