The impact of healthcare delivery configuration on patients’ perceived service quality: Mediating roles of patient partnership and trust in Nanning, China

This research aims to analyze the arrangement of governance, the management of human resources (HR) systems, and the improvement of public service quality on patient satisfaction and patient trust at the BP AL Driyorejo Clinic. This study employs a quantitative approach using a survey method involving 100 patient respondents. Data were collected through questionnaires measuring variables of governance arrangement, HR system management, public service quality improvement, patient satisfaction, and patient trust, which were then analyzed using Partial Least Squares - Structural Equation Modeling (PLS-SEM). The results of the study indicate that governance arrangement has a positive but non-significant effect on both patient satisfaction and patient trust. The HR management system has a positive and significant impact on patient satisfaction, while its effect on patient trust is non-significant. Furthermore, the improvement of public service quality shows a positive but non-significant influence on both patient satisfaction and trust. Patient satisfaction was found to have a positive and significant impact on patient trust. These findings emphasize that the higher the level of patient satisfaction with the services received, the greater the patient's trust in the healthcare institution. This research is expected to provide insights for the clinic to enhance its human resource systems and overall service quality.

This study examines the factors that affect patient's behavioral intention, with patient satisfaction, perceived value, and trust as intervening variables, as well as service quality as an independent variable. Service quality variable using the five dimensions that was first proposed by Parasuraman et al. (1985). The dimensions are tangibility, reliability, responsiveness, assurance, and empathy. The population used in this study were inpatients at Siloam Hospital Bali, with a total sample of 155 patients. Data were collected by using questionnaire. The sampling method in this study using a type of non-probability sampling with combination method: purposive sampling-accidental sampling-quota sampling. The analysis technique used to analyze the data is SEM (Structural Equation Model). Squared Multiple Correlations results indicate that behavioral intention variables are influenced by patient satisfaction, perceived value, trust, and service quality. Patient satisfaction is influenced by service quality. Perceived value is influenced by service quality, while trust affected by service quality. Service quality, patient satisfaction, and trust, positively significant affect behavioral intention. The conclusion of this research is service quality has a significant positive effect on patient satisfaction, perceived value, trust and behavioral intention patients. Patient satisfaction and trust has a significant positive effect on the patient's behavioral intention. While the perceived value has a negative effect on the patient's behavioral intention. This study is useful for Siloam Hospitals Bali management and other hospital's decision maker as well as feedback about the patient's perception of service quality in order to maintain hospital patients and as the basis for periodic evaluations and initial step in assessing the quality of services to patients. The payment method of payment in the form of standalone services or use insurance seems to be influence the respondent's answers and can provide different analytical results, therefore, next researchers are expected to do better further research.

BackgroundInteraction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study.MethodsWe adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses.ResultsPerception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction.ConclusionsAccording to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers’ demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions.

PurposeThis paper aims to identify and test four competing models with the interrelationships between students’ perceived service quality, students’ satisfaction, loyalty and motivation using structural equation modeling (SEM), and to select the best model using chi-square difference (Δχ2) statistic test.Design/methodology/approachThe study uses survey research design to gather data regarding attitudes of students about quality of services and their level of satisfaction, motivation and loyalty. A total of 1,439 valid questionnaires were collected from four public universities in the state of Andhra Pradesh, India, and the relationships between four variables using SEM are tested.FindingsThe structural model with direct and indirect relationships between the constructs proves as a best among the competing models. The result supported direct effect of students’ perceived service quality on students’ satisfaction and motivation; and indirect effect on students’ loyalty. Implications and research contributions are discussed and directions for further research are indicated.Research limitations/implicationsThe study considers the examinations of the simple bivariate relationships between service quality, satisfaction, motivation and loyalty may mask or overstate their true relationships due to omitted variable bias. Structural theory with simultaneous measurement of the direct and indirect relationships between students’ perceived service quality, satisfaction, motivation and loyalty adds a unique contribution to the existing field of knowledge, especially higher education sector.Practical implicationsThe results of SEM show that the service quality is a key antecedent to students’ satisfaction, loyalty and motivation. Motivating students for present and future studies with better participation in the process is important to increase quality and efficiency in their output. The best services also make students loyal to the institution. The findings suggested that it would be worthwhile for university’s administration to make proper allocation of resources, to provide better educational services. It is believed that this study has a significant competence for engendering more precise applications related to quality of services, especially concerning students’ satisfaction, loyalty and motivation.Social implicationsThe research provides significant insights and demonstrates good understanding of students’ perceived service quality in the context of Indian universities. The changing nature and need of higher education services and increase in competitive intensity necessitates higher performance levels in the realm of Indian higher education (universities). The study identified that students’ perceived service quality is a key antecedent to students’ satisfaction, motivation and loyalty, which conveys that service quality is an important construct.Originality/valueSeveral points are addressed based on the models identified in the study. First, there is sufficient evidence of a significant bivariate relationship between service quality, satisfaction, loyalty and motivation. Second, although service quality is an important determinant of loyalty, the exact nature of this relationship remains unresolved. Third, it is evident that very few studies have investigated multiple direct links between service quality, satisfaction, motivation and loyalty. Further, there is no reported investigation of whether any or all of these variables directly and indirectly influence loyalty when the effects of service quality, satisfaction, motivation are simultaneously considered in Indian higher education sector. Therefore, to present a more pragmatic picture of these relationships, the study identified the “collective model” that investigates the underlying relationships that exist among these constructs.

