J Korean Acad Nurs Adm.  2010 Dec;16(4):497-506.

Causal Relationships among Quality, Service Value, Satisfaction and Loyalty

• Yom YH
• Lee IJ

Abstract

PURPOSE
The purpose of this study was to examine the causal relationships among quality of health care service, service value, satisfaction and loyalty as perceived by hospital inpatients.
METHODS
A survey using a structured questionnaire was conducted with 654 hospital inpatients. Analysis of the data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model.
RESULTS
The modified model yielded Chi-square=7.96 (p=.019), df=2, chi2/df=3.98, GFI=.99, AGFI=.96, RMSEA=.07, NFI=.99, CFI=.99, TLI=.98 and showed good fit indices. Three dimensions of quality had significant direct effects on service value. Functional quality, technical quality and service value had significant direct effects on customer satisfaction. Technical quality, service value, and customer satisfaction had significant direct effects on customer loyalty.
CONCLUSION
These results suggest that quality of health care is an important element in service value, and through both quality and service value, customer satisfaction and customer loyalty can be enhanced. Further study with a larger sample from various hospitals and a longitudinal design is necessary.

Keyword

Quality of Health Care; Service Value; Customer Satisfaction; Customer Loyalty

MeSH Terms

Humans
Inpatients
Quality of Health Care
Surveys and Questionnaires

Figure

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  Figure 1 Path diagram of the hypothetical model

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  Figure 2 Path diagram of the modified model

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