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This paper aims to investigate how patient satisfaction affects propensity to return, i.e. loyalty.

Data from 678 hospitals were matched using three sources. Patient satisfaction data were obtained from Press Ganey Associates, a leading survey firm; process‐based quality measures and hospital characteristics (such as ownership and teaching status) and geographic areas were obtained from the Centers for Medicare and Medicaid Services. The frequency with which end‐of‐life patients return to seek treatment at the same hospital was obtained from the Dartmouth Atlas. The study uses regression analysis to estimate satisfaction's effects on patient loyalty, while holding process‐based quality measures and hospital and market characteristics constant.

There is a statistically significant link between satisfaction and loyalty. Although satisfaction's effect overall is relatively small, contentment with certain hospitalization experience may be important. The link between satisfaction and loyalty is weaker for high‐satisfaction hospitals, consistent with other studies in the marketing literature.

The US hospitals analyzed are not a random sample; the results are most applicable to large, non‐profit teaching hospitals in competitive markets.

Satisfaction ratings have business implications for healthcare providers and may be useful as a management tool for private and public purchasers.

The paper is the first to show that patient satisfaction affects actual hospital choices in a large sample. Because patient satisfaction ratings are also correlated with other quality measures, the findings suggest a pathway through which individuals naturally gravitate toward higher‐quality care.

The purpose of this study is to analyze how to improve the satisfaction and loyalty of Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) health patients in Indonesia based on services in Islamic hospitals, where the service quality was analyzed from a Sharīʿah perspective.

The sample for this study was 470 Muslim patients from BPJS health, 248 from large Islamic hospitals and 232 from small Islamic hospitals in Central Java, Indonesia. Overall, the respondents were from five large hospitals and five small hospitals. The study used eight service quality variables that were modified from the SERVQUAL, PAKSERV and CARTER models. All the variables used indicators of Sharīʿah principles and tested their effects on satisfaction and loyalty.

The results of the study showed that the insurance system has been proven to significantly increase the satisfaction and loyalty of BPJS health patients. This means that the efforts of the Indonesian Government to improve the level of health by establishing BPJS can benefit the community. Satisfaction can also be increased through the variables of reliability, empathy and responsiveness, while the loyalty of BPJS Health patients is strongly influenced by satisfaction. The sincerity variable can increase the satisfaction and loyalty of BPJS health patients in small hospitals, but not in large hospitals. On the other hand, the variable of compliance can increase the satisfaction and loyalty of BPJS health patients in large hospitals, but not in small hospitals.

The insurance system implemented in Indonesia can influence the improvement of satisfaction and loyalty. Also, hospitals that are fair in serving patients and that apply amanah (trust), tabligh (responsiveness) and are fast in handling BPJS health patients’ complaints are important indicators that need attention from BPJS health and hospitals. These indicators can form variables that can increase satisfaction and loyalty.

This study aims to investigate the link of functional service quality (hospital’s reputation, administrative procedures, trustworthiness, patient-care provider relationship and waiting time), satisfaction and patient loyalty on the obstetrics services in private health-care in Malaysia.

A total of 419 mothers who had obtained obstetrics services had participated in this study in a continuous and coordinated manner. The study was conducted in 10 private hospitals in Malaysia throughout April 2018.

Results show that providing excellent service had increased the level of patient satisfaction and achieved patient loyalty. Patients tend to switch to other obstetricians if they are unhappy with the current services that are being offered. The findings showed that patient satisfaction was found to be mediating the relationship between hospital reputation and patient loyalty; trustworthiness and patient loyalty; patient care relationship and patient loyalty; and waiting time and patient loyalty. However, this study also found that administrative procedures do not influence patient satisfaction significantly.

The outcome of this study able to assist the management of the private hospitals to have more operational and practical strategies that would enhance their service quality for the betterment in their services for their patients in this competitive industry.

This paper provides patients’ perception of their loyalty towards obstetrics services offered by private hospitals in Malaysia.

The purpose of this paper is to explain the patients’ views towards private healthcare service providers. The study focussed on hospital service quality and analysed the relative significance of quality measurements in anticipating the patients’ satisfaction and loyalty. The mediating role of patient satisfaction is assessed between quality of hospital healthcare services and patient loyalty.

A total 611 patients (both indoor and outdoor) participated in a questionnaire survey from the six private hospitals of capital city, Islamabad, Pakistan. Data were analysed through descriptive statistics, common method variance, reliability, correlation and regression in order to investigate customer perceived service quality and how the quality of services stimulates loyalty intentions towards private service suppliers.

