Dear Editor-in-Chief

Hospital gradation systems are used to examine the performance of hospitals to promote the effi-cient use of medical resources (1). Patient-per-ceived service quality may differ for differing grades of medical institutions under gradation sys-tem, which has been rarely reported. The aim of the present study was to explore the relation be-tween the hospital gradation system and patient perceptions under Taiwanese hospital gradation system. The specialty of dentistry was investigated due to dental care being significantly different from other medical services (2). Dental care is more personal, intimate, and lasting contact with the patient (3). Nevertheless, quality assessment of dental service remains relatively primitive (4). T