Document Type : Original Research


1 School of Management, Jiangsu University, Zhenjiang 212013, P.R. China

2 School of Business Administration, Zhejiang Gongshang University, Hangzhou 310018, China

3 School of Public Affairs, University of Science and Technology of China, Anhui, China


The healthcare industry in developing nations has recorded high progress rate in recent years, leading an initiative varied studies into the examination of patients’ comparative and varied views with regards to private healthcare providers service delivery. This study objectively focused on the hospital’s service quality, and patients’ satisfaction as a predictor and collective impact or on patient’s loyalty; it attempted to draw a distinctive border amongst quality of service and satisfaction of the patient, one with more effect size and predictive relevance to drive greater loyalty amongst the patients in a private healthcare delivery setting. A total of 562 patients recruited, participated in a cross-sectional survey with a questionnaire as the main and only data collection tool from four major private hospitals in Ghana. A path and linear regression analysis of the data was performed through SPSS 23 and Smart PLS version 3 in order to compute path coefficients, direct and indirect impacts of the factors; service quality and patient's satisfaction on patient’s loyalty to the hospital.  The study suggested that both clientele perceived service quality and patient satisfaction significantly influence patient loyalty. However, patient satisfaction with service delivery had a better predictive relevance and effect size than the quality of the service on patient loyalty in this study.


