The Role of Hospital Image in Building Patient Loyalty : A Systematic Literature Review
Keywords:
hospital image, patient loyalty, trust, service quality, patient experience
Abstract
This study aims to systematically review the role of hospital image in building patient loyalty through a Systematic Literature Review (SLR) and bibliometric analysis approach. Articles were searched using a combination of Boolean keywords for the period 20202025. The screening process followed the PRISMA protocol, resulting in 30 articles that met the final criteria for thematic and bibliometric analysis using VOSviewer. The results showed four main clusters: (1) the relationship between hospital image, service quality, and satisfaction; (2) the reputation of doctors and institutions as determinants of trust; (3) brand image and patient experience as predictors of revisit intention; and (4) trust and service quality as the main mediating mechanisms. Publication trends increased rapidly after 2023, with the focus shifting from classic satisfaction-based models to a new paradigm emphasizing patient experience and trust. This study provides conceptual and practical contributions for hospitals in managing their image, strengthening their digital reputation, and building patient loyalty in a sustainable manner through services oriented towards patient experience and emotional value.
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References
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[24] Ardiani S, Yulsiati H. The Effect of Hospital Image and Service Quality on Customer Loyalty Through Customer Satisfaction. 3rd Forum in Research, Science, and Technology (FIRST 2019), Atlantis Press; 2020, p. 84–7.
[25] Haryadi C. The influence of image and service quality on patient satisfaction that has an impact on patient loyalty. Asian Journal of Engineering, Social and Health 2023;2:792–807.
[26] Ramba AT, Sugiyanto LB. The Influence of Service Quality and Brand Image on Patient Loyalty Mediated by Patient Satisfaction (An Empirical Study on Patients at “X” Hospital in East Bekasi). Edunity Kajian Ilmu Sosial Dan Pendidikan 2025;4:642–56. https://doi.org/10.57096/edunity.v4i9.436.
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[28] Khan MS, Baig MK, Ahmed MSS. Service Quality and Cost of Care as Preferred Strategies for Patient Satisfaction and Loyalty: The Mediating Role of Brand Image and Perceived Value in Healthcare Services. Open Access Public Health and Health Administration Review 2025;4:159–76. https://doi.org/10.59644/oaphhar.4(1).217.
[29] Akbolat M, Amarat M, Ünal Ö, Sütlü ES. The mediating role of hospital reputation in the effect of doctor reputation on patients loyalty. Int J Healthc Manag 2023;16:12–8. https://doi.org/10.1080/20479700.2022.2062853.
[30] Aladwan MA, Salleh HS, ALhwadi H. The Impact of Hospital Reputation on Patient Loyalty Mediated by Patient Satisfaction. Turkish Online Journal Of Qualitative Inquiry 2021;12.
[31] Aladwan MA, Anuar MM, Aladwan RM, Salleh HS. The effect of service quality, patient trust and hospital reputation on patient satisfaction in Jordanian public hospital. WSEAS Transactions on Business and Economics 2024;21:410–26.
[32] Qasim H, Riaz Z, Nawaz Q, Raza H, Arooj A, Khan S. Impact of Service Quality, Patient Trust and Hospital Reputation on Patient Satisfaction-Evidence from Health Sector. Center for Management Science Research 2024;2:310–24.
[33] Gunawan TE, Permatasari P, Setiawati ME, Utari D. Relationship Between Hospital Image With Patient Loyalty In Hospitalized Patients. Jurnal Kesehatan Prima 2020;14:68–74.
[34] Lubis AZE, Nuraini N, Nasution RS. Determinants of Patient Loyalty in a Regional Hospital: The Impact of Satisfaction, Image, and Trust. Jurnal Perilaku Kesehatan Terpadu 2024;3:15–29.
[35] Melmambessy D, Tuhumena R. The Mediating Role of Satisfaction, Image, and Trust in the Impact of Service Quality on Loyalty: Jurnal. International Journal of Social Science and Business 2024;8:515–30.
[36] Trisno AO, Berlianto MP. The effect of perceived value, brand image, satisfaction, trust and commitment on loyalty at XYZ hospitals, Tangerang. Jurnal Manajemen Kesehatan Indonesia 2023;11:22–33.