Findings depict that private healthcare service providers are attempting to deliver well improved healthcare services to their customers. Results confirmed that better quality of healthcare services inclines to build satisfaction and loyalty among patients. The healthcare service quality aspects (i.e. physical environment, customer-friendly environment, responsiveness, communication, privacy and safety) are positively related with patient loyalty which is mediated through patient satisfaction.

Findings will help the hospital managers to articulate effective strategies in order to ensure superior quality of healthcare services to patients. The study will induce hospital management to deliver attentions towards the quality of private healthcare service systems and improvements towards the deficient healthcare services. Furthermore, the study will present a clear picture of patient’s behavioural attitudes; satisfaction and loyalty intentions towards the quality of healthcare services.

The study provides the views and perceptions of patients towards the quality of healthcare services. The healthcare service quality dimensions, i.e., physical environment, customer-friendly environment, responsiveness, communication, and privacy and safety were assessed. Hospital healthcare service quality was examined in order to find out its effect on patient satisfaction and patient loyalty.

This study aims to reveal the mediating role of patient satisfaction on the impact of relationship marketing on hospital loyalty.

The scale questionnaires used in the study was the Relationship Marketing, Hospital Loyalty and the Patient Satisfaction Scale. The population of the study is made up of the patients who received in-hospital services in private hospitals operating in Kocaeli province. The field study was conducted between August 1 and October 31, 2019. After determining the sample size, the study was conducted on 401 patients in private hospitals primarily using the purposive sampling method. Descriptive statistics, correlation analysis and statistical package for the social sciences Process Macro were used to analyze the data.

According to the findings of this study, patient satisfaction has an effect on hospital loyalty. Relationship marketing has an impact on hospital loyalty, and this effect is further enhanced by patient satisfaction. In other words, patient satisfaction has a mediating role in the impact of relationship marketing on hospital loyalty. Relationship marketing plays an important role in creating hospital loyalty and patient satisfaction. For this reason, it is recommended that health institutions adopt relationship marketing practices. Hospital loyalty and patient satisfaction will be ensured through relationship marketing. This will allow the health-care institution to continue to exist and to be more advantageous than other institutions.

The uniqueness of the paper lies not only in the only regression findings but also in the methodology used to capture the impact of the lagged effect of marketing relationships on hospital loyalty. Specifically, a regression model is based on both direct and indirect effects.

The aim of this research is to uncover issues that inhibit patients' satisfaction and loyalty and identify factors that could enhance customer retention by government hospitals in the United Arab Emirates (UAE). The mediating impact of outpatient satisfaction on service quality, word of mouth (WoM), hospital image, outpatient–physician relationship and outpatient loyalty were tested.

The sample data used to test the hypotheses were drawn from a pool of patients served by a government healthcare agency in Abu Dhabi. Questionnaires were provided to 418 participants using methods such as short message service, e-mail and face-to-face delivery. The data were analyzed using SmartPLS 3.3.2 software.

The results indicate that service quality, WoM and outpatient–physician relationship positively impact outpatient satisfaction and indirectly effect outpatient loyalty; that hospital image positively impacts outpatient satisfaction and loyalty and has a partially mediating effect on loyalty; that waiting time satisfaction has no effect on outpatient satisfaction and no moderating effect on the outpatient satisfaction–loyalty relationship and that switching cost has a positive effect on loyalty but no moderating effect on the outpatient satisfaction–loyalty relationship.

The first limitation of this study concerns the fact that only patients who had previously been served by these hospitals' outpatient units were included. Furthermore, the research was not able to obtain extensive findings related to the various factors that negatively impacted patient satisfaction and loyalty among all of the departments of government hospitals, such as inpatient care and emergency care.

Centered on the findings from this research, increasing switching costs would prevent patients from switching to other healthcare providers. Therefore, it has the potential to create a false loyalty or a hostage customer (Jones and Sasser, 1995). Additionally, making patients feel connected to their treatment plan and engaged in their care by developing a tool to maintain their enthusiasm about their health is important. It is therefore recommended that government hospital care providers and management consider providing online tools that patients can use to self-manage their care.

The results regarding patients' satisfaction level suggest several areas for improvement. The first pertains to waiting area entertainment and comfort because patients indicated that there is not enough entertainment or ways to pass the time when waiting for services. In addition to enhancing the entertainment and comfort of waiting areas, government hospital staff should maintain contact with patients who are waiting to ensure that they are aware of the time they will spend. Another area for improvement is the parking lot. During summer, patients prefer to walk less in the sun, which causes them to seek parking closer to the door. Government hospital management should consider different methods for transporting patients closer to the door, such as golf carts or valet services.

