Exploring Patient Trust as a Mediator in Factors Influencing Inpatient Revisit Intention

Adjra Safira Hidayat

doi:10.33751/jsi.v7i2.12811

Exploring Patient Trust as a Mediator in Factors Influencing Inpatient Revisit Intention

Adjra Safira Hidayat

Abstract

This research investigates the impact of healthcare service quality and patient satisfaction on the intention to revisit, with patient trust serving as a mediating factor, among inpatients at Ciawi Regional Hospital. Employing a quantitative approach with a causal-comparative design, primary data were obtained from 108 hospitalized respondents through questionnaires. The analysis utilized Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS version 4.0. Results from the measurement model confirmed that all indicators met the validity and reliability standards, covering convergent and discriminant validity using the Fornell-Larcker criterion, cross-loadings, and the HTMT ratio. Structural model testing revealed strong explanatory capacity, with R-square values of 74.4% for revisit intention and 40.7% for patient trust, alongside predictive relevance indicated by a Q-square value of 0.668. Hypothesis testing showed that both healthcare service quality and patient satisfaction exert significant positive effects on revisit intention and patient trust. Additionally, patient trust itself demonstrated a significant and positive impact on revisit intention. Mediation analysis further established that patient trust significantly mediates the relationship between healthcare service quality, patient satisfaction, and revisit intention. These results reinforce the relevance of the Theory of Planned Behavior within healthcare contexts and emphasize the pivotal role of patient trust in linking service quality and satisfaction to foster revisit intention. Practical implications suggest that Ciawi Regional Hospital should prioritize strengthening service quality and cultivating patient trust as strategies to enhance loyalty and encourage repeat visits.

Keywords

patient satisfaction; patient trust; revisit intention; Ciawi Hospital

References

D. J. Lee and M. R. Kim, “Determinants of patient loyalty in healthcare: The mediating role of trust and satisfaction,” Health Serv. Manage. Res., vol. 36, no. 2, pp. 87–98, 2023.

C. R. Chen and A. Gupta, “Consumer behavior in healthcare: From satisfaction to loyalty,” J. Serv. Mark., vol. 38, no. 3, pp. 215–229, 2024.

S. L. Thomas and M. Rahman, “Patient trust as a mediator between service quality and loyalty intention,” BMC Health Serv. Res., vol. 23, 1127, 2023.

L. N. Boateng, “Service excellence and revisit behavior in healthcare: The moderating effect of communication,” Patient Exp. J., vol. 10, no. 2, pp. 112–128, 2023.

A. Parasuraman, V. A. Zeithaml, and L. L. Berry, “Reassessing SERVQUAL for healthcare applications,” J. Health Care Mark., vol. 39, no. 1, pp. 11–20, 2022.

R. K. Chahal and R. Kumari, “Service quality and patient satisfaction in tertiary care hospitals: A systematic review,” Int. J. Qual. Health Care, vol. 34, no. 7, 2022.

A. F. Bakar and M. A. Mohd, “Trust as a driver of patient loyalty: The case of Malaysian hospitals,” Int. J. Health Policy Manage., vol. 12, no. 4, pp. 422–433, 2023.

N. R. Dagger and M. J. O'Brien, “The role of trust in healthcare relationships: A conceptual synthesis,” Soc. Sci. Med., vol. 288, 114377, 2021.

E. W. Tsai, J. C. Chou, and Y. H. Lin, “Trust transfer and revisit intention in digital health platforms,” Telemed. e-Health, vol. 30, no. 1, pp. 44–54, 2024.

M. Rahman, S. H. Lee, and A. Khan, “Exploring patient trust and satisfaction in developing countries: Evidence from Bangladesh,” Health Serv. Res., vol. 58, no. 3, pp. 421–439, 2023.

P. Kaur and R. Sharma, “Moderating influence of trust in the service quality–satisfaction–loyalty link,” Total Qual. Manage. Bus. Excell., vol. 35, no. 5, pp. 534–550, 2024.

