The Effect of Healthcare Management Practices on Patient Satisfaction at the General Administration of Hajj and Umrah Affairs in Madinah, Saudi Arabia: The Mediating Roles of Staff Training and Service Quality

Abstract

Background: Saudi Arabia receives millions of Hajj and Umrah pilgrims each year, and the healthcare services supporting them operate under seasonal demand peaks, linguistic diversity and compressed treatment windows that differ from routine hospital care. Management practices are widely assumed to drive patient satisfaction in such settings, but the mechanisms through which they do so have not been tested empirically in the pilgrimage healthcare context.

Objective: To determine the direct effect of healthcare management practices on patient satisfaction at the General Administration of Hajj and Umrah Affairs in Madinah, and to test whether staff training and service quality mediate that relationship.

Methods: A cross-sectional, analytical, quantitative design was used. A total of 316 healthcare professionals were recruited through simple random sampling across professional categories. Healthcare management practices were measured with the scale of Zhao et al. (2023), staff training with the scale of Bai et al. (2018), service quality with HEALTHQUAL (Lee, 2017), and staff-perceived patient satisfaction with the PSQ-18 (Marshall & Hays, 1994). Partial least squares structural equation modelling was performed in SmartPLS 4, with indirect effects estimated through bias-corrected bootstrapping (5,000 resamples).

Results: Healthcare management practices had a direct effect on patient satisfaction (β = .34, p < .001), an effect on staff training (β = .65, p < .001) and an effect on service quality (β = .70, p < .001). Staff training (β = .22, p < .001) and service quality (β = .24, p < .001) both predicted patient satisfaction. Both indirect paths were significant: staff training (β = .14, 95% CI [.089, .203]) and service quality (β = .17, 95% CI [.112, .231]). The total effect was β = .65, of which the two mediators carried 47.7%. The model explained 58.1% of the variance in patient satisfaction.

Conclusion: Management practices reach patient satisfaction partly through direct structural means and partly through the workforce capability and service delivery pathways they set up. Investment in training and in the service quality dimensions that pilgrims experience directly is therefore not separable from management reform.