A cross-sectional study on exploring the antecedents of patient's revisit intention: Mediating role of trust in the hospital among patients in India

BACKGROUND

In the healthcare domain, patients' trust in the hospital plays an instrumental role in determining the behavioral intention of the patient. This article attempts to investigate the impact of service quality perception on behavioral intention with the mediating effect of trust in the hospital and patient satisfaction.

METHODS

This research was carried out in multispecialty hospitals located in Bangalore Urban and Mysore districts of Karnataka during August 2021. This was a questionnaire-based study and the sample size was 242. Statistical Package for the Social Science (SPSS) 27.0 and SmartPLS 3.0 software was used to analyze the data.

RESULTS

The findings revealed that perceived service quality significantly influences trust through patient satisfaction (observed partial mediation) and patient satisfaction significantly impacts behavioral intention through trust (observed partial mediation).

CONCLUSION

This study empowers hospital managers to understand the factors influencing behavioral intention. Healthcare professionals must ensure that good quality service is delivered to enhance patient satisfaction and trust in adverse services, which influence behavioral intention among the patients.

Factors That Influence Patient Satisfaction With the Service Quality of Home-Based Teleconsultation During the COVID-19 Pandemic: Cross-Sectional Survey Study

BACKGROUND

Ontario stroke prevention clinics primarily held in-person visits before the COVID-19 pandemic and then had to shift to a home-based teleconsultation delivery model using telephone or video to provide services during the pandemic. This change may have affected service quality and patient experiences.

OBJECTIVE

This study seeks to understand patient satisfaction with Ontario stroke prevention clinics' rapid shift to a home-based teleconsultation delivery model used during the COVID-19 pandemic. The research question explores explanatory factors affecting patient satisfaction.

METHODS

Using a cross-sectional service performance model, we surveyed patients who received telephone or video consultations at 2 Ontario stroke prevention clinics in 2021. This survey included closed- and open-ended questions. We used logistic regression and qualitative content analysis to understand factors affecting patient satisfaction with the quality of home-based teleconsultation services.

RESULTS

The overall response rate to the web survey was 37.2% (128/344). The quantitative analysis was based on 110 responses, whereas the qualitative analysis included 97 responses. Logistic regression results revealed that responsiveness (adjusted odds ratio [AOR] 0.034, 95% CI 0.006-0.188; P<.001) and empathy (AOR 0.116, 95% CI 0.017-0.800; P=.03) were significant factors negatively associated with low satisfaction (scores of 1, 2, or 3 out of 5). The only characteristic positively associated with low satisfaction was when survey consent was provided by the substitute decision maker (AOR 6.592, 95% CI 1.452-29.927; P=.02). In the qualitative content analysis, patients with both low and high global satisfaction scores shared the same factors of service dissatisfaction (assurance, reliability, and empathy). The main subcategories associated with dissatisfaction were missing clinical activities, inadequate communication, administrative process issues, and absence of personal connection. Conversely, the high-satisfaction group offered more positive feedback on assurance, reliability, and empathy, as well as on having a competent clinician, appropriate patient selection, and excellent communication and empathy skills.

CONCLUSIONS

The insights gained from this study can be considered when designing home-based teleconsultation services to enhance patient experiences in stroke prevention care.

Moderating Effects of Individual Traits on the Association Between Nature and Patient Wait Experiences

OBJECTIVES

We empirically investigated to what extent plants in the emergency department (ED) waiting areas influence patient wait experiences (i.e., anxiety, perceived service quality, and perception of wait time) depending on individual differences in cognitive thinking styles and one's bonds with the natural world.

BACKGROUND

Positive effects of nature on patient experiences in healthcare environments are well established by empirical research findings. However, evidence is scarce on the impact of nature on patient wait experiences and the roles of patient traits often related to their backgrounds.

METHODS

A within-subjects study was conducted (N = 116) with two virtually built ED waiting rooms: with versus without indoor and outdoor plants.

RESULTS

Findings confirmed that plants lower anxiety and improve perceptions of service quality and wait time. Cognitive thinking style significantly moderated how plants affected patient wait experiences. Although participants with higher connectedness to nature showed more positive responses to the nature condition, connectedness to nature did not significantly affect the association between nature and wait experiences.

CONCLUSIONS

This study contributes to the existing body of knowledge on nature's effects in healthcare environments by examining the roles of individual differences in patients' and visitors' cognitive styles and connectedness to nature. Results highlighted the impact of these differences in patient experiences for effective implications of nature in waiting areas of healthcare facilities.

Importance-Performance Analysis of Clinical Forensic Services Quality at Bhayangkara Hospital Pekanbaru, Indonesia

Background

Service quality improvement efforts must focus on the utilisation of resources for continuous quality improvement. The importance-performance analysis (IPA) method is useful in finding service quality items that require corrective action. This study implemented the IPA method to obtain items that should be prioritised in improving the quality of a hospital's clinical forensic services.

Methods

A cross-sectional study of 284 clinical forensic patients at Bhayangkara Hospital, Pekanbaru, Indonesia was conducted. Self-administered and paper-based questionnaires, specifically the modified service quality (SERVQUAL)-based questionnaire, were used as the study instruments. Twenty-two service quality items were used as indicators and they were divided into five dimensions of service quality: i) reliability, ii) responsiveness, iii) assurance, iv) empathy and v) tangibility. The data were analysed using the IPA method.

Results

The results showed that only seven items had a gap and a level of conformity that met the expectations of clinical forensic patients. Improvements in service quality should prioritise four items: i) providing a more private examination room for clinical forensic patients, ii) improving healthcare workers' understanding of patient needs, iii) improving the readiness of healthcare workers to conduct examinations and iv) enhancing the clarity of information about examination procedures.

Conclusion

The IPA method yielded several high-priority items that need to be improved; therefore, the hospital must focus on improving the quality of clinical forensic services.

Impact of Long-Term Care Service Quality on User Cooperation/Participation: Mediating Effect of Self-Determination

The purpose of this study is to determine whether home care service quality affects users' voluntary cooperation/participation through self-determination. For this purpose, survey data from 358 long-term care service users in Korea were analyzed by applying a structural equation model. Data collection was conducted from February to March 2019. Data collection was conducted in February-March 2019. The results showed that home care quality did not directly affect users' voluntary cooperation/participation in the service delivery process, and self-determination fully mediated the relationship between quality and cooperation/participation. Based on these results, the importance of providing appropriate information, reflecting users' voices, and the attitude and role of experts was emphasized in order to promote user participation/cooperation through self-determination.

Determinants t of patient satisfaction with pharmacy services at Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia

Background

Patients have explicit desire for quality services when they visit health institutions. Patient satisfaction is a primary means of measuring the effectiveness of healthcare delivery. However, inadequate discovery of their needs may result in patient dissatisfaction. Patients who are satisfied with pharmaceutical care are likely to adherence, seeking for medical attentions and take medications properly. Providing better access to quality pharmacies is a way to improve patient satisfaction with healthcare services.

Study objective

The study was aimed to assess patient satisfaction with pharmacy services at Felege Hiwot Comprehensive Specialized Hospital (FHCSH).

Methods and materials

An institution-based cross-sectional study design was conducted at FHCSH from 1 May 2021 to 30 October 2021. Data were collected by interview with structured questionnaires. Then the data were coded, entered, and then analyzed by SPSS version 23. The association between predictors and outcome was measured using bivariate logistic regression.

Result

In this study, 384 study participants were included. Majority of the participants were males (55.37%, N=227). The overall satisfaction score of the participants of this study was 65.37%. In our study, clients showed greater satisfaction towards pharmacists' commitment to correct myths (92%), pharmacist availability (88.78), and cleanliness (87.8%). Multivariate analysis indicated physical restriction [adjusted odds ratio (AOR)=6:95%; 95% CI (2.98, 25.9)] and rural residence [AOR=2.43; 95% CI (1.71, 9.6)] had significant association with pharmacy service dissatisfaction. Among the quality pharmacy service indicators, counselling on how medications work [AOR=9; 95% CI (1.48, 8.85)], keeping to dosage regimen [AOR=7.3; 95% CI (5.49, 11.06)], and advice on the current medical condition had greater odds of client dissatisfaction.

