Amidst China’s escalating aging population challenge, the efficacy and quality of private elderly care services are garnering increasing scrutiny. This research focuses on evaluating how service quality and customer perceived value influence the loyalty of elderly clients, with customer satisfaction acting as a mediating factor. Grounded in established service quality frameworks and loyalty theories, the study utilizes a quantitative methodology, administering surveys across eight private elderly care institutions in H city, China. A total of 600 surveys were collected, providing a comprehensive data set that encompasses five dimensions of service quality—tangibility, assurance, responsiveness, reliability, and empathy—as well as customer perceived value, satisfaction, and loyalty. Structural Equation Modeling (SEM) was employed to validate the hypothesized relationships. Findings reveal that service quality significantly boosts customer perceived value and satisfaction, which in turn markedly enhance customer loyalty. Notably, customer satisfaction emerged as a crucial mediator between service quality and loyalty, as well as between perceived value and loyalty. This study not only advances theoretical understanding of service quality impacts but also offers actionable insights for enhancing service delivery and customer loyalty in the context of private elderly care.

The purpose of this study is to investigate customer satisfaction with quality of service known as SERVQUAL improvement or service quality competitiveness in emerging markets. Using Indonesian government medical care as an example the author examines the satisfaction of patients. Information and data were collected through a survey of 399 BPJS users in Indonesia. All data were analyzed using Smart PLS. This study demonstrates that there is a negative value associated with the five-dimensional gap. As a result, the care provided to BPJS patients is below par. Specifically, the sensitivity dimension has the largest disparity at 0.15, while the physical evidence dimension has the smallest at 0.49. In order to raise the level of service provided, it may be necessary to take direct measures or examine tangible evidence. This study develops the relationship between different quality service models. There appears to be a substantial increase in the body of literature in the area of service quality, allowing for constant updates and the incorporation of the lessons learned from the experiences of the departed. These revised guidelines are intended to aid SERVQUAL study participants. The study gives practical support to academics and practitioners in directing service quality improvement through the use of data collected from large-scale surveys of patients and medical professionals as doctors in Indonesia.