The Impact of Health Service Quality on Patient Satisfaction and Treatment Adherence in Primary Healthcare Settings

Abstract

Health service quality is a fundamental component of effective primary healthcare delivery and has significant implications for patient satisfaction and treatment adherence. This study aimed to examine the direct and indirect effects of perceived health service quality on treatment adherence, with patient satisfaction as a mediating variable, in primary healthcare settings. A mixed-methods design was employed, combining a quantitative cross-sectional survey analyzed using structural equation modeling with qualitative in-depth interviews to enrich interpretation of the findings. Quantitative data were collected from 420 adult patients using validated instruments measuring service quality dimensions, patient satisfaction, and treatment adherence. The results indicated that perceived health service quality had a strong and positive effect on patient satisfaction, which in turn significantly influenced treatment adherence. Patient satisfaction partially mediated the relationship between service quality and adherence, with interpersonal dimensions such as empathy, assurance, and clarity of communication emerging as the most influential factors. Qualitative findings supported these results, highlighting the role of trust, respectful interactions, and clear information in motivating adherence behaviors. Overall, the study provides robust evidence that patient-centered service quality improvements are essential for enhancing satisfaction and promoting adherence in primary healthcare, offering important implications for health service management and policy development.