Background Following the Chinese government’s initiative to reform the universal basic medical insurance system in 2009, the development of multilevel medical security systems has become increasingly important to address the financial burden of critical illnesses on patients’ families. The Employee Critical Illness Mutual Aid Fund (ECIMAF), launched by Affiliated Hospital of Nanjing University of Chinese Medicine in 2015, aims to provide supplementary financial protection against severe health crises for employees. Despite its operational maturity, the service quality of ECIMAF requires further optimization to meet evolving employee needs. Methods This cross‐sectional study employed the SERVQUAL model to assess the gap between employees’ expectations and perceptions of ECIMAF services. A total of 225 ECIMAF members participated by convenience sampling in the survey from January to June 2025. A total of 225 valid responses were collected, yielding a response rate of 88.49%. The sample was demographically diverse: 56.89% female, with the majority aged 36–55 years (49.78%). Clinicians constituted the largest occupational group (60.44%; nurses and physicians), and 93.78% held at least a bachelor’s degree. Service quality was assessed using the SERVQUAL model across five dimensions (tangibles, reliability, responsiveness, assurance, and empathy) with 21 indicators. Data analysis integrated the analytic hierarchy process–fuzzy comprehensive evaluation (AHP–FCE) for overall grading, alongside least absolute shrinkage and selection operator (LASSO) regression and random forest (RF) algorithms to identify signature indicators, validated by importance–performance analysis (IPA). Results From the SERVQUAL questionnaire, the overall Cronbach’s α coefficients for service expectation and actual perception were 0.748 and 0.712, respectively, with Kaiser–Meyer–Olkin (KMO) and Bartlett’s test of sphericity confirming feasibility. The average service expectation score was 6.03 ± 0.05, while the actual perception score was 4.57 ± 0.04, resulting in a significant gap of −1.46 ± 0.07. The overall service quality was rated “Good” (38.44%). The largest gaps were observed in responsiveness (−2.22) and empathy (−1.97). LASSO and RF algorithms identified signature indicators, with intersection analysis revealing four consensus indicators (L4, R1, A3, and E2). Integration with IPA matrix analysis further prioritized A3 (fairness and impartiality of the compensation process) and E2 (efforts to provide convenience and assist with problem‐solving) as the two primary improvement targets in the “Intensive Improvement” quadrant‐high importance but relatively low performance. Conclusions While ECIMAF demonstrates “Good” overall service quality, significant gaps exist between employee expectations and actual perceptions, indicating actionable insights for targeted improvements. Prioritizing improvements in fairness and impartiality of the compensation process (A3) and proactive problem‐solving (E2) would substantially enhance member satisfaction and service quality. Optimizing staff allocation, strengthening internal supervision, and implementing service‐friendly practices are recommended for effective quality improvement in ECIMAF.
Lu et al. (Thu,) studied this question.