Objects: Total Quality Management (TQM), Perceived Service Quality (PSQ), and expectations are key factors that improve Customer Satisfaction (CS). This study investigates an integrated model that includes total quality management, perceived service quality, and expectations related to consumer satisfaction.Methods: A survey was conducted at the highest Hospital, Vietnam, in April 2018. A self-administered questionnaire was delivered to respondents. A confirmatory factor analysis was used to test the structural equation modelling of the proposed hypotheses.Findings: The study's hypotheses are supported. Total quality management, perceived service quality, and expectations directly influence customer satisfaction.Originality: These findings reveal that TQM plays a mediator role in the PE and PSQ, PSQ is a mediating factor in the relationship between TQM and PS.Practice Implications: Our study has implications for managers and policymakers when considering factors' effects on satisfaction, including total quality management, perceived service quality, and expectations in strategic planning, and aims to improve customer satisfaction.