Healthcare service quality, satisfaction and loyalty in university hospitals: themoderating effects of age and visit frequency.

Hospitals are an integral part of the health care system, where the pharmaceutical installation plays an important role in supporting service quality. Quality pharmaceutical services can improve patient satisfaction and loyalty. This study aims to analyze the effect of service quality on patient satisfaction and loyalty, and to see the mediating role of satisfaction in the relationship. The study was conducted quantitatively with the Structural Equation Modeling–Partial Least Square (SEM-PLS) approach using SmartPLS 4.0. The research locations were RSKDIA Siti Fatimah and RSIA Paramount Makassar, with a population of outpatients of the pharmaceutical installation in 2023. Data collection was carried out through questionnaires and interviews, with a sample of some patients from the total population. The results showed that service quality had a direct and significant effect on patient loyalty, with a greater contribution at RSIA Paramount. Service quality also affected patient satisfaction, and satisfaction had a significant role in mediating the relationship between service quality and loyalty. SERVQUAL dimensions such as reliability, responsiveness, assurance, empathy, and physical aspects are the main determining factors in creating satisfaction. The implementation of the patient-centered care approach has been proven to increase positive patient experiences. In conclusion, improving the quality of comprehensive pharmaceutical services is very important in shaping patient satisfaction and loyalty in hospitals, especially in primary care facilities.

Patient satisfaction and loyalty are essential indicators of healthcare quality, directly impacting patient outcomes and the long-term success of healthcare facilities. Despite the growing importance of patient-centered care in Saudi Arabia, there is limited research exploring the factors that influence patient satisfaction and loyalty, particularly in the Riyadh region. This study aims to identify the key factors influencing patient satisfaction and loyalty among Saudi patients attending public and private healthcare facilities in the Riyadh region. The study focuses on how healthcare service quality, communication, and demographic factors contribute to patient satisfaction and loyalty. A cross-sectional study was conducted with a sample of 350 Saudi patients from 10 healthcare facilities in Riyadh. Data were collected using the Patient Satisfaction Questionnaire (PSQ-18) and the Patient Loyalty Questionnaire (PLQ). Descriptive statistics, Pearson correlation, and multiple linear regression were employed to identify predictors of patient satisfaction and loyalty. Significant predictors of patient satisfaction included general satisfaction (β = 0.48, p < 0.001), communication (β = 0.35, p < 0.001), and the frequency of healthcare visits (β = 0.13, p = 0.011). Private healthcare facilities had higher satisfaction (p < 0.001) and loyalty scores (p < 0.001) compared to public facilities. Patient loyalty was strongly predicted by general satisfaction (β = 0.55, p < 0.001) and communication (β = 0.42, p < 0.001). Communication quality and patient satisfaction are key drivers of patient loyalty in Saudi healthcare facilities. Private facilities outperform public ones in patient satisfaction and loyalty. These findings emphasize the need for healthcare providers to enhance communication and service quality to foster patient loyalty. Tailored approaches to meet the diverse needs of patients, particularly in terms of education and visit frequency, are crucial for improving healthcare outcomes in Saudi Arabia.

Introduction: In response to the demand for high-quality services, healthcare providers are faced with an increasing number of hospitals in Indonesia, which encourages competition to offer these services. Patient satisfaction, influenced by their expectations and experiences of the services received, is a key indicator in evaluating service quality. Additionally, patient loyalty is established through their trust in the hospital and contributes to the sustainability of healthcare services. Objective: This literature review aims to identify factors that play a role in influencing patient loyalty and satisfaction. Methods: The inclusion criteria are articles published between 2020 and 2024, research conducted in hospitals, with open access and full text. The article selection process resulted in seven articles that will be examined further. Results: Service quality (tangible, reliability, responsiveness, assurance, and empathy), trust, and hospital image have a positive influence on patient satisfaction and loyalty. Furthermore, patient satisfaction plays a crucial role in directly reinforcing patient loyalty. Therefore, improving service quality and establishing a good hospital image is essential not only to satisfy patients but also to ensure the sustainability and competitiveness of the hospital amid increasingly fierce competition in healthcare service provision. Conclusions: The findings of this study indicate that hospital image and service quality have a positive influence on patient loyalty and satisfaction.

