Patient-reported service quality can identify priorities for improving inpatient care, but its association with satisfaction must be distinguished from a causal effect. This cross-sectional study examined the five SERVQUAL dimensions and inpatient satisfaction at Doloksanggul Regional General Hospital, North Sumatra, Indonesia. A purposive sample of 245 respondents completed a structured questionnaire. Descriptive statistics, Pearson’s chi-square tests, and Cramér’s V were used, and multiple logistic regression was attempted with all five dimensions entered simultaneously. Men accounted for 50.6% of respondents; intermediate education was the largest educational category (45.3%), and 46.1% had been hospitalized for 2–5 days. Overall, 126 respondents (51.4%) were satisfied. High service-quality ratings ranged from 50.6% for assurance to 53.1% for tangibles. All five dimensions were associated with satisfaction (all p < 0.001), with Cramér’s V ranging from 0.837 for tangibles to 0.984 for assurance. Satisfaction was reported by 124/124 respondents with high assurance and 2/121 with low assurance. However, the logistic model did not converge after 20 iterations, and collinearity diagnostics indicated substantial overlap among predictors. Consequently, interpretable adjusted odds ratios and a defensible ranking of independent determinants could not be established. The findings describe strong unadjusted associations between perceived service quality and satisfaction. Assurance, responsiveness, and the substantial proportion of dissatisfied respondents warrant attention in service evaluation, but intervention priorities should be supported by verified measurement, operational indicators, and prospective assessment.