Redefining service quality in long term organization. A systematic literature review

As global populations age, long-term care (LTC) services face increasing pressure to deliver high-quality, person-centered care. Although service quality in LTC has received attention in healthcare literature, limited research has explored it from a multi-stakeholder perspective. This study aims to identify the key drivers of service quality in LTC organizations and develop a comprehensive framework that reflects the complexity of care delivery in these settings. A systematic literature review (SLR) was conducted using the SCOPUS database, resulting in a final sample of 70 peer-reviewed articles selected from an initial pool of 1.661. The studies were analyzed through descriptive and thematic content analysis to uncover patterns related to quality dimensions, stakeholder involvement, and best practices in LTC. Results indicate that LTC settings' quality is shaped by functional elements (e.g., safety, efficiency, physical environment) and relational-intangible aspects (e.g., empathy, autonomy, communication). The study proposes an extended framework - LTO CARE SERVQUAL model an expanded model that integrates the perspective of four stakeholder groups - residents, families, frontline staff, and management - and highlight the importance of co-creation, dignity-centered care, and operational excellence. This study advances existing service quality models by incorporating a multi-stakeholder and multidimensional approach specific to LTC settings. The proposed framework provides healthcare managers, policymakers, and service designers with a practical tool to assess and enhance the quality of care in elderly support organizations, addressing current gaps in theory and practice.