Patients as strategic partners in hospital settings: Trust, participation, relational value, and loyalty

Objective: The need to motivate patients to participate as strategic partners in healthcare exists, and this has prompted the development of relational models of value creation. This study assesses the effect of trust-in doctor/nurse on patient participation as well as the outcomes on perceived relational value and loyalty. Methods: An empirical model from the patient’s point of view was designed and tested. Data were collected from 209 patients, who had attended public (10) and private (10) hospitals/clinics, and analyzed using the principles of structural equation modelling. Results: The results show that patients’ perception of trust-in-doctor/nurse is an antecedent of patient participation. Patient participation has positive effects on perceived patient relational value, and this subsequently affects patient satisfaction, affective commitment, and loyalty. Conclusions: The study shows that trust affects patient participation behaviour, and the outcome of this behaviour contributes to value creation and loyalty in service delivery. Managerial implication: Nurses and doctors who build trust and involve patients create relational value with them, which enable patients to experience satisfaction and commitment, and this leads to long term relationships with the hospital. The study indicates that building trust and promoting patient participation should be a strategic imperative for management.