H. S. Zhang and T. Zhang, “Patient-centered care and behavioral intentions: A trust-based analysis,” Front. Psychol., vol. 14, 1128345, 2023.

I. Ajzen, “The theory of planned behavior: Revisited and updated,” Organ. Behav. Hum. Decis. Process., vol. 170, pp. 1–13, 2022.

M. J. Bitner, A. L. Ostrom, and S. W. Morgan, “Service encounters and emotional mechanisms in healthcare,” J. Serv. Res., vol. 26, no. 2, pp. 251–267, 2023.

A. Khairuddin, R. Suryani, and H. Pramono, “Applying the theory of planned behavior in predicting hospital revisit intention,” Asian J. Bus. Res., vol. 13, no. 1, pp. 33–51, 2023.

Ministry of Health of Indonesia, Indonesia Health Profile Report 2023, Jakarta: Kemenkes RI, 2024.

I. W. Suryawan and D. Utami, “Hospital service innovation and patient satisfaction in Indonesia’s regional healthcare system,” J. Health Serv. Manage., vol. 28, no. 3, pp. 187–202, 2023.

E. P. Nugraha and Y. Rahmawati, “Determinants of patient trust and revisit intention in Indonesian hospitals,” Int. J. Health Policy Manage., vol. 12, no. 9, pp. 1104–1116, 2023.

R. K. Chahal and R. Kumari, “Service quality and patient satisfaction in tertiary care hospitals: A systematic review,” Int. J. Qual. Health Care, vol. 34, no. 7, 2022.

P. C. Nguyen and D. T. Le, “Empathy and reliability as predictors of patient trust in healthcare providers,” Health Serv. Manage. Res., vol. 36, no. 1, pp. 21–31, 2023.

E. W. Tsai, J. C. Chou, and Y. H. Lin, “Trust transfer and revisit intention in digital health platforms,” Telemed. e-Health, vol. 30, no. 1, pp. 44–54, 2024.

J. K. Lee, K. M. Park, and Y. Kim, “Operational efficiency and quality management in healthcare systems,” Int. J. Health Care Qual. Assur., vol. 35, no. 7, pp. 761–778, 2022.

A. Boateng, “Patient satisfaction and behavioral loyalty: An empirical analysis,” Patient Exp. J., vol. 10, no. 2, pp. 115–129, 2023.

S. L. Thomas and M. Rahman, “Patient trust as a mediator between service quality and loyalty intention,” BMC Health Serv. Res., vol. 23, 1127, 2023.

N. R. Dagger and M. J. O’Brien, “The role of trust in healthcare relationships: A conceptual synthesis,” Soc. Sci. Med., vol. 288, 114377, 2021.

L. N. Boateng, “Service excellence and revisit behavior in healthcare: The moderating effect of communication,” Patient Exp. J., vol. 10, no. 2, pp. 112–128, 2023.

A. F. Bakar and M. A. Mohd, “Trust as a driver of patient loyalty: The case of Malaysian hospitals,” Int. J. Health Policy Manage., vol. 12, no. 4, pp. 422–433, 2023.

C. R. Chen and A. Gupta, “Consumer behavior in healthcare: From satisfaction to loyalty,” J. Serv. Mark., vol. 38, no. 3, pp. 215–229, 2024.

J. F. Hair, C. M. Ringle, and M. Sarstedt, Partial Least Squares Structural Equation Modeling (PLS-SEM): Updated and Expanded Guide, 3rd ed., Thousand Oaks: SAGE Publications, 2022.

F. S. Ali, R. S. Park, and T. M. Nguyen, “Applications of SmartPLS in healthcare management research: A methodological review,” J. Health Res. Methods, vol. 18, no. 3, pp. 211–225, 2023.

M. Rahman and S. H. Lee, “Advanced modeling in health service research: Integrating PLS-SEM and mediation analysis,” BMC Health Serv. Res., vol. 23, 1149, 2023.

M. W. Carter and T. Lapierre, “Improving hospital efficiency: Frameworks and methods,” Health Care Manage. Rev., vol. 47, no. 4, pp. 285–294, 2022.