* Corresponding author. E-mail address: drasyrafafthanorhan@gmail.com (A. Afthanorhan) © 2019 by the authors; licensee Growing Science, Canada doi: 10.5267/j.msl.2019.2.011 Management Science Letters 9 (2019) 911–920 Contents lists available at GrowingScience Management Science Letters homepage: www.GrowingScience.com/msl The influence of hospital image and service quality on patients’ satisfaction and loyalty Assila Anis Asnawi, Zainudin Awang, Asyraf Afthanorhan * , Mahadzirah Mohamad and Fazida Karim Faculty of Economics and Management Sciences, Universiti Sultan Zainal Abidin 21300 Kuala Nerus, Terengganu, Malaysia C H R O N I C L E A B S T R A C T Article history: Received: January 3, 2019 Received in revised format: Feb- ruary 21, 2019 Accepted: February 24, 2019 Available online: February 24, 2019 The increasing numbers of public and private hospitals have resulted in the competitive environ- ment 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’ sat- isfaction and loyalty to keep on tapping the service provided. This study reports on a research find- ing that undertakes 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 patients’ satisfaction. Furthermore, patients’ satisfaction had a big impact to- wards 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 pro- vided by the hospital will influence patients’ satisfaction and loyalty and a positive and compelling hospital image is an important factor to ensure the patients’ satisfaction. © 2019 by the authors; licensee Growing Science, Canada Keywords: Hospital Image Service Quality Patients’ satisfaction Patients’ loyalty SEM 1. Introduction Globalisation has brought up a competitive competition in all sectors. Accomplishment gain in the com- petition is determined by probability and effective feedback towards every prerequisite variation of cus- tomers’ behaviours. Organisation is obliged to be more creative and innovative in engaging customer by endorsing product through providing the best necessity and service (Aryani & Rosinta, 2010; Pariyo et al., 2009). The revolution of quality is a phenomenon which has big impact towards management system in an organisation. A good service quality can be described as a part of the organisation to be successful in this industry (Ramli et al., 2009). Besides, service sector is one of the sectors which drive the economy development. Service-based sector has become the primary key to support the organisations in various fields such as banking, healthcare, hospitality, telecommunication and others (Boon & Nasir, 2011). Ac- cording to Pariyo et al. (2009), the service quality offered to the customer indicates the level of knowledge, ability and willingness of the employee to serve them. The effectiveness of the service quality