[37] Yuliani D, Qomariah N, Nursaid N. The Mediating Role of Patient Satisfaction: The Influence of Trust and Brand Image on Patient Loyalty. International Social Sciences and Humanities 2024;3:728–42.
[38] Marchama H, Pasinringi SA, Rivai F, Sidin AI, Anggraini R, Kadir R. The Impact of Brand Image, Trust, and Satisfaction on Patient Revisit Intentions in the Outpatient Unit of a Regional Hospital in Indonesia. Pak J Life Soc Sci 2024;22.
[39] Fook TN, Peng LM, Mun YW. Hospital brand image and trust leading towards patient satisfaction: medical tourists’ behavioural intention in Malaysia. Healthc Low Resour Settings 2024;12.
[40] Priyanto EB, Euis Rahayuningsih, Sarfilianty Anggiani. The Impact of Hospital Service Technology and Service Quality on Patient Revisit Intention: Mediating Role of Patient Experience. Paradoks?: Jurnal Ilmu Ekonomi 2025;8:209–23. https://doi.org/10.57178/paradoks.v8i3.1375.
[41] Siddiqui K. Analyzing the Impact of Patient Experience and the Hospital ‘Image’on Patient Satisfaction and Patient Loyalty in Healthcare Organizations in the United Arab Emirates. SBS Journal of Applied Business Research 2025;1.
[42] Aziz A, Mulyana N, Nuraini N. The Influence of Hospital Image and Trust on Inpatient Satisfaction at Hospital X. International Journal of Business, Law, and Education 2025;6:519–24.
[43] Kalhor R, Khosravizadeh O, Kiaei MZ, Shahsavari S, Badrlo M. Role of service quality, trust and loyalty in building patient-based brand equity: Modeling for public hospitals. Int J Healthc Manag 2021;14:1389–96.
[44] Muin A, Menap M, Setiawan S. The Impact of Hospital Image on Patient Loyalty: A Study on Private Islamic Hospitals in Mataram City West Nusa Tenggara. Bioscientist?: Jurnal Ilmiah Biologi 2024;12:2159. https://doi.org/10.33394/bioscientist.v12i2.13298.
[45] Sukamuljo L, Ruswanti E, Aida M. Hospital image and service quality are not able to provide patient satisfaction and loyalty effect. Journal of Multidisciplinary Academic 2021;5:321–7.
[46] Yanuarista GS, Arso SP, Winarni S. Correlation between Hospital Image and Patient Satisfaction toward Loyalty in Hospital: A Scoping Review. Media Publikasi Promosi Kesehatan Indonesia (MPPKI) 2025;8:371–87.
[47] Listyorini PI, Maryati W, Anjani S. Hospital patient loyalty: in terms of brand image, service quality, patient satisfaction, and trust. Proceeding of International Conference on Science, Health, And Technology , Surakarta: 2021, p. 124–7.
[48] Liu S, Li G, Liu N, Hongwei W. The Impact of Patient Satisfaction on Patient Loyalty with the Mediating Effect of Patient Trust. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021;58. https://doi.org/10.1177/00469580211007221.
[49] Rosyida HL, Suprapto SI, Agusta Dian, Indasah. Building Patient Loyalty: The Role of Brand Image and Service Quality in Outpatient Healthcare Revisit Behavior-A Systematic Review. Journal of Applied Nursing and Health 2025;7:23–34. https://doi.org/10.55018/janh.v7i1.272.
[50] Toreh C, Wuisan DSS. The influence of service quality, brand image, and communication on patient satisfaction and loyalty of urology patient at Siloam hospital manado in 2023. JMBI UNSRAT (Jurnal Ilmiah Manajemen Bisnis Dan Inovasi Universitas Sam Ratulangi) 2024;11:505–22.
[51] Taneja U. Brand image to loyalty through perceived service quality and patient satisfaction: A conceptual framework. Health Serv Manage Res 2021;34:250–7. https://doi.org/10.1177/0951484820962303.
