Influence of Perceived Service Quality on Patient Satisfaction in an Ecuadorian Healthcare Center

Authors

DOI:

https://doi.org/10.26439/ddee2026.n009.8926

Keywords:

perceived service quality, patient satisfaction, impact, case study, private medical center

Abstract

Citizens are becoming increasingly informed, leading to heightened expectations regarding the services they receive, particularly in healthcare, where they seek high-quality care and high levels of satisfaction. This study aims to analyze the impact of service quality on patient satisfaction in a medical center in Ecuador. This study employs a quantum approach, utilizing a cross-sectional and non-experimental design with an explanatory scope. It measures five dimensions encompassing both objective and subjective quality through the SERVQHOS model. Data were collected from 276 users of health services, including both virtual and face-to-face interactions, and participants were categorized into two groups: those with health insurance and those without. The researchers processed data using SPSS alongside a structural model. The primary findings indicate that responsiveness, empathy, and reliability significantly influence customer satisfaction, which over time increases the likelihood of service recommendations and repeat patronage. Contemporary health service users seek higher quality; therefore, health centers must implement strategies that foster customer satisfaction, ultimately achieving sustained market positioning and viability.

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References

Adner, R. (2006). Match your innovation strategy to your innovation ecosystem. Harvard Business Review, 84(4), 98-107.

Ahen, F. (2022). Community-level health interventions are crucial in the post-COVID-19 era: Lessons from Africa’s proactive public health policy interventions. Humanistic Management Journal, 7(3), 369-390. https://doi.org/10.1007/s41463-022-00127-3

Athey, S., Grabarz, K., Luca, M., & Wernerfelt, N. (2023). Digital public health interventions at scale: The impact of social media advertising on beliefs and outcomes related to COVID vaccines. Proceedings of the National Academy of Sciences, 120(5), e2208110120. https://doi.org/10.1073/pnas.2208110120

Becker, J. M., Ringle, C. M., & Sarstedt, M. (2018). Estimating moderating effects in PLS-SEM and PLSc-SEM: Interaction term generation*data treatment. Journal of Applied Structural Equation Modeling, 2(2), 1-21. https://doi.org/10.47263/jasem.2(2)01

Blanco, A., & Rivero, V. (2009). Calidad de servicio percibida por los clientes residenciales en las oficinas de atención al cliente (OAC) de una empresa telefónica. Ingeniería Industrial: Actualidad y Nuevas Tendencias, 1(3), 31-42. https://www.redalyc.org/articulo.oa?id=215016887004

Chión, S., & Charles, V. (2016). Analítica de datos para la modelación estructural. Pearson.

Coral-Almeida, M., Carrington, S. J., Carrión-Yaguana, V. D., & Mascialino, G. (2022). How not to manage a pandemic, and how to recover from it: Lessons from Ecuador. Facets, 7, 1367-1384. https://doi.org/10.1139/facets-2022-0064

Crosby, P. B. (1992). La calidad no cuesta. El arte de cerciorarse de la calidad. Compañía Editorial Continental.

Czepiel, J. A., & Rosenberg, L. J. (1977). Consumer satisfaction: Concept and measurement. Journal of the Academy of Marketing Science, 5(4), 403-411. https://doi.org/10.1007/BF02722070

Donabedian, A. (1980). Explorations in quality assessment and monitoring: The definition of quality and approaches to its assessment. Health Administration Press.

Federación Ecuatoriana de Seguros. (2022). Datos coyunturales en imágenes. https://www.fedeseg.org/datos

Giese, J. L., & Cote, J. A. (2000). Defining consumer satisfaction. Academy of Marketing Science Review, (1), 1-24. https://www.researchgate.net/publication/235357014

Greenhalgh, T., Humphrey, C., Hughes, J., Macfarlane, F., Butler, C., & Pawson, R. (2009). How do you modernize a health service? A realist evaluation of whole-scale transformation in London. The Milbank Quarterly, 87(2), 391-416. https://doi.org/10.1111/j.1468-0009.2009.00562.x

Guevara-Rosero, G. C. (2023). The effect of the healthcare system’s structure on COVID-19 dynamics in Ecuador. Regional Science Policy and Practice. 15(8), 1795-1820. https://doi.org/10.1111/rsp3.12666

Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2014). Multivariate data analysis (7th ed.). Pearson Education Limited.