Conclusion

The findings of the current study showed that patients' satisfaction towards outpatient pharmacy services provided by FHCSH is very low as it is indicated in their perception towards revealing written information about medication use, medication availability, medication storage, and instructions about medication side effects.

Designing a doctor evaluation index system for an online medical platform based on the information system success model in China

Objective

In the context of "internet + medical health" and emphasis on evaluation mechanism for medical and health talents in China, we design an evaluation index system for doctors on online medical platforms by synthesizing two patterns of existing online medical platforms, which is the first step to enhance the capabilities of doctors on online medical platforms.

Methods

Based on the doctor evaluation model integrating information systems success model (ISS-DE model) and grounded theory, the evaluation indicators were obtained through expert interviews, offline medical institutions investigation, online platforms investigation, and literature research, and were assigned weights using the analytic hierarchy process (AHP) method. A working group composed of 23 experts was set up to review and determine the competency standards of doctors on the online medical platforms.

Results

A new indicator framework covering 3 dimensions of system quality, service quality and information quality was constructed in this study. The index system included 3 first-level indicators, 8 s-level indicators and 60 third-level indicators, and each indicator was given different weightage.

Conclusion

The complete index system constructed by the Delphi method in this study is suitable for China's online medical platforms, which will help to improve the quality of platforms and the ability of doctors, thus promoting the process of internet medical integration.

Impact of brand equity and service quality on the reputation of universities and students' intention to choose them: The case of IIUM and UIN

Background: Numerous studies have been carried out on the impacts of brand equity and service quality of higher education institutions (HEIs) on their reputation and students' satisfaction. This research aimed to compare the impact of brand equity and service quality on universities' reputations, namely Universitas Islam Negeri (UIN) in Indonesia and International Islamic University Malaysia (IIUM) in Malaysia, and Indonesian students' intention to choose the universities, which is moderated by study expense (price). UIN and IIUM are HEIs with a similar university concept, and Indonesian students have recently shown a high interest in them. The two universities have faculties not only in the field of Islamic studies but in general fields of studies as well, which are usually held by non-Islamic Universities. Therefore, their competitiveness against non-Islamic universities, especially the University of Indonesia (UI) has increased. Methods: The statistical measurement tool used was structural equation modeling (SEM). The number of items stated in the questionnaire was 45. Therefore, minimum data to be collected were 5 × 45 or 225 which rounded up to 228 from Indonesian students at UIN and IIUM (114 UIN students, and 114 Indonesian student respondents from IIUM). Results: The study results show that the universities' reputations are strongly affected by their brand equity and service quality, which then affect students' intention to choose the universities. Students had a higher intention to choose IIUM than UIN. The limitation of this research is that the effect of study expense on the intention of Indonesian students to study at UIN or IIUM has not yet been conducted. It will be conducted in the next study. Conclusions: These results are expected to be useful to UIN, IIUM, and especially Politeknik Negeri Jakarta (PNJ) in determining a strategy to enhance their reputations and the intention of Indonesian students to study there.

How Nurses' Person-Organization Fit Influences Organizational Loyalty

Background

High turnover rates among nurses are a global concern due to the shortage of skilled professionals and increasing demand for high-quality healthcare. This study aims to enhance understanding of organizational fit by examining the impact of Person-organization fit (P-O fit) on organizational loyalty through the mediating role of organizational support and service quality, and the moderating impact of role ambiguity.

Methods

Using a convenience sampling technique, we employed a survey methodology by developing a questionnaire. Data were collected from a sample of 614 nurses in five different healthcare sectors in China. Employing SmartPLS 3.3, we conducted a Structural Equation Modeling (SEM) analysis to examine the relationships among the specified variables.

Results

The findings of the structural analysis suggest that the P-O fit influences organizational loyalty in the healthcare sector. Organizational support and service quality were identified as partial mediators of the P-O fit-organizational loyalty link. Additionally, the role of ambiguity represented a negative moderating impact between service quality and organizational loyalty.

Discussion

Overall, the study's findings extend the understanding of person-organization fit, organizational support, service quality, role ambiguity, and organizational loyalty in the context of healthcare sectors and offer implications for medical authorities. Discussions, limitations, practical implications, and suggestions for further research are also provided.

Effects of Servicescapes on Interaction Quality, Service Quality, and Behavioral Intention in a Healthcare Setting

This study develops a conceptual framework that encompasses servicescapes and customer perceptions and behaviors, and conducts an empirical investigation of healthcare service facilities. Structural equation modeling is performed using a sample of 271 patients who received treatment within one year at hospitals and clinics located in the metropolitan area of Seoul, South Korea. The results of the empirical analysis show that service quality improvements and patient revisits to healthcare facilities can be induced through servicescape improvements and interaction quality. These results make theoretical contributions to the service management literature and have practical implications for the operations of healthcare facilities.

Drivers of Patients' Behavioral Intention toward Public and Private Clinics' Services

In an era of growing competition in the healthcare market, adopting a patient-centered approach is mandatory for the survival and growth of any public or private hospital. This requires a better understanding of patients' behavior and an increased focus on satisfying their needs and expectations. This paper was developed in this context and aims to study the main drivers of patients' behavioral intentions. A conceptual model was proposed, highlighting the linkages between service quality, doctors' reputation, patients' trust, service value, and patients' behavioral intentions. To examine the different research hypotheses, a quantitative study including 242 patients was conducted in Saudi Arabia using the convenience sampling method. The smart PLS approach was used to test the measurement and structural models. The findings indicated that trust and service value positively affected patients' behavioral intentions. Trust in the healthcare provider was positively affected by two dimensions of service quality: healthcare provider concern and physician concern. Trust in doctors was found to be positively related to the reputation of the doctor. Service value was positively influenced by the convenience of the healthcare process, healthcare provider concerns, and doctors' reputations. This study is original because it is among the few studies that investigate patients' behavioral intentions toward healthcare services in a developing country (Saudi Arabia). Furthermore, it is among the rare studies to examine the role of doctors' reputations in service values. The findings would offer meaningful implications for practitioners in the healthcare market for maintaining relationships with their patients.

The Impact Mechanism of Consumer's Initial Visit to an Automobile 4S Store on Test Drive Intention: Product Aesthetics, Space Image, Service Quality, and Brand Image

[Purpose/Significance] Under the influence of various factors such as the pandemic, oil prices, and economic conditions, the global automotive industry has entered a period of downturn. Therefore, how to activate market potential and increase consumers' willingness to purchase cars has become an important research topic. Unlike many other products, test drives play a significant role in the car-buying process. [Method/Procedure] This study employs a questionnaire survey to explore how consumer perceptions of product aesthetics, space quality, and service quality during their initial visit to an automobile 4S store influence their test drive intention through two dimensions of brand image: symbolic and experiential. A structural equation model is used to establish a test drive intention impact model incorporating these dimensions. [Results/Conclusions] The study found that brand image, both symbolic and experiential, plays a significant mediating role in enhancing potential consumers' test drive intentions. Space image had the most significant impact on brand image. Although product aesthetics did not directly affect brand image experientially, they remained an important factor in enhancing brand image symbolically. [Contribution/Value] The results of this study can provide insights for automotive brand managers, automobile 4S store designers, and others aiming to promote the sustainable development of automotive consumption.

