Exploring Facility Revisit Intentions Among the Kidney Dialysis Patient's Attendance: Evidence from a Cross-Sectional...

Chronic kidney disease (CKD) is a rising public health concern in low- and middle-income countries (LMICs), with urban populations disproportionately affected. In Bangladesh, particularly in Dhaka, dialysis services have become essential for CKD management. This study investigates the determinants of revisit intention among adult attendants of dialysis patients in Dhaka, using partial least squares structural equation modeling. A cross-sectional survey was conducted across four major dialysis centers totaling 399 valid responses. A purposive sampling technique was employed to ensure the inclusion of respondents with relevant experience and engagement in dialysis service utilization. Among respondents, over half were male, 43% had primary to higher secondary education, and one-third reported household incomes between BDT 40,001 and 60,000. The largest age group was 45-49 years (32.3%), and nearly 60% selected the facility due to nearness. Reliability and validity metrics met recommended thresholds, and multivariate normality was not assumed (Mardia's test, p < 0.05). The structural model revealed significant direct effects of cost (β = 0.167, p = 0.003), Perceived trust in healthcare providers (β = 0.252, p < 0.001), and Perceived patient satisfaction (β = 0.422, p < 0.001) on Perceived revisit intention. Dialysis Delivery Service and word of mouth influenced revisit behavior indirectly through Perceived patient satisfaction. All mediation paths were statistically significant and classified as complementary. To improve patient retention, the policymaker should prioritize affordability, perceived trust in healthcare providers, and overall service quality, which together enhance perceived patients' satisfaction and revisit intention.