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 chronicled high development rate in our current dispensation. This study sought to identify the most critical factors in hospitals related service delivery quality that will drive loyalty and hence ensure the survival and success of the hospital in the future; it ideally tested if the satisfaction of a patient had any role to play in such relationship. This study was conducted using data from (562) patients who received services from (4) four major but different private hospitals in Ghana. The five Service Quality dimensions; Tangibility, reliability, responsiveness, assurance and empathy, patient satisfaction and loyalty to the hospital were the variables well-thought-out for this study. A path analysis was done utilizing SmartPLS V3.2.8; a second-generation multivariate data analysis method (PLS-SEM) in order to compute path coefficients, direct and indirect effects of the variables on patient's satisfaction and also loyalty to the hospital. The study prompted that empathy, responsiveness and tangibility (not assurance and reliability) impact patients’ satisfaction and patient's satisfaction is directly related to patients’ loyalty to the hospital/clinic.


Aftab, J., & Razzaq, M. (2016). Service quality in public and private hospitals in Pakistan: An analysis using SERVQUAL model.
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.
Anderson, E. W., Fornell, C., & Lehmann, D. R. J. J. o. M. (1994). Customer satisfaction, market share, and profitability: Findings from Sweden. 58(3), 53-66.
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.
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.
Bucher, S., Jäger, U., & Prado, A. M. J. J. o. B. R. (2016). Scaling private health care for the base of the pyramid: Expanding versus broadening service offerings in developing nations. 69(2), 736-750.
Caruana, A. J. E. j. o. m. (2002). Service loyalty: The effects of service quality and the mediating role of customer satisfaction. 36(7/8), 811-828.
Choné, P. J. H. P. (2017). Competition policy for health care provision in France. 121(2), 111-118.
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.
Farooq, M. S., Salam, M., ur Rehman, S., Fayolle, A., Jaafar, N., & Ayupp, K. J. E. T. (2018). Impact of support from social network on entrepreneurial intention of fresh business graduates.
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.
Ferdousi, M. J. J. M. (2014). Patient satisfaction with community clinic care: facility and household based survey in a sub-district in Bangladesh. 1(1), 23-28.
Field, J. M. (2016). Designing service processes to unlock value: Business Expert Press.
Frankel, R. M., & Sherman, H. J. O. d. (2015). The secret of the care of the patient is in knowing and applying the evidence about effective clinical communication. 21(8), 919-926.
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.
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.
Hu, H.-Y., Cheng, C.-C., Chiu, S.-I., & Hong, F.-Y. J. A. J. o. B. M. (2011). A study of customer satisfaction, customer loyalty and quality attributes in Taiwan's medical service industry. 5(1), 187.
Iloh, G. U. P., Onya, O. N., Nwamoh, U. N., Onyemachi, P. E. N., Chukwuonye, M. E., & Godswill-Uko, E. U. J. N. P. M. J. (2019). Patient–Doctor relationship in underserved environment: A cross-sectional study of attitudinal orientation, practice inclination, barriers and benefits among medical practitioners in Abia State, Nigeria. 26(2), 87.
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.
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.
Kumar, V., Dalla Pozza, I., & Ganesh, J. J. J. o. R. (2013). Revisiting the satisfaction–loyalty relationship: empirical generalizations and directions for future research. 89(3), 246-262.
Lee, D. J. S. B. (2017). HEALTHQUAL: a multi-item scale for assessing healthcare service quality. 11(3), 491-516.
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.
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. (1988). Servqual: A multiple-item scale for measuring consumer perc. Journal of retailing, 64(1), 12.
Paul, J., Sahadev, S. J. J. o. R., & Services, C. (2018). Service failure and problems: Internal marketing solutions for facing the future. 40, 304-311.
Pizam, A., Shapoval, V., & Ellis, T. J. I. J. o. C. H. M. (2016). Customer satisfaction and its measurement in hospitality enterprises: a revisit and update.
Ringle, C. M., Wende, S., & Becker, J.-M. J. B. S. G. (2015). SmartPLS 3.
Tenkorang, E. Y. J. H. S., & Reform. (2016). Health provider characteristics and choice of health care facility among Ghanaian health seekers. 2(2), 160-170.
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.