The Influence of Service Quality and Brand Image on Patient Loyalty Mediated by Patient Satisfaction (An Empirical Study on Patients at “X” Hospital in East Bekasi)

Authors

  • Alfa Tiara Ramba Universitas Bunda Mulia, Indonesia
  • Liem Bambang Sugiyanto Universitas Bunda Mulia, Indonesia

DOI:

https://doi.org/10.57096/edunity.v4i9.436

Keywords:

Service Quality, Brand Image, Patient Satisfaction, Patient Loyalty

Abstract

This study aims to examine the effect of service quality and brand image on patient loyalty, with customer satisfaction as a mediating variable at X Hospital, East Bekasi, Indonesia. A quantitative survey was conducted using an online questionnaire distributed to 154 respondents who had received services at the hospital more than twice and were aged 17 years or older. Data were analyzed using Smart PLS 3. The results show that service quality and brand image significantly influence patient satisfaction, which, in turn, has a strong effect on patient loyalty. Both service quality and brand image also directly influence patient loyalty, with service quality identified as the strongest contributor, followed by brand image. Furthermore, patient satisfaction mediates the relationship between the independent variables and loyalty, confirming its critical role in shaping patient behavior. The study concludes that delivering high service quality and maintaining a positive brand image are essential strategies to enhance patient satisfaction and loyalty. Limitations of this study include its relatively small sample size and focus on a single hospital, restricting generalizability. Theoretically, the study contributes to the literature on patient loyalty by emphasizing the mediating role of satisfaction. Practically, it provides insights for hospital management to prioritize service improvements and strengthen brand perception. Future research is recommended to expand the sample across multiple hospitals and to explore additional mediating variables such as corporate reputation, perceived value, and revisit intention to provide a more comprehensive understanding of loyalty drivers.

References

Agarwal, R., & Dhingra, S. (2023). Factors influencing cloud service quality and their relationship with customer satisfaction and loyalty. Heliyon, 9(4), e15177. https://doi.org/10.1016/j.heliyon.2023.e15177

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

Chaysiri, S., Leecharoen, B., & Sangthong, T. (2023). A causal relationship model of factors influencing customer loyalty in private hospitals in Thailand. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4647671

Lu, J., & Lu, Y. (2009). Dimensions and influencing factors of customer loyalty in the intermittent service industry. Frontiers of Business Research in China, 3(1), 14–26. https://doi.org/10.1007/s11782-009-0004-4

Supriyanto, A., Wiyono, B. B., & Burhanuddin, B. (2021). Effects of service quality and customer satisfaction on loyalty of bank customers. Cogent Business & Management, 8(1), 1937847. https://doi.org/10.1080/23311975.2021.1937847

Abutar, A. U., & Wuisan, D. S. S. (2024). The influence of service quality, word of mouth, patient physician trust on revisit intentions mediated by patient satisfaction in Primaya Hospital patients. Jurnal Ilmiah Manajemen, 12(2), 591–601. https://doi.org/10.56457/jimk.v12i2.591

Dayan, M., Al Kuwaiti, I. A., Husain, Z., Ng, P. Y., & Dayan, A. (2022). Factors influencing patient loyalty to outpatient medical services: An empirical analysis of the UAE’s government healthcare system. International Journal of Quality & Reliability Management, 39(1), 176–203. https://doi.org/10.1108/IJQRM-11-2020-0373

Garem, R. A. A. E., Fuad, A., & Muhammad, H. (2023). Factors associated with patient loyalty in private healthcare sector in Egypt. Journal of Humanities and Applied Social Sciences, 6(2), 181–206. https://doi.org/10.1108/JHASS-08-2022-0103

Gou, Y., Zhou, Y., Xing, X., & Li, X. (2020). Exploring the relationship between service quality of private hospitals and patient loyalty from the perspective of health service. Iranian Journal of Public Health, 49(6), 1097–1105. http://ijph.tums.ac.ir/

Hai, P. T., Cuong, N. T., Nguyen, V. C., & Thuong, M. T. (2021). Sustainable business development of private hospitals in Vietnam: Determinants of patient satisfaction, patient loyalty and revisit intention. Problems and Perspectives in Management, 19(4), 68–81. https://doi.org/10.21511/ppm.19(4).2021.06

Hair Jr, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2022). Multivariate data analysis (8th ed.). Cengage Learning.

Kotler, P., Armstrong, G., & Balasubramanian, S. (2024). Principles of marketing (19th ed.). Pearson.

Kotler, P., Keller, K. L., & Chernev, A. (2022). Marketing management (16th ed.). Pearson Education.

Lin, W., & Yin, W. (2022). Impacts of service quality, brand image, and perceived value on outpatient’s loyalty to China’s private dental clinics with service satisfaction as a mediator. PLoS ONE, 17(5), e0269233. https://doi.org/10.1371/journal.pone.0269233

Oliver, R. L. (1999). Whence consumer loyalty? Journal of Marketing, 63(4_suppl1), 33–44. https://doi.org/10.1177/00222429990634s105

Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1985). A conceptual model of service quality and its implications for future research. Journal of Marketing, 49(4), 41–50. https://doi.org/10.1177/002224298504900403

Sofia, T. A. (2023). Dampak kepuasan pasien dan loyalitas pasien dimediasi oleh kepercayaan pasien dan citra merek rumah sakit pada rumah sakit pendidikan gigi dan mulut Jakarta. Journal of Social Research. http://ijsr.internationaljournallabs.com/index.php/ijsr

Woo, S., & Choi, M. (2021). Medical service quality, patient satisfaction and intent to revisit: Case study of public hub hospitals in the Republic of Korea. PLoS ONE, 16(4), e0252241. https://doi.org/10.1371/journal.pone.0252241

Downloads

Published

2025-09-02