<![CDATA[The decline in the number of inpatients and the Bed Occupancy Rate (BOR) at RSI Unisma Malang indicates challenges in service utilization and perceptions of the hospital. This condition demonstrates the importance of understanding the factors that can shape Hospital Image, including the 7P Marketing Mix strategy and Patient Trust. Previous studies generally examine the influence of the 7P Marketing Mix on patient satisfaction and loyalty, while studies exploring its influence on Hospital Image through Patient Trust as a mediating variable are still limited. This study offers novelty by positioning Patient Trust as a mediating mechanism that explains how the 7P Marketing Mix elements shape Hospital Image. Based on this gap, this study aims to analyze the mediating role of Patient Trust in the relationship between the 7P Marketing Mix and Hospital Image at Unisma Islamic Hospital, Malang. This quantitative study used a survey design involving 110 respondents, consisting of patients and their companions. Data were analyzed using the Structural Equation Modeling-Partial Least Squares (SEM-PLS) method with SmartPLS version 4. The structural model assessment shows that among the 7P Marketing Mix elements, only Physical Evidence has a dominant and significant direct influence on Hospital Image. Meanwhile, the People, Price, and Process elements show a significant influence on Patient Trust. The main findings prove that Patient Trust plays a full mediator in bridging the impact of People, Price, and Process on Hospital Image. Furthermore, within the overall structural framework, Patient Trust emerged as the most dominant variable in shaping the overall hospital image. This finding provides a theoretical contribution by broadening the understanding of the role of Patient Trust as a psychological mechanism in hospital image formation. Practically, hospitals need to optimize Physical Evidence to build positive initial perceptions, and strengthen People, Price, and Process to foster trust as the foundation for a long-term reputation. ]]>
