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Purpose Customer satisfaction is a tool for measuring providers’ service quality and may be evaluated based on measurement of perceived quality and customer expectations with respect to several aspects of service. The purpose of this study was to examine the relationships between various factors in the integrated model, including patient expectation (PE), total quality management (TQM), perceived service quality (PSQ), patient satisfaction (PS), patient complaint (PC) and patient loyalty (PL). Design/methodology/approach A self-administered questionnaire was distributed to inpatients who were treated in April 2018 at a tertiary-level hospital in Vietnam. The data set was analyzed using the Statistical Package of Social Sciences version 25.0 for descriptive statistics and AMOS 25.0 for structural equation modeling. Findings All hypotheses were supported by the results. TQM and PE positively influence PSQ; PE influences TQM; PE, PSQ and TQM influence PS; PC and PS influence PL; and PS influences PC. Practical implications These findings have implications for management, highlighting the importance of considering these factors in strategic planning aimed at improving customer satisfaction. Originality/value An integrated model was used to measure customer satisfaction and loyalty. The analyses indicate that TQM, PE and PSQ are the main factors that directly influence PS.

Objective: Total quality management (TQM) is a useful tool for improving the perceived service quality to increase the customers' satisfaction (CS) and to maintain their loyalty. The purpose of this study examines TQM in relation to CS and loyalty. Method: A self-administered questionnaire was administered to the inpatients who were treated at the National Cancer Hospital, in Vietnam, in April 2018. A total of 516 documents used the analyzed procedure. The dataset was analyzed via the SPSS software 25.0, and the Amos 25.0. A confirmatory factor analysis was performed to test the structural equation modeling of the proposed hypotheses. Results: TQM directly influences CS and has a positive influence on loyalty. Our findings revealed that TQM is the key factor that directly influences CS and loyalty; CS performs a mediating role in the relationship between TQM and loyalty. Implications: The findings have implications for managers and policymakers that TQM factors include Process, Interaction, and Environment quality should be considered in planning with an aim to increase CS and to maintain their loyalty. Therefore, it increases profits for providers that contribute to sustainable survival in a competitive environment. Besides, satisfaction is a mediator factor of TQM and loyalty, so the service organization should consider customers' satisfaction to maintain loyalty.

The COVID-19 pandemic has caused severe issues, including loss of quality of life, negative economic impacts and, most of all, exposed weaknesses in health systems. A major weakness was the inability to respond to population needs during a pandemic, especially vulnerable groups, as well as supporting the impacts on mental health and increase in poverty, Research on how to redistribute high-quality healthcare to develop early diagnosis and treatment will be most welcome. Also, new evidence on how to strengthen primary healthcare for the elderly, especially those with chronic diseases and those at risk of severe complications. Efforts should be made to strengthen evidence on infection control and support and protect critical care workers and healthcare workers on the front lines of emergency, as well as on how to improve the training of human resources at the grassroots and the use of diagnostics technology at local level. Evidence on successful processes of upgrading health data systems and the usage of digital data, smartphone applications for quarantine monitoring, robotic devices, and artificial intelligence to track the origin and spread of infections. spread and spread of the virus, should also be welcome.. Finally, we should appeal for further evidence on improving the effectiveness of vaccination and promote access to international cooperation, avoid barriers to the intellectual property transfer and intellectual property and approach multilateral licensing commitments,. The Covid - 19 pandemic has brought great lessons and it is a lever for a profound change in the way we develop healthcare learning from a shared world perspective. In short, we should support the process of generating evidence on innovation for global healthcare improvements.

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The study examines the effect of perceived service quality (PSQ) and patient expectation (PE) on patient satisfaction (PS) and patient loyalty (PL). A questionnaire delivered to inpatients who were treated at the highest-level hospital, Viet Nam in April 2018. The data were analyzed by SPSS version 25.0 software and AMOS 25.0 software. A confirmatory factor analysis was performed to test the structural equation modelling for the proposed hypotheses. Results showed PSQ influences PS and PL; PE influences PS but doesn't influence PL; PS influences PL, indicating PSQ and expectation affect directly satisfaction, therefore consider PSQ increase satisfaction and maintain loyalty.