Service quality and patient satisfaction of Internet hospitals in China: A cross-sectional evaluation with the SERVQUAL (Preprint)

Abstract

Internet hospitals which refer to service platforms that integrate consultation, prescription, payment, and drug delivery based on hospital entities has been developing in a rapid pace in China since 2014. However, assessments regarding their service quality and patient satisfaction have not well developed. There is an urgent need to comprehensively evaluate and improve the service quality of Internet hospitals.

To investigate the current status of patients' use of Internet hospitals, as well as knowledge and intention to use Internet hospitals; to evaluate patients’ expected and perceived service qualities of Internet Hospitals using the Chinese version of Service Quality Questionnaire (SERVQUAL-C) with a national representative sample; and to explore the association between service quality of Internet Hospitals and patients’ overall satisfaction towards associated medical platforms.

This cross-sectional survey was conducted through face-to-face or online interviews from June to September in 2022. A total of 1481 outpatient participants (635 males and 846 females; Mage = 33.22, SD = 13.22). Participants reported their use of Internet hospitals, and then rated their expectations and perceptions of service quality towards Internet hospitals via the SERVQUAL-C, along with their demographic information.

Among the surveyed participants, 51.2% (758/1481) had used Internet hospitals service(s). Usage varied across age, education level, and annual income. Although the majority of which did not know Internet hospital services well, 68.1% expressed the willingness to adopt this service. Service quality evaluation revealed that the perceived service quality did not match with the expectation, especially the responsiveness dimension. Important-Performance Analysis (IPA) results further alerted that reliable diagnosis, prompt response, clear feedback pathway, and active feedback handling were typically the services awaiting substantial improvement. More importantly, multiple linear regressions revealed that knowledge and intention to use Internet hospitals services were significant predictors of satisfaction, above and over Tangibles, Reliability, and Empathy service perspectives, and demographic characteristics such as gender, age, education level, and annual income.

In the future, Internet hospitals should focus more on how to narrow the gaps between the expected and perceived service quality. Promotion of Internet hospitals should also be facilitated to increase patients' knowledge of, and intention to use these services.

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