Cyberspace Supplementary Health Services and Patient Loyalty: The Role of Patient Experience in Saudi Arabia.

Background

Digital transformation has changed how patients interact with hospitals, making online supplementary services an important part of perceived service quality and relationship outcomes. This study examined the association between cyberspace supplementary health services (CSS), conceptualized as the Online Flower of Service (OFOS), and patient loyalty in private hospitals in Jeddah, Saudi Arabia, and evaluated whether patient experience mediates this relationship.

Methods

A cross-sectional survey was conducted among adult inpatients and outpatients who had used at least one online hospital service. Data were collected electronically between 10 February 2026 and 10 May 2026 using a structured Arabic questionnaire administered via Google Forms. The final sample included 730 complete responses. CSS was measured across five digital supplementary dimensions (E-Information, E-Order Taking, E-Consultation, E-Billing, and E-Payment), alongside patient experience and patient loyalty, using five-point Likert scales. The measurement model was evaluated using confirmatory factor analysis, and the structural relationships were tested using structural equation modeling.

Results

CSS demonstrated a significant positive association with patient loyalty (β = 0.282, p < 0.001) and a strong positive association with patient experience (β = 0.591, p < 0.001). Patient experience was also positively associated with patient loyalty (β = 0.431, p < 0.001), supporting its mediating role in the CSS-patient loyalty relationship.

Conclusions

Digitally delivered CSS components were positively associated with patient loyalty, with patient experience serving as an important mediating mechanism. Strengthening online information access, appointment-related processes, digital consultation, billing transparency, and payment convenience may be associated with more favorable patient experiences and stronger loyalty intentions in private hospital settings in Saudi Arabia.