The Impact of Service Quality on Patient Satisfaction and Revisiting Intentions: The Case of Public Emergency Departments.

BACKGROUND AND OBJECTIVES: This study attempts to (a) identify the main quality indicators that affect "service quality" and (b) examine the effect of "patient satisfaction" on patient "revisiting intentions."

METHODS: The sample includes patients of 2 hospitals, 1 urban and 1 provincial. The comparative analysis of 2 emergency departments (EDs) with different characteristics aims at understanding their diverse problems and their specific needs from a patient point of view. Empirical data were collected in the fall of 2015. Three hundred questionnaires were distributed in person. A total of 169 valid questionnaires, 80 from hospital A and 89 from hospital B, were returned, with a response rate of 56.3%.

RESULTS: The Structural Equation Modeling technique revealed that overall satisfaction is strongly influenced by "perceived service quality" (β = .79), while it positively affects patient "behavioral intentions" (β = .39). Also, "perceived waiting time" proved to have a more intense impact on "perceived service quality" (β = -.59), rather than on "perceived technical and functional quality" (β = .18). Moreover, it was determined that patients visiting the urban ED pay more attention in waiting times, while patients visiting the provincial ED care about receiving both quality and timely health care services. Overall, the study provides insight about the main factors affecting "perceived service quality" and "overall satisfaction." These factors fall into 2 distinct categories: "perceived technical and functional quality" and "perceived waiting time."

CONCLUSIONS: The study concludes that "overall satisfaction" acts as a mediator between "perceived service quality" and patient "behavioral intentions," while "perceived waiting time" is the most significant indicator of service quality and the most crucial predictor of ED patient satisfaction. Moreover, it offers empirical evidence concerning the differences in the way patients rate the services offered by a hospital, based on the hospital size and the region it is located (urban or provincial).