The quality of medical services provided to patients affects hospital performance under severe competition amongst large-sized hospitals and increases the rights of patients. A hospital, specifically a large-sized one, can demonstrate successful performance when it satisfies the factors of quality a customer expects, enhances the value of care and invests its resources to improve the factors of quality. This study explores the factors of quality affecting the value of care and patient satisfaction, and tests the correlations among the value of care, patient satisfaction and intention to re-visit. Large-sized hospitals that increase the value of care and patient satisfaction ensure patients will re-visit and also increase revenue by taking the above factors into consideration. This study uses interview data obtained from outpatients in a large-sized university hospital located in Seoul, Korea with approximately 1000 hospital beds. In addition, this study uses the causal relationship model for the analysis. The purposes of this study are to: (i) to analyse the utility of established factors of service quality discovered in the studies of service quality when measuring the quality of medical services in large-sized hospitals, (ii) to examine systematically the correlations amongst the quality of medical services, value of care, satisfaction level and re-visit intention, and (iii) to suggest marketing implications for large-sized hospitals to offer patients effective medical services based upon the results of this study.

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Hospitals today are pressured to move away from the conventional health services management techniques and provide higher-quality health care to survive in intense competition. In our study, we aimed to develop health care evaluation criteria for the mental health care sector based on the existing Malcolm Baldrige National Quality Award model, and verify the causality of the evaluation model to lay groundwork for future research on the outcomes of national quality awards for mental health care. We focused on comparison groups comprising five state-operated mental hospitals in Korea using 92 survey questions derived from the MBNQA criteria for health care through structural equation modeling techniques. We verified that Leadership drives Foundation and Direction, which affect System that creates Results with 15 hypotheses supported out of 18 hypotheses established. We believe our findings will provide valuable implications to the top management of mental hospitals for self-examining quality management and promoting competitiveness.