Interrelationships between service quality, customer satisfaction and customer loyalty in health sector: A comparison of public, private and university hospitals

Service quality and customer satisfaction, especially for the service sector, are regarded as the two important key factors in consumers' purchasing decision process. Conditions of fierce competition in today?s global world order affects industrial companies as well as the health care businesses deeply. Due to the reforms in health area, hospitals in Turkey are attracting new prospects and increasing the loyalty of existing customers. Because of this, the hospitals are showing efforts to develop quality standards and increase the perceived value in the eyes of the customers.In this study, the affect of the service quality provided by government, private and university hospitals on patients? satisfaction and loyalty was measured. In the survey the data was collected from 551 patients who have provided at least one overnight stay at the Five-hospitals in the province of Adana (2 government hospitals, 2 private hospitals and a university hospital). According to the collected data, quality dimensions of the services provided by hospitals have been determined.This of eight subscales services determined by conducting a factor analysis in health industry are as follows; in-room services, nursing services, physician services, food services, appearance, access to services, information services for prior to enrollment and patient services. Then, the eight sub-dimensions according to the type of hospital, and commitment to customer satisfaction were analyzed. Anova, regression analyzes and various descriptive statistics (mean, standard deviation, cross tables, etc.) were used to test the hypothesis included in the model.According to the results of the tests, there is meaningful relationship among the factors through hospitals. There is a significant difference between customer satisfaction and quality dimensions. According to the results, public hospitals? patients(consumers) are effected more from the services of ?nursing? and ?food? ; private hospitals? patients are effected more from the services of ?provided to patients? guests/relatives?, ?nursing? and ?General Appearance and accessing? ; and for University hospitals consumers? satisfaction is effected from the services of ? patient services?. It was found that customer loyalty is affected by perceived quality dimensions indirectly, however, there s direct effect of customer satisfaction on customer loyalty.