Consumer-perceived value: the key to a successful business strategy in the healthcare marketplace

Factors affecting revisit intention for medical services at dental clinics

Recent changes in the medical paradigm highlight the importance of patient-centered communication. However, because of the lack of awareness of dental clinics and competency of medical personnel, the quality of medical services in terms of the communication between doctors and patients has not improved. This study analyzed the impact of health communication and medical service quality, service value, and patient satisfaction on the intention to revisit dental clinics. The study participants were outpatients treated at 10 dental clinics in Seoul. The research data were collected using a questionnaire during visits to these dental clinics from December 1 to December 30, 2016. A total of 600 questionnaires were distributed (60 copies to each clinics) and 570 valid questionnaires were used for the analysis. The influence of the factors was determined using structural equation modeling. The factors influencing service value were reliability (β = 0.364, p < 0.001), expertise (β = 0.319, p < 0.001), communication by doctors (β = 0.224, p < 0.001), and tangibility (β = 0.136, p < 0.05). In addition, the factors influencing patient satisfaction were reliability (β = 0.258, p < 0.001), tangibility (β = 0.192, p < 0.001), communication by doctors (β = 0.163, p < 0.001), and expertise (β = 0.122, p < 0.01). Further, service value (β = 0.438, p < 0.001) raised patient satisfaction, which was found to influence the intention to revisit dental clinics (β = 0.383, p < 0.001). Providing accurate medical services to inpatients based on smooth communication between doctors and patients improves patient satisfaction. In addition, doctors can build long-term relations with patients by increasing patients’ intention to revisit through patient-oriented communication.

Perceived service quality, repeat use of healthcare services and inpatient satisfaction in emerging economy

Purpose

The purpose of this study is to understand that how different demographic variables and repeated availing of service from the same doctor or same hospital shape the overall perception of health-care service quality and satisfaction among inpatients admitted in private hospitals in an emerging economy.

Design/methodology/approach

A self-administered, cross-sectional survey of inpatients using a questionnaire was translated into Hindi and Gujarati. The data were collected from 702 inpatients from 18 private clinics located in three selected cities from Western India.

Findings

The results indicate that experience with hospital administration, doctors, nursing staff, physical environment, hospital pharmacy and physical environment is significant predictor of inpatient satisfaction. Physical environment was found to be significantly associated with satisfaction only among female inpatient. It was also found that repeat availing of services either from the same hospital or doctor does not increase patient satisfaction. The feasibility, reliability and validity of the instrument that measures major technical and nontechnical dimensions of quality of health-care services were established in the context of a developing country.

Originality/value

The study makes important contribution by empirically investigating the inpatient assessment of health-care service quality based upon their demographic information and repeated availing of services to understand how repeat visit shapes the service quality perception.

Analysis of the relationships among perceived service encounter quality, service value, satisfaction and behavioral intention for physical therapy patients

[Purpose] The purpose of this study was to investigate the relationships among perceived service encounter quality, service value, patient satisfaction, and behavioral intention in physical therapy patients. [Subjects and Methods] This study surveyed 335 patients who received physical therapy treatment at five medical institutions in Jeonju-si, Republic of Korea. This study conducted path analysis on the collected data using Smart PLS 2.0 M3. [Results] The analysis of this study showed that service encounter quality had significantly positive relationship with service value, patient satisfaction, and behavioral intention. Service value had significantly positive relationship with patient satisfaction and behavioral intention. Patient satisfaction had significantly positive relationship with behavioral intention. [Conclusion] Improving the perceived quality of service encounters for physical therapy patients increases service value and patient satisfaction, and positively influences behavioral intention.

An assessment of national healthcare service delivery: a Ghanaian illustration

Purpose

The purpose of this paper is to propose and test a healthcare framework of service quality, perceived value, and satisfaction in Ghana. More specifically, this study investigates the role and effect of service quality on patient satisfaction and perceived value in Ghana’s healthcare delivery.

Design/methodology/approach

Data were gathered through surveys administered to 113 healthcare patients in Ghana. partial least square-structural equation modeling analysis was used to empirically test the research model.

