The influence of hospitable design and service on patient responses

ABSTRACT

A study of 216 respondents examined a medical center environment’s influence on patient responses. A stimulus–organism–response (S-O-R) model was adapted to the theory that more hospitable healthcare servicescape elements will affect patients’ overall satisfaction with healthcare experience, loyalty intentions, and willingness to pay out-of-pocket expenses for healthcare services. Servicescape elements included atmospherics of the healthcare environment, service delivery by healthcare staff, physical design of the healthcare environment, and wayfinding. Results of structural equation modeling confirmed that the four servicescape elements – had a significant impact on patients’ overall satisfaction with the healthcare experience. Furthermore, overall satisfaction with the healthcare experience predicted patients’ loyalty intentions and willingness to pay out-of-pocket expenses for healthcare services. The study makes a significant contribution to the empirical modeling of patients’ behavioral responses to hospitable healthcare environments.     

Social media's contribution to customer satisfaction with services

An important recent initiative in the effective transmission of healthcare services is the establishment of the patient-centered medicine (PCM) philosophy as a mechanism for enhancing customer satisfaction. Although the goals of PCM are important, there is less understanding of the means by which service providers can promote this philosophy.

This study examines the relationship between customers’ attitude toward and use of social media, PCM, and their satisfaction with healthcare services. Data were collected from a large, urban-based pediatric office in the northeast. The sample consisted of 234 respondents who were classified as ‘e-Patients’ – that is, they reported having access to the Internet and going online for health information. A three-stage regression analysis, conducted to establish the path coefficients for each stage in the model, shows that customers’ (patients’) attitude toward social media can be an effective method to enhance PCM and, ultimately, satisfaction. The findings contribute to theory in services by exploring the challenges of managing service delivery at the interface between customer satisfaction and the role and usefulness of adopting and effectively using social media.     

Providing a critical service today for tomorrow's consumers: A relational model of customer evaluations and responses in the child care industry

Based on data collected in the important and rapidly expanding child care services industry, this study develops and tests a model that examines the relationships among customers’ evaluations of service performance dimensions, their satisfaction with and trust in the organization, as well as their word-of-mouth intentions and also investigates the role of social status in the proposed relationships. The results show that non-interpersonal (i.e., hard) service quality attributes have a greater impact on customer satisfaction while interpersonal (i.e., soft) service quality attributes have more influence on trust. Word-of-mouth intentions are primarily driven by trust and the hard dimension of service performance. Social status is shown to act as a moderator of many of the relationships in the model. The findings of the study offer important implications for providers of child care and other consumer services that are high in credence qualities.     

Exploring quality perceptions of health care operations: a study of public hospitals of Mauritius

Patient care has become increasingly important in the health care environment of Mauritius. Patients' satisfaction and their expectations of health care are valid indicators of quality health care. The present paper reports the results of a survey of patient satisfaction with heath care, administered by face-to-face interview to 300 in-patient adults discharged from five main regional hospitals based in Mauritius. It examines the predictors and level of patients' satisfaction across the five regional hospitals of Mauritius. In this study, a modified version of HEALTHQUAL scale was used for determining patient satisfaction with health care in the regional public hospitals. Multiple regression analysis was conducted to understand the relationships among patients' perceptions of in-patient services and their overall perceptions of health care quality, and also satisfaction with their care and willingness to return or recommend the same hospital's services to others. The dimensions labelled as "Patients' perceptions of ward/hospital environment" and "Patients' perceptions of medical and nursing staff" served a significant impact on nearly all measures of patient satisfaction in the regional public hospitals of Mauritius.     

Perceived value and customer loyalty in financial services

Taking into account how expensive it is to maintain customer loyalty programmes, it is necessary to know which aspects of the firm’s service are the ones that really deliver value to the customer. The aim of this paper is to study the relationships between perceived value, satisfaction and consumer loyalty in the financial services market, in order to know which factors are the most important for gaining the customers’ loyalty. A personal survey was made of 200 customers of financial entities, and structural equations models were used to test the relationships posited.     