Improving the service quality of cross-border e-commerce: How to understand online consumer reviews from a cultural differences perspective

Introduction

Cross-border e-commerce (CBEC) consumers come from different countries; thus, cultural differences may affect their evaluations and perceptions of service quality. This paper follows Hofstede's framework as a theoretical anchor to explore how to use online consumer reviews that reflect cultural differences to improve the service quality of CBEC.

Methods

First, based on a latent Dirichlet allocation model, 14 service quality issues that consumers are concerned about in CBEC were identified. Second, a generalized ordered logistic regression model was explored to analyze the cultural influences on consumer sentiment orientation. Finally, the effect of each cultural dimension on consumer service quality perception in CBEC was evaluated by employing a binary logistic regression model.

Results

The results showed that consumers paid more attention to the service quality of logistics service, customs efficiency and tariff, shopping experience, and so on. Cultural dimensions significantly impacted consumers' emotional tendencies. Moreover, cultural dimensions had significant impacts on consumers' service quality perception (e.g., logistics service, trust in sellers, customs disputes, and cell phone performance). Still, consumers' quality perceptions of some services (e.g., cell phone functions, items as described, logistics package quality, and gifts) were less affected by cultural dimensions.

Discussion

Our findings not only provide new perspectives for CBEC consumer behavior studies on quality improvement but also provide practical implications for CBEC enterprises.

Analysis of COVID-19-Related User Content on the Baseball Bulletin Board in 2020 through Text Mining

The world engaged in online sport watching during COVID-19. Fortunately, in Taiwan, the pandemic was stably controlled in 2020, allowing for the continuation of the Chinese Professional Baseball League (CPBL); this attracted international attention and encouraged relevant discussions on social media in Taiwan. In the present study, through text mining, we analyzed user content (e.g., the concepts of sports service quality and social identity) on the Professional Technology Temple (PTT) baseball board-the largest online bulletin board system in Taiwan. A predictive model was constructed to assess PTT users' COVID-19-related comments in 2020. A total of 422 articles and 21,167 comments were retrieved. PTT users interacted more frequently during the closed-door period, particularly during the beginning of the CPBL in April. Effective pandemic prevention, which garnered global attention to the league, generated a sense of national identity among the users, which was strengthened with the development of peripheral products, such as English broadcasting and live broadcasting on Twitch. We used machine learning to develop a chatbot for predicting the attributes of users' comments; this chatbot may improve CPBL teams' understanding of public opinion trends. Our findings may help stakeholders develop tailored programs for online spectators of sports during pandemic situations.

Radiotherapy service amidst COVID-19: Experience from Tertiary Referral Hospital in Semarang, Indonesia

Background

Several changes in hospital policies took place to mitigate the spread of Coronavirus disease 2019 (COVID-19). However, the patient's perception to these abrupt changes in medical services is not known. This study analyzed the quality of radiotherapy service during the COVID-19 pandemic and the patient's perception of them.

Methods

This descriptive study will qualitatively assess cancer patient perception of the quality of radiotherapy service during COVID-19 pandemic. Willing participants were given a questionnaire that explore two major aspects: the patient's general knowledge of COVID-19 and their perception of radiotherapy service during the pandemic.

Results

The 145 participants of this study were generally well-informed about the significance of COVID-19 pandemic. Most respondents claimed to adequately practice preventive measures and put high regards in personal protective equipment (PPE) worn by them and healthcare workers for their safety. Their level of trust to all healthcare workers remained high and identified hospital announcements (television, brochures) educated them the most in regards to the relationship of COVID-19 and cancer.

Conclusion

The changes in hospital policies and radiation oncology service in our institution were well-received by the study population. Despite the majority of respondents were afraid and anxious of being infected of COVID-19 while undergoing treatment, only a minority of them contemplated to delay or completely stop going for treatment. By adhering to major guidelines and adjustments of local resources, the delivery of radiotherapy service can remain consistent during the pandemic.

A Conceptual Model to Evaluate Service Quality of Direct-to-Consumer Telemedicine Consultation from Patient Perspective

Objective and Background: This research aims to develop a theoretical service quality (SQ) model for direct-to-consumer (DTC) telemedicine consultations. Although it can change care delivery for the better, it is crucial to create the appropriate measurement tool to collect and analyze patient's perceptions of SQ to identify any service pitfall and encourage a faster adoption. To the best of the authors' knowledge, this article is one of the first to investigate and propose a SQ model for DTC telemedicine consultations. This study is therefore motivated by a clear need for such a model as it is currently inexistent. Methods: A literature review of health and e-service quality (e-SQ) models was conducted to identify a suitable instrument for the research. A total of 60 studies were included. Results: The main findings are threefold: (1) DTC telemedicine SQ is interdisciplinary: it encompasses generic and context-specific dimensions from the health, e-SQ, and information system literature; (2) the existing SQ models are not adequate, they do not cover all dimensions of DTC telemedicine services; (3) although LeRouge et al.'s Telemedicine service encounter quality model was identified as a reference model, it is inadequate to simply transpose it to the context of the study. Thus, the elaboration of a more suitable instrument and creation of a new updated model by the authors. Conclusion: The conceptual model captures three primary dimensions (system quality, interaction quality and use quality) that represent SQ of DTC telemedicine consultations from a patient perspective.

The Effect of Service Quality on Patient Citizenship Behaviors: Evidence from the Health Sector

BACKGROUND

Nowadays, health organizations seek to bring innovations to their services to stand out in competition with their rivals by improving service quality (SQ), encouraging patients to always make the same organizational choices, and enhance the behavior of patient citizenship.

OBJECTIVE

This study aims to determine the mediating role of patient satisfaction (PS), patient loyalty (PL), and employee responsiveness (ER) between the service quality and patient citizenship behaviors (PCB).

METHODS

In order to test the proposed hypotheses, quantitative research methods were utilized; cross-sectional data was collected using scales between December 2021 and March 2022. Results were obtained from 422 participants. The data were analyzed using descriptive statistics, correlation, confirmatory factor analysis, and structural equation modeling methods, using AMOS 21.

RESULTS

SQ was found to have a significant and positive effect on PL, PS, and ER. PL, PS, and ER were found to have a significant and positive effect on PCB. The indirect effect of SQ on PCB was found to be positive.

DISCUSSION

The findings demonstrate that SQ does not directly affect or create PCB, but it is affected by the mediators in order to create PCB via satisfaction, loyalty, and employee responsiveness.

Analysis of Home Healthcare Practice to Improve Service Quality: Case Study of Megacity Istanbul

Home healthcare services are public or private service that aims to provide health services at home to socially disadvantaged, sick, needy, disabled, and elderly individuals. This study aims to increase the quality of home healthcare practice by analyzing the factors affecting it. In Megacity Istanbul, data from 1707 patients were used by considering 14 different input variables affecting home healthcare practice. The demographic, geographic, and living conditions of patients and healthcare professionals who take an active role in home healthcare practice constituted the central theme of the input parameters of this study. The regression method was used to look at the factors that affect the length of time a patient needs home healthcare, which is the study's output variable. This article provides short planning times and flexible solutions for home healthcare practice by showing how to avoid planning patient healthcare applications by hand using methods that were developed for home health services. In addition, in this research, the AB, RF, GB, and NN algorithms, which are among the machine learning algorithms, were developed using patient and personnel data with known input parameters to make home healthcare application planning correct. These algorithms' accuracy and error margins were calculated, and the algorithms' results were compared. For the prediction data, the AB model showed the best performance, and the R² value of this algorithm was computed as 0.903. The margins of error for this algorithm were found to be 0.136, 0.018, and 0.043 for the RMSE, MSE, and MAE, respectively. This article provides short planning times and flexible solutions in home healthcare practice by avoiding manual patient healthcare application planning with the methods developed in the context of home health services.

