Healthcare Service Quality among Residents Enrolled in the Resident Medical Insurance Program: Evidence from Primary Healthcare Institutions in Zigong City, China
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Abstract
This study aimed to examine residents’ expectations and perceptions of service quality in primary healthcare institutions in Zigong City, Sichuan Province, compare expectation–perception gaps across five SERVQUAL dimensions, and explore residents’ experiences and recommendations for improvement using a mixed-methods design. A SERVQUAL-based survey included 400 residents selected through stratified sampling, while semi-structured interviews involved ten residents and one government official. Quantitative data were analyzed with descriptive statistics, paired samples t-tests, and qualitative data through content analysis. 1) The results showed that residents’ overall expectations of healthcare service quality were very high, while their overall perceptions were high. Expectations exceeded perceptions across all five dimensions. 2) Residents’ overall expectations were significantly higher than their perceptions, with statistically significant differences across all five dimensions. Responsiveness exhibited the largest expectation–perception gap, whereas Assurance exhibited the smallest. 3) The interviews helped interpret the main service-quality gaps by highlighting inefficient care-seeking processes, limited doctor–patient communication, and insufficient understanding of insurance policies. Residents proposed improvements in service efficiency, medical equipment, health education, reimbursement procedures, and referral coordination to address these gaps. The findings indicate that primary healthcare institutions performed relatively well on professional competence but require systematic improvements in service responsiveness, communication, and policy transparency.
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