influences patient loyalty among elderly chronic disease patients in Chhattisgarh, India, with a particular focus on the mediating roles of patient trust and patient satisfaction. We further examine whether these relational mechanisms differ between government and private hospital settings. A quantitative, descriptive, and explanatory design was employed, and primary data were collected from 628 elderly patients aged 60 years and above who were undergoing treatment for chronic conditions such as diabetes, hypertension, and cardiovascular disorders across selected hospitals. A structured questionnaire using validated five-point Likert scales captured responses on service quality, trust, satisfaction, and loyalty. We conducted confirmatory factor analysis and structural equation modeling using SPSS and AMOS, followed by multi-group analysis to compare ownership types. The results demonstrate that hospital service quality significantly and positively affects patient trust, satisfaction, and loyalty. Patient satisfaction emerged as the strongest direct predictor of loyalty, while trust significantly influenced both satisfaction and loyalty. Moreover, sequential mediation effects were confirmed: trust and satisfaction jointly transmit the influence of service quality onto loyalty outcomes. Notably, ownership based comparisons revealed distinct pathways—trust driven loyalty was more pronounced in government hospitals, whereas satisfaction-driven mechanisms dominated in private hospitals. This research contributes an integrated relational model validated within the underexplored context of elderly chronic care in a mixed healthcare system. The findings offer actionable insights for policymakers and hospital administrators, suggesting that strategies to improve patient loyalty must be tailored to hospital ownership type. The study underscores the importance of trust in public-sector care and satisfaction in private-sector care for enhancing long-term patient relationships. ...
Authors: Pashupatinath Tripathi, Dr. Deepa Bakhshi.