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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.

This study aims to investigate the simultaneous effect of subjective norm, perceived behavioral control and trust on patient loyalty.

The empirical data were collected through survey. The respondents of the survey are 157 patients of a health-care service institution in Bogor, Indonesia. Multiple regressions analysis was performed to test the conceptual model and the proposed hypotheses.

The findings showed that subjective norm and trust influence patient loyalty positively. However, this research also found that perceived behavioral control does not influence patient loyalty significantly.

The survey was only conducted at one health-care service institution in Bogor, Indonesia. In addition, convenience sampling method was used. These conditions may cause that the research results can not be generalized to the other contexts. Therefore, replication research is needed to test the stability of the findings in the other contexts.

Health-care service institutions need to pay attention to trust and subjective norm to establish patient loyalty.

This study is believed to be the first to develop and test patient loyalty model that includes subjective norm, perceived behavioral control and trust.

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 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.

This paper aims to examine the effect of customer relationship management (CRM) on patient satisfaction and patient loyalty, controlling for other socio-demographic characteristics.

The study used a two-stage sampling process and structured questionnaires to collect data from 788 patients from three health facilities (public, quasi-public and private) in Greater Accra, Ghana. The data collected was analyzed using descriptive statistics and regression via the partial least squares-based structural equation model.

The results suggest that CRM is significantly positively correlated with patient satisfaction and patient loyalty, with patient satisfaction also significantly correlated with patient loyalty. Additionally, the results suggest that the introduction of education, health facility ownership, health insurance status and gender, neither impact significantly on the relationship between CRM and patient satisfaction/patient loyalty nor influenced patient satisfaction and patient loyalty directly.

The findings of the current paper can have substantial practice implications for operators in the health-care industry in Ghana. CRM components such as service quality, customer service, communication and the use of appropriate technology to deliver service will be fundamental if organizations operating in the health-care ecosystem in Ghana are to be able to compete effectively.

This is one of the very few papers on the relationship between CRM and patient satisfaction and patient loyalty in African health-care literature. Thus, the findings of the paper can constitute a great resource not only to academics but also to practitioners who are looking to be competitive in the health-care market.

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 research aims to investigate the simultaneous effect of trust, subjective norm, image and perceived risk on patient loyalty.

This research used quantitative research methodology. The authors surveyed the patient of a healthcare service institution in Depok, Indonesia, and 163 of the institution patients participated in the survey. Multiple regressions analysis was performed to analyze the empirical data.

The findings showed that subjective norm and image have positive influence on patient loyalty. However, this research also found that trust and perceived risk do not have significant impact on patient loyalty.

The author(s) used convenience sampling method, and the sample only involved respondents from a healthcare service institution in Depok, Indonesia. Hence, the findings of this research may not be generalized to the other contexts. Therefore, we recommend further research to replicate this research to examine the stability of this research’s findings.

The research results show that subjective norm and image affect the patient loyalty. Thus, the management of healthcare service institution should consider and manage all of these factors proactively.

This study is believed to be the first to develop and test patient loyalty model that includes trust, subjective norm, image, perceived risk and trust.

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.

Drawing on social identification theory, this research aims to explore an important mechanism – patients’ perceived empathy from a hospital, which is defined as caring, individualized attention provided by the hospital – that explains how service quality influences patients’ loyalty to the hospital.

This study adopts a structural equation modelling framework to estimate the mediation relationship between service quality and patient loyalty using two studies based on hospital employees and patients.

In Study 1, hospital staff survey data showed that service quality enhanced patients’ perceived empathy from the hospital. In Study 2, the authors confirmed and extended the findings of Study 1 by using patient survey data that suggested that patients’ empathy mediated the relationship between service quality and patients’ loyalty to the hospital.

The results of the two studies suggested that service quality increased patients’ empathy, which in turn improved patients’ loyalty to a hospital. The results extend the customer loyalty literature by exploring the critical antecedents and mechanisms of customer loyalty in the healthcare context. The studies interpret healthcare phenomena from the service aspect of fulfilling patients’ unique needs and providing a good hospital service experience. Moreover, the authors offer an insightful approach to explaining the service quality–patient loyalty linkage in the healthcare industry. Important theoretical and managerial contributions and suggestions for future research are discussed.

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.