Service quality, patient trust, and satisfaction across outpatient care settings: Evidence from a stratified healthcare system

This timing was selected to ensure that respondents’ evaluations reflected recent and salient service experiences, including interaction quality, process performance, and waiting conditions during the outpatient visit.

A proportionate sampling strategy was employed to ensure balanced representation across the three levels of healthcare institutions. Trained research assistants approached eligible patients in outpatient waiting areas, explained the study purpose, and obtained informed consent prior to questionnaire administration. Inclusion criteria required respondents to be at least 18 years of age, to have completed the current outpatient visit, and to be able to read Chinese.