<![CDATA[This study evaluates the dimensions of healthcare service quality in hospital settings and identifies the critical structural factors that define patient-perceived quality. Utilizing a quantitative survey approach, data were collected from health consumers and analyzed using First-Order and Second-Order Confirmatory Factor Analysis (CFA). The structural framework evaluated six core dimensions: Tangibles, Reliability, Responsiveness, Assurance, Empathy, and Access and Coverage. The Second-Order CFA results revealed that not all theoretical dimensions significantly contribute to the overarching construct of healthcare quality. Based on the statistical cut-off values for loading factors and sampling adequacy, Reliability and Tangibles emerged as the most critical, dominant, and statistically significant dimensions driving the structural model, followed by Assurance. Conversely, Responsiveness, Empathy, and Access and Coverage failed to meet the empirical significance thresholds due to low loading factors or negative coefficients. Interestingly, a research paradox was identified: while descriptive data showed that patients highly praised the empathetic care and low costs, these dimensions lacked discriminant power due to highly homogenous positive scores. In contrast, Reliability—the most critical structural determinant—recorded the lowest average performance score among all variables, specifically regarding staff professionalism and cost consistency. Consequently, this study concludes that strategic quality improvement in healthcare facilities should shift from generic courtesy or cost-reductions toward rigorous structural reforms in operational reliability, staff competency, and the continuous modernization of physical medical infrastructure.]]>
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