Causal Relationships among Quality, Service Value, Satisfaction and Loyalty

Young-Hee Yom; In Ja Lee

doi:10.11111/jkana.2010.16.4.497

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Yom and Lee: Causal Relationships among Quality, Service Value, Satisfaction and Loyalty

Original Article

Journal of Korean Academy of Nursing Administration

Journal of Korean Academy of Nursing Administration 2010; 16(4): 497-506.

Published online: 31 December 2010

DOI: https://doi.org/10.11111/jkana.2010.16.4.497

Causal Relationships among Quality, Service Value, Satisfaction and Loyalty

Young-Hee Yom¹, In Ja Lee²

¹Professor, Department of Nursing, Chung-Ang University, Korea.

²Doctoral Student, Department of Nursing, Chung-Ang University, Korea.

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 3 November 2010 Revised 26 November 2010 Accepted 26 November 2010

Abstract

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.

Keywords: Quality of Health Care, Service Value, Customer Satisfaction, Customer Loyalty

Figures and Tables

Figure 1

Path diagram of the hypothetical model

Figure 2

Path diagram of the modified model

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.

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