Re-Engineering Public Healthcare Consumption: Evaluating the Impact of the 7ps Service Marketing Framework on Patient Patronage in Government-Owned Hospitals

Abstract

This study evaluated the empirical relationship between service marketing mix dimensions (the 7Ps) and patient patronage within government-owned tertiary healthcare institutions in Nigeria. The persistent underutilization and negative public perception of public healthcare facilities, despite substantial state subsidies, necessitated this inquiry. A cross-sectional survey design was adopted to gather primary data from a structured sample of 384 outpatients across selected government hospitals. Data collection was executed using a validated 5-point Likert scale questionnaire, and hypotheses were tested using multiple linear regression analysis. The findings revealed that while basic structural elements like Price and Product (Core Clinical Care) served as baseline entry expectations, they did not significantly drive long-term behavioral loyalty or active referrals. Conversely, soft service infrastructure specifically People (\beta = 0.314, p < 0.05), Process (\beta = 0.289, p < 0.05), and Physical Evidence (\beta = 0.241, p < 0.05) exerted the most statistically significant positive impact on patient patronage. The study concluded that public health institutions cannot optimize capacity utilization through subsidized pricing strategies alone. Consequently, it is recommended that hospital directorates re-engineer public health consumption by systematically reducing procedural bottlenecks, implementing institutionalized patient-centered hospitality training for frontline staff, and upgrading the physical ambient conditions of care environments.