The COVID-19 pandemic impacts all sectors and aspects of life, including in health care facilities. To meet the demands of improving health care quality, public hospitals must continue to strive to increase patient satisfaction and loyalty. However, previous studies did not provide much insight into patient satisfaction and loyalty in public hospitals during the COVID-19 pandemic. This study reviewed at articles that discussed factors and strategies for increasing patient satisfaction and loyalty in public hospitals during the COVID-19 pandemic.This study employs a narrative review method to examine 12 research articles on patient satisfaction and patient loyalty published between January 2020 and December 2021 on the Science Direct, Google Scholar, and ProQuest databases. During a pandemic, the overall quality of health services contributes to patient satisfaction. Furthermore, hospital image, patient experience, patient trust, quality of service, customer value, perceived value, hospital health promotion, and service innovation all have an impact on patient satisfaction and loyalty. This review identified the determinants of patient loyalty and patient satisfaction in public hospitals during the COVID-19 pandemic, allowing them to meet the demands of meeting service quality targets.

This study aimed to investigate the impact of perceived health care service quality on patient satisfaction and patient loyalty in mafraq governmental hospital. A survey was conducted to gather data with a complete of 400 patients. To obtain the results and to analyse the hypothesis, the study used PLS-SEM Statistical technique. The findings showed that service quality had a positive direct effect on patient loyalty and patient satisfaction. Meanwhile, patient satisfaction mediated the relationship between service quality and patient loyalty. The study recommends that public hospital managers and healthcare providers should initiate continuous quality improvement programs and monitor healthcare quality to gain patient satisfaction patient and loyalty in return. Future studies may include other factors such as perceived value, trust, availability of hospital resources that can affect patient satisfaction and loyalty.

Research related to the Effect of Service Quality, Image, and Business Ethics on Patient Satisfaction and Loyalty at Hospitals in Makassar City. This research was conducted which aims to: (1) test and analyze the effect of service quality, image, business ethics on patient satisfaction, (2) test and analyze the effect of service quality, image, business ethics on patient loyalty, (3) test and analyze the effect satisfaction with patient loyalty, (4) test and analyze the indirect effect of service quality, image, and business ethics on patient loyalty through mediating patient satisfaction. This study uses primary data through distributing questionnaires to a total of 203 inpatients as samples from the total number of patients in 2018 totaling 69.337, data collection was carried out from December 2019 to January 2020. Data were analyzed using Structural Equation Modeling (SEM) analysis with program assistance AMOS and SPSS. The results showed that (1) service quality, image, and business ethics had a positive and significant direct effect on patient satisfaction, (2) service quality, image, and business ethics had a positive and significant direct effect on patient loyalty, (3) satisfaction has a positive and not significant direct effect on patient loyalty, (4) an indirect relationship of service quality, image, and business ethics, through mediation satisfaction has a positive and not significant effect on patient loyalty. This means that the provision of good quality services, the application of the hospital's image, and the application of ethical behavior will have a direct role in patient satisfaction and loyalty. Patient satisfaction does not significantly affect patient loyalty due to the existence of a system of tiered referral system which makes it impossible for patients to directly choose the hospital, except in an emergency. Quality of service, image, and business ethics through satisfaction has a positive and not significant effect on patient loyalty. This shows that patient satisfaction is not able to mediate to have a significant influence on patient loyalty.

The purpose of this study was to describe service quality and patient satisfaction and loyalty at RSIA Fatma Bojonegoro, to determine and analyze the effect of service quality on patient satisfaction, the influence of service quality directly on patient loyalty, the effect of patient satisfaction on patient loyalty, and the influence of service quality indirectly. on patient loyalty with patient satisfaction as an intervening variable. This type of research is explanatory using a quantitative approach. The population of 700 patients at RSIA Fatma Bojonegoro in November 2021 with a sample of 88 respondents. The sampling technique used was quota sampling. The data collection method used in this study is a questionnaire and documentation by analyzing it using path analysis, especially Partial Least Square (PLS). Based on the results of the analysis, it can be concluded that service quality and patient satisfaction and loyalty at RSIA Fatma Bojonegoro are in good category, service quality has a significant influence on patient satisfaction, service quality has a direct significant effect on patient loyalty, patient satisfaction has a significant influence on patient satisfaction. patient loyalty, service quality has a significant indirect effect on patient loyalty with patient satisfaction as an intervening variable.

