Structural Equation Modeling of Associations Between Quality of Services and Satisfaction, Loyalty, and Trust of Patients Referring to Health and Medical Centers

Background: Today, the hospital's priority is to attract and retain customers.Recent research has shown that the provided quality of services can influence customer reuse, loyalty, trust and satisfaction.The purpose of this study was to investigate the relationship between service quality and loyalty, trust and satisfaction of patients in health and medical centers of Guilan University of Medical Sciences through structural equation modeling.Methods: The present study was conducted on 384 people referred to Guilan University of Medical Sciences.Service quality was assessed using a questionnaire on 5 dimensions of infrastructure, space, object, interaction and process quality.The validity of the research instrument was assessed by factor analysis and its reliability was estimated by Cronbach's alpha coefficient.The conceptual model of research was tested through structural equation technique in SmartPLS software.Results: Infrastructure (r = 0.51), object (r = 0.2), atmosphere (r = 0.11), interaction (r = 0.09), and process quality (r = 0.14) had direct and significant impact on satisfaction.Satisfaction as a mediator variable was also positively influenced trust (r = and loyalty. Conclusion:The results of this study revealed that Infrastructure quality followed by object quality had greatest impact on satisfaction.