Configural algorithms of patient satisfaction, participation in diagnostics, and treatment decisions ' influences on hospital loyalty

Purpose – This empirical study aims to explore sufficiency conditions for patient loyalty to a hospital. Design/methodology/approach – The study collected 645 self-administered questionnaires from patients in a major medical center in Taiwan and applied fuzzy set qualitative comparative analysis (fs/QCA) to explore the sufficiency conditions for patient loyalty. Findings – The findings support the conclusion that the three conditions (patient satisfaction, patient participation in the process of diagnosis, and patient participation in treatment decision-making) in combination are sufficient for high patient loyalty to the hospital but high patient satisfaction alone is insufficient. While the three conditions in configural algorithm are sufficient, this expression is not necessary, which means the findings do not reject possible alternative conditions for high patient loyalty. Research limitations/implications – The study applies a relatively new method, fuzzy set qualitative comparative analysis (fs/QCA) to test the sufficiency proposition of the theory. This method enables researchers to focus on examining sufficient conditions without worrying about various confounding factors and informs this study ' s conclusion that patients exhibiting high scores in all three conditions mentioned above constitute a near-perfect subset of highly loyal patients. Hospitals thus should provide their satisfied patients opportunities to share a role in the process of diagnosis and treatment decision-making. Originality/value – Along with patient satisfaction, this study clearly identifies two important stages of patient participation (i.e., participation in the process of diagnosis and treatment decision-making) that are important in forming patient loyalty to a hospital. Prior studies do not present empirical evidence to this proposition.