<![CDATA[Background: Dr. Soehadi Prijonegoro Hospital, Sragen, Central Java, Indonesia, served 127,443 outpatient visits in 2019; however, visits declined sharply during 2020–2021 and began to increase again in 2022. A decline in service quality may reduce patient visits, which represent an important asset for hospitals. This study aimed to analyze the effects of service quality, patient education, patient status, and insurance status on patient satisfaction at RSUD dr. Soehadi Prijonegoro Sragen. Subjects and Method: This was a cross-sectional study conducted among 200 outpatients selected using purposive sampling based on inclusion and exclusion criteria. The study population comprised all outpatients at RSUD dr. Soehadi Prijonegoro Sragen. Data were collected using a Google Form questionnaire and analyzed using multiple linear regression and path analysis with Structural Equation Modeling (SEM). Results: Service quality had a direct, positive, and significant effect on patient satisfaction (b = 0.44; 95% CI = 0.24–0.63; p < 0.001). Empathy was the dominant factor, showing the strongest indirect effect (b = 0.77; 95% CI = 0.69–0.86; p < 0.001), followed by assurance (b= 0.69; 95% CI= 0.59–0.78; p < 0.001), tangibles (b= 0.55; 95% CI= 0.43–0.67; p < 0.001), responsiveness (b= 0.42; 95% CI = 0.29–0.55; p < 0.001), and reliability (b = 0.25; 95% CI = 0.11–0.39; p = 0.001). Patient trust had a significant indirect effect on service quality (b = 0.64; 95% CI= 0.54–0.74; p < 0.001), and insurance status also showed a significant indirect effect on service quality (b = 0.37; 95% CI = 0.24–0.50; p < 0.001). The direct effect of trust on patient satisfaction was positive but not statistically significant (b = 0.21; 95% CI = 0.04–0.37; p = 0.12). Conclusion: Service quality has a significant positive effect on patient satisfaction, with empathy as the most influential factor, followed by assurance, responsiveness, tangibles, and reliability. Patients with certain insurance coverage reported better perceptions of service quality. These findings suggest that strengthening empathy and assurance is crucial for improving patient satisfaction and loyalty in hospital settings.]]>
