Healthcare Management Practices and Pilgrim Satisfaction in a Hajj-Season Hospital: Mediation by Staff Training and Service Quality and Moderation by Pilgrimage-Specific Factors

Abstract

This study investigated the integration of evidence-based samples of staff and pilgrim perspectives on the integration of healthcare management practices at a Hajj-season tertiary hospital to patient satisfaction. The study employed a cross sectional, dual sample design in the 2026 season at King Salman bin Abdulaziz Medical City, Madinah, Saudi Arabia. A 200 clinical and administrative staff completed an instrument measuring management practices, staff training, service quality and staff perceived satisfaction. A multilingual service quality measure was completed by three hundred and eighty-four pilgrims, which included measures of perceived service quality, level of pilgrim satisfaction, and four pilgrimage-specific moderators: cultural-linguistic competence, religious sensitivity, information accessibility, and surge-capacity management. Partial least squares (PLS) structural equation modeling was used to estimate the model and bootstrapped indirect effects were calculated, along with a two-stage approach to interaction terms. The reliability and validity of all constructs were consistent with convention. For the staff sample, management practices accounted for the training and service quality and the mediators accounted for 76.6 percent of the management effect on the satisfaction, resulting in a partial complementarity. In the pilgrim sample, service quality was a significant predictor of satisfaction, while three of four pilgrimage-specific factors enhanced this association, but surge-capacity management did not. The most important, but lowest-scoring, feature of the pilgrimage was information accessibility, which was also the most practical. The results suggest that management practices were achieved through the service process and that pilgrim satisfaction was dependent upon service to meet cultural, religious and informational needs.