Cultural values and health service quality in China

Int J Health Care Qual Assur. 2013;26(1):55-73. doi: 10.1108/09526861311288640.


Purpose: Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments.

Design/methodology/approach: The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis.

Findings: Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance.

Research limitations/implications: The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions.

Practical implications: In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions.

Originality/value: The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • China
  • Cultural Characteristics*
  • Female
  • Health Expenditures
  • Humans
  • Male
  • Patient Satisfaction / ethnology*
  • Perception*
  • Quality of Health Care*
  • Socioeconomic Factors