Aduo-Adjei, K. (2015). Patients Satisfaction with Quality Healthcare in Ghana: A Comparative Study between University of Ghana and University of Cape Coast Hospitals. University of Ghana.
Aftab, J., & Razzaq, M. (2016). Service quality in public and private hospitals in Pakistan: An analysis using SERVQUAL model.
Afthanorhan, A., Awang, Z., Salleh, F., Ghazali, P., & Rashid, N. J. M. S. L. (2018). The effect of product quality, medical price and staff skills on patient loyalty via cultural impact in medical tourism. 8(12), 1421-1424.
Ahmed, S., Tarique, K. M., & Arif, I. J. I. j. o. h. c. q. a. (2017). Service quality, patient satisfaction and loyalty in the Bangladesh healthcare sector.
Al-Borie, H. M., & Sheikh Damanhouri, A. M. J. I. j. o. h. c. q. a. (2013). Patients' satisfaction of service quality in Saudi hospitals: a SERVQUAL analysis. 26(1), 20-30.
AL-Mhasnah, A., Salleh, F., Afthanorhan, A., & Ghazali, P. J. M. S. L. (2018). The relationship between services quality and customer satisfaction among Jordanian healthcare sector. 8(12), 1413-1420.
Al-Neyadi, H. S., Abdallah, S., & Malik, M. J. I. J. o. H. M. (2018). Measuring patient's satisfaction of healthcare services in the UAE hospitals: Using SERVQUAL. 11(2), 96-105.
Alhaddad, A. J. I. J. o. M. R., & Reviews. (2015). A structural model of the relationships between brand image, brand trust and brand loyalty. 5(3), 137.
Aliman, N. K., Mohamad, W. N. J. P.-S., & Sciences, B. (2016). Linking service quality, patients’ satisfaction and behavioral intentions: an investigation on private healthcare in Malaysia. 224, 141-148.
Amin, M., & Zahora Nasharuddin, S. J. C. G. A. I. J. (2013). Hospital service quality and its effects on patient satisfaction and behavioural intention. 18(3), 238-254.
Anabila, P. J. H. m. q. (2019). Service quality: A subliminal pathway to service differentiation and competitive advantage in private healthcare marketing in Ghana. 36(2), 136-151.
Anbori, A., Ghani, S. N., Yadav, H., Daher, A. M., & Su, T. T. J. I. J. f. Q. i. H. C. (2010). Patient satisfaction and loyalty to the private hospitals in Sana'a, Yemen. 22(4), 310-315.
Andaleeb, S. S., Siddiqui, N., Khandakar, S. J. H. p., & planning. (2007). Patient satisfaction with health services in Bangladesh. 22(4), 263-273.
Anhang Price, R., Elliott, M. N., Zaslavsky, A. M., Hays, R. D., Lehrman, W. G., Rybowski, L., . . . Cleary, P. D. (2014). Examining the role of patient experience surveys in measuring health care quality. Medical Care Research and Review, 71(5), 522-554.
Asnawi, A., Awang, Z., Afthanorhan, A., Mohamad, M., & Karim, F. J. M. S. L. (2019). The influence of hospital image and service quality on patients’ satisfaction and loyalty. 9(6), 911-920.
Baloglu, S. J. C. H., & Quarterly, R. A. (2002). Dimensions of customer loyalty: Separating friends from well-wishers. 43(1), 47-59.
Bisschoff, C., & Clapton, H. (2014). Measuring customer service in a private hospital.
Boadi, E. B., Wenxin, W., Bentum-Micah, G., Jerry, I. K. J. C. J. o. A. S., & Technology. (2019). Impact of Service Quality on Customer Satisfaction in Ghana hospitals: A PLS-SEM Approach. 7(3), 503-511.
Bowen, J. T., Shoemaker, S. J. C. H., & Quarterly, R. A. (2003). Loyalty: A strategic commitment. 44(5-6), 31-46.
Chotivanich, P. J. I. J. o. A., & Sciences. (2014). Service Quality, Satifaction, and Customer Loyalty in a Full-Service Domestic Airline in Thailand. 7(3), 161.
Cohen, J. (2013). Statistical power analysis for the behavioral sciences: Routledge.
Dabholkar, P. A. (2015). How to improve perceived service quality by increasing customer participation. Paper presented at the Proceedings of the 1990 academy of marketing science (AMS) annual conference.
Danaher, P. J. (1997). Using conjoint analysis to determine the relative importance of service attributes measured in customer satisfaction surveys. 73(2), 235-260.
ElManstrly. (2010). Examining the interrelationships between the four stages of customer loyalty: a mixed method approach. University of Glasgow.
Erickson, S. M., Rockwern, B., Koltov, M., & McLean, R. M. J. A. o. i. m. (2017). Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians. 166(9), 659-661.
Fatima, T., Malik, S. A., Shabbir, A. J. I. J. o. Q., & Management, R. (2018). Hospital healthcare service quality, patient satisfaction and loyalty: An investigation in context of private healthcare systems. 35(6), 1195-1214.
Gill, L., & White, L. (2009). A critical review of patient satisfaction. Leadership in Health Services, 22(1), 8-19.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations: John Wiley & Sons.
Hair, J., Hollingsworth, C. L., Randolph, A. B., Chong, A. Y. L. J. I. M., & Systems, D. (2017). An updated and expanded assessment of PLS-SEM in information systems research. 117(3), 442-458.
Hayes, A. F. J. C. m. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. 76(4), 408-420.
Henseler, J., Ringle, C. M., & Sarstedt, M. J. J. o. t. a. o. m. s. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. 43(1), 115-135.
Henseler, J. J. I. M., & Systems, D. (2016). New developments in partial least squares parh modeling. 116(9), 1842-1848.
Henseler, J. J. Q., & Quantity. (2018). Partial least squares path modeling: Quo vadis? , 52(1), 1-8.
Iqbal, M., Shah, A. B. A. J. J. o. B. M., & Studies, E. (2016). The impact of customer satisfaction on customer loyalty: Mediating role of customer trust. 1(1), 1-15.
Jamaluddin, J., Ruswanti, E. J. J. o. B., & Management. (2017). Impact of service quality and customer satisfaction on customer loyalty: a case study in a private hospital in Indonesia. 19(5), 23-33.
Kandampully, J. A., Suhartanto, D. J. J. o. H., & Marketing, L. (2000). Customer loyalty in the hotel industry: The role of customer satisfaction and image. 12(6), 3-25.
Kassim, N., Abdullah, N. A. J. A. p. j. o. m., & logistics. (2010). The effect of perceived service quality dimensions on customer satisfaction, trust, and loyalty in e‐commerce settings.
Katona, M. R., & Komáromi, N. (2015). Quality-satisfaction-loyalty: consumer behaviour in catering.
Kitapci, O., Akdogan, C., Dortyol, I. T. J. P.-S., & Sciences, B. (2014). The impact of service quality dimensions on patient satisfaction, repurchase intentions and word-of-mouth communication in the public healthcare industry. 148, 161-169.
Lei, P., & Jolibert, A. J. B. H. S. R. (2012). A three-model comparison of the relationship between quality, satisfaction and loyalty: an empirical study of the Chinese healthcare system. 12(1), 436.
Meesala, A., Paul, J. J. J. o. R., & Services, C. (2018). Service quality, consumer satisfaction and loyalty in hospitals: Thinking for the future. 40, 261-269.
Min, K. L., Kim, J., Forlizzi, J., & Kiesler, S. (2015). Personalization Revisited: A Reflective Approach Helps People Better Personalize Health Services and Motivates Them to Increase Physical Activity. Paper presented at the The 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing (UbiComp 2015).
Moisescu, O.-I. (2014). Assessing customer loyalty: A literature review.
Mosadeghrad, A. M. J. I. j. o. h. p., & management. (2014). Factors influencing healthcare service quality. 3(2), 77.
Mustak, M., Jaakkola, E., Halinen, A., & Kaartemo, V. J. J. o. S. M. (2016). Customer participation management: developing a comprehensive framework and a research agenda. 27(3), 250-275.
Naidu, A. J. I. j. o. h. c. q. a. (2009). Factors affecting patient satisfaction and healthcare quality. 22(4), 366-381.
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1985). A conceptual model of service quality and its implications for future research. Journal of marketing, 49(4), 41-50.
Ramli, A. H. J. B., & Review, E. (2019). Patient Satisfaction, Hospital Image and Patient Loyalty in West Sulawesi Province. 17(1), 1-14.
Ringle, C. M., Wende, S., & Becker, J.-M. J. B. S. G. (2015). Smart PLS 3.
Ryu, G., & Han, J. K. J. J. o. C. P. (2009). Word-of-mouth transmission in settings with multiple opinions: The impact of other opinions on WOM likelihood and valence. 19(3), 403-415.
Setiawan, H., Sayuti, A. J. J. I. J. o. B., & Management. (2017). Effects of service quality, customer trust and corporate image on customer satisfaction and loyalty: an assessment of travel agencies customer in South Sumatra Indonesia. 19(5), 31-40.
Shabbir, A., Malik, S. A., Malik, S. A. J. I. J. o. Q., & Management, R. (2016). Measuring patients’ healthcare service quality perceptions, satisfaction, and loyalty in public and private sector hospitals in Pakistan. 33(5), 538-557.
Urden, L. D. (2002). Patient satisfaction measurement: current issues and implications. Professional case management, 7(5), 194-200.
Wang, I.-M., Shieh, C.-J., Hsiao, J. J. J. o. I., & Sciences, O. (2005). The relationship between service quality, customer satisfaction and customer loyalty: A study on the management consulting industry. 26(2), 371-384.
Wu, C.-C. J. A. J. o. B. M. (2011). The impact of hospital brand image on service quality, patient satisfaction and loyalty. 5(12), 4873.
Yarimoglu, E. K. J. J. o. M. M. (2014). A review on dimensions of service quality models. 2(2), 79-93.