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Original Article

Causal Relationships among Quality, Service Value, Satisfaction and Loyalty

Young-Hee Yom1, In Ja Lee2
Journal of Korean Academy of Nursing Administration 2010;16(4):497-506.
Published online: December 31, 2010

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Correspondence: Yom, Young-Hee. Department of Nursing, Chung-Ang University, 221, Huksuk-Dong, Dongjak-Ku, Seoul 156-752, Korea. Tel: 82-11-756-9310, Fax: 82-2-820-5700, yhyom@cau.ac.kr
• Received: November 3, 2010   • Revised: November 26, 2010   • Accepted: November 26, 2010

Copyright © 2010 Korean Academy of Nursing Administration

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  • Purpose
    The purpose of this study was to examine the causal relationships among quality of health care service, service value, satisfaction and loyalty as perceived by hospital inpatients.
  • Methods
    A survey using a structured questionnaire was conducted with 654 hospital inpatients. Analysis of the data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model.
  • Results
    The modified model yielded Chi-square=7.96 (p=.019), df=2, χ2/df=3.98, GFI=.99, AGFI=.96, RMSEA=.07, NFI=.99, CFI=.99, TLI=.98 and showed good fit indices. Three dimensions of quality had significant direct effects on service value. Functional quality, technical quality and service value had significant direct effects on customer satisfaction. Technical quality, service value, and customer satisfaction had significant direct effects on customer loyalty.
  • Conclusion
    These results suggest that quality of health care is an important element in service value, and through both quality and service value, customer satisfaction and customer loyalty can be enhanced. Further study with a larger sample from various hospitals and a longitudinal design is necessary.
  • Key Words: Quality of Health Care; Service Value; Customer Satisfaction; Customer Loyalty
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Figure 1
Path diagram of the hypothetical model
jkana-16-497-g001.jpg
Figure 2
Path diagram of the modified model
jkana-16-497-g002.jpg
Table 1
Demographic characteristics (N=654)
jkana-16-497-i001.jpg
Table 2
Means, standard deviations and correlations of variables
jkana-16-497-i002.jpg
Table 3
Goodness fit indies for the hypothetical and modified models
jkana-16-497-i003.jpg

GFI=goodness of fit index; AGFI=ajusted goodness of fit index; RMR=root mean squared residual, RMSEA=root mean squared error of approximation; NFI=normed fit index; CFI=comparative fit index); TLI=tucker-lewis index.

Table 4
Standardized direct effect, indirect effect and total effect in modified path model
jkana-16-497-i004.jpg

SMC=Squared multiple correlations.

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • The Effect of Outpatients’ Perceived Service Quality on Satisfaction with Treatment and Willingness to Recommend Hospital
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    • The Effect of Service Qualities with University Hospitals in Daejeon on their Overall Service Satisfaction
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      The Korean Journal of Health Service Management.2013; 7(4): 93.     CrossRef
    • Causal Relationships Among Perceived Risk, Satisfaction, Switching Cost and Loyalty in Outpatient Health Services
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    • The Effect of Hospital SCM on Logistics Performance
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    Causal Relationships among Quality, Service Value, Satisfaction and Loyalty
    J Korean Acad Nurs Adm. 2010;16(4):497-506.   Published online December 31, 2010
    DOI: https://doi.org/10.11111/jkana.2010.16.4.497
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    Causal Relationships among Quality, Service Value, Satisfaction and Loyalty
    J Korean Acad Nurs Adm. 2010;16(4):497-506.   Published online December 31, 2010
    DOI: https://doi.org/10.11111/jkana.2010.16.4.497
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    Causal Relationships among Quality, Service Value, Satisfaction and Loyalty
    Image Image
    Figure 1 Path diagram of the hypothetical model
    Figure 2 Path diagram of the modified model

    Figure 1

    Figure 2

    Causal Relationships among Quality, Service Value, Satisfaction and Loyalty

    Demographic characteristics (N=654)

    Means, standard deviations and correlations of variables

    Goodness fit indies for the hypothetical and modified models

    GFI=goodness of fit index; AGFI=ajusted goodness of fit index; RMR=root mean squared residual, RMSEA=root mean squared error of approximation; NFI=normed fit index; CFI=comparative fit index); TLI=tucker-lewis index.

    Standardized direct effect, indirect effect and total effect in modified path model

    SMC=Squared multiple correlations.
    Table 1 Demographic characteristics (N=654)

    Table 2 Means, standard deviations and correlations of variables

    Table 3 Goodness fit indies for the hypothetical and modified models

    GFI=goodness of fit index; AGFI=ajusted goodness of fit index; RMR=root mean squared residual, RMSEA=root mean squared error of approximation; NFI=normed fit index; CFI=comparative fit index); TLI=tucker-lewis index.

    Table 4 Standardized direct effect, indirect effect and total effect in modified path model

    SMC=Squared multiple correlations.

    Table 1

    Table 2

    Table 3

    Table 4

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