Purpose This paper aims to provide a conceptual framework containing SERVQUAL original dimensions and add two additional dimensions: patient satisfaction and loyalty in the hospital SQ model that demonstrates the relationship between hospital service quality, patient satisfaction and loyalty from patients’ perspective. Design/methodology/approach This research conducted a thorough literature review using specific keywords and electronic databases, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Through analysis, the key dimensions of service quality in Indian hospitals were identified, with the addition of patient satisfaction and loyalty as variables. Of 1,000 initially downloaded papers, 497 were included. Findings While many researchers rely on the SERVQUAL model, some introduce new or modified dimensions, often renaming existing ones. This study identifies the RATER factors as the main dimensions patients use to evaluate hospital services. This study finds a positive relationship between service quality, patient satisfaction and loyalty. Practical implications An understanding of how health-care service quality dimensions, directly and indirectly, affect patient satisfaction and loyalty is important for hospital marketing managers. This study helps them take action to improve patient satisfaction, which encourages patients to be loyal. Originality/value This research provides a comprehensive framework for measuring health-care service quality, combining SERVQUAL dimensions and new variables. This study offers useful insights for academics and health-care professionals, promoting more accurate measurement and enhancement of service quality. The use of PRISMA in this context is also innovative, as it is less common in administrative health-care research.

This study aims to analyze the effect of service quality and hospital image on patient satisfaction and loyalty of Dental and Oral Hospital in Jakarta. The research method used is a quantitative method with primary data from 200 patients who have or are receiving treatment at RSGM Jakarta. Non-probability sampling technique in the form of purposive sampling was used to take samples in this study using a Google Form questionnaire. Analysis of each research variable was carried out with SPSS version 25 and analysis of the influence between variables was carried out using Structural Equation Modeling (SEM). The results of the study stated that there were several hypotheses that had a positive effect including; (H1) The hospital's image of patient satisfaction; (H2) Quality of service for patient satisfaction; (H4) The hospital's image of patient loyalty; (H5) Quality of service for patient loyalty; (H6) The hospital's image of patient loyalty through patient satisfaction; (H7) Quality of service to patient loyalty through patient satisfaction. The conclusion in this study is that patient satisfaction does not have a positive effect on patient loyalty. This research is used as evaluation material for the management of the Dental and Oral Hospital to make various innovations to improve the quality of service and the image of the hospital in order to shape patient satisfaction to gain patient loyalty.

This study aims to analyze the factors influencing patient loyalty at Sawit Indah General Hospital in Perbaungan, focusing on the role of hospital image, service quality, and patient satisfaction. Using a quantitative approach with an associative method, this research connects the variables of hospital image (X1), service quality (X2), patient satisfaction (Z), and patient loyalty (Y) to examine the relationships among these variables. Data were collected through questionnaires, interviews, and documentation, and then analyzed using descriptive statistical analysis and path modeling with Structural Equation Modeling (SEM) and Partial Least Squares (PLS) methods. The results show that hospital image and service quality significantly affect patient satisfaction, which in turn influences patient loyalty. This research is expected to provide insights for hospital management to improve patient satisfaction and loyalty, as well as contribute to the sustainability of the hospital's operations.

This study aims to analyze the influence of corporate image and service quality on patient loyalty, with patient satisfaction as a mediating variable, at the Kota Bekasi Regional General Hospital (RSUD) in Bekasi City. This RSUD is a public health facility that faces challenges in maintaining and increasing patient satisfaction and loyalty amidst fluctuations in service quality and patient complaints. A quantitative research method with an explanatory approach was used, with data analyzed using Partial Least Square – Structural Equation Modeling (PLS-SEM). A total of seven hypotheses were tested in this study. The results showed that corporate image and service quality have a positive and significant influence on patient satisfaction. In addition, corporate image also has a positive and significant influence on patient loyalty, and patient satisfaction has a positive and significant influence on patient loyalty. Another important finding is that patient satisfaction is able to mediate the influence of corporate image on patient loyalty significantly. However, service quality does not have a significant direct influence on patient loyalty, and patient satisfaction is also unable to significantly mediate the influence of service quality on patient loyalty.

Nepal’s healthcare market has become competitive. Hospitals have known the importance of patient satisfaction and service quality and how it impacts patient retention and loyalty. However, it is still under researched. This study explores the impact of perceived service quality on patient satisfaction and its subsequent effect on patient loyalty within private healthcare organizations in Nepal. The study uses the 5Q model to examine the five core dimensions of service quality related to Quality of Object, Process, Infrastructure, Atmosphere and Interaction. Data were collected from 387 Outpatient Department patients of KIST teaching hospital aged between 22 and 65 years. Structural equation modelling was conducted using SmartPLS 4, with bootstrapping 5,000 resamples applied to assess the significance of path coefficients. The results indicate that Quality of Atmosphere, Object and Process significantly influence patient satisfaction while Quality of Interaction and Infrastructure do not show a statistically significant impact. Patient satisfaction is seen to positively affect patient loyalty, confirming its mediating role. Perceived service quality has a strong direct effect on patient satisfaction but its direct influence on patient loyalty was not supported statistically. These results provide useful information for Nepali policymakers and healthcare professionals by highlighting the aspects of service quality that successfully influence patient loyalty and satisfaction. Improvements in object quality, processes and environmental atmosphere may increase patient-centered care and enhance loyalty in patients. Future studies could expand this framework to include more public and private hospitals in order to better understand how people perceive service quality in various healthcare settings.