[2] Kompas.com. Jumlah Rumah Sakit di Indonesia Meningkat, tapi Masih Belum Merata. Kompas 2024. https://lestari.kompas.com/read/2024/03/18/140000686/jumlah-rumah-sakit-di-indonesia-meningkat-tapi-masih-belum-merata (accessed October 15, 2025).
[3] Kebijakan Kesehatan Indonesia. Tiap Tahun, 600 Ribu Orang Indonesia Berobat ke Luar 2025. https://kebijakankesehatanindonesia.net/tiap-tahun-600-ribu-orang-indonesia-berobat-ke-luar-negeri/#:~:text=Ini%20angka%20yang%20cukup%20besar%20bagi%20Indonesia,tidak%20terbuang%20sia%2Dsia%20ke%20luar%20negeri%2C%E2%80%9D%20ujarnya (accessed October 15, 2025).
[4] Cham TH, Cheng BL, Low MP, Cheok JBC. Brand image as the competitive edge for hospitals in medical tourism. European Business Review 2021;33. https://doi.org/10.1108/EBR-10-2019-0269.
[5] Kotler P, Keller KL. Marketing management. 16th ed. London: Pearson Education; 2022.
[6] Mbuwel D, Ahmed J, Nwosu L, Aigbiremhon J. The effect of patient relationship management on patient loyalty in Buea, Cameroon: Mediating role of patient satisfaction. Quantitative Economics and Management Studies 2023;4:1240–51.
[7] Dayan M, Al Kuwaiti IA, Husain Z, Ng PY, Dayan A. Factors influencing patient loyalty to outpatient medical services: an empirical analysis of the UAE’s government healthcare system. International Journal of Quality & Reliability Management 2022;39:176–203.
[8] Shie A-J, Huang Y-F, Li G-Y, Lyu W-Y, Yang M, Dai Y-Y, et al. Exploring the relationship between hospital service quality, patient trust, and loyalty from a service encounter perspective in elderly with chronic diseases. Front Public Health 2022;10:876266.
[9] Batra M, Taneja U. Examining the effect of servicescape, perceived service quality and emotional satisfaction on hospital image. Int J Pharm Healthc Mark 2021;15:617–32.
[10] Groves PS, Bunch JL, Kuehnle F. Increasing a patient’s sense of security in the hospital: A theory of trust and nursing action. Nurs Inq 2023;30:e12569.
[11] Medina-Aguerrebere P, Gonzalez-Pacanowski T, Medina E. Online reputation management by cancer hospitals: A systematic literature review in the USA and Spain. Profesional de La Información 2020;29.
[12] Singh A, Kotzur T, Vivancos-Koopman I, Emukah C, Brady C, Martin C. A component-based analysis of metabolic syndrome’s impact on 30-day outcomes after hip fracture: reduced mortality in obese patients. OTA International 2024;7. https://doi.org/10.1097/OI9.0000000000000301.
[13] Durmu? A, Akbolat M. The impact of patient satisfaction on patient commitment and the mediating role of patient trust. J Patient Exp 2020;7:1642–7.
[14] Nguyen NX, Tran K, Nguyen TA. Impact of service quality on in-patients’ satisfaction, perceived value, and customer loyalty: A mixed-methods study from a developing country. Patient Prefer Adherence 2021:2523–38.
[15] Hernandes C, Riptiono S. Building Loyalty through Trust: The Role of Sharia Compliance, Satisfaction, and Service Quality at Muhammadiyah Amanah Sumpiuh Hospital. Jurnal Economic Resource 2025;8:949–71.
[16] Majid U, Wasim A, Truong J, Bakshi S. Public trust in governments, health care providers, and the media during pandemics: A systematic review. Journal of Trust Research 2021;11:119–41.
[17] Kitchenham B, Charters S. Guidelines for Performing Systematic Literature Reviews in Software Engineering, Technical Report EBSE 2007-001. Durham: 2007.
[18] Zehra S, Ranjan J, Shukla M. Service quality in healthcare: understanding the relationship between patient experience and healthcare outcomes. Int J Health Care Qual Assur 2025:1–18.
[19] Bartolini M, Bottani E, Grosse EH. Green warehousing: Systematic literature review and bibliometric analysis. J Clean Prod 2019;226:242–58.
