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Open Access Research article

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

Ching-Sheng Chang1, Su-Yueh Chen2* and Yi-Ting Lan3

Author affiliations

1 R.O.C. Naval academy, Kaohsiung, Taiwan

2 Division of Nursing, Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

3 Postgraduate Programs in Management, I-Shou University, Kaohsiung, Taiwan

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Citation and License

BMC Health Services Research 2013, 13:22  doi:10.1186/1472-6963-13-22

Published: 16 January 2013



Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study.


We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses.


Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction.


According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers’ demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions.

Interpersonal-based medical service encounters; Service quality; Patient trust; Patient satisfaction; Structural equation modeling (SEM)