Demographic influences on service quality perceptions in rural public healthcare: a pilot cross-sectional study from Mizoram, Northeast India

Background: Patient satisfaction in rural public healthcare is shaped by service quality dimensions and patient demographic characteristics. Evidence from rural northeast India remains sparse. This pilot study examined how SERVPERF-based service quality dimensions predict patient satisfaction and whether demographic variables moderate dimension scores in rural Mizoram. Methods: A cross-sectional survey was conducted with 400 patients from 14 public healthcare facilities (Primary Health Centres and District Hospitals) across seven districts of rural Mizoram between October 2023 and May 2024. A 22-item SERVPERF instrument measuring tangibles, reliability, responsiveness, assurance, and empathy was administered face-to-face. Multiple regression analysis examined service quality dimension predictors of satisfaction; Kruskal-Wallis tests and one-way ANOVA with Tukey’s post-hoc analysis examined demographic variation in dimension scores. Results: The instrument demonstrated strong reliability (α=0.847; KMO=0.836). Multiple regression explained 41.3% of variance in patient satisfaction (R2=0.413, F=762.516, p<0.001), with Reliability (β=0.857) and Assurance (β=0.623) as strongest predictors. Age was the only demographic variable to show significant differences across all five SERVPERF dimensions (p<0.01), with patients aged 60 years and above reporting consistently higher satisfaction. Gender, education, employment, visit frequency, and purpose showed no significant differences. Conclusions: Service reliability and staff assurance are the primary determinants of patient satisfaction in rural Mizoram’s public healthcare facilities. Age-specific expectations represent the dominant demographic moderator. These pilot findings informed subsequent larger-scale instrument development for the main study.