This study investigates how Healthcare Delivery Configuration (HDC) impacts Patients' Perceived Service Quality (SQ) in smart healthcare environments, specifically examining the mediating role of Patient Trust (PT) and the moderating influence of Secular Rationality (SR). A cross-sectional survey yielded 465 valid responses from tertiary hospital patients in Nanning, China. Data were analyzed using SPSS and AMOS, employing Confirmatory Factor Analysis (CFA) for validation and Structural Equation Modeling (SEM) with bootstrap sampling to test mediating and moderating effects. Results indicate that HDC significantly and positively predicts SQ. Patient Trust serves as a partial mediator, explaining approximately 20% of the total effect. However, the moderating effect of Secular Rationality was not statistically significant, suggesting that institutional efficiency builds trust across diverse individual value orientations. The study confirms a synergy between "hard" technical configuration and "soft" psychological trust. In high-stakes public healthcare, robust institutional design possesses a universal capacity for trust-building that transcends individual rational orientations. Hospital administrators should prioritize optimizing intelligent resource scheduling and transparency. Since individual rationality did not significantly moderate outcomes, implementing standardized, equalized smart healthcare strategies is essential for enhancing regional service quality.

Purpose – Businesses need to be able to meet changing customer demands in order to be able to sustain their assets in the face of intense competition. To this end, businesses need to make a difference by paying greater attention to issues such as service quality and corporate image that are important to customers, as well as to compensate for service failures, which have become important in recent years. In the literature, it is emphasized that compensation strategies applied by businesses after customer complaints affect customer service quality and corporate image perceptions. In this study, it is aimed to determine the effect of each service failure compensation strategy applied in the tourism sector on customer perceptions of service quality and corporate image perceptions. Design/methodology/approach – The research was designed as a quantitative research, and the questionnaire method was chosen to learn the opinions of the participants on the subject. Percentage, frequency, reliability, factor analysis and structural equation modeling were used in the analysis of the data obtained. Findings – According to the results of the study, it was determined that the apology strategy affected customers' perceptions of service quality and institutional image perceptions positively. Also service quality perceptions have positively affects on corporate image perception. Discussion – It is known that tourists report their experiences to the business about service failure in accommodation businesses through complaints. In addition that service failure negatively affects the service quality and corporate image perceptions of businesses. Therefore, it is considered important to take into account tourist complaints and to compensate for service failure. When the findings are evaluated, it is seen that the apology strategy, especially one of the service failure compensation strategies, is important. It is important for accommodation businesses to effectively manage the complaint process and use all compensation strategies, especially the apology strategy, in order to compensate for service failure which negatively affects their quality and image perceptions.

Objective: Healthcare branding is a recent concept, and its theoretical modeling is still somewhat inadequate. This paper examines how perceived service quality affects healthcare brand performance, brand image, and behavioral intention. Methods: The present study uses survey responses from 678 patients who have taken treatment in multi-specialty medical institutes. Standard scales were used from the literature to measure the variables used. The conceptual model was validated using structural equation modeling using AMOS. SPSS was used to determine the validity and reliability of the questionnaire. Results: The theoretical model has a relatively high and significant coefficient path for each of the hypotheses. The R2 value for satisfaction was 0.70 or 70 percent. The R2 value for the trust was 0.78. For Brand performance, Brand image and behavioral intentions were 81, 82.5, and 74%, respectively. Overall, the scores suggest an acceptable level of measure score and predictive ability of the relevant constructs. The results disclose the dimensions of service quality in the circumstances of healthcare. The patients place relatively more importance on healthcare service quality than any other attributes of healthcare institutions. Service quality has a high beta value of 0.98 and p p-value of 0.000. Conclusion: The study makes an innovative theoretical contribution by establishing a relationship between experience-centric healthcare brand performance and brand image. Patient satisfaction and trust were demonstrated to mediate the relationship between perceived service quality, brand performance, brand image, and behavioral intention in a healthcare context. The study established the novel finding that trust and satisfaction play a significant role in service quality, brand performance, and brand image of healthcare institutions. This study also shows that brand performance has a positive and significant direct effect on brand performance. This shows the dependency of brand image on brand performance in the healthcare institution context.

