To evaluate the loyalty and its influential factors for outpatients with high-end medical services in a comprehensive grade-A tertiary hospital.
 Methods: A total of 3 196 outpatients from July 2017 to June 2018, who visited the International Medical Department of a comprehensive grade A tertiary hospital, were investigated by a self-designed loyalty questionnaire. The Cronbach's alpha coefficient was 0.893. A third-party organization conducted the survey and 1 883 valid questionnaires were collected. Chi-square test and logistic stepwise regression model was used to analyze the influential factors for patients' loyalty.
 Results: The loyalty of outpatients with high-end medical services was 95.8%, and the satisfaction of all aspects of outpatient service was more than 94%. After adjusting for sex, age, the protective factors were diagnostic and therapeutic effect (OR=5.45, P<0.001), service level of nurses (OR=3.91, P=0.044), doctors' skills of communication and explanation (OR=2.95, P=0.046), degree of convenience (OR=3.04, P=0.038) and visits in recent three months (OR=2.11, P=0.008).
 Conclusion: The loyalty of outpatients with high-end medical services in a comprehensive grade A tertiary hospital is relatively high. Significant diagnostic and therapeutic effect, good service of nurses, good skills of communication and explanation, convenience and multiple visits are related to high loyalty.