The increasing numbers of public and private hospitals have resulted in the competitive environment in healthcare industry. This situation needs cooperation and support from the hospitals to focus on setting up compelling hospital image and providing satisfaction to the patients to ensure and secure their loyalty. Therefore, providing a high Service Quality will ensure the patients’ satisfaction and loyalty to keep on tapping the service provided. This study reports on a research finding that under-takes to analyze the effect of Image and Service Quality provided by the hospital towards patients’ satisfaction and loyalty in public hospital in Terengganu. Structural Equation Modelling (SEM) was used to test the proposed hypothesis model in the study. The finding of this study illustrates that although hospital image did not have any effect on the patients’ loyalty, but it had a big impact on pa-tients’ satisfaction. Furthermore, patients’ satisfaction had a big impact towards patients’ loyalty. This study also clarifies that the Service Quality provided by the hospital had a direct influence on the patients’ satisfaction and loyalty. Hence, a high service quality provided by the hospital will influence patients’ satisfaction and loyalty and a positive and compelling hospital image is an im-portant factor to ensure the patients’ satisfaction.

A constant concern of academic institutions has been to improve the customer satisfaction in university libraries. The service quality within academic library context is pivotal for satisfying customers by meeting the customers’ needs to create loyalty amongst customers. This research uses LibQual to analyze the gap between customer’s perception and expectation, concerned with the services at the University Sultan Zainal Abidin (UniSZA) Library. There are six dimensions in service quality; namely general services, search for materials, library collection, staff, environment and environment, considered for this empirical research. The purpose of this paper is to 1) know service quality dimensions that satisfy the customers and 2) to observe the impact of service quality on customer satisfaction. The research methodology is carried out using a questionnaire survey distributed among 170 samples through simple random sampling. The data obtained was analyzed by using covariance-based structural equation modeling and importance-performance analysis. The results suggest that quality of service had a significant impact on customer satisfaction. Among the service quality dimensions, library environment and general service were viewed as high importance and strong performance index. Implication for research and practice resulting from these findings were also discussed.

The aim of this research is to understand the effect of product quality, medical price and staff skill on patient’s loyalty through cultural impact in medical tourism. In this study, three exogenous con-structs; namely product quality, medical price, and staff skill constructs were adopted to find their effects on patient’s loyalty. Meanwhile, the cultural impact is also adopted as a mediator construct. This study uses confirmatory approach as Covariance based Structural Equation Modeling (CBSEM) for testing the research hypotheses. The study explores inbound medical tourists loyalty from 324 respondents sampled comprised from different countries using stratified sampling. In terms of the direct effect, the method reveals that medical price and staff skill had positive significant effects on cultural impact and patient loyalty. In terms of indirect effect, the cultural impact mediates the relationships between product quality, medical price, and staff skills on patient’s loyalty.

Structural Equation Modeling (SEM) includes measurement and structural model for hypothesis testing. The results yielded from structural model is unlikely to be valid if a poor loading of an indicator is selected. The impact of these erroneous result on standardized loading is disregard. Thus, knowing how poor loading can affect the validity of measurement model is a crucial issue. This paper attempts to compare the standardized loadings result between two prominent SEM methods (CBSEM and PLS-SEM) using three varied of simulation models (TRA, Loyalty and UTAUT model) to investigate their effects on reliability and validity of measurement model. The data for each model were generated using R software by setting the value of standardized loading and the construct correlations (N=50, 100, 200 and 500). The value of standardized loadings was set to 0.60 for each construct in the model while the construct correlations were set in the range between 0.45 to 0.65. Then, the AMOS 21.0 and ADANCO 2.0 were used to perform the statistical analysis. It shows that good standardized loading can increase the reliability and validity of construct representation. CBSEM is particularly yielded valid and unbiased estimation under confirmatory condition (established theory) compared with PLS-SEM. The results are illustrated with empirical examples. This paper provides updated evidence about CBSEM and PLS-SEM when assessing the measurement model.