PurposeThe purpose of this research is to examine the impact of perceived service quality (PSQ) on the behavioural intention (BI) of patients in Indian government hospitals. The underlying mechanism of trust and patient satisfaction (SAT) is examined as multiple mediating effect.Design/methodology/approachData from 510 respondents were collected using structured questionnaires. Six government hospitals, namely, S.M.S. Hospital, J.L.N. Hospital, New Medical College Hospital, Maharana Bhupal Medical Hospital, Mathuradas Hospital and P.B.N. Hospital, were selected from the cities of Jaipur, Ajmer, Kota, Udaipur, Jodhpur and Bikaner, respectively. The data were collected from adult patients (>18 years old) who spent at least two nights in a government hospital between 1 October, 2020 and 30 December, 2020. PSQ formed as a reflective-formative model was analysed using the repeated indicator approach. Structural equation modelling (SEM) using SMART-PLS software was used to test the hypothesised model(s) derived deductively from literature.FindingsThe findings support the following conclusions: (1) the positive relationship between PSQ and BI is significant; (2) SAT mediates the PSQ and BI relationship; (3) trust mediates the PSQ and BI relationship; (4) the mediation effect of SAT is stronger than that of trust.Practical implicationsThe results indicate that, in order to enhance the positive BI of patients towards government hospitals, it is necessary for the hospitals to work on strategies to enhance the service quality provided to patients. The outcome of this study will enable state government hospitals to get a better understanding of the different dimensions of service quality and will help in observing the factors that contribute to patients' satisfaction and trust in building long-term relationships by encouraging a positive BI.Originality/valueThere is a dearth of research in India that evaluates the relationships between the constructs PSQ, trust, BI and SAT in the context of healthcare service. This empirical study is an attempt to fill this gap by focussing on the government hospitals in India.

Bayesian networks and structural equation modelling to develop service quality models: Metro of Seville case study

The Highway Capacity and Quality of Service Committee of TRB, which oversees the development of the Highway Capacity Manual, has formally recognized a need to improve the current level-of-service (LOS) methodologies. Among the concerns about the methodologies is the extent to which LOS estimates correspond to road users' perceptions. In recognition of these concerns, the objectives of this study were to ( a) develop and test a methodology to obtain drivers' opinions with regard to urban street quality of service (QOS), ( b) apply the methodology to identify the factors that affect drivers' perceptions of QOS on urban streets, and ( c) provide a qualitative foundation for the development of quantitative QOS tools that are based on the perceptions of drivers. This study used an in-vehicle field approach to determine the factors that affect automobile drivers' perceptions of service quality on urban streets. While driving on a preselected route, 22 participants in four cities were asked to speak aloud about their driving experience and the factors that influenced their perception of service quality. Afterward, drivers also completed a written questionnaire. The drivers expressed their opinions about a wide range of issues, including simple observations, more detailed evaluations, and broad concerns related to the roadway environment. From the drivers' comments, 40 factors were identified as relevant to their perception of service quality on urban streets. The authors believe that by identifying a wide range of factors that influence drivers' perceptions of service quality on urban streets, this study has increased the knowledge and understanding of the needs and values of automobile drivers on urban streets and has laid the groundwork for future studies aimed at developing quantitative QOS tools and models.

Agricultural Marketing Cooperative Societies (AMCOS) serve both business and association roles. While the association role emphasizes collective action, the business role focuses on generating surplus and maximizing member welfare. To sustain loyalty, AMCOS must ensure service quality. This study examines members’ perceptions of AMCOS service quality in rural Kaliua District, Tanzania, offering a unique perspective beyond financial cooperatives by integrating qualitative and quantitative insights. A cross-sectional survey was conducted with eight randomly selected AMCOS, involving 239 respondents. Primary data were collected through structured questionnaires and Focus Group Discussions (FGDs). The SERVQUAL model was used to assess service quality, with quantitative data analysed using descriptive statistics and paired samples t -tests, while thematic analysis was applied to qualitative data. Findings indicate that AMCOS service quality was unsatisfactory, with reliability as the most problematic dimension. Members’ expectations did not align with their perceptions. Compared to similar studies in Tanzania, service quality challenges were linked to inadequate funds, bureaucratic delays in delivering tobacco inputs, and unskilled board members and management. To improve service quality, AMCOS should allocate sufficient funds for regular governance training to enhance board and management competence. Additionally, the Tanzanian government, through the Ministry of Agriculture and the Registrar of Cooperatives, should revise mechanisms to ensure timely delivery of farm inputs to tobacco farmers.

