Abstract
BACKGROUND: In an increasingly competitive healthcare sector, delivering exceptional services is crucial for enhancing patient satisfaction and fostering long-term loyalty. However, the direct impact of leadership and governance on patient experience and retention remains underexplored. This study examines the relationships between corporate governance, service quality, patient satisfaction, and loyalty, with a particular focus on entrepreneurial leadership in healthcare organizations in Indonesia. METHODS: A cross-sectional survey was conducted with 384 executive patients across hospitals in Indonesia. Data were analyzed using structural equation modeling (SEM), with p-values reported to indicate statistical significance. RESULTS: The findings reveal that entrepreneurial leadership significantly enhances both corporate governance and service quality. Corporate governance positively influences patient satisfaction and loyalty. Service quality was found to moderately influence patient satisfaction, but had a stronger, direct effect on patient loyalty. Additionally, patient satisfaction emerged as a critical mediator in the development of patient loyalty. CONCLUSIONS: This study provides valuable insights for healthcare managers and policymakers seeking to improve organizational performance and patient retention. Theoretically, it advances the understanding of how leadership and governance frameworks impact patient retention and service quality in the Indonesian context. Practically, the study offers actionable recommendations for hospital administrators to enhance patient satisfaction and loyalty by implementing entrepreneurial leadership, robust governance practices, and continuous service improvement.