Is transparency a double-edged sword in citizen satisfaction with public service? Evidence from China's public healthcare

Purpose The purpose of this paper is to explain the direct and moderating effects of perceived transparency on citizen satisfaction with public healthcare services. Design/methodology/approach This paper extends the classic framework of service quality, value and satisfaction by adding perceived transparency as an essential component, applies service-dominant logic to develop hypotheses regarding the effects of transparency and empirically tests the extended framework with secondary household survey data on China's public healthcare. Findings The classic framework of service quality, value and satisfaction that originated from the private sector is robust in public service. Perceived transparency has a positive impact on perceived value and citizen satisfaction, but the positive effects of service quality and perceived value on citizen satisfaction were weakened with the increasing level of perceived transparency. Research limitations/implications Perceived transparency is a double-edged sword regarding citizen satisfaction: although transparency increases perceived value and satisfaction by enhancing citizens' service co-creation and inspiring citizen confidence, increased transparency raises citizens' expectations for service products, which subsequently dampens the positive effects of service quality and perceived value on citizen satisfaction. Practical implications In a context with higher transparency, local authorities must learn to manage citizen expectations that influence satisfaction, and increase the probability of satisfaction by avoiding too high citizen expectations. Originality/value This paper highlights the importance of transparency in enhancing public service co-creation, and contributes a novel perspective on the effects of transparency in the formation of citizen satisfaction, which may serve as the starting point for studying the role of transparency in public affairs.