The Mediating Role of Customer Satisfaction in the Relationship Between Service Quality, Perceived Value, and Customer Loyalty Among Patients at Leona General Hospital, Kupang
Abstract
This study focuses on patient loyalty at Leona General Hospital in Kupang. It investigates whether service quality and perceived value shape that loyalty by way of patient satisfaction, which acts as the mediating variable. To test the causal relationships among the four constructs, it adopts a quantitative, cross-sectional design. Data came from 200 respondents who completed a closed-ended Likert-scale questionnaire. They were recruited through non-probability purposive sampling and had to be at least 17 years old, willing to complete the instrument, and finished with their treatment. Data analysis was performed with PLS-SEM using SmartPLS. The measurement (outer) model was evaluated before the structural (inner) model, and a bootstrapping procedure then tested the significance of each hypothesized path. The findings indicate that satisfaction has a significant influence on loyalty, and that both service quality and perceived value strongly predict satisfaction. Neither service quality nor perceived value affects loyalty directly; their influence operates only indirectly through satisfaction, which serves as the mediating variable. The model explains a large share of the variance in satisfaction and loyalty, confirming satisfaction as the key mediator in building patient loyalty.
Downloads
References
Akob, M., Yantahin, M., Ilyas, G. B., Hala, Y., & Putra, A. H. P. K. (2021). Element of Marketing: SERVQUAL Toward Patient Loyalty in the Private Hospital Sector. Journal of Asian Finance, Economics and Business, 8(1), 419–430. https://doi.org/10.13106/jafeb.2021.vol8.no1.419
AlOmari, F., & Hamid, A. B. A. (2022). Strategies to improve patient loyalty and medication adherence in Syrian healthcare setting: The mediating role of patient satisfaction. PLOS ONE, 17(11), e0272057. https://doi.org/10.1371/JOURNAL.PONE.0272057
Baía, A., & Baptista, T. (2020). Impact of Service quality on Patient Satisfaction: In a Public Hospital in Cap Vert. European Journal of Business and Management Www.Iiste.Org ISSN, 12(27). https://doi.org/10.7176/EJBM/12-27-01
Chang, C. S., Chen, S. Y., & Lan, Y. T. (2013). Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters. BMC Health Services Research 2013 13:1, 13(1), 22-. https://doi.org/10.1186/1472-6963-13-22
Depkes. (2008). Standar pelayanan minimal rumah sakit.
Eris, H. (2022). The relationship among perceived value, patient loyalty and patient satisfaction in the hospitals. International Journal of Health Sciences, 6(S7), 5376–5391. https://doi.org/10.53730/IJHS.V6NS7.13251
Fatonah, S. (2019). The Role of Mediation of Customer Satisfaction in Service quality Relationship on Hospital Patient Loyalty in Indonesia.
Gde, T., & Sukawati, R. (2021). Hospital Brand Image, Service quality, and Patient Satisfaction in Pandemic Situation. JMMR (Jurnal Medicoeticolegal Dan Manajemen Rumah Sakit), 10(2), 103–118. https://doi.org/10.18196/JMMR.V10I2.12230
Ghozali, I. (2018). Aplikasi analisis multivariate dengan program IBM SPSS 25 edisi ke-9. http://slims.umn.ac.id/index.php?p=show_detail&id=19545
Hair, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., & Ray, S. (2021). Partial Least Squares Structural Equation Modeling (PLS-SEM) Using R. Springer International Publishing. https://doi.org/10.1007/978-3-030-80519-7
Harmen, E. L., Semiarty, R., & Lita, R. P. (2020). Model Keterkaitan Persepsi Nilai, Citra Merek, Kepuasan dan Loyalitas Pelanggan Rumah Sakit. Jurnal Manajemen Dan Kewirausahaan, 8(2), 216–225. https://doi.org/10.26905/JMDK.V8I2.5094
