The Effect of Service Quality on Patient Satisfaction, Happiness, and Loyalty in Primary Healthcare Centers in the United Arab Emirates: A Cross-sectional Study

Published date: Dec 31 2025

Journal Title: Dubai Medical Journal

Issue title: Dubai Medical Journal (DMJ): Volume 8, Issue 4

Pages: 436-453

DOI: 10.18502/dmj.v8i4.20481

Zainab M. Alameeriz-alamiri@hotmail.comPrimary Healthcare Department, Emirates Health Services, Dubai

Fatma SajwaniLaboratory Department, Emirates Health Services, Dubai

Aji GopakumarData and Statistics Department, Emirates Health Services, Dubai

Amal Al SuwaidiTraining and Development Centre, Emirates Health Services, Dubai

Amal El NagarAl Qassemi Women’s and Children’s Hospital, Emirates Health Services, Dubai

Sabu SivaramanPhysical Medicine and Rehabilitation, Umm Al Quwain Hospital, Emirates Health Services, Dubai

Introduction: The United Arab Emirates has proven its lead position in modern healthcare delivery and is considered an important medical tourism destination in the region. Government and public institutions have the opportunity to distinguish themselves in a competitive industry by providing outstanding and superior healthcare services. Enhancing patient care has become a paramount focus for all healthcare service providers, aiming to achieve high levels of patient satisfaction as their ultimate goal.

Aim: The study aimed to determine the level of satisfaction, happiness, and loyalty among patients attending primary healthcare centers (PHCCs) and finding the factors that lead to improved patient satisfaction.

Method: A self-administered survey was used to conduct this cross-sectional study in six main PHCCs that covers different Emirates in the United Arab Emirates and included 350 participants.

Results: The study revealed that 82% of patients reported feeling happy after receiving care at the center, while 86% expressed high satisfaction with the primary healthcare (PHC) services. Additionally, 81% of patients demonstrated loyalty by maintaining trust in the PHC staff and returning to the center for future medical care. A strong correlation was observed between patient satisfaction and their level of happiness with the healthcare services provided, which, in turn, was significantly linked to loyalty, reinforcing trust and preference for future care.

Conclusion: Using data from this study as a baseline to improve services in future is crucial since the patient’s perspectives and their voices are increasingly influential in enhancing health care delivery system.

Keywords: primary healthcare, customers, satisfaction, UAE

[1] Senitan M, Alhaiti AH, Gillespie J. Patient satisfaction and experience of primary care in Saudi Arabia: A systematic review. Int J Qual Health Care. 2018;30(10):751–759.

[2] Aiken LH, Sloane DM, Ball J, Bruyneel L, Rafferty AM, Griffiths P. Patient satisfaction with hospital care and nurses in England: An observational study. BMJ Open. 2018;8(1):e019189.

[3] Wali RM, Alqahtani RM, Alharazi SK, Bukhari SA, Quqandi SM. Patient satisfaction with the implementation of electronic medical records in the Western Region, Saudi Arabia, 2018. BMC Fam Pract. 2020;21(1):37.

[4] Manzoor F, Wei L, Hussain A, Asif M, Shah SI. Patient satisfaction with health care services: An application of physician’s behavior as a moderator. Int J Environ Res Public Health. 2019;16(18):3318.

[5] Bowers MR, Swan JE, Koehler WF. What attributes determine quality and satisfaction with health care delivery? Health Care Manage Rev. 1994;19(4):49–55.

[6] Senić V, Marinković V. Patient care, satisfaction and service quality in health care. Int J Consum Stud. 2013;37(3):312–319.

[7] Marley KA, Collier DA, Meyer Goldstein S. The role of clinical and process quality in achieving patient satisfaction in hospitals. Decis Sci. 2004;35(3):349–369.

[8] Altinay L, Alrawadieh Z, Tulucu F, Arici HE. The effect of hospitableness on positive emotions, experience, and well-being of hospital patients. Int J Hospit Manag. 2023;110:103431.

