This study explores how service quality in hospitals is perceived and measured among different groups of patients from four major continents (i.e. Asia, Europe, Australia and North America) who came to receive medical services in Thailand. Using stratified random sampling, data were collected from 2189 patients from 80 countries and four continents at six hospitals which provide healthcare services to international patients in Thailand. Four different models of measuring service quality based on different continents were developed with different numbers of quality dimensions and also a variation in the number of quality attributes. Asian patients provided a four dimension model with 20 items; while a two-dimension model with 16 items was identified for European patients. Australian patients also revealed a two-dimension model but with 22 items, while patients from America provided a three-dimension model, also with 17 items. The study reveals that the development of service quality measurement models should not only consider context-specific items such as size and location, but should also include the nationality and demographic of the patient population. The findings also support that service quality has a significant impact on service satisfaction and the retention level of customers at the hospital. The concluded frameworks may guide healthcare providers to deliver better quality healthcare services and to sustain competitiveness.

This study proposes a new methodology to analyse hospital service quality. The new methodology was used at the largest private international hospital in Thailand. To understand differences in the perceived service quality among patients from different nationalities (Japan, Myanmar, Arabic States, and Thailand), a comparative analysis was conducted. An integration of a modified SERVQUAL scale and the Kano model was used to categorise and prioritise the hospital's service quality attributes. Analysis of variance was applied to differentiate market segmentation based on nationality, and a proposed importance analysis grid for improvement was applied to prioritise areas of improvements. The quality attributes showed a significantly different level among different nationalities. The results obtained by this research can provide important clues to improve the perceived service quality by offering different quality improvement strategies to meet different nationalities' needs.