Quality Perceptions, Expectations, and Individual Characteristics among Adult Patients Visiting Primary Healthcare Centers in Saudi Arabia: A Cross-Sectional Study

Quality is a main concern of primary healthcare centers, and pursuing quality can lead to service improvement as well as affordable healthcare. The purpose of this cross-sectional study was to describe patients' healthcare quality perceptions and expectations and determine the relationships between them and associated factors. The study was conducted on a convenience sample of 470 patients visiting primary healthcare centers. Data were collected between April and July 2022 using an anonymous questionnaire. Bivariate and multivariate analyses were conducted. Most participants reported high levels of quality perceptions and expectations. Bivariate analyses showed a significant correlation between quality perceptions and expectations. Both being single and having a higher level of education were statistically different in terms of quality perception and expectations, respectively. Further, being single, highly educated, and employed had significant differences in terms of expectations. In regression, primary education and expectations influenced quality perceptions. Marital status, profession, and perception were the only variables that significantly influenced participants' expectations. Patients' healthcare quality perceptions and expectations are important for ensuring the efficiency of healthcare services. Primary healthcare centers are the key avenue for disease prevention and early detection. The optimization of primary healthcare centers' quality and addressing its potential issues should be performed through interdisciplinary teamwork.

Factors influencing quality of transnational education: Evidence from a Sino-UK MA program

With the internationalization of higher education, transnational education (TNE) has gradually become one of the main means to mobility of education resources in many countries. There have been many studies on service quality research, but not many of these studies attempt to directly explore the in-depth factors contributing to service quality. This study investigated the factors impacting the quality of TNE based on the interpretation of students' experiences on a Sino-UK MA program. Semi-structured interviews with seven participants revealed that high-quality educational resources and professional and sympathetic lecturers are the two major factors impacting the service quality. The results suggested that educational resources that meet the local social needs are considered desirable service offerings. Lecturers are key factors guaranteeing the service delivery. This study sheds light on service quality components of TNE that have not been given much attention in the literature of previous research, as well as informs host and export institutions on TNE programming.

How Servant Leadership Influence Employee Service Quality of Fitness Centers During COVID-19: The Interacting Effects of Self-Efficacy

Purpose

Drawing on conservation of resource theory, social cognitive theory and person-environment fit theory, this study aims to investigate the impact of servant leadership and self-efficacy on service quality in fitness centers.

Patients and Methods

Cross-sectional data came from 771 employees of fitness center. All participants completed the perceived servant leadership scale, self-efficacy scale and service quality scale. The polynomial regression and response surface analysis techniques were used to investigate the mediating influence and boundary conditions of self-efficacy.

Results

Self-efficacy acts as a mediator between servant leadership and employee service quality, with servant leadership having a positive, substantial impact on both. Meanwhile, regarding the relationship, the level of service quality is inversely correlated with the degree to which servant leadership and employee self-efficacy are aligned. The smaller the degree of alignment, the lower the level of employee service quality.

Conclusion

The findings of this study can help fitness centre practitioners better improve the service quality of employees through service-oriented servant leadership during the COVID-19 pandemic, thereby contributing to the development of the sports and service industries.

A Systematic Review and Meta-Analysis of Health Care Quality in Iran Based on the Comprehensive Quality Measurement in Health Care Model

Background

Comprehensive assessment of health care quality is the first step in improving care and achieving health service goals. Therefore, this study aimed to conduct a systematic review and meta-analysis of health care quality in Iran based on the Comprehensive Quality Measurement in Health Care model.

Methods

In this study, the databases of PubMed, Scopus, Web of Science, Iranian Scientific Information Database (SID), MagIran, and Google Scholar were searched using English and Iran keywords without time limit. STATA 16 software and a random effect model were used for conducting meta-analysis.

Results

Of the 750 articles found, 20 were finally included; 13 of which were related to service quality, five to customer quality, and four to technical quality. Overall mean score of service quality was 7.79 [95% CI 7.43-8.15, df = 12, I² = 98.48, P value < 0.000] out of 10, and overall mean score of customer quality was 73.20 ± 4.56 [95% CI 65.18-81.22, df = 5, I² = 99.34, P value < 0.001] out of 100. Among the 12 dimensions of service quality, the confidentiality dimension (9.55 ± 0.12) had the highest mean score and the group support dimension (5.92 ± 0.901) had the lowest score. In general, from the viewpoint of service receivers, the technical quality is relatively favorable.

Conclusions

According to the results of this study, the quality of health care in Iran is significantly far from ideal. Therefore, planning to improve providing health care is essential.

Assessing Quality Gap of Outpatient Service in Public Hospitals: A Cross-Sectional Study in China

In China, most ambulatory care is provided by public hospitals. However, many public hospitals' outpatient services fall short of meeting patients' demands. This study aimed to assess the quality gap of outpatient service in public hospitals by using an indicator system developed based on the SERVQUAL model. This cross-sectional study was conducted from June to July 2019 at 13 public hospitals in Shenzhen. In total, 1876 outpatients were included in the study, and participants were asked to fill out the modified SERVQUAL questionnaire. The scale consists of 23 items scattered in 6 dimensions, including Safety, Reliability, Responsiveness, Tangibles, Assurance, and Empathy. Descriptive analysis, t-test or F-test, and optimal scale analysis were performed. The patients' expectation of outpatient services exceeded the hospitals' services they perceived and resulted in negative gaps between the mean expectation and perception scores for each indicator. The gaps were as follows: Reliability = Empathy > Responsiveness > Safety > Assurance > Tangibles. Quality gaps differed significantly between age, education, and hospital type. The overall impression mean scores are 7.45 ± 1.18 (out of 9 points) and 7.27 ± 1.23 for general and specialized hospitals. And the willingness to recommend the hospital to others mean scores are 4.06 ± 0.62 (out of 5 points) and 3.92 ± 0.65 for general and specialized hospitals. Patients' impression of the hospital and willingness to recommend the hospital were significantly correlated with age, citizenship, health insurance, referral type, frequency of visits, Safety, Tangibles, Reliability, and Assurance. The outpatient service provided by Shenzhen's public hospitals did not meet patients' needs. Hospital administrators should evaluate the quality gap of outpatient services to identify the flaws within the delivery of ambulatory care and make improvements according to the findings to drive patient-centered care.

Are Retail Customers Ready for Service Robot Assistants?

The use of service robots is rapidly expanding in many industries, including the retail sector. In some Asian countries retail companies already deploy in-store humanoid robot assistants that interact with customers in a personalized and dynamic way. However, little is known about customers' perceptions of these robot-assisted interactions. Therefore, we compared customers' perceived service quality of a human-robot interaction with a human-human interaction in a retail store, using an experiment with hypothetical scenarios (N = 425). Participants' general attitudes towards robots, their age, gender, and educational level were included as moderators in the analyses (a mixed-design ANOVA model). Results showed that participants valued service quality higher in the human-human interaction scenario. Additionally, findings from the moderation analyses indicated that perceived service quality of the human- robot interaction and the human-human interaction did not statistically significantly differ for participants with relatively high positive attitudes towards robots. Participants with relatively low positive attitudes towards robots, however, held statistically significantly lower perceptions of service quality for the human-robot interaction. Neither age, gender nor educational level statistically significantly influenced participants' perceived service quality scores for both service encounters.

Online health community-An empirical analysis based on grounded theory and entropy weight TOPSIS method to evaluate the service quality

Introduction

With the enhancement of people's health awareness and the impact of the coronavirus pandemic in recent years, people's demand for online health information continues to expand, and online health communities (OHCs) have developed rapidly. However, the service quality of OHCs is uneven, and problems such as content quality, privacy disclosure are increasingly prominent. It's of great significance to establish normalized OHC service quality evaluation standards and develop effective evaluation tools and methods for the improvement of OHC service quality.

