Analyzing Patient Satisfaction and Loyalty in a University Dental Clinic: A Structural Equation Modeling Approach; تحلیل رضایتمندی و وفاداری بیماران در رویکرد مدل معادلات ساختاری یک درمانگاه دندانپزشکی دانشگاهی:



Hosseini SH ; Shahsavari S ; Poormoosa Y ; Rahimzadeh M
Source: Journal of Payavard Salamat Published:2025

Abstract

Background and Aim: Medical university-affiliated dental clinics, particularly those located in metropolitan areas, provide oral healthcare services to a wide range of patients with diverse demographic and socio-cultural backgrounds. The sustainability and continued effectiveness of these clinics largely depend on patients’ satisfaction and loyalty. Understanding the determinants of these two critical factors and exploring their interrelationship is essential for improving service delivery and enhancing patient retention. Therefore, the present study aimed to analyze patient satisfaction and loyalty in a university dental clinic using a structural equation modeling (SEM) approach. Materials and Methods: This cross-sectional, descriptive-analytical study was conducted during 2023–2024 on a sample of 190 patients who visited the dental clinic of Alborz University of Medical Sciences. Participants were selected through convenience sampling. Data were collected using two standardized questionnaires: one assessing dental patient satisfaction and the other measuring patient loyalty. Structural equation modeling was employed using AMOS software, and model fit was evaluated using standard indices including the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA). Results: The SEM analysis revealed a significant and positive relationship between patient satisfaction and loyalty (β=0.931, P<0.001). Among the dimensions of satisfaction, hygiene and physical conditions (β=0.939), responsiveness and service delivery (β=0.847), appointment scheduling and waiting time (β=0.761) had the most substantial impact on overall satisfaction (P<0.001). Additionally, attitudinal (β=0.996) and behavioral (β=0.859) components emerged as key dimensions of patient loyalty. Model fit indices demonstrated an acceptable level of fit with the data (CFI=0.893, RMSEA=0.077). Conclusion: To enhance patient satisfaction and foster loyalty, university dental clinics should prioritize internal operational improvements, particularly in the areas of environmental hygiene, service responsiveness, and time management. Creating a positive mental impression through these factors can serve as a foundational step in cultivating long-term loyalty, ultimately contributing to the clinic’s credibility and sustainable performance within a competitive healthcare environment. © 2025 Elsevier B.V., All rights reserved.