Consumers’ views of breast care services in Ireland

One Irish woman in 14 develops breast cancer. There are 1700 new cases each year. These rates compare poorly with EU figures. The government indicated in 1995 that it favoured rapid, comprehensive diagnostic facilities, using the triple assessment model of clinical care, to improve survival rates and to diminish the anxiety women experience about breast cancer. Implementation of this policy was delayed until 1999, when a plan for centres of excellence in breast care was conceived. To compliment this plan, the Department of Health and Children wanted consumer views on existing breast care services. The Women’s Health Council was asked by the Department of Health and Children, through the National Cancer Forum, to conduct research on women’s views and reactions as consumers of existing services for symptomatic breast disease. The research team was asked to document women’s views on: diagnostic services; counselling; additional treatment services such as surgery and radiotherapy. The methodology consisted of four strands: questionnaires and focus groups with consumers of breast care services; postal questionnaires to clinic staff and a literature review. Striking aspects were the long delays women experienced before obtaining a completed diagnosis; often chaotic clinic settings which added greatly to women’s shock and anxiety; the lack of support if they received a diagnosis of cancer; and problems relating to limited resources for cancer treatment, including radiotherapy. We explored women’s coping mechanisms and their experiences, in the context of the model of quality of care. Finally, we argue that a centre of excellence must develop a multidimensional model of breast disease care that incorporates the full range of psycho‐social dimensions for women, if it is to earn its claim to excellence.     

Citizen and consumer involvement in UK public services

This paper is concerned with the involvement and participation of citizens and consumers in UK public services. It reflects on levels of involvement over a 30‐year period and maps this accordingly. Using models of participation, the paper reviews the citizen and consumer concepts. Conclusions are drawn about involvement and participation in practice and how this will develop in the future.     

Encouraging male participation in cancer resource centers

ABSTRACT

This research investigates reasons why male cancer patients may refrain from patronizing cancer resource centers. By drawing upon a wide range of research from the social sciences and visual design literatures, the authors put forth original propositions that suggest how cancer resource center managers can manipulate a center's servicescape, or built environment, as well as its service offerings, website design, and printed communications to attract more male cancer patients. Despite the inherent challenges of discussing gender in cancer care and limitations to its generalizability in all settings, this research reveals that differences exist regarding the way men and women respond to cancer resource center marketing initiatives. Given the profound benefits that cancer resource centers often assume in a cancer patient's life, including a decreased mortality rate, we encourage service marketing and public health researchers, as well as cancer resource center directors, to consider the propositions put forth in this paper.     

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.     

An investigation of consumer intention to use pick-up point services for last-mile distribution in a developing country

Pick-up point services are one response to last-mile distribution challenges in the e-commerce growth scenario. However, in large cities in developing countries where the low-income and high-income groups are clearly divided, differences in consumer behavior between income groups may affect service distribution. The literature shows that most consumers may use pick-up points when available. However, the service implementation is facing huge inertia. A survey was carried out with 396 consumers in São Paulo, and a conceptual framework was proposed to expand the Diffusion of Innovation Theory to reveal these behaviors. Data were accessed using advanced structural equation modeling techniques (Multigroup and IPMA) to conduct a case study. The findings suggest that ‘Trialability’, ‘Compatibility’, and ‘Relative advantage’ constructs most affect consumer behavior. Location security and accessibility are matters of great concern. The higher preference to use the pick-up point system comes from low-income consumers (social classes D and E); almost 96% of them reported being affected by delivery issues. They also prefer personal attendance and supermarkets as safe and accessible locations. Higher social classes (A and B) still prefer home delivery. This research will help retailers to understand how to operate in a given market to provide an effective, fair, and sustainable service, promoting its diffusion.     

Unfairness in consumer services: Outcomes of differential treatment of new and existing clients

In a consumption context, there is a growing interest in understanding unfair behaviour of firms towards customers. Our research focuses on unfairness perceptions driven by differential treatment, particularly through price discrimination, i.e. the practice of charging differential prices to different customers. Our purpose is to investigate the consequences of these practices for unfairness perceptions, satisfaction, trust and patronage, showing a dual perspective: the perceptions of new vs existing clients when they face the advantaged or disadvantaged conditions. A survey-based experimental design approach was used. We conclude that unfairness perception is stronger for existing than for new clients, prompting negative attitudinal and behavioural consequences when the former are exposed to disadvantaged conditions in relation to the latter. Our study aims to provide marketers with a perspective on the pitfalls related to differential treatment between present and prospective clients, with implications in terms of design and implementation of customer management strategies.     

