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Nurana Sadıgova, Magsud Mirzayev: Service Quality as a Determinant of Patient Satisfaction: An
Empirical Study in the Healthcare Sector

Service Quality and Patient Satisfaction
Patient satisfaction is a multidimensional construct that reflects patients’ subjective
evaluations of their healthcare experiences (Westbrook & Oliver, 1991). It is closely
linked to service quality, as patients’ perceptions of the care they receive directly
influence their overall satisfaction and loyalty to healthcare providers (Kotler & Keller,
2016). The relationship between service quality and patient satisfaction is grounded in
the Expectancy-Disconfirmation Theory, which posits that satisfaction arises when
perceived service performance meets or exceeds expectations (Oliver, 1980). In
healthcare, this theory suggests that patients compare their expectations of service
quality (e.g., timely care, competent staff, and compassionate interactions) with their
actual experiences, and the resulting gap shapes their satisfaction levels.
Prior research has consistently shown that high service quality enhances patient
satisfaction, leading to improved patient retention, positive word-of-mouth, and better
clinical outcomes (Choi et al., 2004). For example, Zaim et al. (2010) found that Empathy
and Assurance were particularly influential in shaping patient satisfaction in hospital
settings, as patients often prioritize emotional support and trust in healthcare providers.
Similarly, Tangibles, such as clean and modern facilities, have been shown to create a
positive first impression, indirectly contributing to satisfaction (Andaleeb, 2001).

LITERATURE REVIEW
Service quality has long been recognized as a critical determinant of satisfaction
across service industries, particularly in healthcare, where the stakes are high and the
emotional intensity is greater than in other sectors. The relationship between service
quality and patient satisfaction is multidimensional, encompassing tangible and
intangible factors that shape the patient’s overall experience.
Service quality is commonly conceptualized through the SERVQUAL model
developed by Parasuraman et al. (1988), which includes five core dimensions:
tangibles, reliability, responsiveness, assurance, and empathy. Satisfaction, in
contrast, refers to the emotional response resulting from the perceived discrepancy
between expectations and actual service performance (Kotler, 1999; Oliver, 1997).
Miarsih (2025) conducted an empirical study at Sultan Imanuddin General Hospital
in Indonesia, confirming that four of the five SERVQUAL dimensions reliability,
assurance, empathy, and responsiveness had significant positive relationships with
outpatient satisfaction, while physical evidence (tangibles) did not. Empathy emerged
as the most influential factor, highlighting the importance of interpersonal care, such
as attentiveness, concern, and emotional support provided by healthcare staff
(Miarsih, 2025). This finding aligns with earlier assertions by Supriyanto and
Ernawaty (2010), who emphasized that satisfaction in healthcare begins with the first
point of contact and is shaped by the consistency and responsiveness of staff

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