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Quality of service has increasingly become an important part of our lives as we continuously strive to seek the best quality in products and services. In the context of healthcare, quality has become a basic requirement for consumers and healthcare providers. Medical organizations, including hospitals and clinics, recognize quality as an indispensable element in attaining competitive advantages (Mosadeghrad, 2014a). A plethora of literature is available on the subject of healthcare service quality in which researchers have identified many factors that influence the quality. In previous studies, quantitative research was conducted with a questionnaire instrument to measure and test healthcare service quality using known models such as SERVQUAL (service quality), a generic quality of service model that has been used in many different areas and sectors (Lucadamo, Camminatiello, D’Ambra, 2021; Sharifi et al., 2021; Akdere, Top, & Tekingündüz, 2020; Al Bolushi, Olorogun, Boubacar, & Houjeir, 2017; Al-Neyadi et al., 2018; Upadhyai et al., 2019; Parasuraman et al., 1988). The model consists of five quality dimensions: tangibility, reliability, responsiveness, assurance, and empathy. Previous researchers in the UAE context also used the SERVQUAL questionnaire to evaluate healthcare service quality (Al-Neyadi et al., 2018; Al Bolushi et al., 2017). In the context of healthcare, HEALTHQUAL model, which primarily focuses on care processes and outcomes, was developed by Lee (2016). This model comprises five components: empathy, tangibles, safety, efficiency, and the degree of improvement in care services. According to Lee (2016), HEALTHQUAL is an integrated model that assesses healthcare service quality from multiple perspectives, including patients, hospitals, and accreditation institutions.
Although the SERVQUAL model has wide application for measuring the quality of service in many different sectors, including healthcare, the model has been criticized at the methodological and conceptual levels (Purcărea, Gheorghe, & Petrescu, 2013; Upadhyai et al., 2019). Ladhari (2008) argued that the SERVQUAL model is context-specific and emphasized that the instrument, typically a questionnaire, is not universally applicable. It needs to be tailored to specific services within particular contexts. Consequently, the present study does not adopt the SERVQUAL model or its extended versions, such as the HEALTHQUAL model for assessing healthcare service quality. This decision is based on the understanding that the dimensions of healthcare quality can vary depending on factors such as country, culture, public or private institutions, healthcare requirements, rural or urban locations, and the types of healthcare practitioners involved (Upadhyai et al., 2019). For instance, Sohail's (2003) research on service quality measurement in hospitals in Malaysia did not validate any of the five generic SERVQUAL dimensions. Similarly, Yesilada and Direktor (2010) measured SERVQUAL model dimensions at private and public hospitals in Northern Cyprus using factor analysis and did not confirm the model’s five generic dimensions. Estiri et al. (2023) also pointed out that other studies had claimed that assessing health care patients’ expectations is a complicated task, and that SERVQUAL should be modified rather than being used as it is. Thus, in the present study, existing models such as SERVQUAL and HEALTHQUAL were not used, as the quality dimensions cannot be generalized as each context (i.e., healthcare service in Dubai) might be unique beyond the five generic dimensions of SERVQUAL or HEALTHQUAL service quality. In the present study, a qualitative research approach was used instead of predefined constructs examined using a questionnaire as qualitative research permits new quality issues and dimensions to emerge from the context itself.