Effects of personalized e-mail messages on privacy risk: Moderating roles of control and intimacy

New communication platforms have enabled firms to collect personal data on their consumers and provide more personalized services. Personalized service facilitates interpersonal communication and interactions based on consumers’ personal and preference information, and therefore constitutes a way to improve firm–customer relationships. However, such personalized services may be vulnerable to privacy issues. This study investigates the effects of personalized e-mail messages (an archetypal example of personalized service) on consumers’ risk perceptions and two moderating variables: consumers’ control and message intimacy. In three experiments, we show that an increase in the level of personalization in e-mail messages increases consumers’ privacy risk perceptions. However, giving consumers more control over their personal information and adding intimate cues to e-mail messages moderate the negative effects of personalized e-mail messages on their privacy risk perceptions. The study provides important implications for both academics and managers in developing and employing personalized service in new media communication.     

Rating healthcare services: consumer satisfaction vs. health system performance

The complex healthcare services and the consumer’s lack of technical knowledge to assess them engender a debate over using consumer satisfaction ratings as a quality-of-care marker. This paper aims firstly to investigate the effect of socio-demographic, socio-economic and spatial characteristics on the perception of quality of healthcare and secondly to evaluate the relationship between consumer satisfaction and health system performance. Reporting a Eurobarometer survey and the scores of the Euro Health Consumer Index, the finding is that some socio-demographic groups are more likely to get unsatisfied with healthcare services than others (e.g. women, those over 24 years old, those who self-define themselves as working class). Moreover, a strong relationship is revealed between consumer satisfaction and health system performance. The higher the performance of a health system, the higher the propensity to have consumers with positive perception of the healthcare services (satisfied consumers). The implications of the findings are then discussed.     

Dimensions of service quality and satisfaction in healthcare: a patient’s satisfaction index

The assessment of patients’ satisfaction levels, and the knowledge of what factors influence satisfaction are very important for healthcare managers as it influences healthcare results and healthcare institutions financial results. The objective of this research is to analyse patients’ satisfaction levels in a set of four Portuguese primary Healthcare Centres, through the estimation of a satisfaction index, which simultaneously explains which dimensions of healthcare quality influence that satisfaction the most. For that, a conceptual model of patients’ satisfaction in primary healthcare was tested using data from a sample of 414 patients. Partial Least Squares path modelling (PLS) was the technique chosen to evaluate the proposed model. The results show that patients’ satisfaction is 60.887 in a scale from 1 to 100, revealing only a medium level of satisfaction. It is also possible to conclude that the most important positive effects on satisfaction are the ones linked to the patient/doctor relationship, the quality of facilities and the interaction with administrative staff, by this order.     

Consumer Satisfaction with a Managed Health Care Plan

This study estimates the effects of four categories of variables hypothesized to influence patient satisfaction with a managed care health benefits plan. Ordinal probit is used to include the full spectrum of information available on the satisfaction measure. Results indicate that personal experience, expectations, and judgments about services covered influence overall satisfaction with the plan. Individual differences have little effect on satisfaction.     

Impact of operational innovations on customer loyalty in the healthcare sector

This study investigates the effects of operational innovations, such as application of advanced information technology (IT) systems and supported knowledge and skills (SKSs), on care quality and customer loyalty in the healthcare industry. A research model is proposed based on previous studies and examined the relationships among the constructs using the structural equation modeling approach. Research data were collected through a survey of patients and employees of participating hospitals in Korea, with a patient and an employee as one set. The results of the study indicate that operational innovations result in improved customer closeness, which is associated with IT systems usage and SKSs for delivery of quality care, which have a positive impact on patient satisfaction and customer loyalty. Thus, hospital managers should encourage employees to generate new ideas for work efficiency, care quality, customer loyalty, and organizational performance.     

