Examining the Relationship Between Health Service Quality and Patient Satisfaction in Cambodian Public Hospitals: A SERVPERF-Based Study

DOI:

https://doi.org/10.58421/misro.v5i1.1321

Authors

  • Kosal Thay Preah Sihamoniraja Buddhist University, Phnom Penh
  • Sarom Mok Preah Sihamoniraja Buddhist University, Phnom Penh https://orcid.org/0009-0007-4605-0790
  • Mengheang Hor Ministry of Labour and Vocational Training, Phnom Penh
  • Somuny Som Royal Academy of Cambodia, Phnom Penh

Keywords:

Cambodia, Health service quality, Patient satisfaction, Public hospitals , SERVPERF

Abstract

The quality of health services in Cambodia continues to face multiple challenges. Despite ongoing reforms, gaps remain in meeting the expectations of key stakeholders. The purposes of this study were threefold: (1) to find out the level of service quality practice; (2) to determine the relationship between health service quality and patient satisfaction; (3) to examine the effect of each dimension of service quality on patient satisfaction. A quantitative approach was adopted, with structured questionnaires used to collect data, with a reliability between 0.82 and 0.96. A total of 220 patients visiting 11 public hospitals across Cambodia participated in this study, which used a purposive sampling method. The collected data were analyzed using descriptive and inferential statistics in SPSS. The results showed that overall service quality practice was perceived at a high level (M = 4.22, S.D. = 0.60). Among all SERVPERF dimensions, empathy and assurance had the highest mean scores (4.26 and 4.25, respectively), followed by reliability, tangibles, and responsiveness. The results also showed that all dimensions are positively and significantly associated with patient satisfaction at the 0.01 level, with overall correlation coefficients ranging from r = 0.62 to r = 0.89. This finding provides empirical validation of the SERVPERF model in Cambodian public hospitals, with empathy and assurance as key dimensions for enhancing patient satisfaction. Policymakers and health educators working in Cambodia are given recommendations. The Ministry of Health and international health partners may find this study useful.

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References

M. Alfatafta et al., “Impact of functional and technical quality on patient satisfaction in prosthetic and orthotic care: A cross-sectional study,” PLoS One, vol. 20, no. 10, e0333481, 2025, doi: 10.1371/journal.pone.0333481.

M. A. Beheshtinia, M. Fathi, M. Ghobakhloo, and M. F. Mubarak, “Enhancing hospital services: Achieving high quality under resource constraints,” Health Services Insights, vol. 18, 11786329251331311, 2025, doi: 10.1177/11786329251331311.

T. J. Vogus and L. E. McClelland, “When the customer is the patient: Lessons from healthcare research on patient satisfaction and service quality,” Organ. Dyn., vol. 45, no. 2, pp. 99–106, 2016, doi: 10.1016/j.hrmr.2015.09.005.

V. van Engen et al., “A decade of change towards Value-Based Health Care at a Dutch University Hospital: A complexity-informed process study,” Health Research Policy and Systems, vol. 22, no. 1, pp. 1–14, 2024, doi: 10.1186/s12961-024-01181-z.

World Health Organization, WHO Country Cooperation Strategy for Cambodia 2009–2015. Geneva, Switzerland: WHO, 2009. [Online]. Available: https://iris.who.int/server/api/core/bitstreams/0c167653-5942-433a-a1af-84bef0f5482a/content.

Ministry of Health, Health Strategic Plan 2025–2034. Phnom Penh, Cambodia, 2025. [Online]. Available: https://hismohcambodia.org/public/fileupload/HEALTH%20STRATEGIC%20PLAN%202025-2034_Eng%20Final.pdf.

A. Parasuraman, V. A. Zeithaml, and L. L. Berry, “A conceptual model of service quality and its implications for future research,” J. Marketing, vol. 49, no. 4, pp. 41–50, 1985, doi: 10.1177/002224298504900403.

L. L. Berry, V. A. Zeithaml, and A. Parasuraman, “Five imperatives for improving service quality,” MIT Sloan Manage. Rev., vol. 29, no. 1, pp. 29–38, 1988. Available: https://sloanreview.mit.edu/article/five-imperatives-for-improving-service-quality/.

R. Carman, “Consumer perceptions of service quality: An assessment of SERVQUAL dimensions,” J. Retailing, vol. 66, no. 1, pp. 33–55, 1990. Available: https://psycnet.apa.org/record/1990-24205-001.

A. Parasuraman, V. A. Zeithaml, and L. L. Berry, “SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality,” J. Retailing, vol. 64, no. 1, pp. 12–40, 1988. Available: https://cir.nii.ac.jp/crid/1574231874748108288.

F. Buttle, “SERVQUAL: Review, critique, research agenda,” Eur. J. Marketing, vol. 30, no. 1, pp. 8–32, 1996. Available: https://francisbuttle.com.au/wp-content/uploads/2014/10/SERVQUAL-review-critique-research-agenda-EJM.pdf.

