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Drawing upon the stimulus-organism-response model, this study aims to explore the impact of soft aspects of service quality on revisit intention through the mechanism of perceived empathy.

For the examination of the hypothesized relationships, the study adopts structural equation modelling to analyse the data of 562 respondents (i.e. 281 family members and 281 inpatients).

The empirical results suggest that service quality increased family member empathy perception, which, in turn, improved inpatients’ revisit intentions.

Past studies have focused on the roles of overall service quality. The authors have extended the literature by examining the specific but important aspect of service quality and its effects on emotional response. Importantly, the study explains that the affective reactions of a patient’s family, fastened with perceived empathy, have a central role in influencing the patients’ subsequent reactions. Moreover, the prior studies collected the data either from hospital employees or patients. However, in the present study, the authors used a unique sample (family members as well as patients) to have a deeper understanding. Thus, the study enhances the literature on the stimuli-response (i.e. service quality – revisit intentions) relationship in the context of service marketing in general and health care in specific. Important academic and managerial contributions and recommendations for future research are discussed.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

Based on the stimuli-organism-response model and relationship marketing theory, the effect of different dimensions of Servicescape (Ambience, Cleanliness, Functionality, Spatial Layout, Employee Service Quality) on Customer Satisfaction and Behavioral Intention in hospitals during the COVID-19 pandemic are considered.

The study takes a quantitative approach, applying structural equation model using partial least square structural equation modeling to test the hypotheses. A total of 360 responses were collected using questionnaires distributed to different individuals who visited private hospitals in the past two months in India.

Contradicting previous research, this study found that among servicescape dimensions, employee service quality had the maximum influence on customer satisfaction and cleanliness does not have any significant impact on customer satisfaction as hypothesized. Mediation results show that customer satisfaction has a partial mediation effect for all servicescape dimensions except ambience, as both direct and indirect effects are significant. Importance-performance map analysis was performed on the responses collected, and it was found that employee service quality is the most important dimension affecting servicescape, followed by functionality and spatial layout. Thus, health-care institutions should focus on these factors to keep their customers satisfied.

Past studies have focused on the roles of servicescape and customer satisfaction separately. The authors have extended the literature by examining the combined effects of both servicescape and customer satisfaction. The findings from the study, therefore, help in developing a deeper understanding of the literature on the behavior intention relationship in the context of health care, as well as in service marketing.

This study aims to investigate the influence of cognitive and affective trust on the revisit intention of medical tourists to a developing country like India, focusing on the role of country image as a moderator.

This study used partial least square-based structural equation modelling to test the hypotheses using data from 297 medical tourists visiting India from abroad for treatment.

The findings of this study confirmed that all the dimensions of cognitive trust, namely, perceived expertise, performance and reputation of the health-care service providers, have a positive and significant impact on the revisit intention of medical tourists to India. In contrast, none of the two dimensions of affective trust have a significant effect on the revisit intention of medical tourists to India. This study also confirmed that country image significantly moderates the relationship between performance dimensions of cognitive trust and medical tourists’ revisit intention to India.

The study’s findings have significant theoretical and managerial implications as they explore the effect of cognitive and affective trust on medical tourists’ the revisit intention to visit an emerging economy, considering the country’s image as a moderator.

本研究旨在调查认知和情感信任对印度等发展中国家医疗游客重游意愿的影响, 重点关注国家形象的调节作用。

本研究采用基于偏最小二乘的结构方程模型, 使用 297 名从国外到印度接受治疗的医疗游客的数据来检验假设。

本研究的结果证实, 认知信任的所有维度, 即医疗服务提供者的专业知识、绩效和声誉, 对印度医疗游客的重游意愿产生积极且显着的影响。相比之下, 情感信任的两个维度都没有对印度医疗游客的重游意愿产生显着影响。这项研究还证实, 国家形象显着调节认知信任绩效维度与医疗游客重访印度意愿之间的关系。

该研究的结果具有重要的理论和管理意义, 因为他们探讨了认知和情感信任对医疗游客重访新兴经济体的意愿的影响, 并考虑到该国作为调节者的形象。

Este estudio tiene como objetivo investigar la influencia de la confianza cognitiva y afectiva en la intención de volver a visitar a un país en desarrollo como la India por parte de turistas médicos, centrándose en el papel de la imagen del país como moderador.

Este estudio empleó un modelo de ecuaciones estructurales parcial basado en mínimos cuadrados para probar las hipótesis utilizando datos de 297 turistas médicos que visitaron la India desde el extranjero para recibir tratamiento.

Los hallazgos de este estudio confirmaron que todas las dimensiones de la confianza cognitiva, es decir, la experiencia percibida, el desempeño y la reputación de los proveedores de servicios de atención médica, tienen un impacto positivo y significativo en la intención de volver a visitar a la India por parte de los turistas médicos. Por el contrario, ninguna de las dos dimensiones de la confianza afectiva tiene un efecto significativo en la intención de volver a visitar la India por parte de los turistas médicos. Este estudio también confirmó que la imagen del país modera significativamente la relación entre las dimensiones de desempeño de la confianza cognitiva y la intención de los turistas médicos de volver a visitar la India.

