The theoretical framework of this study adopted the CCSI. Base on the theoretical framework, 11 hypotheses are constructed.
H1: Brand image has a positive effect on the expected quality
H2: Expected quality has a positive influence on perceived quality.
H3: Brand image has a positive influence on perceived quality.
H4: Brand image is positively associated with perceived value.
H5: Expected quality has a positive relationship with perceived value.
H6: Perceived quality is positively associated with perceived value.
H7: Perceived value has a positive influence on patient satisfaction.
H8: Brand image is positively associated with patient satisfaction.
H9: Expected quality has a positive relationship with patient satisfaction.
H10: Perceived quality is positively associated with patient satisfaction.
H11: Patient satisfaction has a positive influence on patient loyalty.
Of these, the brand image refers to the clinic's recognition, credibility, and reputation. Perceived quality consists of 16 items, including physician medical technology, clinic medical equipment, patient treatment effect (degree of relief), handling complaints, waiting time for treatment, waiting time for payment, attitude of physician work, attitude of physician service, explanation of diagnosis and treatment, choice of treatment plan, health education, physician's clothing, sanitary conditions, environmental comfort, facility sign, and convenience service. Expected quality includes overall impression, satisfaction with service items before treatment, expectations of treatment outcomes, and expectations of services. The perceived value comprises the evaluations regarding service fees compared to the quality of services received and service quality compared to the service fee by patients. Patient satisfaction is measured by overall satisfaction, satisfaction about the services provided compared to the expectations, and satisfaction about the private clinics compared to other types of dental clinics. Patient loyalty includes two items: First, the willingness to choose private clinics next time; and second, the willingness to recommend private clinics to family members or friends. Each item is coded as an ordinal variable on scales ranging from 1 to 5, in which a higher score indicates a lower satisfaction level. The Cronbach’s alpha for perceived quality, expected quality, clinic brand image, perceived value, patient satisfaction, and patient loyalty ranges from 0.79 to 0.97, indicating that the internal consistency of these dimensions is good.
This is a cross-sectional survey study, being conducted in Dongguan City, Guangdong Province, China in January 2019. The rationale for choosing China’s private dental clinics as the setting for collecting data lies in the fact that dental service is the most privatized sectors in China. The participants were selected by convenience sampling method. A total of 230 residents were surveyed. Among them, 125 had received services in private dental clinics, being the valid sample of this study. This study got ethical approval from School of Public Administration,JiNan University. Verbal consent has been obtained from the participants.
Descriptive statistics were used to analyze the sample’s characteristics. Then a multiple regression model was run to explore factors influencing patient loyalty. Subsequently, the path analysis was used to understand the relationship of service quality, brand image, perceived value, patient satisfaction, and patient loyalty. All data were analyzed with SPSS 24.0 and AMOS 21.0 software.