[20] Huang C, Yang C, Wang S, Wu W, Su J, Liang C. Evolution of topics in education research: a systematic review using bibliometric analysis. Educ Rev (Birm) 2020;72:281–97. https://doi.org/10.1080/00131911.2019.1566212.
[21] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021:n71. https://doi.org/10.1136/bmj.n71.
[22] Phonthanukitithaworn C, Naruetharadhol P, Gebsombut N, Chanavirut R, Onsa-Ard W, Joomwanta P, et al. An investigation of the relationship among medical center’s image, service quality, and patient loyalty. Sage Open 2020;10:2158244020982304.
[23] Vimla, Taneja U. Navigating from brand image to patient loyalty: mediating effect of service quality and patient satisfaction. J Health Manag 2020;22:430–45.
[24] Ardiani S, Yulsiati H. The Effect of Hospital Image and Service Quality on Customer Loyalty Through Customer Satisfaction. 3rd Forum in Research, Science, and Technology (FIRST 2019), Atlantis Press; 2020, p. 84–7.
[25] Haryadi C. The influence of image and service quality on patient satisfaction that has an impact on patient loyalty. Asian Journal of Engineering, Social and Health 2023;2:792–807.
[26] Ramba AT, Sugiyanto LB. The Influence of Service Quality and Brand Image on Patient Loyalty Mediated by Patient Satisfaction (An Empirical Study on Patients at “X” Hospital in East Bekasi). Edunity Kajian Ilmu Sosial Dan Pendidikan 2025;4:642–56. https://doi.org/10.57096/edunity.v4i9.436.
[27] Do?an G, Özhan ?. A research on the effects of perceived service quality, perceived value and hospital image on patient satisfaction and loyalty. ODÜ Sosyal Bilimler Ara?t?rmalar? Dergisi (ODÜSOB?AD) 2025;15:1012–37. https://doi.org/10.48146/odusobiad.1484731.
[28] Khan MS, Baig MK, Ahmed MSS. Service Quality and Cost of Care as Preferred Strategies for Patient Satisfaction and Loyalty: The Mediating Role of Brand Image and Perceived Value in Healthcare Services. Open Access Public Health and Health Administration Review 2025;4:159–76. https://doi.org/10.59644/oaphhar.4(1).217.
[29] Akbolat M, Amarat M, Ünal Ö, Sütlü ES. The mediating role of hospital reputation in the effect of doctor reputation on patients loyalty. Int J Healthc Manag 2023;16:12–8. https://doi.org/10.1080/20479700.2022.2062853.
[30] Aladwan MA, Salleh HS, ALhwadi H. The Impact of Hospital Reputation on Patient Loyalty Mediated by Patient Satisfaction. Turkish Online Journal Of Qualitative Inquiry 2021;12.
[31] Aladwan MA, Anuar MM, Aladwan RM, Salleh HS. The effect of service quality, patient trust and hospital reputation on patient satisfaction in Jordanian public hospital. WSEAS Transactions on Business and Economics 2024;21:410–26.
[32] Qasim H, Riaz Z, Nawaz Q, Raza H, Arooj A, Khan S. Impact of Service Quality, Patient Trust and Hospital Reputation on Patient Satisfaction-Evidence from Health Sector. Center for Management Science Research 2024;2:310–24.
[33] Gunawan TE, Permatasari P, Setiawati ME, Utari D. Relationship Between Hospital Image With Patient Loyalty In Hospitalized Patients. Jurnal Kesehatan Prima 2020;14:68–74.
[34] Lubis AZE, Nuraini N, Nasution RS. Determinants of Patient Loyalty in a Regional Hospital: The Impact of Satisfaction, Image, and Trust. Jurnal Perilaku Kesehatan Terpadu 2024;3:15–29.
[35] Melmambessy D, Tuhumena R. The Mediating Role of Satisfaction, Image, and Trust in the Impact of Service Quality on Loyalty: Jurnal. International Journal of Social Science and Business 2024;8:515–30.
[36] Trisno AO, Berlianto MP. The effect of perceived value, brand image, satisfaction, trust and commitment on loyalty at XYZ hospitals, Tangerang. Jurnal Manajemen Kesehatan Indonesia 2023;11:22–33.