Los hallazgos del estudio tienen importantes implicaciones teóricas y administrativas, ya que exploran el efecto de la confianza cognitiva y afectiva en la intención de los turistas médicos de visitar una economía emergente, considerando la imagen del país como moderador.

The advancement of technologies has made it possible for health-care organizations to provide convenient online services that enable people to manage their health conditions. Although many studies have investigated the adoption and benefits of e-health services, there has been little focus on health-oriented behaviors after adoption, particularly in relation to service quality and user satisfaction.

This paper is based on the SOR model and service quality theories to investigate behavioral responses, including word-of-mouth, intention to use and intention to act. The authors use a partial least squares structural equation modeling analysis with 194 participants and the diabetes risk test survey in Finland.

The results show that people are willing to engage in health self-management behaviors if they intend to use the e-health service and are satisfied with it. User satisfaction can be enhanced by improving the visual appeal of the website presentation, the quality of the presented information, as well as the usability of the website, all as components of e-health services.

The authors contribute by creating a construct “intention to act,” referring to health-oriented behaviors resulting from e-health service use. In addition, this study is among the first to apply the SOR model to investigate how user satisfaction leads to intention to use, intention to act and word-of-mouth.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

The mental healthcare is experiencing an ever-growing surge in understanding the consumer (e.g., patient) engagement paradox, aiming to vouch for the quality of care. Despite this surge, scant attention has been given in academia to conceptualize and empirically investigate this particular aspect. Thus, drawing on the Stimulus-Organism-Response (S-O-R) paradigm, the study explores how patients engage with healthcare service providers and how they perceive the quality of the healthcare services.

Data were collected from 279 respondents, and the derived conceptual model was tested by using Smart PLS 3.2.7 and PROCESS. To complement the findings of partial least squares (PLS)-based structural equation modeling (SEM), the present study also applied fuzzy set qualitative comparative analysis (fsQCA) to identify the necessary and sufficient conditions to explore substitute conjunctive paths that emerge.

Findings show that patients’ perceived intimacy (PI), cohesion and privacy enhance the quality of mental healthcare service providers. The results also suggest that patients’ PI, cohesion and privacy have indirect effects on the perceived quality of care (PQC) by the service providers through consumer engagement. The fsQCA results derive that the relationship among conditions leading to patients’ perception of the quality of care in regard to mental healthcare service providers is complex and is best reflected as multiple and conjectural causation configurations.

The findings from this research contribute to the advancement of studies on patients’ experiences by empirically examining the unique dynamics of interaction between consumers (patients) and mental healthcare service providers, thereby enriching both the literature on social interactions and the understanding of the consumer–provider relationship.

The results of this study provide practical implications for mental healthcare service providers on how to combine the study variables to enhance the quality of care and satisfy more patients.

A significant research gap has ascertained the inter-relationship between PI, cohesion, privacy, engagement and PQC from the perspective of mental healthcare service providers. This research is one of the primary studies from a managerial and methodological standpoint. The study contributes by combining symmetric and asymmetric statistical tools in service marketing and healthcare research. Furthermore, the application of fsQCA helps to understand the interactions that might not be immediately obvious through traditional symmetric methods.

This study aims to examine nurses’ motivation for leadership and explore important challenges nurses face in leadership positions.

Semi-structured interviews were conducted with 20 nurses in leading positions. Thematic analysis was used to analyse the data.

Nurse leaders are recruited from clinical settings, and the transition process from clinical nurse to leader is demanding. Their motivation for leadership seems to be in human values and caring for others. Lack of strategic focus might be a challenge. Nurses in leadership positions emphasize the importance of good relationships with the staff and require an increased focus on strategic leadership.

Studies have revealed the frustration associated with the role of a nursing leader. According to an evaluation of a clinical leadership development programme, nurses were found to be inadequately prepared for their roles. They had not experienced positive role models, they felt overwhelmed and they regarded colleagues and nursing management structures as unsupportive. There is a need for further research into effective measures to strengthen nurse managers.

The role of leaders has changed over time. There are now increasing requirements and objectives with regard to laws, action plans, improvement projects and cost-effectiveness. A nurse leader has both many tasks and great responsibility. Good leadership relies on skilled nurse leaders meeting statutory requirements in patient care and delivering good quality and patient-safe services. Engaging in process-oriented guidance, such as mentoring, is one way to become more aware of oneself as a professional leader (Mathena, 2002).

By identifying and understanding the specific challenges that nurse leaders face, this study can contribute to the development of interventions and strategies to improve leadership practices, thereby enhancing organizational effectiveness.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating role of the sociodemographic factors.

The data were gathered from 462 patients via a structured questionnaire, while structural equation modeling was utilized for the analysis.

Results indicated that trust, perceived value and patient satisfaction have important roles in shaping the patient loyalty, while patient satisfaction was found to fully mediate the patient’s perceived service quality. Loyalty relationship was also found to partially mediate the trust–loyalty relationship. Nonetheless, the patient’s satisfaction–loyalty relationship was found to be only moderated by the age factor.

Implications are provided to the Egyptian private hospitals in order for them to formulate improvement plans as well as set higher standards of conduct.

This original research is the first one, up to the researcher knowledge, that explores the drivers of patient satisfaction in the private hospitals in Egypt.