J. J. Cronin and S. A. Taylor, “Measuring service quality: A reexamination and extension,” J. Marketing, vol. 56, no. 3, pp. 55–68, 1992, doi: 10.1177/002224299205600304.

R. N. Bolton and J. H. Drew, “A multistage model of customers’ assessments of service quality,” J. Consumer Res., vol. 17, no. 4, pp. 375–384, 1991, doi: 10.1086/208564.

M. D. Hartline and O. C. Ferrell, “The management of customer-contact service employees,” J. Marketing, vol. 60, no. 4, pp. 52–70, 1996, doi: 10.1177/002224299606000406.

V. A. Zeithaml, M. J. Bitner, and D. D. Gremler, Services Marketing: Integrating Customer Focus Across the Firm, 4th ed. New York, NY, USA: McGraw-Hill, 2006.

B. Culiberg and I. Rojšek, “Identifying service quality dimensions as antecedents to customer satisfaction,” Managing Service Qual., vol. 20, no. 3, pp. 285–303, 2010, doi: 10.15458/2335-4216.1245.

D. E. Bowen et al., “Learning from the pioneering founders of the service research field,” J. Service Management, vol. 34, no. 4, pp. 605–630, 2023, doi: 10.1108/JOSM-03-2023-0121.

R. L. Oliver, “Whence consumer loyalty?” J. Marketing, vol. 63, pp. 33–44, 1999, doi: 10.1177/00222429990634s105.

D. Gursoy, L. Lu, R. Nunkoo, and D. Deng, “Metaverse in services marketing: An overview and future research directions,” Service Industries J., vol. 43, no. 15–16, pp. 1140–1172, 2023, doi: 10.1080/02642069.2023.2252750.

R. Vandamme and J. Leunis, “Development of a multiple-item scale for measuring hospital service quality,” Int. J. Service Industry Management, vol. 4, no. 3, pp. 30–49, 1993, doi: 10.1108/09564239310041661.

M. Chawla and T. Sharma, “Service quality in higher education: A comparative study of management and education institutions,” NMIMS Management Review, vol. 24, no. 1, pp. 59–72, 2014, doi: 10.5296/gjes.v1i2.7965.

N. Chowdhary and M. Prakash, “Prioritizing service quality dimensions,” Managing Service Quality: An International Journal, vol. 17, no. 5, pp. 493–509, 2007, doi: 10.1108/09604520710817325.

Z. Ulziibadrakh, K. Sándor, and Z. Szakály, “Influence of the service marketing mix on audience decision-making in Mongolian performing arts,” Humanities and Social Sciences Communications, vol. 12, no. 1, pp. 1–12, 2025. Available: https://www.nature.com/articles/s41599-025-05167-2.pdf.

M. Moslehpour, K. Y. Chau, J. Zheng, A. N. Hanjani, and M. Hoang, “The mediating role of international student satisfaction in the influence of higher education service quality on institutional reputation in Taiwan,” International Journal of Engineering Business Management, vol. 12, 1847979020971955, 2020, doi: 10.1177/1847979020971955.

A. Colicev, “How can non-fungible tokens bring value to brands,” International Journal of Research in Marketing, vol. 40, no. 1, pp. 30–37, 2023, doi: 10.1016/j.ijresmar.2022.07.003.

F. Tian, J. Zhou, and F. Liu, “Construction of the national fitness public service satisfaction model in China based on American Customer Satisfaction Index,” PLoS One, vol. 20, no. 1, e0317551, 2025, doi: 10.1371/journal.pone.0317551.

R. L. Oliver, “A cognitive model of the antecedents and consequences of satisfaction decisions,” J. Marketing Research, vol. 17, no. 4, pp. 460–469, 1980, doi: 10.1177/002224378001700405.

J. W. Thibaut and H. H. Kelley, The Social Psychology of Groups. New York, NY, USA: Wiley, 1959. Available: https://psycnet.apa.org/record/1986-97677-000.

Y. Zhang and Z. F. Ma, “Impact of the COVID-19 pandemic on mental health and quality of life among residents in Liaoning Province, China: A cross-sectional study,” International Journal of Environmental Research and Public Health, vol. 17, no. 7, 2381, 2020, doi: 10.3390/ijerph17072381.

A. Noviyani and P. Viwattanakulvanid, “Exploring patients’ perspectives on healthcare service quality in outpatient settings at a public hospital in Palembang, Indonesia: A qualitative study,” Belitung Nursing Journal, vol. 10, no. 6, p. 703, 2024. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC11586620/.

G. J. Agami, M. Muryati, and I. Rupiwardani, “The effect of service quality and promotion on patient interest and decision to return, mediated by patient satisfaction (A study in the THT Clinic of Linggajati Regional General Hospital, Kuningan, West Java),” International Journal of Economics and Management Research, vol. 4, no. 3, pp. 865–877, 2025, doi: 10.55606/ijemr.v4i3.709.