Instituto Nacional de Estadística y Censos. (2020). Estadísticas vitales: registro estadístico de defunciones generales 2020. https://www.ecuadorencifras.gob.ec/documentos/web-inec/Poblacion_y_Demografia/Defunciones_Generales_2020/2021-06-10_Principales_resultados_EDG_2020_final.pdf

Instituto Nacional de Estadística y Censos. (2022a). Estadísticas vitales: registro estadístico de defunciones generales 2021 (Resultados principales, v2). https://www.ecuadorencifras.gob.ec/documentos/web-inec/Poblacion_y_Demografia/Defunciones_Generales_2021/Principales_resultados_EDG_2021_v2.pdf

Instituto Nacional de Estadística y Censos. (2022b). Registro estadístico de recursos y actividades de salud 2020. https://www.ecuadorencifras.gob.ec/actividades-y-recursos-de-salud/

International Organization for Standardization. (2015). ISO 9000:2015 — Quality management systems: Fundamentals and vocabulary (4th ed.). https://www.iso.org/obp/ui/#iso:std:iso:9000:ed-4:v1

Jabs, J. M., Schwabe, A., Wollkopf, A. D., Gebel, B., Stadelmaier, J., Erdmann, S., Radicke, F., Grundmann, H., Kramer, A., Monsef, I., Rücker, G., Rupp, J., Scheithauer, S., Schmucker, C., Simon, A., & Mutters, N. T. (2022). The role of routine SARS-CoV-2 screening of healthcare-workers in acute care hospitals in 2020: A systematic review and meta-analysis. BMC Infectious Diseases, 22(1), Article 587. https://doi.org/10.1186/s12879-022-07554-5

Jiménez Paneque, R. (2004). Indicadores de calidad y eficiencia de los servicios hospitalarios: Una mirada actual. Revista Cubana de Salud Pública, 30(1), 17-36. https://www.redalyc.org/articulo.oa?id=21430104

Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing Open, 6(2), 535-545. https://doi.org/10.1002/nop2.237

Li, X., Krumholz, H. M., Yip, W., Keung Cheng, K., De Maeseneer, J., Meng, Q., Mossialos, E., Li, C., Lu, J., Su, M., Zhang, Q., Roman Xu, D., Li, L., Normand, S.-L. T., Peto, R., Li, J., Wang, Z., Yan, H., Gao, R., … Hu, S. (2020). Quality of primary health care in China: Challenges and recommendations. The Lancet, 395, 1802-1812. https://doi.org/10.1016/S0140-6736(20)30122-7

Malhotra, N. K. (2019). Marketing research: An applied orientation (7th ed.). Pearson.

Masterson, D., Areskoug Josefsson, K., Robert, G., Nylander, E., & Kjellström, S. (2022). Mapping definitions of co-production and co-design in health and social care: A systematic scoping review providing lessons for the future. Health Expectations, 25(3), 902-913. https://doi.org/10.1111/hex.13470

Masuet, A. M. (2010). La calidad de la atención médica ambulatoria en el Hospital Pediátrico del Niño Jesús, de la Ciudad de Córdoba [Tesis de maestría, Universidad Nacional de Córdoba]. Repositorio Digital UNC. https://rdu.unc.edu.ar/handle/11086/254

Ministerio de Salud Pública del Ecuador. (2020). Aumento de capacidad de camas UCI y de hospitalización en Guayas permite atender oportunamente casos COVID-19. https://www.salud.gob.ec/aumento-de-capacidad-de-camas-uci-y-de-hospitalizacion-en-guayas-permite-atender-oportunamente-casos-covid-19/

Mira, J. J., Aranaz, J., Rodríguez-Marín, J., Buil, J. A., Castell, M., & Vitaller, J. (1998). SERVQHOS: Un cuestionario para evaluar la calidad percibida de la atención hospitalaria. Medicina Preventiva, 4, 12-18. http://calite-revista.umh.es/indep/web/art_servqhos.pdf

Mora Contreras, C. E. (2011). La calidad del servicio y la satisfacción del consumidor. Revista Brasileira de Marketing, 10(2), 146-162. https://doi.org/10.5585/remark.v10i2.2212

Mosquera, D. (2017). Encontrar trabajo, un problema para los nuevos médicos en el Ecuador. Edición Médica. https://www.edicionmedica.ec/secciones/profesionales/encontrar-trabajo-un-problema-para-los-nuevos-m-dicos-en-el-ecuador-89684

