Impact of Service Quality on In-Patients’ Satisfaction, Perceived Value, and Customer Loyalty: A Mixed-Methods Study from a Developing Country

Figures & data

Figure 1 The conceptual model and research hypotheses.

Table 1 Demographic Characteristics of the Qualitative Samples

No	Name	Age	Gender	Salary (VNĐ)	Job	Treatment
1	A	Over 35	Female	30.000.000	Business at home	Neurology
2	B	Over 30	Female	15.000.000	Technician in laps	Lung
3	C	24	Male	10.000.000–15.000.000	Journalist	Not reported
4	D	23	Female	10.000.000	Staff at Hospital	Gastroenterology
5	E	23	Female	10.000.000	Student	General Medicine

Table 2 Demographic Characteristics of the Quantitative Samples

Demographic Characteristics		Sample’s Specifics N=368
		Frequency	Percentage (%)
Gender	Male	188	51.1
	Female	180	48.9
Age	0–25	43	11.7
	26–35	89	24.2
	36–50	113	30.7
	51–60	123	33.4
Educational Level	High school and below	88	23.9
	Vocational training	78	21.2
	Associate	99	26.9
	Bachelor’s and higher	103	28.0
Income (VND)	0–10,000,000	97	26.4
	10,000,001–15,000,000	108	29.3
	15,000,001–30,000,000	90	24.5
	Above 30,000,000	73	19.8
Job	Student	96	26.1
	Civic officer	98	26.6
	Researcher-Educational activist	55	14.9
	Blue-collar worker	52	14.1
	Artist	46	12.5
	Other	21	5.7

Table 3 Questionnaire Structure for Inpatients in the Quantitative Phase

Dimension	Item	Code	References
Trust	This hospital has a good reputation	TRUST1	Adopt from the qualitative result
	Staff at the hospital are honest and trustworthy	TRUST2
	The staff of this hospital cares to solve the inpatients’ problems	TRUST3
	My health care provider offers me the highest quality in medical care	TRUST4
	Hospital commitment is to meet in-patient needs and satisfaction	TRUST5
Function	Doctors fulfilled my expectation	FUNTI1	Adopt from the literature^Citation17*
	Reception personnel fulfilled my expectation	FUNTI2
	The cleanliness of the hospital fulfilled my expectation	FUNTI3
	Working time at the hospital fulfilled my expectation	FUNTI4
	Diagnostic examination at the hospital fulfilled my expectation	FUNTI5
Emotion	Using services would make me feel/experience well after leaving	EMOTI1	Adopt from the literature^Citation20**
	I believe the hospital strives to do the best for inpatients	EMOTI2
	I believe the hospital knows what kind of experience inpatients want	EMOTI3
Social influence	I found out that other inpatients always leave me a good impression of the hospital’s services	SOFLU1	Adopt from the qualitative result
	The presence of other inpatients does not affect the hospital’s ability to provide the best service	SOFLU2
	The hospital understands that other inpatients influence my comment about their services	SOFLU3
Customer perceived value	The hospital provides high-quality services	PERVA1	Adopt from the qualitative result
	My effort to get to this hospital was well-deserved	PERVA2
	Overall, I was satisfied with this hospital fee	PERVA3
	The hospital offers a reasonable price for its services	PERVA4
	The hospital’s services are worth the money spent	PERVA5
	The hospital offered good value for my money	PERVA6
Customer satisfaction	I am satisfied with the health care provided	SATIS1	Adopt from the literature^Citation42***
	The hospital has met all our expectations	SATIS2
	Compared with other hospitals, the level of satisfaction was high	SATIS3
	Choosing this company has proven a wise decision	SATIS4
	Overall, I am satisfied with this hospital	SATIS5
Revisit intention	I consider the organization the first choice among all healthcare service organizations in the area.	REVISI1	Adopt from the literature^Citation43***
	We will continue to use the existing products and services and purchase additional product lines offered by this hospital	REVISI2
	We will keep in touch with employees of the company for future coverage	REVISI3
Word of mouth	We will introduce this hospital to others	WOROFM1	Adopt from the literature^Citation43***
	I seldom do more than mention the name of this service organization to others	WOROFM2
	We will tell people more about this company than any other insurance company	WOROFM3
	We will not miss the opportunity to tell others about this hospital	WOROFM4
	We will say good things about this hospital	WOROFM5
	We are proud to tell others about the products and services offered by this company	WOROFM6