Background It is imperative to deliver exceptional services in order to improve patient contentment and cultivate enduring loyalty in the healthcare sector, which is becoming more competitive. The direct impact of leadership and governance on patient experience and retention remains underexplored, despite the increasing recognition of their role in determining care delivery. This investigation investigates the connections between healthcare organizations’ corporate governance, service quality, patient satisfaction, and loyalty, as well as entrepreneurial leadership. Methods Data were obtained from 384 executive patients in hospitals throughout Indonesia using structural equation modeling (SEM). Results The findings indicate that corporate governance and service quality are considerably improved by entrepreneurial leadership, while patient satisfaction and loyalty are positively impacted by corporate governance. Nevertheless, patient satisfaction was found to be moderately influenced by service quality, while patient loyalty was significantly influenced. As a result, patient satisfaction was demonstrated to be a critical factor in the development of patient loyalty. These results emphasize the importance of high service quality, effective governance, and entrepreneurial leadership in promoting patient satisfaction and loyalty. Conclusions The research offers valuable insights for healthcare managers and policymakers who are interested in enhancing organizational performance and improving patient retention. This research theoretically enhances comprehension of the impact of leadership and governance frameworks on patient retention and service quality. In practical terms, it provides valuable recommendations for hospital administrators and policymakers to improve patient satisfaction and loyalty by implementing effective leadership, robust governance, and continuous service improvement.

BackgroundSaudi Arabia’s Vision 2030 places significant emphasis on the health sector, including dental clinics, as a vital contributor to economic growth and the enhancement of quality healthcare services. Patient satisfaction and loyalty, measured through willingness to revisit, serve as key indicators of success in this evolving healthcare landscape. This study evaluates how service quality dimensions influence patient satisfaction and revisit intentions within dental clinics, Aligning with the goals of improving healthcare standards under Vision 2030.MethodsA primary data was collected using random sampling method among 236 patients visiting dental clinics, with an age range of 10 to 70 years. The SERVQUAL model was employed to evaluate service quality across five dimensions: tangibility, accountability, responsiveness, assurance, and empathy. T-test and regression analysis were used to analyze the influence of these dimensions on patient satisfaction and willingness to revisit.ResultsThe average scores for tangibility, accountability, responsiveness, assurance, and empathy were 3.95/5, 2.93/5, 3.04/5, 3.55/5, and 3.08/5, respectively. Responsiveness, assurance, and empathy significantly influenced both patient satisfaction and willingness to revisit, while accountability had a negative impact. The regression analysis revealed that 42.8% of the variation in patient satisfaction and 42.9% in willingness to revisit could be explained by the service quality dimensions. Empathy emerged as a crucial factor, positively impacting patient satisfaction and willingness to revisit.ConclusionThe study highlights the importance of responsiveness, assurance, and empathy in determining patient satisfaction and loyalty in dental clinics. While tangibility was not a significant factor in patient satisfaction, it influenced the willingness to revisit, suggesting that the physical aspects of the clinic play a role in patient loyalty. The findings underscore the need for dental clinics to focus on improving scheduling systems, providing financial assurances, and enhancing personal care to improve patient experiences. This research contributes to the understanding of service quality in dental clinics and provides insights for enhancing patient satisfaction and loyalty, Aligning with the goals of Vision 2030.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12903-025-06879-2.

The role of private hospitals is increasingly important in Vietnam. The study aims to determine associations between service quality and hospital brand image with satisfaction and patient loyalty, revisit intention at private hospitals in Vietnam. Quantitative cross-sectional data were collected from 268 patients in DaNang city, Vietnam. Scales to measure hospital service quality, hospital brand image, patient satisfaction, loyalty, and patient revisit intention were developed. The methods used to test the hypotheses of the study include exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM). One notable finding in this study provides practical evidence on the relationship of hospital service quality and hospital brand image with patient satisfaction and loyalty. In addition, service quality has a direct influence on patient satisfaction and revisit intention as the indicator of patient loyalty. Meanwhile, hospital brand image has a direct influence on patient loyalty, although it did not influence patient satisfaction. Results of this study help providing the basis for the marketing and customer care programs of private hospitals in DaNang city, Vietnam.