International medical services quality in Taiwan: gaps between international patients’ expectations and perceptions of healthcare providers’ practices

<jats:sec> <jats:title>Purpose</jats:title> <jats:p>The globalization of medical services has emerged as a significant international trend, underscoring the importance of quality supervision in international medical services (IMS). Despite its growing relevance, the perceptions of international cancer patients regarding IMS quality remain underexplored. This study aims to assess gaps between international patients’ expectations and their perceptions of healthcare providers’ (HCPs’) practices in IMS and explore predictors of these gaps to further improve IMS quality.</jats:p> </jats:sec> <jats:sec> <jats:title>Design/methodology/approach</jats:title> <jats:p>A quantitative comparative approach was used with 63 patients from a medical center in northern Taiwan. The SERVQUAL questionnaire, which assesses five dimensions—reliability, assurance, tangibles, empathy, and responsiveness—was employed to evaluate patients’ expectations and perceptions of the quality of IMS. Data were collected at two time points: on the first day of treatment (patients’ expectations) and the day before treatment completion (patients’ perceptions). Paired t-tests and multiple regression were conducted for data analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Findings</jats:title> <jats:p>Although no significant differences were observed in the overall SERVQUAL scores between expectations and perceptions (t = −1.724, p = 0.090), significant gaps were identified in the reliability (t = −4.600, p &amp;lt; 0.001) and assurance (t = −2.504, p = 0.015) subscales. Self-reported health status was a significant predictor of expectation–perception gaps. Patients had higher expectations regarding the dependability, accuracy, knowledge, and courtesy of HCPs than their actual experiences.</jats:p> </jats:sec> <jats:sec> <jats:title>Originality/value</jats:title> <jats:p>This study revealed notable expectation–perception gaps in IMS quality among international cancer patients, particularly in reliability and assurance. Strengthening oncology-specific IMS through dependable, reassuring, and patient-centered care can enhance satisfaction, build trust, and reinforce Taiwan’s competitiveness in the regional medical tourism market.</jats:p> </jats:sec>