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초록

Background Although service quality is a key determinant of patient outcomes in primary care, theoretical evaluation tools may not fully reflect the actual structure of patients' perceptions. This study aimed to explore and validate the underlying structure of primary care service quality as perceived by patients with hypertension or diabetes in South Korea.Methods We conducted a nationwide, cross-sectional web-based survey with 300 South Korean patients in their 50s who had been diagnosed with hypertension or diabetes and were currently receiving treatment. The psychometric properties of primary care service quality were evaluated using exploratory factor analysis and internal consistency testing. Multiple linear regression analysis was conducted to examine the associations between the identified dimensions and overall satisfaction and intention to reuse services.Results Factor analysis revealed a simplified two-dimensional structure of service quality: "Care Excellence," which encompassed health outcomes, patient-centeredness, professionalism, and the physical environment; and "Cost," which reflected the cost and convenience of services. Multiple regression analysis showed that both factors significantly predicted patient satisfaction (beta = 0.70 and beta = 0.18, respectively). However, only "Care Excellence" (beta = 0.70) emerged as a significant predictor of the intention to reuse services.Conclusions Primary care service quality exhibits a two-dimensional structure, with each factor exerting a unique level of impact on patient satisfaction and service reuse. To enhance service quality, particular emphasis should be placed on improving "Care Excellence," highlighting the need for an integrated and holistic approach to strengthening the clinical aspects of primary care valued by patients.

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