DOI: 10.4103/jehp.jehp_1113_25 ISSN: 2277-9531

Strategic management in healthcare: Influence of service quality and brand image on patient loyalty: A cross-sectional study

Arnold Rafiq, Oluwasoye Mafimisebi, Adekunle Ogunsade, Kolawole Alo, Daud Masih
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BACKGROUND:

Hospital service quality and brand image are essential factors influencing patient satisfaction and loyalty in competitive healthcare environments. This study aimed to assess their effects on patient loyalty, mediated by patient satisfaction.

MATERIALS AND METHODS:

This cross-sectional quantitative study was conducted in public and private hospitals of Rawalpindi, Pakistan, from January to April 2025, where 200 hospitalized patients were tested. A validated structured questionnaire was used to collect data about four domains: service quality, brand image, patient satisfaction, and patient loyalty. The analysis was made using SPSS version 25; the statistical techniques used were descriptive statistics, Pearson correlation, and multiple regression, followed by Preacher and Hayes bootstrapped mediation analysis ( n = 5000 repetitions). The significance level was set at P < 0.05.

RESULTS:

Hospital service quality significantly predicted both patient satisfaction (β = 0.410, P < 0.001) and patient loyalty (β = 0.570, P < 0.001). Brand image also significantly predicted patient satisfaction (β = 0.100, P < 0.002) and loyalty (β = 0.120, P < 0.032). Patient satisfaction was positively associated with loyalty (β = 0.560, P < 0.001). Mediation analysis confirmed that patient satisfaction significantly mediated the relationships between service quality and loyalty (β = 0, P < 0.0013) and between brand image and loyalty (β = 0.0591, P < 0.002).

CONCLUSION:

This study showed that patient satisfaction mediates the effects of service quality and brand image on loyalty. It contributes novel evidence from Pakistan’s healthcare sector and calls for future research in diverse hospital settings.

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