The mediating role of trust in physicians in the effect of health services quality on patient satisfaction

Throughout human history, health has been a vitally important issue and a fundamental component of social life. Playing a key role in sustaining life, health has always been a subject of great importance, and the medical profession has attained a sacred status during this period. This sacredness stems largely from the profession's vital function of protecting and saving human life. Therefore, the possibility that physicians could intentionally cause harm has not historically been a factor in public consciousness. However, today, a number of factors, including global competition, population growth, socioeconomic transformations, and increased cognitive awareness, have led patients to adopt a more cautious and critical attitude in their perception of trust in physicians. At the same time, increasing competition, the development of patient rights awareness, and technological advances have led to the concept of quality gaining central importance in the field of healthcare. Consequently, quality improvement efforts have become widespread; national and international standards have been developed to measure patient experience qualitatively and quantitatively, and the pursuit of quality in healthcare has become a prominent feature of government policies and healthcare reform agendas. The primary objective of this study is to empirically examine and evaluate the mediating role of trust in physicians in the effect of healthcare service quality on patient satisfaction. Data were collected via surveys from 509 participants aged 18 and over who had utilized healthcare services within the past year. The Service Quality Scale (2021), the Outpatient Satisfaction Scale (2021), and the Physician Trust Scale (2020) were used as data collection tools in the study. SPSS 28.0 and the PROCESS Macro add-on (Model 4) were used for quantitative data analysis, while MAXQDA software was utilized for supporting analyses of qualitative data. Findings revealing the demographic profile of the participants revealed a balanced age distribution. While females constituted the majority (63.1% (n=321) in the gender distribution, 52.5% (n=267) of the participants were married. Regarding educational background, undergraduates represented the largest group (47.0% (n=239)). In the income distribution, individuals earning between minimum wage and twice the minimum wage account for the highest share at 35.0% (n=178). Results regarding healthcare service usage habits are as follows: When examining the frequency of participants' visits to healthcare institutions in the past year, those who have applied 1-3 times have the highest rate at 39.5% (n=201). When considering institution type preferences, public healthcare institutions stand out as the most preferred institutions at 55.8% (n=284). The research findings support the proposed hypotheses. Analyses showed that healthcare quality has a statistically significant and positive impact on patient satisfaction. Similarly, trust in physicians positively and significantly predicts patient satisfaction. Furthermore, healthcare quality provides an indirect contribution by increasing trust in physicians; the indirect effect on this relationship was also found to be positive and significant. Consequently, the mediation analysis conducted reveals that trust in physicians plays a significant mediating role in the relationship between healthcare quality and patient satisfaction, supporting the theoretical model.