Weathering consumer pricing sensitivity: The importance of customer contact and personalized services in the financial services industry

In a low-cost switching environment, certain firm actions undertaken by service employees can improve consumer loyalty, satisfaction and reduce price sensitivity. Interestingly, consumers' satisfaction levels can actually increase when experiencing a price increase. Counterintuitively, when consumers experience a price decrease, their loyalty decreases, suggesting that it might be in the firm's best interest to not offer such pricing discounts as these customers may be hypersensitive to price. Overall, it appears much easier for service employees to positively influence customer satisfaction than customer loyalty; satisfied consumers do not necessarily become loyal consumers.     

Health Care Entrepreneurship in the Democratic Republic of the Congo: An Exploratory Study

In this empirical study, the authors explore entrepreneurship in the health care business in the Eastern Kasai Province of the Democratic Republic of the Congo (DRC) using cross-cultural literature and the resource-based view to ground its analyses. The data were collected using a questionnaire targeted toward the health care entrepreneurs in Mbuji Mayi, the capital city of the Eastern Kasai Province in July 2010, which yielded 68 responses. The results indicated that the entrepreneurs were predominantly middle-aged Congolese men with backgrounds in the health services field who had raised their startup capital mostly from personal savings or friends and family. Their businesses, which were mostly in the form of sole proprietorships, were likely to be located in areas underserved by public medical facilities and usually provided both curative and preventative medical services.     

Reconstructing consumer participation in evidence‐based health care: a polemic

Consumer participation in the evidence‐based health‐care movement is largely seen as important by those who promote evidence‐based health care but is surrounded by a range of competing discourses that variously critique medicine, nursing or health‐care systems; situate consumers as powerless players within systems characterized by controlling health professionals; or politicize the role of the consumer as activist and defender of patient rights. This paper explores these competing discourses and develops an argument that asserts that the social construction of the evidence‐based movement has rendered previously accepted terminology regarding the user or receiver of health services relatively meaningless. The result has been the ‘politicisation’ and ‘professionalisation’ of consumer participation and the time has come to reconstruct consumer participation in evidence‐based health care – from the generation of evidence to guideline development.     

Blockchain application in consumer services: A review and future research agenda

The potential of blockchain technology (BCT) to modify and innovates established business structures and frameworks has received widespread attention. Academia and businesses are becoming increasingly curious about how this technology could be used to improve and refine consumer services and operations. Despite the growing popularity of blockchain research in consumer services, there remains a dearth of detailed summaries in the literature. Hence, this bibliometric analysis, combined with a systematic literature review (SLR) using SPAR-4-SLR protocol with the theories, characteristics, contexts, and methods framework (A hybrid review), aims to convey qualitative and quantitative knowledge on the ever-evolving subject of blockchain application in consumer services in an organized manner. Specifically, this article analyses: (1) the current publication trends in studies devoted to blockchain-based applications for consumers, (2) the most important publications and themes of research in this field, (3) the evolution of blockchain in consumer service over the years, and the most current trends in this field, (4) the advantages and challenges of incorporating BCT into consumer services, (5) gaps in the existing literature that future researchers should investigate. In addition, this review also describes the widely used theories, characteristics, and methods in the application of blockchain in consumer service research by examining the most applied theories, methods, constructs, and study contexts and paving the way for new research directions. The review includes 417 documents after searching for scholarly publications in two databases (Web of Science and Scopus) and choosing documents based on their relevance to the stated goals.     

An investigation of consumer evaluation of brand extensions

This paper deals with the effects of perceived quality, perceived fit and perceived difficulty, and interaction between perceived quality and fit on consumer evaluations of brand extension. We used multi‐item scales to measure these constructs. Data were analysed via structural equation models. Results show that both perceived quality and perceived fit have direct positive effects on consumer evaluation of extensions. We find support for the chance of transferring the positive values of a brand to an extension is greater when consumers see the extension as a good fit with the original brand and the original brand is considered as of high quality.     

An evaluation of strategic responses to consumer boycotts

This article documents the relative effectiveness of the various marketing strategies, in particular the public relations strategies, that firms use to combat the likelihood of boycotts as a politically motivated form of anti-consumption. This study focuses on boycotts that relate to corporate practices and aims to provide a rationale for appropriate publicity-based responses to the threat of corporate practice related boycotts. The purpose is to determine whether the techniques that firms use to mitigate the detrimental effects of negative publicity will be similarly effective for a boycott situation. The authors use two experiments to investigate the influence of publicity-based strategic responses to boycott requests on consumers' perceptions and behavior.     

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.     

