# Impact of Health Service Quality on Patient Loyalty in Government and Private Hospitals in the Asir Region, Saudi Arabia

## TL;DR

This study shows that better healthcare service quality increases patient loyalty in hospitals in Saudi Arabia's Asir region.

## Contribution

The study identifies specific service quality dimensions most strongly linked to patient loyalty in government and private hospitals.

## Key findings

- All five healthcare service quality dimensions are significantly and positively associated with patient loyalty.
- Responsiveness, empathy, and assurance show the strongest correlations with patient loyalty.
- Three distinct patient loyalty groups were identified through cluster analysis.

## Abstract

Background

Healthcare service quality is a critical determinant of patient satisfaction and loyalty. In Saudi Arabia, several hospitals continue to face service-related challenges, including prolonged waiting times, inconsistent communication, and limited patient-centered practices. This study aimed to examine the impact of the five dimensions of healthcare service quality on patient loyalty in government and private hospitals with 100 or more beds in the Asir region.

Methods

A quantitative cross-sectional study was conducted between April and October 2024 using a self-administered bilingual (Arabic-English) survey disseminated online. A total of 1,043 valid responses were obtained. Service quality and loyalty were measured using a five-point Likert scale. Descriptive statistics, Pearson correlation, and hierarchical cluster analysis were carried out using the Statistical Package for the Social Sciences (SPSS) software version 23 (IBM Corp., Armonk, USA).

Results

A total of 1,043 respondents (100%) were included in the analysis. Participants were predominantly aged 30-49 years (n=581; 55.7%) and female (n=559; 53.6%). Asir Central Hospital was the most frequently visited facility (n=461; 44.2%). Pearson correlation analysis showed that all five healthcare service quality dimensions were significantly and positively associated with patient loyalty (p < 0.001). Responsiveness demonstrated the strongest correlation with loyalty (r = 0.480), followed by empathy (r = 0.478), assurance (r = 0.463), reliability (r = 0.449), and tangibility (r = 0.440). Hierarchical cluster analysis identified three loyalty groups: high loyalty (n=563; 54.0%), average loyalty (n=378; 36.2%), and low loyalty (n=102; 9.8%).

Conclusion

Healthcare service quality strongly and significantly influences patient loyalty in the Asir region. Enhancing responsiveness, empathy, and assurance should be prioritized to strengthen patient trust and retention. Improving service quality is essential for building a sustainable, patient-centered healthcare system.