Material and Methods

Based on the grounded theory, the raw materials obtained from semi-structured interviews were coded in three stages to construct a service quality evaluation system for OHC. Through empirical analysis, the rationality and effectiveness of the evaluation system were verified. Then six representative Chinese OHCs were selected and their service quality was evaluated by the entropy weight TOPSIS method.

Results

The service quality evaluation system of OHC was constructed which includes 4 first-level indicators and 16 second-level indicators. The weights of the first-level indicators from large to small are content quality, emotional experience quality, interaction quality and function quality. Among the second-level indicator weights, the top three are perceived cost reasonableness, content professionalism and effectiveness of interactive content.

Conclusions

The indicator system is reasonable and effective and the evaluation method has strong applicability and operability. This study will provide theoretical guidance for community platform operators and relevant departments to design effective evaluation mechanism of OHC service quality, offering a reference for decisions and policymakers.

The Impact of Narrative Reviews on Patient E-doctor Choice in Online Health Communities

As online health communities (OHCs) continue to proliferate, narrative reviews on doctors have become a vital reference source for patients when choosing online health services. However, the potential value of subjective information reflecting patient experiences in OHCs has not been fully explored. The present study seeks to investigate the impact of narrative reviews on patients' selection of e-doctors and the extent to which such reviews are moderated by doctors' specialties. This paper collected data from 747 doctors and 105 032 reviews from WeDoctor, one of China's most popular OHCs, in 2019. We employed Latent Dirichlet Allocation topic modeling to extract 3 topics and analyzed their effects on patient e-doctor choice using a multiple regression method. Our findings indicate that Topic 1, clinical skills and effects, had a positive impact on patient choice in OHCs (β₁ = .243, P < .001), as did Topic 2, service attitude and trust (β₂ = .130, P < .05). However, the impact of Topic 3, convenience, did not show a significant effect in this study. Moreover, our results suggest that the specialty of Internal Medicine can positively moderate the relationship between Topic 1 (clinical skills and effects) and patient e-doctor choice (β₉ = .087, P < .05). Based on the findings of this study, e-doctors are encouraged to enhance their technical competence to improve treatment effectiveness and adjust their communication methods to increase patient trust and sense of security. OHC platform managers should accurately understand the key factors that influence patient choice and take measures to improve their service quality accordingly.

Exploring customer concerns on service quality under the COVID-19 crisis: A social media analytics study from the retail industry

The COVID-19 pandemic has triggered a set of government policies and supermarket regulations, which affects customers' grocery shopping behaviours. However, the specific impact of COVID-19 on retailers at the customer end has not yet been addressed. Using text-mining techniques (i.e., sentiment analysis, topic modelling) and time series analysis, we analyse 161,921 tweets from leading UK supermarkets during the first COVID-19 lockdown. The results show the causes of sentiment change in each time series and how customer perception changes according to supermarkets’ response actions. Drawing on the social media crisis communication framework and Situational Crisis Communication theory, this study investigates whether responding to a crisis helps retail managers better understand their customers. The results uncover that customers experiencing certain social media interactions may evaluate attributes differently, resulting in varying levels of customer information collection, and grocery companies could benefit from engaging in social media crisis communication with customers. As new variants of COVID-19 keep appearing, emerging managerial problems put businesses at risk for the next crisis. Based on the results of text-mining analysis of consumer perceptions, this study identifies emerging topics in the UK grocery sector in the context of COVID-19 crisis communication and develop the sub-dimensions of service quality assessment into four categories: physical aspects, reliability, personal interaction, and policies. This study reveals how supermarkets could use social media data to better analyse customer behaviour during a pandemic and sustain competitiveness by upgrading their crisis strategies and service provision. It also sheds light on how future researchers can leverage the power of social media data with multiple text-mining methodologies.

Measuring the quality of mental health services from the patient perspective in China: psychometric evaluation of the Chinese version of the World Health Organization responsiveness performance questionnaire

Background

Despite the large population of patients with mental disorders and the rapid development of mental health services in China, there are few evaluations of Chinese mental health services from the patient perspective. Relevant instruments with robust psychometric properties are lacking.

Objective

This study aimed to translate, adapt and validate the WHO responsiveness performance questionnaire for measuring the quality of hospital mental health services among Chinese patients.

Methods

The adaption of the translated questionnaire incorporated experts’ and patients’ opinions. For psychometric testing, 193 outpatients and 168 inpatients completed outpatient and inpatient modules, respectively.

Results

The adapted questionnaire adhered to the WHO framework of responsiveness domains, and just four items had some wording changes. Item missing rates were below 6%. Both the outpatient and inpatient modules had acceptable internal reliability (Cronbach’s α = 0.837 and 0.730) and most domains had desirable average inter-item correlation coefficients. The confirmatory factor analysis indicated an acceptable model fit for the inpatient module, while some goodness-of-fit indices for the outpatient module were a little outside of the recommended ranges. Except for ‘talking privately’ from the domain of confidentiality (both outpatient and inpatient modules) and ‘waiting time’ from the domain of prompt attention (the inpatient module), factor loadings of all other items were above 0.5.

Conclusions

The Chinese version of the responsiveness performance questionnaire has acceptable feasibility, reliability, and validity in general and it can be used to measure, assess and improve the quality of mental health services in China.

Patient satisfaction with quality of care in public hospitals in Albania

Healthcare service quality and hospitalized patient satisfaction in Albania have never truly received the necessary attention. The aim of this study is the assessment of key elements of service quality and their relationship with patients' satisfaction with receiving healthcare at public health institutions in Albania. The study examines five key dimensions of quality such as responsiveness, reliability, assurance, tangibles, and staff empathy to assess properly the healthcare quality and patient satisfaction in Albania based on the SERVQUAL instrument, which measures the differences between patient's perceptions of service quality received, and their expectations in terms of these five dimensions. A total of 800 randomly selected patients were interviewed in the main cities of Albania in public hospitals. A respective literature review was also a necessity to determine not only the appropriate methodology to be applied, together with the right quality dimensions to use but also for a better understanding of the link between service quality and patient satisfaction. The determination of the main quality factors which contribute to patient satisfaction, as well as, their order of importance, is another key aspect of the study, which finalizes with appropriate recommendations that might help quality improvement in future. The analysis shows that overall patient satisfaction is affected in public hospitals by all dimensions of service quality. Therefore, patients' perspective is extremely important in assessing healthcare service quality and should be taken into consideration by healthcare managers and policymakers in Albania, whenever significant reforms will be undertaken to improve the quality of services in this sector.

Service Value and Repurchase Intention in the Egyptian Fast-Food Restaurants: Toward a New Measurement Model

Service value is a crucial dominant indicator in customer decision-making. However, there is a lack of hospitality literature that investigates the multi-dimensional service value in emerging markets. Thus, this study aims to create a multi-dimensional scale for service value and to analyze how different service value dimensions affect customers repurchase intentions at fast-food restaurants. We make a conceptual framework with eight constructs, including service value and repurchase intention. A self-administrated questionnaire is used to gather empirical data from fast-food restaurant customers in Egypt. We employ confirmatory factor analysis to extract the model's reliability and validity. Moreover, we use a structural equation model to extract the model regressions and correlations using AMOS software. We find that each of the eight proposed service value variables impacts fast-food restaurant customers' repurchase intention. However, the factors that strongly influence customers' preferences to make more purchases are service equity, confidence benefits, service quality, and service reputation. We contribute to the literature on hospitality customer value and repurchasing intentions by presenting a comprehensive multi-dimensional service value framework that affects customers' repurchase intentions in fast-food restaurants. Practically, eight service value variables can help managers of fast-food restaurants meet customer needs and gain a competitive advantage. We suggest many crucial recommendations to restaurant managers regarding the priority of the service value constructs. For example, managers should consider service equity, service quality, and service reputations as a priority of the restaurant service value.