Purpose – The purpose of this paper is to extract and validate the dimensions of service quality in retail banking services in India by adopting an integrated and hierarchical perspective of service quality determinants. Design/methodology/approach – The paper empirically validates a parsimonious (multi-dimensional and multi-level) model of service quality in retail banking services in India. The analysis was conducted using structural equation modeling. A hypothesized second-order model was tested and compared with a first-order model of service quality. The dimensions were extracted through exploratory factor analysis and validated through confirmatory factor analysis. Findings – The second-order service quality model was accepted based on parsimony as it consisted of five primary dimensions: Service delivery (describing the efficiency with which the service is provided), tangibles (the quality of physical service environment), reliability (the promise of right service being provided), core service (the attributes and features of the service product) and competence (the capability of employees and systems for providing the service). The second-order model enhances the understanding of the structure of service quality for retail banking services in India. The most important dimension was tangibles, especially the physical environment which facilitates efficient delivery of service. Research limitations/implications – The research provides support for a multi-dimensional second-order model of service quality in retail banking service in India. The results show that customers form perceptions of overall service quality which are reflected by five primary dimensions. The primary dimension of tangibles is the most influential. Practical implications – Organizations need to measure and manage overall service quality perceptions to build trust and reinforce loyalty intentions among their customers. Banks need to adopt a multi-level approach to managing service quality perceptions, i.e. both at the dimensional level and organizational level. Social implications – This study would contribute to the enhancement of service quality outcomes in retail banking services in India which has a crucial role in the economic development. Originality/value – The study proposes and validates a parsimonious and hierarchical model of service quality in the context of retail banking in Indian cultural context. Thus this research provides support to existing knowledge of service quality measurement and management and extends the understanding of its structure by validating the multi-level model in an emerging market context.

Doctor–patient trust is not strong in China, but studies examining this factor remain insufficient. The present study aimed to explore the effect of doctor–patient communication, medical service quality, and service satisfaction on patient trust in doctors. Five hundred sixty-four patients with tuberculosis participated in this cross-sectional study in Dalian, China. They completed questionnaires assessing socio-demographic characteristics, doctor–patient communication, medical service quality, service satisfaction and patient trust in medical staff. A structural equation model was applied to examine the hypotheses, and all the study hypotheses were supported: (1) doctor–patient communication, medical service quality and service satisfaction were positively associated with building doctor–patient trust; (2) service quality positively mediated the relationship between doctor–patient communication and trust; (3) medical service satisfaction positively mediated the relationship between doctor–patient communication and trust; (4) medical service satisfaction positively mediated the relationship between medical service quality and doctor–patient trust; and (5) medical service quality and service satisfaction were the positively sequential mediators between communication and doctor–patient trust. Based on these findings, improvements in doctor–patient communication, medical service quality, and service satisfaction are the important issues contributing to the rebuilding of doctor–patient trust in medical service delivery.

This study examines how outpatient service quality affects patient satisfaction through patient trust and whether perceived waiting pressure acts as a boundary condition shaping this relationship, from an organizational service delivery perspective. A cross-sectional survey of 345 adult outpatients in medical centers, regional hospitals, and clinics in Taiwan was conducted. Service quality was conceptualized as interaction, process, and environmental quality. Structural equation modeling and a first-stage moderated mediation approach were used for analysis. Service quality is positively associated with outpatient satisfaction, both directly and indirectly through patient trust. Patient trust partially mediates this relationship. While perceived waiting pressure negatively affects trust, it positively moderates the relationship between service quality and trust, indicating that high-quality service plays a stronger trust-building role under higher waiting pressure. The findings suggest that maintaining high service quality - particularly in staff interactions and process management - can buffer the negative effects of waiting pressure and enhance patient trust and satisfaction, especially in high-pressure outpatient environments. By showing how organizational service practices can mitigate the negative effects of waiting pressure, this study highlights the role of healthcare organizations in fostering patient trust and supporting patient-centered care. By integrating service quality, patient trust, and satisfaction within a moderated mediation framework, this study conceptualizes waiting pressure as a critical boundary condition that reshapes how service quality translates into patient trust, rather than solely a service deficiency.

This paper focuses on university students' perceptions of educational service quality. Results suggest that both technical and functional quality are important dimensions that shape students' perceptions of their university's service quality. Although both dimensions are important, the findings suggest that the quality of education, campus facilities and the environment, and course process impact significantly on students' perceptions of service quality. The authors empirically measure students' perceptions using the SERVPREF methodology. Four hypotheses are formulated about the relationship between two main service quality dimensions, technical and functional, and perceived service quality. These relationships are tested using multiple regression analysis and ANOVA. The findings are discussed as are the implications for educational marketers and managers.