The algebra of health concerns: implications of consumer perception of health loss,illness and the breakdown of the health system on anxiety

The current and expected future state of the American health care system creates much concern and anxiety at the national and individual level among Americans. This study is in response to the call of the Institute of Medicine to further study the lack of confidence among Americans about their future ability to receive high‐quality health care. This study compares perceived anxiety and its amelioration as a result of three possible health situations: illness with infectious disease, losing one's health and a breakdown of the health care system. This empirical study was conducted within the framework of conjoint analysis. We conducted an experimental design of ideas, identified attributes that increased or reduced anxiety in each of the three health‐related situations and then segmented consumers on the basis of their patterns of reactions to the attributes. We found that the highest anxiety was attributed to the breakdown of the health care system. The segmentation further suggested that the anxiety emerging from the breakdown of society's health care system generated a different extent of anxiety than that which emerged from one's illness or one's loss of own health. The attributes that drove anxiety across the health situations were, surprisingly, charities, one's company, the local hospital and supplemental insurance. Attributes that reduced anxiety differed among segments. The attributes were found to be: close friends, family, distribution of information by authorities and the belief in God. At a practical level, these data and patterns of response allow health care policy makers to enhance the coping ability of patients by understanding the nature of what reduces the anxiety of individual types of patients. The approach in this study provides a person‐centred system for communication and anxiety reduction that can be implemented as part of a public health policy.     

The influences of consumer innovativeness and consumer evaluation attributes in the purchase of fashionable ethnic wear in India

This paper highlights the consumer motivations for purchase of an innovative product like fashionable ethnic wear in India. It attempts to combine consumer innovativeness constructs and consumer evaluation attributes to understand buying behaviour in fashionable ethnic wear through a consumer survey. It confirms the relationship between product usage (the number of brands bought) and ethnic wear domain‐specific innovativeness. It also explores the correlations among different dimensions of consumer innovativeness like domain‐specific innovativeness, optimum stimulation level and consumers' need for uniqueness constructs. It shows the difference in importance attached to the chosen consumer innovativeness constructs and consumer evaluation attributes by buyers and non‐buyers in the purchase process.     

The morality of spending in Finnish youth consumer culture

This article discusses the morality of spending (i.e. the unnecessary spending) as well as the freedom of spending in Finnish consumer narratives written by 16‐ to 19‐ year‐old pupils. First, the study explores different meanings of the unnecessary spending discourse. Second, the study argues that young consumers are using a wastrel metaphor (i.e. a squanderer, a prodigal son/daughter) as a symbol of liberation from the shame of spending. A narrative research approach is applied for the collection and analysis of data and illustrating the results. The qualitative data were collected in five upper secondary schools between November 2001 and May 2002. The morality of spending comprises various significances, although the discourse is often pleasure‐oriented for youth. Some youngsters define the unnecessary spending as a criticism of the consumer society. Furthermore, the discourse strengthens self‐control as well as helps to arrange both positive and negative consumer experiences. Thus, the morality of spending is a part of the process of growing up as a consumer and constructing a consumer identity.     

An integrative model of consumer satisfaction in the context of e‐services

This research examines how customer satisfaction affects its antecedent and outcome variables such as expectation, performance, disconfirmation, word‐of‐mouth, brand loyalty, attribution and repurchase. This research also takes the important integrative step of understanding the consumer behavioural constructs of consumer satisfaction. Although researchers have focused on the antecedents of consumer satisfaction, our integrative model has extended the outcomes of consumer behaviour on consumer satisfaction. Furthermore, this model strongly suggests a positive view of the inter‐relationships between the antecedent variables and outcome variables of satisfaction. In particular, our model is not consistent with Oliver's attribution models in which satisfaction is a consequence of attribution processing. All hypothesized variables were supported by our empirical study. The findings present a variety of guides to formulating marketing strategies for both practitioners and academics.     

Foreign environments: The internationalisation of environmental producer services

The ‘greening’ of manufacturing firms has created new markets for environmental producer services. Environmental service providers from industrialised countries are more and more forced to internationalise, often due to the international activities of their client firms or to an insufficient offer of such services in the host countries. While knowledge-intensive services in general face problems entering foreign markets, environmental producer services are particularly confronted with specific non-tariff barriers. The latter are not only related to regulatory frameworks, accreditation problems (‘neo-protectionism’) or missing cultural skills, but also to specific aspects such as confidence between service provider and client firm.     

Older consumer opportunities: small firm response in a selected group of UK service sector markets

Socio-demographic trends mean that the 50+ age group are wealthier and now enjoy high per capita incomes. Some large firms are now exploiting the opportunities within this market. This study aims to assess whether small UK service firms are also revising their marketing practices in response to socio-demographic change. A survey suggests most small firms have not yet recognised the opportunities available. The exceptions are the more entrepreneurially orientated small firms. Discussion is provided on the need for further research to small firm behaviour in the 50+ market.     

Assessing primary healthcare services quality in Spain: managers vs. patients perceptions

This paper measures the perceptions of the service quality by both the users and the health centre managers in Spain. With this information, it was possible to calculate the size of Gap-6, proposed by Lewis of discrepancy among the customers' perceptions and the perceptions of health centre managers. Using factor analysis and multiple regressions, significant associations were found between the service quality dimensions and patient satisfaction. Implications and future research issues are discussed.