Scenarios to Improve the Patient Experience Time in a Tertiary Academic Hospital Using Simulation

Background Shortening the patient experience time (PET) in the emergency department (ED) improves patient quality and satisfaction and reduces mortality and morbidity. Worldwide, the PET target in the ED is ≤ 6 hours; however, the PET awaiting admission to inpatient Medicine at Hamad General Hospital (HGH) in the Qatar State, through ED is currently 15.3±6.4 (mean ± SD) hours. Aim Identify solutions to reduce the PET duration at HGH-ED to the international target. Method A cohort study was done using the Discrete-event simulation (DES) model, utilizing a commercial simulation software package (Process Model Inc., Utah, version 5.2.0). One-year data, January 1, 2019 - December 30, 2019, was analyzed and found to follow seven subprocesses. The duration of each subprocess was recorded, and the average time was calculated. A computer simulation scheme was developed for all the subprocesses of the actual PET duration. The simulated PET was validated, and scenarios were proposed and assessed for each subprocess separately and in combination, A constructed simulatory design using an iterative process involving a construction model. This model starts with the logical organization of submitted tasks based on their cycle times. A subject-matter expert interview was conducted to determine the appropriateness and frequency of actions. The duration of each activity in the considered process was defined using a triangular distribution. Results The actual PET duration for the Medical Department was 15.3±6.4 (mean + SD) hours. The three most prolonged PET subprocess durations were in the referral to internal medicine, the decision to admit, and finding a free bed; these represent 17.9%, 53.8%, and 16.7% of the PET, respectively. Adding two physicians to each shift, which shortens the subprocess of the decision to admit, reduced the PET duration by 27.5%. Moreover, creating a new admitting team (unit) that takes care of new patients admitted to the ED reduced PET duration by another 12.5%. Combining these two scenarios reduced the average PET duration to only 10.2±0.5 hours. In addition to these scenarios, the PET can be further decreased to six hours by increasing the number of inpatient beds. Conclusions The simulated scenarios indicated that restructuring the medical teams, adding two physicians to each shift, and creating an admissions team dedicated to the ED would reduce the total PET duration to 10.2 hours, Furthermore, PET's further reduction to six hours is predictable by increasing the bed number.

Using Telemedicine during the COVID-19 Pandemic: How Service Quality Affects Patients' Consultation

The COVID-19 epidemic put pressure on the traditional healthcare system and offline consultation methods. Telemedicine platforms provide a more convenient and safer channel for online health communication. Based on the signaling theory, our study explores the impacts of three dimensions of physicians' service quality (need fulfillment, security, and responsiveness) on online patient consultation on telemedicine platforms. A negative binomial model was used to test cross-sectional data of 2982 physicians obtained from Haodf.com. The results show the following: (1) the need fulfillment dimension variables positively affect online patient consultation; (2) the security dimension variables positively affect online patient consultation; (3) the responsiveness dimension variables positively affect online patient consultation. Our results contribute to the theoretical aspect of signaling theory and service quality in the context of telemedicine platforms and have several practical implications for telemedicine platform physicians and platform operators.

Primary Health Institutions and Service Quality in China: Implications for Health Policy

BACKGROUND

To protect and improve the health of populations, the important role of primary health institutions has been strengthened through a series of health policies, especially the implementation of a national hierarchical diagnosis and treatment system. In this light, we aim to evaluate the development of primary health institutions between 2013, before the implementation of the hierarchical diagnosis and treatment system, and 2020 as well as people's perception of the quality of primary healthcare services.

METHOD

The national-level data (e.g., the numbers of primary health institutions, personnel, beds, visits, and hospitalizations) regarding primary health institutions were collected from the Health Statistics Yearbook, and the perceptions of the quality of primary healthcare services were collected by a web-based questionnaire survey using an internationally recognized assessment tool (i.e., PCAT-AE). In total, 10,850 persons were surveyed, and 10,419 participants were incorporated into the final analysis after removing invalid questionnaires. A descriptive statistical analysis (i.e., frequency and percentage) was used to analyze the national-level characteristics of primary health institutions and people's perceptions of the quality of primary healthcare services. Moreover, a logistic regression model was used to analyze the factors influencing the perceptions of the quality of primary healthcare services.

RESULTS

From the macro perspective, the number of primary health institutions, beds, and personnel per 10 thousand residents slightly increased from 2013 to 2020, especially in the eastern and central areas. However, the average number of visits and the hospitalization rate in primary health institutions showed a decrease, especially in central and eastern areas. Among participants, 92.2% (9606/10,419) of them had previously sought healthcare services in primary health institutions, and most were seeking general outpatient services (57.06-63.45%), followed by medicine purchasing (16.49-21.51%), physical examinations (9.91-11.49%), preventive health services (5.11-6.48%), and hospitalization services (3.17-5.67%). The total perception scores on the quality of primary healthcare services reported by the participants were 26.19 and 27.00 for rural and urban areas, respectively, which accounted for 65.5% and 67.5% of the total score, respectively, and 26.62, 26.86, and 25.89 for the eastern, central, and western areas, respectively, with percentages of 66.6%, 67.2%, and 64.7%. The perception score on the quality among people contracted with a family doctor (29.83, 74.58%) was much higher than those who were not (25.25, 63.13%), and the difference was statistically significant (p < 0.001). Moreover, people who were female, married, had higher incomes, and were diagnosed with various diseases had better perceptions of the primary healthcare services compared to their counterparts (p < 0.05).

CONCLUSION

Improvements were seen for primary health institutions, especially in terms of hardware resources such as beds and personnel. However, the service utilization in primary health institutions did not improve between 2013 and 2020. The perception score on the quality of primary healthcare was moderate to low in rural and urban as well as eastern, central, and western areas, but it was significantly higher among people contracted with a family doctor than those who were not. Therefore, it is important for policy makers to take or adjust measures focusing on quality improvement and increasing the service utilization in primary health institutions with good first contact, accessibility, continuity, comprehensiveness, and coordination, such as raising the enrollment rate of family doctors and promoting the provision of high-quality services.

The Quality of Puhui Early Education Services in Chinese Teachers' Perspectives: Evidence from a National Validation Study

In this study, we examined the quality of Puhui early education services perceived by Chinese teachers with evidence from a national validation study. Firstly, using a stratified cluster sampling method, the Puhui Early Education Service Quality Scale (PEESQ) was developed and validated with 994 Chinese teachers. Secondly, the psychometric properties indicated that PEESQ is a reliable and valid scale with three dimensions: service adequacy, service balance, and public service welfare. Thirdly, descriptive statistics found that Chinese teachers generally appreciated the quality of Puhui services, ranking the construct of "public welfare" the highest and "service balance" the lowest. Finally, hierarchical regression analysis found that urbanicity positively predicted teacher evaluations after controlling for demographic and kindergarten factors. The findings imply that more funding support and policy attention should be provided to help enhance the quality of Puhui early education services (EES). Moreover, this study extends the framework of research on teacher evaluation of EES and provides useful tools to evaluate universal EES in China and beyond.

The Effects of Information Continuity and Interpersonal Continuity on Physician Services Online: Cross-sectional Study

BACKGROUND

Web-based medical services have become an effective supplement to traditional services in hospitals and an essential part of medical services. Studies have shown that web-based medical services are useful for shortening the delayed admission time and for enhancing the treatment effect from the service continuity perspective. However, the specific measures that patients and physicians should take to improve service continuity remain unknown.

OBJECTIVE

Based on the information richness theory and continuity of care, this study investigates the dynamic effects of information continuity and interpersonal continuity on physician services online.

METHODS

Data of 7200 patients with 360 physicians covering complete interaction records were collected from a professional web-based platform in China. Content analysis was performed to recognize matching patients and physicians, and least square regression analysis was performed to obtain all empirical results.