[9] Zhou WJ, Wan QQ, Liu CY, Feng XL, Shang SM. Determinants of patient loyalty to healthcare providers: An integrative review. Int J Qual Health Care. 2017;29(4):442–449.

[10] Prakash B. Patient satisfaction. J Cutan Aesthet Surg. 2010;3(3):151–155.

[11] Baba I. Experiences in quality assurance at Bawku Hospital Eye Department, Ghana. Community Eye Health. 2004;17(50):31.

[12] Al-Abri R, Al-Balushi A. Patient satisfaction survey as a tool towards quality improvement. Oman Med J. 2014;29(1):3–7.

[13] National Agenda. [Internet] The United Arab Emirates’ Government Portal. 2022 November 24. Available at: https://u.ae/en/about-the-uae/strategies-initiatives-and-awards/strategies-plans-andvisions/ strategies-plans-and-visions-untill-2021/national-agenda/

[14] Alsayali MM, Al-Sahafi A, Mandoura N, Usman Shah HB, Abdul Rashid OA, AlSharif K, et al. Patients’ satisfaction after primary health care centers’ integration with Ministry of Health hospitals, Jeddah. J Epidemiol Glob Health. 2019;9(2):135–142.

[15] Search for JCI-Accredited Organization. [Internet] Joint Commission International. 2025. Available at: https://www.jointcommissioninternational.org/who-we-are/accredited-organizations/#sort= %40aoname%20ascending&numberOfResults=25&f:@aocountry=[United%20Arab%20Emirates]

[16] Gong T, Yi Y. The effect of service quality on customer satisfaction, loyalty, and happiness in five Asian countries. Psychol Mark. 2018;35(6):427–442.

[17] Setyawan FE, Supriyanto S, Ernawaty E, Lestari R. Understanding patient satisfaction and loyalty in public and private primary health care. J Public Health Res. 2020;9(2):1823.

[18] Bawakid K, Rashid OA, Mandoura N, Usman Shah HB, Ahmed WA, Ibrahim A. Patients’ satisfaction regarding family physician’s consultation in primary healthcare centers of Ministry of Health, Jeddah. J Family Med Prim Care. 2017;6(4):819–823.

[19] Alibrandi A, Gitto L, Limosani M, Mustica PF. Patient satisfaction and quality of hospital care. Eval Program Plann. 2023;97:102251.

[20] Fatima T, Malik SA, Shabbir A. Hospital healthcare service quality, patient satisfaction and loyalty: An investigation in context of private healthcare systems. Int J Qual Reliab Manage. 2018;35(6):1195–1214.

[21] Asabea Addo A, Wang W, Dankyi AB, Abban OJ, Bentum-Micah G. Sustainability of health institutions: The impact of service quality and patient satisfaction on loyalty. EJBMR. 2020;5(4).

[22] Prakoeswa CR, Hidayah N, Dewi A. A systematic review on hospital’s patient satisfaction and loyalty in Indonesia. Open Access Maced J Med Sci. 2022;10(F):655–664.

[23] Anggarayana DP, Pramudana KA. Pengaruh Kualitas Layanan terhadap Kepuasan Pelanggan dan Loyalitas Pelanggan pada Ud. Dewa Putu Toris Gianyar. E-Jurnal Manajemen Universitas Udayana. 2013;2(10):1346–1360.

[24] Liu S, Li G, Liu N, Hongwei W. The impact of patient satisfaction on patient loyalty with the mediating effect of patient trust. Inquiry. 2021;58:469580211007221.

[25] Ismail A, Yunan Y. Service quality as a predictor of customer satisfaction and customer loyalty. LogForum, Sci J Log. 2016;12(4):269–283.

[26] Sweeney JC, Danaher TS, McColl-Kennedy JR. Customer effort in value cocreation activities: Improving quality of life and behavioral intentions of health care customers. J Serv Res. 2015;18(3):318–335.