Patient Experience–behavioral Loyalty Relationship: The Mediating Role of the Service Marketing Mix

Abstract

The aim of this study is to examine the relationship between patient experience and behavioral loyalty, and to evaluate the mediating role of the service marketing mix (7P) in this relationship. Data were obtained through a survey conducted with 460 participants who received services from public and private hospitals across Türkiye. The study utilized the Experience Quality (EXQ), Service Marketing Mix, and Behavioral Loyalty scales. Data were analyzed using Structural Equation Modeling (SEM) and bootstrap-based mediation analyses. Findings indicate that experience quality has a direct and significant effect on behavioral loyalty, and that this effect is also indirectly transmitted through the marketing mix. Mediation analysis results revealed that process management, physical evidence, and people dimensions play a significant mediating role in the experience–loyalty relationship, with the highest mediation rate observed in the process dimension. Furthermore, the mediating relationships of each sub-dimension of the marketing mix were analyzed first collectively and then separately. These analyses showed that the promotion (communication) dimension alone was insufficient to increase behavioral loyalty, whereas its distinctive contribution became apparent when other marketing components were included in the model. The results demonstrate that marketing mix elements based on patient experience and structured with a holistic approach have a decisive effect on behavioral loyalty.