Notes: *Adapted from: Budrevičiūtė A, Kalėdienė R, Bagdonienė L, Paukštaitienė R, Valius L. Perceptions of social, emotional, and functional values in patients with type 2 diabetes mellitus and their satisfaction with primary health care services. Primary Health Care Research & Development. 2019;20:e122.¹⁷ © The Author(s) 2019. Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/). **Reprinted from: Sweeney JC, Soutar GN. Consumer perceived value: The development of a multiple item scale. Journal of Retailing. 2001;77(2):203–220.²⁰ Copyright 2001, with permission from Elsevier. ***Reprinted from: Ndubisi NO. Mindfulness, reliability, pre-emptive conflict handling, customer orientation and outcomes in Malaysia’s healthcare sector. Journal of Business Research. 2012;65(4):537–546.⁴² Copyright 2012, with permission from Elsevier. ****Adapted from: Nguyen N. Service quality, customer perceived value and repurchase intention in B2B professional service context – the case of general insurance sector in Vietnam [thesis]. Ho Chi Minh City: Vietnam National University; 2019. Available from: https://hcmiu.edu.vn/wp-content/uploads/2020/08/PhD-DISSERTATION-Nguyen-Xuan-Nhi-after-defense-compressed.pdf. Accessed October 8, 2021.⁴³

Figure 2 Qualitative results: the in-patients’ cognitive map.

Table 4 Constructs Reliability and Validity: Cronbach’s Alpha, Average Variance Extracted (AVE) and Composite Reliability (CR)

Factor	Cronbach’s Alpha	AVE	CR
Trust	0.869	0.911	0.720
Function	0.824	0.892	0.675
Emotion	0.872	0.873	0.836
Social influence	0.847	0.850	0.655
Customer perceived value	0.906	0.946	0.777
Customer satisfaction	0.914	0.916	0.687
Revisit intention	0.906	0.910	0.772
Word of Mouth	0.957	0.955	0.780

Table 5 Status of Research Hypotheses After Performing SEM Analysis

Hypothesis	Latent	Estimate	S.E	P-value	Result
H1a	Trust -> CPV	0.205	0.073	0.005	Supported
H2a	Function -> CPV	0.138	0.070	0.048	Supported
H3a	Emotion -> CPV	0.087	0.048	0.069	Not Supported
H4a	Social influence -> CPV	0.276	0.082	***	Supported
H1b	Trust -> Customer satisfaction	0.217	0.068	0.001	Supported
H2b	Function -> Customer satisfaction	0.048	0.064	0.450	Not Supported
H3b	Emotion -> Customer satisfaction	0.118	0.044	0.008	Supported
H4b	Social influence -> Customer satisfaction	0.324	0.078	***	Supported
H5	CPV -> Customer satisfaction	0.205	0.073	0.124	Not Supported
H6a	CPV -> Revisit intention	0.081	0.052	***	Supported
H6b	CPV -> WoM	0.253	0.057	***	Supported
H7a	Customer satisfaction -> Revisit intention	0.305	0.066	***	Supported
H7b	Customer satisfaction -> WoM	0.297	0.060	***	Supported
H8	WoM -> Revisit intention	0.247	0.061	***	Supported

Note: ***0.000.

Budrevičiūtė A, Kalėdienė R, Bagdonienė L, Paukštaitienė R, Valius L. Perceptions of social, emotional, and functional values in patients with type 2 diabetes mellitus and their satisfaction with primary health care services. Prim Health Care Res Dev. 2019;20:e122. doi:10.1017/S1463423619000471

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Sweeney JC, Soutar GN. Consumer perceived value: the development of a multiple item scale. J Retailing. 2001;77(2):203–220. doi:10.1016/S0022-4359(01)00041-0

 Web of Science ®Google Scholar

Ndubisi NO. Mindfulness, reliability, pre-emptive conflict handling, customer orientation and outcomes in Malaysia’s healthcare sector. J Bus Res. 2012;65(4):537–546. doi:10.1016/j.jbusres.2011.02.019

 Web of Science ®Google Scholar

Nguyen N. Service quality, customer perceived value and repurchase intention in b2b professional service context – the case of general insurance sector in Vietnam; 2019. Available from: https://hcmiu.edu.vn/wp-content/uploads/2020/08/PhD-DISSERTATION-Nguyen-Xuan-Nhi-after-defense-compressed.pdf. Accessed October 8, 2021.

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