[37] Yuliani D, Qomariah N, Nursaid N. The Mediating Role of Patient Satisfaction: The Influence of Trust and Brand Image on Patient Loyalty. International Social Sciences and Humanities 2024;3:728–42.
[38] Marchama H, Pasinringi SA, Rivai F, Sidin AI, Anggraini R, Kadir R. The Impact of Brand Image, Trust, and Satisfaction on Patient Revisit Intentions in the Outpatient Unit of a Regional Hospital in Indonesia. Pak J Life Soc Sci 2024;22.
[39] Fook TN, Peng LM, Mun YW. Hospital brand image and trust leading towards patient satisfaction: medical tourists’ behavioural intention in Malaysia. Healthc Low Resour Settings 2024;12.
[40] Priyanto EB, Euis Rahayuningsih, Sarfilianty Anggiani. The Impact of Hospital Service Technology and Service Quality on Patient Revisit Intention: Mediating Role of Patient Experience. Paradoks?: Jurnal Ilmu Ekonomi 2025;8:209–23. https://doi.org/10.57178/paradoks.v8i3.1375.
[41] Siddiqui K. Analyzing the Impact of Patient Experience and the Hospital ‘Image’on Patient Satisfaction and Patient Loyalty in Healthcare Organizations in the United Arab Emirates. SBS Journal of Applied Business Research 2025;1.
[42] Aziz A, Mulyana N, Nuraini N. The Influence of Hospital Image and Trust on Inpatient Satisfaction at Hospital X. International Journal of Business, Law, and Education 2025;6:519–24.
[43] Kalhor R, Khosravizadeh O, Kiaei MZ, Shahsavari S, Badrlo M. Role of service quality, trust and loyalty in building patient-based brand equity: Modeling for public hospitals. Int J Healthc Manag 2021;14:1389–96.
[44] Muin A, Menap M, Setiawan S. The Impact of Hospital Image on Patient Loyalty: A Study on Private Islamic Hospitals in Mataram City West Nusa Tenggara. Bioscientist?: Jurnal Ilmiah Biologi 2024;12:2159. https://doi.org/10.33394/bioscientist.v12i2.13298.
[45] Sukamuljo L, Ruswanti E, Aida M. Hospital image and service quality are not able to provide patient satisfaction and loyalty effect. Journal of Multidisciplinary Academic 2021;5:321–7.
[46] Yanuarista GS, Arso SP, Winarni S. Correlation between Hospital Image and Patient Satisfaction toward Loyalty in Hospital: A Scoping Review. Media Publikasi Promosi Kesehatan Indonesia (MPPKI) 2025;8:371–87.
[47] Listyorini PI, Maryati W, Anjani S. Hospital patient loyalty: in terms of brand image, service quality, patient satisfaction, and trust. Proceeding of International Conference on Science, Health, And Technology , Surakarta: 2021, p. 124–7.
[48] Liu S, Li G, Liu N, Hongwei W. The Impact of Patient Satisfaction on Patient Loyalty with the Mediating Effect of Patient Trust. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021;58. https://doi.org/10.1177/00469580211007221.
[49] Rosyida HL, Suprapto SI, Agusta Dian, Indasah. Building Patient Loyalty: The Role of Brand Image and Service Quality in Outpatient Healthcare Revisit Behavior-A Systematic Review. Journal of Applied Nursing and Health 2025;7:23–34. https://doi.org/10.55018/janh.v7i1.272.
[50] Toreh C, Wuisan DSS. The influence of service quality, brand image, and communication on patient satisfaction and loyalty of urology patient at Siloam hospital manado in 2023. JMBI UNSRAT (Jurnal Ilmiah Manajemen Bisnis Dan Inovasi Universitas Sam Ratulangi) 2024;11:505–22.
[51] Taneja U. Brand image to loyalty through perceived service quality and patient satisfaction: A conceptual framework. Health Serv Manage Res 2021;34:250–7. https://doi.org/10.1177/0951484820962303.
Published
2025-11-13
Section
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Copyright (c) 2025 Subiantoro Subiantoro, Aflit Nuryulia Praswati, Yusuf Alam Romadhon
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