RESULTS

Empirical results showed that in the short term, information continuity (including offline experience, medical records, and detailed information) influences physicians' web-based services, and their influences show heterogeneity. Moreover, if a patient's online physician is the same physician who he/she has visited offline, we find that interpersonal continuity is important for service. In the long term, information continuity and interpersonal continuity positively improve service continuity by facilitating repeat purchases.

CONCLUSIONS

Overall, our findings not only shed new light on patient behavior online and cross-channel behavior but also provide practical insights into improving the continuity of care in online health communities.

Mediating effects on the relationship between perceived service quality and public library app loyalty during the COVID-19 era

The demand for using library apps to search for information has been increasing after the COVID-19 outbreak. To look into how the pandemic affects the users’ perception of the loyalty of using library apps, we designed this research by amalgamating the updated IS success model and S–O-R model to evaluate the service quality of a public library app under the Hong Kong Government mobile applications initiative. A third-order model is established to demonstrate the multi-faceted aspects of service quality and mediating effects of perceived brand image, satisfaction, and e-word of mouth. Using structural equation modeling, data collected from Hong Kong, a metropolis where mobile services empower its citizens, showed the interrelationships among service quality and possible outcomes (i.e., perceived brand image, user satisfaction, e-word of mouth, and user loyalty). Findings also indicate that the influence of perceived service quality on user loyalty could only be achieved through perceived brand image and user satisfaction. This is a timely study during the COVID-19 pandemic, as the lockdown and social distancing arrangements created challenges for citizens to search for information in public libraries in person. Our findings and suggestions reiterate the importance of considering the usability concepts when analyzing the service quality of each unique app. They also provide insights for practitioners in developing the next generation of apps for smart public information services and call for further investigation into the proposed hierarchical model and other potential factors related to service quality.

Mediating Effect of Compassion Competence on the Relationship between Caring Behaviors and Quality of Nursing Services in South Korea

This study aimed to investigate the mediating effect of compassion competence on the relationship between caring behaviors and the quality of nursing services. Participants included nurses working in South Korean hospitals. Data collected from 1 November to 31 December 2020 were analyzed using a t-test, analysis of variance (ANOVA), Pearson’s correlation coefficients, and hierarchical multiple regression. We found that caring behavior had a positive correlation with the quality of nursing services and compassion competence. Moreover, there was a positive correlation between the quality of nursing services and compassion competence. Compassion competence had a significant mediating effect on the relationship between caring behaviors and quality of nursing services. This suggests that nurses’ caring behaviors can enable high-quality nursing services influenced by compassion. Therefore, in order to improve the quality of nursing services, repeated and continuous implementation of training programs including education that can improve compassion competence is necessary.

The Impact of Hotel Customer Engagement and Service Evaluation on Customer Behavior Intention: The Mediating Effect of Brand Trust

Because of the COVID-19, the tourism industry has been greatly affected, especially the occupancy rate of hotel companies. This study analyzes the effects of customer engagement and service evaluation on brand trust and customer behavioral intention based on 437 valid questionnaires from Chinese economy hotel companies using SPSS and AMOS. The components of customer engagement are subdivided into five dimensions: identification, enthusiasm, attention, absorption and interaction, and the impact of these five dimensions on brand trust in the COVID- 19 is investigated. Finally, it verifies the influence of trust on customers' word-of-mouth (WOM) intention and customers' reuse intention. The results of this study not only enrich the research on customer engagement and service evaluation in marketing circles but also give some advice to hotel companies in the COVID-19 customer engagement and service evaluation that can enhance the trust of enterprises and promote the behavior intention of customers, which has certain practical reference value.

Service Quality and Customer Satisfaction in the Post Pandemic World: A Study of Saudi Auto Care Industry

The aim of this research is to examine the impact of service quality on customer satisfaction in the post pandemic world in auto care industry. The car care vendor in the study made effective use of social media to provide responsive updates to the customers in the post pandemic world; such use of social media provides bases for service quality and customer satisfaction. The study examined the relationship between service quality and customer satisfaction using the SERVQUAL framework. According to the findings, empathy, reliability, assurance, responsiveness, and tangibles have a significant positive relationship with customer satisfaction. Our findings suggest that it is critical for workshops to recognize the service quality factors that contribute to customer satisfaction. Findings also suggest that empathy, assurance, reliability, responsiveness, and tangibles contribute to customer satisfaction. Auto repair industry must regularly provide personal attention, greet customers in a friendly manner, deliver cars after services, notify customers when additional repairs are required, and take the time to clarify problems to customers. Furthermore, workshops must screen and hire courteous staff who can clearly communicate the services required to customers both in-person and online and effectively communicate the risks associated with repairs. Service quality seems to be aided by prompt services.

The Impact of Incentives on Job Performance, Business Cycle, and Population Health in Emerging Economies

In the past, different researchers have conducted studies on incentives and how they are linked to employee motivation, influencing emerging economies. This study addresses two gaps as outlined in previous studies. One research gap exists in examining employee loyalty and employee engagement in relation to the business cycle. The other gap is observed in the recommendation that future researchers use different moderators between incentives, the health of employees, and job performance with population health. This focus was explored in the present study by identifying the responses of hospitals and physicians to the business cycle to examine the impact of incentives on job performance and health of workers in public and private sector hospitals in Shandong, Eastern China. Data were collected in the form of questionnaires that consisted of close-ended questions. These questionnaires were then filled out by 171 doctors and 149 nurses working in both public and private sectors in Shandong, Eastern China. The results showed that there is a relation between different variables. Some variables have more impact on other variables such as transformational leadership, which has a significant impact on the job performance and business cycle, whereas monetary incentives also impact job performance and population health, but this impact was lower than that of transformational leadership in terms of how job performance influences emerging economies.

Effect of Brand Experience on Customer Engagement Through Quality Services of Online Sellers to Students in Bekasi

Customer engagement refers to the emotional attachment a student experiences as a customer during repeated and ongoing interactions. Engagement occurs through satisfaction, loyalty, and excitement about the brand experience. Organizations engage customers at the point of behavioral change by exploring opportunities for emotional connection through continuous and consistent positive experiences. When customers engage with a brand experience, they feel emotionally connected and excited about the product and the service quality. This study's purpose is examining the effect of brand experience on customer engagement by using service quality as a mediator variable; this research was conducted by collecting data from 254 students of the iGeneration born in 1995. Overall, 254 students participated in this study. Of them, 172 people or 68% of the total respondents in this study were women, and 82 people or 32% were males. The results show no direct effect of brand experience on customer engagement, and there is a role for service quality mediators that mediate brand experience and customer engagement. The results are discussed, and the implications for the organization are mentioned.

Factors affecting domestic tourists' repeat purchase intention towards accommodation in Malaysia

The hospitality and tourist industries depend on homestays and accommodations. Different factors, i.e., promotion strategies, service quality, cleanliness, and perceived health risks, influence tourists' repeat purchase intention for accommodation. This study highlights different variables influencing domestic tourists' accommodation repurchase decisions in Malaysia. Around 304 respondents from this quantitative survey are tourists who have already experienced choosing their accommodations during travel. Statistical Packages of Social science software (SPSS-23.0) were used to examine the data through multiple regression and descriptive approaches. The finding suggests that promotion, and services, can positively affect visitors' purchasing decisions. However, there is a negative but statistically significant link between perceived health risk and repurchase decisions. Furthermore, the result revealed that the predictors of purchase decisions significantly influence selection. This study observed the undervalued quality of services and facilities provided by the hotel industry. The results identified that sustainable practices could enhance the impressive recovery of the tourism industry during and after the pandemic. Furthermore, cleanliness and cost are vital to be considered a primary quality service factor, reducing the perceived health risk, even if there is a pandemic. The study suggested that lodging providers could upgrade on-site facilities and acquire better promotion strategies. The study's conclusions can increase satisfaction to avoid health risks in any circumstance and promote tourism.