Findings

Results show healthcare quality significantly influences satisfaction and perceived value of healthcare delivery. Additionally, perceived value’s impact on satisfaction and behavioral intention shows that increasing perceived benefits while reducing perceived costs leads to repeat behavior and paves the way for retention strategy for healthcare management.

Research limitations/implications

This study yields a series of limitations in its results and conclusions. These limitations and future research are discussed in Section 7 of the study.

Originality/value

This study contributes to the literature by examining the effects of healthcare service quality on patient satisfaction and perceived value, determining the effect of healthcare service quality on patients’ behavioral intention, and testing the proposed framework in Ghana, a fast growing and economically liberalized emerging country in Sub-Saharan Africa.

Patient perceptions of quality: analyzing patient satisfaction surveys

Purpose

– Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act requires healthcare organizations to collect certain metrics, including patient assessments of quality, in order to monitor and improve the quality of healthcare. These metrics are used as a basis for graduated insurance reimbursements, and are available to consumers as an aid in selecting healthcare providers and insurance plans. The purpose of this paper is to provide healthcare providers with the analytic capabilities to better understand quality of care from the patient’s point of view.

Design/methodology/approach

– This research examines patient satisfaction data from a multi-specialty Medical Practice Group, and uses regression analysis and paired comparisons to provide insight into patient perceptions of care quality.

Findings

– Results show that variables related to Access, Moving Through the Visit, Nurse/Assistant, Care Provider and Personal Issues significantly impact overall assessments of care quality. In addition, while gender and type of care provider do not appear to have an impact on overall patient satisfaction, significant differences do exist based on age group, specialty of the physician and clinic type.

Originality/value

– This study differs from most academic research as it focusses on medical practices, rather than hospitals, and includes multiple clinic types, medical specialties and physician types in the analysis. The study demonstrates how analytics and patient perceptions of quality can inform policy decisions.

End--users' perception of quality of care of children attending children's outpatients clinics of University of Nigeria Teaching Hospital Ituku--Ozalla Enugu

Background

Knowledge of the specific details of end-users actual experiences with health system helps to identify areas for improvement in ways that standardized satisfaction measures are less able to provide in order to save lives, uphold public confidence and trust in healthcare delivery.

The aim of the study was to assess the end-users’ perception of the quality of clinical services rendered to children attending paediatric out-patient clinics of University of Nigeria Teaching Hospital, Ituku – Ozalla, Enugu.

Methods

A cross sectional descriptive study was undertaken using exit point interviewer administered pre-tested/semi-structured questionnaire.

Assessment of perception of quality of care was undertaken in three service areas; waiting time, attitude of staff and comfort of the waiting hall. Data was analyzed using SPSS 16.0 and presented as percentages. Chi-square was used to compare means (p < 0.05).

Results

A total of 367 respondents were interviewed. Over 50% of them were generally satisfied with overall quality of care. 329 (89.6%) were very satisfied with quality of doctors’ services, while the least satisfaction was with the quality of medical records services 139 (37.9%). Majority of the respondents 197 (53.7%) spent between 3–6 hours for each clinic visit and most of the waiting time spent was in the medical records and consultation.

Conclusion

The care – givers perception of the general quality of care was adjudged high. However, overall waiting time was perceived to be unsatisfactory.

Efforts should be made to reduce the time spent by clients while accessing care in the facility.

Electronic supplementary material

The online version of this article (doi:10.1186/1756-0500-7-800) contains supplementary material, which is available to authorized users.

Healthcare quality and moderators of patient satisfaction: testing for causality

PURPOSE

The purpose of this article is to present a comprehensive structural equation based service quality and patient satisfaction model taking into account the patient's condition before and after discharge. The authors aim to test for causality in a sample of patients from United Arab Emirates public hospitals.

