Using structural equation modeling to analyze patient value, satisfaction, and loyalty: a case study of healthcare in China

Understanding patient value is a key mechanism in addressing current healthcare challenges, as well as for establishing a patient-centered healthcare system. With high patient dissatisfaction, and the growing tension between patients and providers in China, understanding patient value and evaluating healthcare delivery performance becomes urgent. The objective of this study is to identify patient value dimensions in healthcare and to understand their relationships with patient satisfaction and loyalty. We conduct a case study in two hospitals in Shanghai, China. We identify economic value, health value, fair value, and supplemental value as four value dimensions. We use the combinational weighting method to evaluate the value-added ability of healthcare services, and use the structural equation model to examine the relationships between patient value, satisfaction, and loyalty. The value-added evaluation indicates significant room for improvement related to economic value for the large hospital, as well as to health value and fair value for the community hospital. Our findings inform hospitals and physicians of areas of focus, particularly improving those with low evaluation and high importance, to maximise patient satisfaction and loyalty. We also provide managerial insights for healthcare policy makers, such as strengthening primary health care, ensuring rational pricing, and improving hospital governance.