This is the first study to investigate the mediating impact of outpatients' satisfaction between its antecedents and loyalty in the UAE. These results provide an improved understanding of the factors influencing patient choices and establish more accurate methods for increasing patient loyalty to retain more patients.

The purpose of this paper is to clarify how enablers of quality management can secure the satisfaction and loyalty of patients through increasing service quality in hospitals.

The current study conducted a review of the existing literature to identify operational dimensions of the research variables. As a result of the review, 17 dimensions were identified; five European foundation for quality management enablers, five SERVQUAL service quality dimensions, four patients’ satisfaction elements and three patients’ loyalty components. To evaluate interrelationships among these 17 research dimensions, decision-making trial and evaluation laboratory technique was applied using experts’ opinions.

Several key relations were found among research dimensions. Research findings could provide a scientific insight for hospital managers to understand how they could increase the level of patients’ satisfaction and loyalty through high-quality services provided by quality management enablers.

This study has been conducted based on the expert’s opinions from private hospitals located in Tehran and Alborz provinces, Iran. Although the results could be useful for hospital managers in different places and could provide them a valuable insight and knowledge, findings are limited to Iranian private hospitals.

It is taken for granted that patients’ satisfaction and loyalty could increase as a result of high-quality medical and treatment services in hospitals. On the other hand, offering excellent services meeting all the needs and expectations of customers could be consequence product of quality management enablers. Even though satisfaction and loyalty of customers, i.e. patients, is the primary target of quality management, there is little research in the literature as to how enablers of quality management can secure the satisfaction and loyalty through increasing service quality in hospitals. The gap is more critical because the specialized dimensions of four research variables have not been previously integrated into a coherent framework and interrelationships among them have not been studied and clarified in detail. The current study attempts to bridge this gap.

This empirical study aims to explore sufficiency conditions for patient loyalty to a hospital.

The study collected 645 self-administered questionnaires from patients in a major medical center in Taiwan and applied fuzzy set qualitative comparative analysis (fs/QCA) to explore the sufficiency conditions for patient loyalty.

The findings support the conclusion that the three conditions (patient satisfaction, patient participation in the process of diagnosis, and patient participation in treatment decision-making) in combination are sufficient for high patient loyalty to the hospital but high patient satisfaction alone is insufficient. While the three conditions in configural algorithm are sufficient, this expression is not necessary, which means the findings do not reject possible alternative conditions for high patient loyalty.

The study applies a relatively new method, fuzzy set qualitative comparative analysis (fs/QCA) to test the sufficiency proposition of the theory. This method enables researchers to focus on examining sufficient conditions without worrying about various confounding factors and informs this study ' s conclusion that patients exhibiting high scores in all three conditions mentioned above constitute a near-perfect subset of highly loyal patients. Hospitals thus should provide their satisfied patients opportunities to share a role in the process of diagnosis and treatment decision-making.

Along with patient satisfaction, this study clearly identifies two important stages of patient participation (i.e., participation in the process of diagnosis and treatment decision-making) that are important in forming patient loyalty to a hospital. Prior studies do not present empirical evidence to this proposition.

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.

The purpose of this paper is to investigate service quality, patient satisfaction and loyalty in Bangladesh’s healthcare sector. It identifies healthcare quality conformance, patient satisfaction and loyalty based on demographics such as gender, age and marital status. It examines the differences between public and private healthcare sectors regarding service quality, patient satisfaction and loyalty.

The authors distributed 450 self-administered questionnaires to hospital patients resulting in 204 useful responses (45.3 per cent response rate). Data were analysed based on reliability analysis, exploratory factor analysis, independent samples t-tests, ANOVA and discriminant analysis using SPSS version 23.

Findings indicate that single patients perceive tangibles, reliability, empathy and loyalty higher compared to married patients. Young patients (⩽20 years) have a higher tangibles, empathy and loyalty scores compared to other age groups. The authors observed that private hospital patients perceive healthcare service quality performance higher compared to patients in public hospitals.

The authors focussed solely on the Bangladesh health sector, so the results might not be applicable to other countries.

The findings provide guidelines for enhancing service quality, patient satisfaction and loyalty in the Bangladesh healthcare sector and other countries.