National Health Service Digital. (2020). NHS outcomes framework indicators — August 2020 release. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-outcomes-framework/august-2020

Olivares, C., Betanzos, N., & Paz, F. (2017). Compromiso organizacional y calidad del servicio en un hospital privado. El Psicólogo Anáhuac, 20, 7-25. https://www.researchgate.net/publication/353196003

Oliver, R. L. (1980). A cognitive model of the antecedents and consequences of satisfaction decisions. Journal of Marketing Research, 17(4), 460-469. https://doi.org/10.1177/002224378001700405

Oliver, R. L. (1997). Satisfaction: A behavioral perspective on the consumer. McGraw-Hill. https://books.google.com.pe/books/about/Satisfaction.html?id=iCeQQgAACAAJ&redir_esc=y

Oliver, R. L., & Swan, J. E. (1989). Consumer perceptions of interpersonal equity and satisfaction in transactions: A field survey approach. Journal of Marketing, 53(2), 21-35. https://doi.org/10.1177/002224298905300202

Ortiz, P. (2016). Nivel de satisfacción del usuario externo sobre la calidad de atención en los servicios de salud según encuesta SERVQUAL, en la micro red Villa-Chorrillos en el año 2014 [Tesis de licenciatura, Universidad Ricardo Palma]. Repositorio URP. https://repositorio.urp.edu.pe/handle/20.500.14138/457

Ortiz-Culcay, O., Fernández-García, C., & Pérez-Rico, C. (2022). Analysis of prepaid medicine coverage in Pichincha. Revista Ciencia UNEMI, 15(38), 1-13. https://doi.org/10.29076/issn.2528-7737vol15iss38.22pp1-13p

Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12-40. https://psycnet.apa.org/record/1989-10632-001

Quintuña Velecela, M. A. (2021). Factores asociados a la calidad de atención al paciente durante la pandemia por SARS-CoV-2/COVID-19. RECIMUNDO, 5(esp. 1), 118-125. https://doi.org/10.26820/recimundo/5.(esp.1).nov.2021.118-125

Shewhart, W. A. (1997). Control económico de la calidad de productos manufacturados. Ediciones Díaz de Santos. https://www.editdiazdesantos.com/libros/shewhart-wa-control-economico-de-la-calidad-de-productos-manufacturados-L03003040101.html

Tan, C. N. L., Ojo, A. O., Cheah, J. H., & Ramayah, T. (2019). Measuring the influence of service quality on patient satisfaction in Malaysia. Quality Management Journal, 26(3), 129-143. https://doi.org/10.1080/10686967.2019.1615852

Thompson, A. G. H., & Suñol, R. (1995). Expectations as determinants of patient satisfaction: Concepts, theory and evidence. International Journal for Quality in Health Care, 7(2), 127-141. https://doi.org/10.1093/intqhc/7.2.127

Torres, M., & Vásquez, C. L. (2015). Modelos de evaluación de la calidad del servicio: Caracterización y análisis. Compendium, 18(35), 57-76. https://www.redalyc.org/articulo.oa?id=88043199005

Van Barneveld, K., Quinlan, M., Kriesler, P., Junor, A., Baum, F., Chowdhury, A., Junankar, P. N., Clibborn, S., Flanagan, F., Wright, C. F., Friel, S., Halevi, J., & Rainnie, A. (2020). The COVID-19 pandemic: Lessons on building more equal and sustainable societies. Economic and Labour Relations Review, 31(2), 133-157. https://doi.org/10.1177/1035304620927107

Westbrook, R. A., & Reilly, M. D. (1983). Value-percept disparity: An alternative to the disconfirmation of expectations theory of consumer satisfaction. Advances in Consumer Research, 10, 256-261. https://www.acrwebsite.org/volumes/6120/volumes/v10/NA-10

Wu, T. C., & Ho, C. T. B. (2023). A scoping review of metaverse in emergency medicine. Australasian Emergency Care, 26(1), 75-83. https://doi.org/10.1016/j.auec.2022.08.002

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Published

2026-07-17

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How to Cite

Barrera-Cercado, S. A., Celdo-Crespo, D. S., Campoverde-Aguirre, R., Arévalo-Avecillas, D., Luciano Alipio, R., & González Jaramillo, V. H. (2026). Influence of Perceived Service Quality on Patient Satisfaction in an Ecuadorian Healthcare Center. Desafíos: Economía Y Empresa, 009, 77-99. https://doi.org/10.26439/ddee2026.n009.8926