Customer satisfaction and qualities in public service: an intermediary customer perspective

From an intermediary customer perspective, this study empirically investigates the causal relationships between service quality, relationship quality, design quality, and customer satisfaction in the public service value chain. Cross-sectional survey data were collected from social work, childcare, and healthcare services and were analyzed using structural equation modeling. It is found that all the quality dimensions are antecedents to customer satisfaction and relations between quality dimensions show distinctive patterns. The results show that relationship quality does not directly affect customer satisfaction, but can indirectly influence satisfaction through the mediation of both service and design qualities. The effect of the relationship and design qualities on customer satisfaction is stronger than that of service quality.     

Promoting the quality of hospital service for children with developmental delays

Quality of hospital services is the spotlight that the public are concerned with. This research established an objective and quality index of physical therapies to systematically analyse and propose an innovation strategy for hospital services. This research was to launch the critical index and to investigate the relationship and relative weight of its importance. Analytic network process and Decision Making Trial and Evaluation Laboratory were adopted. The result showed experts from different groups universally identified the ‘function-oriented therapeutic goal’ as most important. The result indicates that hospitals enforce ‘regular satisfaction survey of the patients’, continuously monitor ‘index of patient safety’, which is ‘function-oriented therapeutic goal’ to promote quality of physical therapies in children with developmental delays.     

Effect of service recovery on customers’ perceived justice,satisfaction, and word-of-mouth intentions on online shopping websites

As consumers become better informed and more demanding about their purchase of services, service provider's failure to satisfy all consumers during delivery of service is unavoidable. Consequently, to alleviate consumer dissatisfaction that results from service failure has become important. However, empirical consensus has been lacking on the effects of various service recovery activities. Thus, this study examines the impact of different types of service recovery on customers’ perceptions of justice, post-recovery satisfaction, and word-of-mouth (WOM) intentions. The results indicated that consumers’ perceptions of distributive and interactional justice differ by the types of service recovery and supported significant relationships among perceptions of justice, satisfaction, and WOM intentions. The results implied that consumers respond differently to different types of service recovery and that consumers particularly favor apology among types of service recovery.     

Impact of shared history on customers’ service evaluations

This paper investigates how shared history affects customers' cultural and personal values and impacts their perception of services’ responsiveness and satisfaction in a high-contact service setting (retail banking) from two countries with a shared history (France & Lebanon). Data were collected from 171 French and 141 Lebanese bank customers. Findings reveal that both cultural and personal values moderate the relationship between responsiveness and satisfaction, and that their impact is independent of each other. Further, findings show that in countries with a shared history, existing cultural models in literature may not be detailed enough to explain cross-cultural differences and similarities.     

A critical review of primary health care reform in Bulgaria: impact on consumers

The Health Care System in Bulgaria is in a period of transition and is undergoing profound changes in financing, organization and ownership. A priority of this reform is to shift the focus of healthcare to the primary sector and to emphasize general practice. New legislation in support of this health care reform has been passed over the last few years. However, this legislation, although consistent with the global aims to be achieved, has proven to be contradictory in terms of its practical implementation. This has had a negative impact on health care consumers’ interests and rights. This paper evaluates the effects of primary health care reform in Bulgaria from the perspective of patient satisfaction. For this purpose, a major task to be fulfilled is to identify the contradictions emerging between the legislation outlining the reforms and the realities of practical implementation with respect to its impact on consumers. The methods applied include: a review of the legislation, a review of the practical progression of the reform process, and an assessment of the new developments in health care consumers’ interests and rights. Considerable contradictions have been found between the legal framework of health care reform in primary care and existing experiences, traditions and expectations. The legislation is inconsistent with the existing realities of healthcare provision. This is leading to turmoil in the health care system during its present transformation and is infringing upon consumers’ rights. Problems emerging in the process of reform need to be identified, and solutions need to be found and worked out as the reforms progress. An assessment system has to be developed to monitor the overall reform process and to evaluate the effectiveness and efficiency of the changes introduced. The impact on consumer and patient satisfaction should be an area of prime concern during these assessments.     