A. W. Gani, K. A. Syarif, and F. Maulana, “Evaluation of satisfaction of participants of contribution assistance recipients of PT BPJS on the quality of health insurance services in Makassar City,” Business Regulation and Integrity Law, pp. 1–6, 2025, doi: 10.70188/kh6k2s86.

M. Scheffler and J. Brunzel, “Destructive leadership in organizational research: A bibliometric approach,” Scientometrics, vol. 125, no. 1, pp. 755–775, 2020, doi: 10.1007/s11192-020-03621-3.

A. J. Bingham, R. Mitchell, and D. S. Carter, A Practical Guide to Theoretical Frameworks for Social Science Research. Routledge, 2024, doi: 10.4324/9781003261759.

S. McQuitty, “The purposes of multivariate data analysis methods: An applied commentary,” Journal of African Business, vol. 19, no. 1, pp. 124–142, 2018, doi: 10.1080/15228916.2017.1374816.

D. S. Mann, “Research methods for business: A skill-building approach,” Leadership & Organization Development Journal, vol. 34, no. 7, pp. 700–701, 2013, doi: 10.1108/LODJ-06-2013-0079.

W. Olsen, “Triangulation in social research: Qualitative and quantitative methods can really be mixed,” Developments in Sociology, vol. 20, pp. 103–118, 2004. Available: https://research.manchester.ac.uk/en/publications/triangulation-in-social-research-qualitative-and-quantitative-met/.

E. Bell, B. Harley, and A. Bryman, Business Research Methods. Oxford, U.K.: Oxford University Press, 2022. Available: https://cir.nii.ac.jp/crid/1360869864174887296.

M. David and C. D. Sutton, Social Research: The Basics. London, U.K.: SAGE Publications, 2004. Available: https://cir.nii.ac.jp/crid/1970304959886607311.

C. N. L. Tan, A. O. Ojo, J. H. Cheah, and T. Ramayah, “Measuring the influence of service quality on patient satisfaction in Malaysia,” Quality Management Journal, vol. 26, no. 3, pp. 129–143, 2019, doi: 10.1080/10686967.2019.1615852.

S. K. Jain and G. Gupta, “Measuring service quality: SERVQUAL vs. SERVPERF scales,” Vikalpa, vol. 29, no. 2, pp. 25–38, 2004, doi: 10.1177/0256090920040203.

R. Likert, “A technique for the measurement of attitudes,” Archives of Psychology, vol. 22, no. 140, pp. 1–55, 1932. Available: https://cir.nii.ac.jp/crid/1572543026134565632.

G. Norman, “Likert scales, levels of measurement and the ‘laws’ of statistics,” Advances in Health Sciences Education, vol. 15, no. 5, pp. 625–632, 2010, doi: 10.1007/s10459-010-9222-y.

C. L. Aberson, Applied Power Analysis for the Behavioral Sciences. Routledge, 2019. Available: https://cir.nii.ac.jp/crid/1971993809680466618.

J. F. Hair, A. H. Money, P. Samouel, and M. Page, “Research methods for business,” Education + Training, vol. 49, no. 4, pp. 336–337, 2007, doi: 10.1108/et.2007.49.4.336.2.

S. P. Mabini Jr., L. O. Narsico, and P. G. Narsico, “Service quality, patient satisfaction, and improvement indicators,” International Journal of Multidisciplinary: Applied Business and Education Research, vol. 5, no. 4, pp. 1331–1345, 2024, doi: 10.11594/ijmaber.05.04.18.

F. AlOmari, “How to improve patient satisfaction, behavioral compliance and hospital image through nurse caring: Strategizing for healthcare during COVID-19,” Health Marketing Quarterly, vol. 38, no. 2–3, pp. 52–69, 2021, doi: 10.1080/07359683.2021.1980658.

A. Hussain et al., “A cross-sectional study on the impact of administrative procedures and medical staff services on patient satisfaction with trust in public sector hospitals: The moderating role of e-health knowledge,” BMC Health Services Research, vol. 25, no. 1, p. 1576, 2025. Available: https://link.springer.com/article/10.1186/s12913-025-13383-4.

A. V. Almadana, S. Suharnomo, and M. S. Perdhana, “Understanding hospital quality: Empirical insights from patients’ perspectives in the growing hospital sector,” Health Services Management Research, 2025, doi: 10.1177/09514848251361317.

K. Adamson et al., “Understanding the patients’ perspective of emotional support to significantly improve overall patient satisfaction,” Healthcare Quarterly, vol. 15, no. 4, pp. 63–69, 2012, doi: 10.12927/hcq.2012.23193.

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Published

2026-03-31

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[1]
K. Thay, S. Mok, M. Hor, and S. Som, “Examining the Relationship Between Health Service Quality and Patient Satisfaction in Cambodian Public Hospitals: A SERVPERF-Based Study”, J.Math.Instr.Soc.Res.Opin., vol. 5, no. 1, pp. 1101–1114, Mar. 2026.

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Vol. 5 No. 1 (2026): March

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