DESIGN/METHODOLOGY/APPROACH

Data were collected using questionnaires completed by adults discharged (n = 244) from UAE public hospitals. The proposed model consists of five main constructs. Three represent service quality: quality of care (four variables); process and administration (four variables) and information (four variables). There is also one construct that represents patient's status (two variables--health status before admission and after discharge). Finally, there is one construct that represents patient's satisfaction with care (two variables--general and relative satisfaction). Structural equation modeling and LISREL using maximum likelihood estimation was used to test hypothesized model(s)/parameters(s) derived deductively from the literature.

FINDINGS

The structural equation modeling representation provides a comprehensive picture that allows healthcare constructs and patient satisfaction causality to be tested. The goodness-of-fit statistics supported the healthcare quality-patient status-satisfaction model.

ORIGINALITY/VALUE

The model has been found to capture attributes that characterize healthcare quality in a developing country and could represent other modern healthcare systems. Also, it can be used to evaluate other healthcare practices from patients' viewpoints. The study highlights the importance of healthcare quality as patient satisfaction predictors by capturing other effects such as patient status.

Testing not-so-obvious models of healthcare quality

PURPOSE

The purpose of this paper is to show that, although there has been some research to identify the dimensions on which healthcare quality and in-patient satisfaction should be measured, the confirmation of constructs and indicators that constitute an overall care quality and satisfaction remains unclear. The objective is to present several models of service quality and satisfaction in healthcare for discharged patients; and to test those models in a sample of discharged patients in public hospitals in the United Arab Emirates.

DESIGN/METHODOLOGY/APPROACH

A detailed in-patient survey (using interviews) was used. Data were collected with questionnaires from adult discharges (n = 244) in public hospitals in the UAE. Several structures are proposed and tested. Confirmatory Factor Analysis (CFA) and LISREL SIMPLIS using maximum likelihood estimation were used to estimate and test the parameters of the hypothesized models derived deductively from the previous literature.

FINDINGS

Several models (with one, two, three and four constructs) with different structures were tested using CFA. The final recommended model is based on three constructs--quality of care, process and administration, and information. The goodness-of-fit statistics supported the basic solution of the healthcare quality-satisfaction model.

ORIGINALITY/VALUE

The model has been found to capture attributes that characterize healthcare quality in a developing country such as the UAE and could represent other modern healthcare systems. It can be used as a basis for evaluation in healthcare practices from discharges (in-patients) point of view. The study highlights the importance of patients' satisfaction with care as predictors of quality of care. The results also confirm the construct validity of the previously discussed healthcare quality scales.

The impact of visit frequency on the relationship between service quality and outpatient satisfaction: a South Korean study

OBJECTIVE

To examine the relative impact of four service quality dimensions on outpatient satisfaction and to test the invariance of the structural relationships between the service quality dimensions and satisfaction across three patient groups of varying numbers of prior visits to the same hospital as outpatients.

DATA SOURCES/STUDY SETTING

Survey of 557 outpatients using a self-administered questionnaire over a 10-day period at a general hospital in Sungnam, South Korea.

DATA COLLECTION

Patients answered questions related to two main constructs, patient satisfaction and health care service quality. The health care service quality measures (30 items) were developed based on the results of three focus group interviews and the SERVQUAL scale, while satisfaction (3 items) was measured using a previously validated scale.

STUDY DESIGN

Confirmatory factor analysis was used to assess the construct validity of the service quality scale by testing convergent and divergent validity. A structural equation model specifying the four service quality dimensions as exogenous variables and patient satisfaction as an endogenous variable was estimated to assess the relative impact of each of the service quality dimensions on satisfaction. This was followed by a multigroup LISREL analysis that tested the invariance of structural coefficients across three groups with different frequencies of outpatient visits to the hospital.

PRINCIPAL FINDINGS

Findings support the causal relationship between service quality and satisfaction in the context of the South Korean health care environment. The four service quality dimensions showed varying patterns of impact on patient satisfaction across the three different outpatient groups.

CONCLUSION

The hospital management needs to be aware of the relative importance of each of the service quality dimensions in satisfaction formation of outpatients, which varies across different hospital utilization groups, and use this in strategic considerations.