The impact of price, perceived quality, and satisfaction on patient loyalty in a public university dental clinic in Iran

Abstract Background Public university-affiliated dental clinics, in addition to their educational mission, provide general and specialized services to diverse populations at government-subsidized rates. Considering the importance of patient loyalty—and the factors influencing it, such as price, quality, and satisfaction—is crucial for the sustainable operation of these clinics. This study aimed to analyze the impact of price, quality, and satisfaction on patient loyalty in the dental clinic of a public university of medical sciences. Methods This cross-sectional study was conducted at the dental clinic of Alborz University of Medical Sciences in Karaj, Iran, during 2023–2024. Data were collected from 190 participants using convenience sampling through four questionnaires: demographic information, perceived price and quality, patient satisfaction, and dental patient loyalty. Structural equation modeling (SEM) with PLS software was used for data analysis, and model fit indices (rms Theta, SRMR, and NFI) were employed to assess model quality. Additionally, relationships between variables were examined using SPSS version 22 with independent t-tests, ANOVA, chi-square tests, and Pearson’s correlation coefficient. Results Price, as well as the combined effects of quality and satisfaction, significantly influenced patient loyalty ( P < 0.001). Furthermore, price had a significant effect on both quality and satisfaction ( P < 0.001). Analysis of demographic variables showed that dental services provided by faculty members—compared to those provided by students—were associated with higher patient loyalty ( P < 0.01). Conclusion Patient loyalty in public university dental clinics is primarily driven by perceived service quality and satisfaction, with price serving as an important secondary factor. To enhance loyalty, clinic administrators should adopt integrated strategies that improve service quality (particularly through increased faculty supervision), optimize patient satisfaction, and maintain affordable pricing structures. These findings underscore the need for balanced attention to both clinical and non-clinical aspects of service delivery in academic dental settings.