A comparative study of Patient Perceptions of Public and Private Healthcare Service Quality: Insights from the SERVQUAL Model

Abstract Background; The quality of healthcare services is a critical factor influencing patient satisfaction, trust, and overall health outcomes. In many countries, both public and private healthcare sectors operate simultaneously, often differing in resources, efficiency, accessibility, and patient experience. The purpose of this study is to compare patient perceptions of service quality in public and private healthcare settings using the SERVQUAL model in the context of Ghana. Methods: A quantitative cross-sectional survey was conducted with a sample of 383 respondents selected through random sampling from two public and two private hospitals. An independent samples t-test was used to compare patient perceptions and experiences across the service dimensions, assessing differences in mean scores, significance levels, and direction of preference. Findings: Affordability emerged as the most distinct factor, with public healthcare significantly more affordable (p < 0.001). Private healthcare was perceived as superior in responsiveness, availability, and empathy (all p ≤ 0.001), while public facilities were viewed as more reliable (p = 0.003). Accessibility strongly favoured private services (p < 0.001), suggesting better reach and convenience. Assurance showed a modest difference (p = 0.009), slightly in favour of public care, while no significant difference was observed in tangibles (p = 0.692), indicating similar quality in physical infrastructure and appearance. Conclusion: This study offers a comprehensive comparison of perceived service quality in public versus private health care settings in Ghana. It highlights the strengths of public facilities in affordability and reliability, and the advantages of private facilities in responsiveness, empathy, and accessibility. The findings provide actionable insights for policymakers and health administrators to develop targeted interventions that bridge service quality gaps and improve patient satisfaction across both sectors.