Creating consumer satisfaction in maternity care: the neglected needs of migrants,asylum seekers and refugees

An estimated 190 million people are now living outside their countries of birth or citizenship, and the rate of this migration is expected to remain high. The resulting growing cultural and ethnic diversity in societies adds specific challenges to the requirement of delivering public services such as health care to consumers. Globally, about half of the migrant population are women. Migrants’ outcomes of pregnancy are known to be poor, showing significant disparities when compared with those of native populations. Although these disparities have been noted, knowledge is limited regarding the availability and accessibility of healthcare services, as well as the acceptability of maternity care for women with experiences of free and forced migration. Healthcare research in general, and maternity care research specifically, have often neglected this population. This paper examines the existing international guidelines intended to address inequities in health outcomes, policies which have been introduced at national levels, and the widely used concepts of ‘patient‐centred’ and ‘woman‐centred’ health services. The ideals implicit in those guidelines and concepts are contrasted with the available evidence of many overseas nationals’ experiences with healthcare provisions in general, and maternity care in particular. This is followed by reflections on deficiencies in current studies and on those methodological problems which make research on maternity care for migrant women particularly challenging. The conclusion considers the appropriateness and relevance of guidelines currently promoting equity in maternity care and suggests a future agenda for priority research.     

国家城市湿地公园游客满意度评价研究——以无锡长广溪湿地公园为例

城市湿地公园因自身功能的限制,其开发旅游有着先天的不足。本文以无锡长广溪城市湿地公园为研究对象,通过问卷调查和实地访谈的方式探讨了城市湿地公园的游客满意度,认为应通过完善基础设施、挖掘文化内涵、提供人性化服务等措施来提高游客的满意度,从而实现城市湿地公园生态环境保护与社会经济双赢的旅游经营目标。     

Cognitive predictors of satisfaction with hospital inpatient service encounters among the elderly: a matter of trust

Given the burgeoning growth of the elderly population, ensuring the satisfaction of senior consumers of health services is worthy of heightened attention by healthcare administrators both on economic and social grounds. By examining inpatient satisfaction among the elderly, we have focused our attention on an important and understudied segment of health consumers within a dominant service delivery context. Moreover, we have supplemented traditional hospital service satisfaction indicators by including a variety of rarely used psychological variables as cognitive predictors of service assessments. This study reinforces the empirical connection between trust in one's physician and elderly inpatient satisfaction at an increased level. The results suggest that increased levels of trust is positively associated with overall satisfaction of elderly inpatients as well as their satisfaction with several subdimensions of service that represent specific attributes of the hospital inpatient encounter.     

Demographics,job satisfaction,and propensity to leave of industrial salesmen

An extremely important and expensive promotional tool used by industrial marketers is personal selling. One of the major costs of personal selling is the cost associated with sales personnel turnover. Past studies in the sales management area have focused on the effect of organizational and psychological factors on the satisfaction of salespeople and their propensity to leave their organizations. However, no study has examined the interrelationships among salespeople's demographic variables, job satisfaction, and propensity to leave, even though such relationships have been studied for nonselling occupations. An empirical study done to at least partly fill this research void is described. The results provide new insights for researchers and practitioners with an interest in the sales management area.     

An integrative model of customers' perceptions of health care services in Taiwan

As the health care service gets more competitive, health care practitioners and academic researchers are increasingly interested in exploring how patients perceive the quality and value of their care before building up their satisfaction levels and generating behavioural intentions. Drawing some theories from marketing and health care service literature, this study tries to propose an integrative model of customers' perceptions of health care services based on the established relationship among four key constructs (service quality, perceived value, satisfaction, and behavioural intentions). Structural equation modelling is then used to validate the model. As Taiwan's universal health insurance offers every citizen equal financial access to all health care providers, Taiwan offers a good opportunity to study how the patients' perception model is structured. The findings reveal both perceived quality and value as antecedent variables in this model illustrating direct and indirect paths from perceived quality and value to patient satisfaction and behavioural intentions.