Understanding the mediating effect of switching costs on service value, quality, satisfaction, and loyalty

This study examines the interrelationships among service quality (SQ), service value (SV), customer satisfaction (CS), and customer loyalty (CL) in Vietnam’s private healthcare sector, and provides empirical evidence on how three types of switching costs—procedural (PSC), financial (FSC), and relational (RSC)—affect these relationships. Using Partial Least Squares Structural Equation Modeling (PLS-SEM) on survey data from 300 users of private healthcare services in Ho Chi Minh City, the study is the first in this context to jointly test PSC, FSC, and RSC as mediators between CS and CL, and between SV and CL. Key contributions include: (1) PSC, FSC, and RSC significantly drive CL; CL is also achieved through perceived value and customer satisfaction; (2) CS mediates the SV–CL relationship, and SV mediates between SQ and CS; (3) PSC and FSC partially mediate the effects of SV and CS on CL. The findings advance the literature and offer managerial recommendations for strengthening customer relationships and retention in healthcare.