Stakeholder perspectives on service factors influencing patient loyalty in Malaysia’s dental tourism sector: a qualitative survey

Abstract Aim To explore stakeholder perspectives on the service-related, organisational, and policy factors perceived to influence patient loyalty in Malaysia’s dental tourism sector. Materials and methods This qualitative study recruited 17 stakeholders directly involved in dental practice, administrative, tourism, and policy/governance roles through purposive and snowball sampling. Data were collected using an online open-ended questionnaire covering four areas: best practices supporting patient loyalty, challenges and barriers, strategies to strengthen loyalty, and training and capacity-building needs. Written responses were analysed using a deductive-inductive framework approach, with four analytical domains specified a priori from the survey structure and subthemes developed from the data within each domain. Results Patient loyalty was perceived to be shaped by a combination of clinical, organisational, and system-level factors. Key enablers included high clinical quality, transparent pricing, ethical practice, patient-centred communication, continuity of care, and coordinated service delivery. Major barriers included communication gaps, limited post-treatment follow-up, cost opacity, logistical constraints, and low sector visibility. Stakeholders emphasised the need to strengthen follow-up systems, improve coordination of care and travel arrangements, enhance partnerships, and expand training in communication, cultural competence, and service management. While affordability was considered important in attracting initial patients, trust, transparency, and continuity were identified as more critical in sustaining repeat visits and recommendations. Conclusion Patient loyalty is driven more by trust, service quality, and continuity of care than by cost alone. Strengthening coordinated, patient-centred service delivery is essential for sustaining Malaysia’s dental tourism sector. Findings may have limited generalisability to other dental tourism markets.