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Through the lens of a total quality management approach, this paper aims to examine the effects of health-care service quality on patient satisfaction, repatronage intention (RI) and positive word-of mouth (PWOM) at a public hospital specialized in women and children’s diseases. The contribution is to measure and compare patient expectations and perceptions related to the public health service quality.

A structured questionnaire was distributed to in-patients who stayed at a public training and research hospital for at least three days. To analyze the relationship between variables, multiple regression analysis was used. To test the difference between expected and perceived service quality, the paired-sample t-test was used.

The findings provided empirical evidence that perceived service quality significantly influenced patient satisfaction, RI and PWOM. The “responsiveness and reliability” factor was found to be the most influential on patient RI and PWOM. The “tangibility” dimension had the strongest influence on patient satisfaction.

The results reveal that a reliable and responsive service, empathic personnel behaviors and appropriate tangibles are the outstanding factors for high levels of patient satisfaction, RI and PWOM.

Although the concepts of perceived service quality, patient satisfaction, RI and PWOM are explored frequently in service literature, there are few researches that focus on specialized health services for women and children’s diseases. By evaluating the service quality, it is hoped to provide an insight to health-care managers about the service quality dimensions and their relationship with patient satisfaction, RI and PWOM, specifically based on women patients.

Technology acceptance is an incremental approach that has developed over the years. Taking technology acceptance or adoption literature into consideration, the paper aims to investigate the mediating role of adoption readiness, constructed on the basis of the unified theory of acceptance and use of technology (UTAUT), on the relationship between user resistance as well as user anxiety and attitude toward using a system.

In consideration of previous studies, the public personnel’s adaptation of electronic document management systems is within the scope of the present research. Gathering data from 262 administrative personnel working in a public university, explanatory and second-order confirmatory factor analyses were done for the UTAUT scale. In addition, reliability and construct validity were tested for each scale; UTAUT, user resistance, user anxiety and attitude toward using. Relationships among variables of the research were controlled by the measurement model and then the structural model was tested.

Confirming previous research, the scales of UTAUT, user resistance, user anxiety and attitude toward using were found to have acceptable reliability and internal consistency. In addition, the implications of the paper showed user resistance influenced attitude toward using indirectly, by affecting adoption readiness. It also indicated that adoption readiness fully mediated the relationship between user anxiety and attitude toward using.

Negative behavioral antecedents of UTAUT are the focus of the paper. Reducing the negative effects of resistance as well as anxiety of individuals on their attitudes using a system is emphasized in the technology acceptance literature. Furthermore, defining each dimension of UTAUT as a single construct, adoption readiness, and proving the intervening role of adoption readiness between user resistance, as well as anxiety, on the attitude toward using a system are contributions to the literature.