Huang, I. C., Du, P. L., Lin, L. S., Liu, T. Y., Lin, T. F., & Huang, W. C. (2021). The Effect of Perceived Value, Trust, and Commitment on Patient Loyalty in Taiwan. Inquiry (United States), 58. https://doi.org/10.1177/00469580211007217
Isbahi, M. B., Zuana, M. M. M., & Toha, M. (2024). The Multi-Social Relation of the Cattle Industry in the Plaosan Subdistrict Animal Market of Magetan Regency. Malacca: Journal of Management and Business Development, 1(1), 31–46. https://doi.org/10.69965/malacca.v1i1.51
Kitapci, O., Akdogan, C., & Dortyol, İ. T. (2014). The Impact of Service quality Dimensions on Patient Satisfaction, Repurchase Intentions and Word-of-Mouth Communication in the Public Healthcare Industry. Procedia - Social and Behavioral Sciences, 148, 161–169. https://doi.org/10.1016/J.SBSPRO.2014.07.030
Layardi, A. Z., Ebuziyya, M., & Ramadhan, A. (2026). The Influence of Electronic Service ….. 9166 The Influence of Electronic Service Quality and Perceived Value on Customer Loyalty of Vidio.com in Pontianak City Through Satisfaction as an Intervening Variable In Indonesian Interdisciplinary Journal of Sharia Economics (IIJSE) (Vol. 9, Number 1).
Liu, S., Li, G., Liu, N., & Hongwei, W. (2021). The Impact of Patient Satisfaction on Patient Loyalty with the Mediating Effect of Patient Trust. Inquiry (United States), 58. https://doi.org/10.1177/00469580211007221;WGROUP:STRING:PUBLICATION
Mohammed, Z. M., Haji, S. L., & Qadar, A. N. (2022). The Mediation Effect of Customer Satisfaction on The Relationship Between Service Marketing Mix, Service Orientation, and The Service quality and Customer Loyalty: Polytechnic Journal of Humanities and Social Sciences, 3(2), 155–163. https://doi.org/10.25156/ptjhss.v3n2y2022.pp155-163
Najmuddin, M. D., & Tan, P. H. P. (2024). The Antecedents of Satisfaction and Its Impact on Loyalty in Inpatient Care: A Study at XYZ Hospital CIREBON). EKUITAS (Jurnal Ekonomi Dan Keuangan), 8(1), 85–104. https://doi.org/10.24034/J25485024.Y2024.V8.I1.5954
Nguyen, N. X., Tran, K., & Nguyen, T. A. (2021). Impact of service quality on in-patients’ satisfaction, perceived value, and customer loyalty: A mixed-methods study from a developing country. Patient Preference and Adherence, 15, 2523–2538. https://doi.org/10.2147/PPA.S333586
Oliver, R. L. (1980). A cognitive model of the antecedents and consequences of satisfaction decisions. In Journal of Marketing Research (Vol. 17).
Vimla, V., & Taneja, U. (2021). Brand image to loyalty through perceived service quality and patient satisfaction: A conceptual framework. Health Services Management Research, 34(4), 250–257. https://doi.org/10.1177/0951484820962303
Zahra, S. A., Farida, N., & Arso, S. P. (2022). Perceived Value and Trust Towards Patient Loyalty: A Literature Review. Medical Technology and Public Health Journal, 6(1), 39–50. https://doi.org/10.33086/MTPHJ.V6I1.3214
Zhang, L., Zhang, Q., Li, X., Shao, W., Ma, J., Zhang, R., Zhou, A., & Li, J. (2022). The effect of patient perceived involvement on patient loyalty in primary care: The mediating role of patient satisfaction and the moderating role of the family doctor contract service. The International Journal of Health Planning and Management, 37(2), 734–754. https://doi.org/10.1002/hpm.3355
Zhou, W. J., Wan, Q. Q., Liu, C. Y., Feng, X. L., & Shang, S. M. (2017). Determinants of patient loyalty to healthcare providers: An integrative review. International Journal for Quality in Health Care, 29(4), 442–449. https://doi.org/10.1093/INTQHC/MZX058
Copyright (c) 2026 Mario Rosindo Menny, Wirawan Endro Dwi Radianto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