Revealing travellers’ satisfaction during COVID-19 outbreak: Moderating role of service quality

User-Generated-Content (UGC) has gained increasing attention as an important indicator of business success in the tourism and hospitality sectors. Previous literature has analyzed travelers' satisfaction through quantitative approaches using questionnaire surveys. Another direction of research has explored the dimensions of satisfaction based on online customers' reviews using the machine learning approach. This study aims to present a new method that combines machine learning and survey-based approaches for customers' satisfaction analysis during the COVID-19 outbreak. In addition, we investigate the moderating role of service quality on the relationship between hotels' performance criteria and customers' satisfaction. To achieve this, the Latent Dirichlet Allocation (LDA) was used for textual data analysis, k-means was used for data segmentation, dimensionality reduction approach was used for the imputation of the missing values, and fuzzy rule-based was used for the prediction of satisfaction level. Following that, a survey-based approach was used to validate the research model by distributing the questionnaire and analyzing the collected data using the Structural Equation Modeling technique. The result of this research presents important contributions from the methodological and practical perspectives in the context of customers' satisfaction in tourism and hospitality during the COVID-19 outbreak. The outcomes of this research confirm the significant influence of the quality of services during the COVID-19 crisis on the relationship between hotel services and travellers’ satisfaction.

Reshaping the bank experience for GEN Z in France

The objective of this research is to understand the service e-quality dimensions that contribute to creating value for Generation Z (Gen Z) consumers when choosing Internet-Only Banks (IOBs) services. The data were collected from a sample of Gen Z IOB users in France. Structural Equation Modeling was used to test the hypotheses. Results suggest that reliability, customer service and support, product portfolio, bank transparency, personalization, and security and privacy are positively related to IOB’s consumer perceived value and that consumers’ perceived value positively affects IOB’s consumer loyalty. This study reveals that IOBs in France should focus on those dimensions to tailor a unique customer experience to Gen Z.

Impact of Service Quality of Low-Cost Carriers on Airline Image and Consumers' Satisfaction and Loyalty during the COVID-19 Outbreak

Low-cost carriers (LCCs) in Saudi Arabia operate in a competitive, highly demanding environment. Customer-related attributes may be influenced by the levels of service quality in a no-frills airline, which might impact satisfaction and loyalty. Given the unique traveler and market characteristics of the aviation sector in the kingdom, we sought to investigate the impact of service quality of LCCs on customer satisfaction and loyalty and the perceived airline image. A total of 299 passengers at two international airports were approached using a modified SERVQUAL scale. Results revealed that service quality was a significant predictor of customer satisfaction (β = 0.46, p < 0.0001), airline image (β = 0.55, p < 0.0001), and customer loyalty (β = 0.16, p = 0.006). The responsiveness dimension was the most important dimension of service quality, since it predicted all other constructs (satisfaction, loyalty, and brand image). Airline tangibles and reliability were independently associated with brand image and loyalty, respectively. Based on these results, LCCs should tailor future strategic plans that rely heavily on improving different service quality measures, particularly the responsiveness domain.

Cycling for a Sustainable Touristic Mobility: A Preliminary Study in an Urban Area of Italy

This study wants to give a contribution for the investigation of sustainable mobility with positive consequences on public health implementing policies starting from cyclists’ perceptions. Data were collected by interviewing cyclists along three bike lanes of an urban area of southern Italy through a face-to-face survey. The survey was conducted in Autumn 2019, interviewing a sample of 129 cyclists. In order to identify the critical aspects of the bike paths, both an importance-performance analysis (IPA) and a gap-IPA were performed. The average values of the cyclists’ perceptions of each aspect have been considered as performance values. The importance values have been obtained by performing a principal component analysis (PCA), which was helpful also for better defining the service quality phenomenon. From the PCA, six latent constructs can be identified as: “Physical Nuisance”; “Non-physical Nuisance”; “Physical Comfort”; “Non-physical Comfort”; “Protection”; and “Ambience”. The results of Gap-IPA confirmed that the criticalities of the bike paths relate to the degree of protection in relation to accidents, and to the degree of nuisance caused by pollution and opposing pedestrians along the path. Based on the conducted analyses, sustainable tourism implementing policies should be oriented in solving the emerged criticalities of the existing bike paths. The results of Gap-IPA are very intuitive and can certainly be helpful for identifying the most convenient strategies.

Management of Loyalty and Its Main Antecedents in Sport Organizations: A Systematic Analysis Review

Sports management is booming, thanks to society's growing interest in sports in general. This work provides an exhaustive review of the scientific literature of one of the variables most coveted by managers: loyalty. Antecedents positively related to loyalty are also conceptualized in this paper. The scientific literature search was limited to the last 15years to achieve a better fit with today's context. The Web of Science database was the main search method used, along with other, secondary resources, for a total of 328 scientific articles obtained as a base for this review. The results of this study bring together the most representative data in a systematic review of the loyalty variable in the field of sports management: the antecedents of loyalty, the terms with the greatest presence in the theory, the most representative authors and sources of this topic, and so on. One of the most significant results obtained from the review of these 300 bibliographical references is that the factors to be borne in mind for marketing strategies in sports organizations are satisfaction, commitment, trust, and service quality. The literature reflects that these variables, present in studies on loyalty in general, can also be found in the literature on sports management - in particular, satisfaction and service quality. However, few papers include all these antecedents at once, making this an interesting field for future research.

Application of Rough Set Theory to Improve Outpatient Medical Service Quality in Public Hospitals Based on the Patient Perspective

Purpose: To analyze the key factors and decision-making behaviors affecting overall satisfaction based on perceptual data of outpatients. Methods: The official satisfaction questionnaire developed by the National Health Commission of the People's Republic of China was used. Rough set theory was used to identify the perception patterns between condition attributes (i.e., service factors) and a decision attribute (i.e., overall service level) and to express them in rule form (i.e., if-then). Results: The four minimal-coverage rules, with strength exceeding 10% in the good class, and six crucial condition attributes were obtained: "Ease of registration (C ₁)," "Respected by registered staff (C ₂)," "Registered staff's listening (C ₃)," "Respected by doctor (C ₉)," "Signpost (C ₁₂)," and "Privacy (C ₁₆)." In addition, the average hit rate for 5-fold cross-validation was 90.86%. Conclusions: A series of decision rules could help decision-makers easily understand outpatients' situations and propose more suitable programs for improving hospital service quality because these decision rules are based on actual outpatient experiences.

Perceived Service Quality in HRI: Applying the SERVBOT Framework

Services are intangible in nature and as a result, it is often difficult to measure the quality of the service. In the service literature, the service is usually delivered by a human to a human customer and the quality of the service is often evaluated using the SERVQUAL dimensions. An extensive review of the literature shows there is a lack of an empirical model to assess the perceived service quality provided by a social robot. Furthermore, the social robot literature highlights key differences between human service and social robots. For example, scholars have highlighted the importance of entertainment value and engagement in the adoption of social robots in the service industry. However, it is unclear whether the SERVQUAL dimensions are appropriate to measure social robot's service quality. The paper proposes the SERVBOT model to assess a social robot's service quality. It identifies, reliability, responsiveness, assurance, empathy, and entertainment as the five dimensions of SERVBOT. Further, the research will investigate how these five factors influence emotional engagement and future intentions to use the social robot in a concierge service setting. The model was tested using student sampling, and a total of 94 responses were collected for the study. The findings indicate empathy and entertainment value as key predictors of emotional engagement. Further, emotional engagement is a strong predictor of future intention to use a social robot in a service setting. This study is the first to propose the SERVBOT model to measure social robot's service quality. The model provides a theoretical underpinning on the key service quality dimensions of a social robot and gives scholars and managers a method to track the service quality of a social robot. The study also extends on the literature by exploring the key factors that influence the use of social robots (i.e., emotional engagement).