Influence of the Quality Perceived of Service of a Higher Education Center on the Loyalty of Students

The aim of this research is to validate the explanatory model of how the quality of service perceived by students of a higher education center influences their loyalty (retaining and attracting new students) through mediating variables: perceived value, expectations, and satisfaction. The methodology used to validate the measurement scales is exploratory, and confirmatory factor analysis and the structural equation modeling (SEM) technique are applied to analyze the causal relationships proposed in the model. The results show that the key variables to improve student's loyalty to the center are the quality of the service provided and the satisfaction perceived by the students. Both variables are postulated as a major source of competitive advantages. It is also observed that service quality is one of the three key variables to achieve student's satisfaction together with expectations and perceived value. This research and its results allow us to understand the relationship between quality and satisfaction with loyalty and to identify the background variables of satisfaction (perceived service quality, perceived value, and expectations), as well as to obtain evidence of the importance that expectations have within the model for the formation of both perceived quality and satisfaction.

Exploring Residents' Purchase Intention of Green Housings in China: An Extended Perspective of Perceived Value

The promotion of green housings (GHs) is considered a potentially effective way to save energy, reduce air pollution, and promote industrial upgrading. However, the low level of public acceptance of GHs leads to insufficient GH market penetration in China. Thus, it is significant to explore GH purchase decisions to understand and enhance the market demand for GHs effectively. From an extended perspective of perceived value, this study proposes a comprehensive research model that integrates residents’ perceptions and personal traits to examine the influencing mechanism of residents’ intention to purchase GHs. The proposed model is empirically tested using data collected from 728 urban residents in China. The results reveal that perceived value is a crucial predictor of GH purchase intention. All dimensions of perceived benefits—including perceived functional benefits, perceived emotional benefits, perceived green benefits, and perceived social benefits—have a positive influence on perceived value, while perceived performance risks have a negative influence on perceived value. Two types of personal traits, namely, environmental concern and social trust, significantly affect residents’ perceived benefits and perceived risks. The findings contribute to a more in-depth analysis of the effects of residents’ perceptions and personal traits on GH purchase behavior. Furthermore, suggestions for policymakers and developers on popularizing GHs are proposed.

The Effect of Perceived Value, Trust, and Commitment on Patient Loyalty in Taiwan

Increasing patient loyalty through improved health care quality and patient–provider relationships becomes the key factor in medical providers’ successes. This study explored the mediated relationship of patients’ perceived value, patient commitment, and patient loyalty and the moderating effect of patient trust on the mediated relationship. A cross-sectional research design was adopted. Mediation and moderated mediation were tested using the PROCESS macro v3.5 for the SPSS supplement. Convenience sampling was used for the distribution of questionnaires to members of the public with experience of seeking medical attention in Taiwan. Among the 254 valid questionnaires recovered, 59.4% of the respondents were male, 38.6% were married, 90.2% were in the 20 to 49 year age range, and 54.7% had a bachelor’s degree or above. This study indicated a significant mediated relationship among patients’ perceived value of medical services, commitment to the patient–provider relationship, and patient loyalty. Furthermore, when the patient demonstrated higher levels of trust in a healthcare provider, the relationship of perceived value, commitment, and patient loyalty was also enhanced. This study discussed and demonstrated the effect of perceived value, trust, and commitment on patient loyalty. The research suggests that improving patient loyalty benefits sustainable operation of medical providers and the treatment effects for patients.

A Study on the Causal Process of Virtual Reality Tourism and Its Attributes in Terms of Their Effects on Subjective Well-Being during COVID-19

In the landscape of Covid-19 pandemic, people's well-being, to some extent, can be affected through virtual reality tourism because it has the opportunity to enhance their level of well-being and destination recovery. To verify this empirically an investigation was conducted among people who used Quanjingke, the largest tourism-related virtual reality website in China, during the pandemic. The specific the aim of this paper is to prove the effectiveness of virtual reality tourism in promoting people's subjective well-being. Hence, an integrated model with the constructs of peripheral attribute, core attribute and pivotal attribute, presence, perceived value, satisfaction, and subjective well-being was proposed and tested. The results indicate that attributes of virtual reality tourism have a positive effect on presence during virtual reality experiences, which positively influences perceived value. The values of virtual reality tourism perceived by tourists result in their satisfaction. Eventually, it was found that tourists' subjective well-being is improved due to their satisfaction with virtual reality tourism. Practical suggestions are also provided based on the findings.

Customer Behavior on Purchasing Channels of Sustainable Customized Garment With Perceived Value and Product Involvement

Online shopping for customized garments has become the fastest-growing field of the Chinese eBusiness market. Most consumers not only limit themselves to buying standardized garments but also want to buy garments customized to their preferences. This phenomenon has pushed the fashion textile and apparel industry to change its supply chain operations to meet the customization demand. Besides, the fashion textile and apparel industry also want to study how different channel factors will affect consumers' perceived value and further influence consumers' purchasing decisions. We initiated this study and empirically tested more than 200 experienced consumers. This study collaborated with a fashion textile and apparel company that aims to implement customized product lines soon. Based on the perceived value theory and risk management theory, we investigated whether product involvement and channel identification on supply chain design will affects potential customized product consumers' purchasing decisions. The findings reveal that channel recognition affects consumer decisions by having a positive impact on their perceived value. The perceived risk and shopping channel involvement of consumers have a negative impact on their perceived values and channel selections. In addition, product involvement has a moderating effect on the relationship between channel's perceived risk, perceived values, and channel selections as well.

Home chef meal kits: Product attributes, perceived value and repurchasing intentions the moderating effects of household configuration

Considering the growing popularity meal kits are undergoing in today's grocery sales market, and also with respect to barriers presented for restaurant dining due to the Covid-19 pandemic, it is essential to obtain more knowledge surrounding those product and service attributes pertaining to consumers and meal kits. Thus, this study was designed to investigate meal kits' essential attributes representing food quality, menu variety, health-oriented, convenience and price in association with their effects upon users' perceived value, and intention to continuously use. Two attributes representing high quality food dishes and menu variety were found to be the most important meal kit attributes because they both strongly improved hedonic and functional value for consumers. Results identified meal kit food quality as having more positive effects upon perceived value for the multi-person household segment when compared with the single-person household group. Comparatively, the effects of menu variety upon perceived value were more positive in the single-person household group than in the multi-person household group. Based on our findings, theoretical, managerial implications, limitations and recommendations for future research are provided.

Future Intentions of Fitness Center Customers: Effect of Emotions, Perceived Well-Being and Management Variables

One of the main objectives of fitness center managers is to obtain high levels of loyalty from the customers of these fitness centers. Within the existing literature on fitness center management, previous research has analyzed the importance of the management variables themselves to determine the behavioral intentions of their customers, ignoring other psychological and sociodemographic aspects and focusing on linear relationship models. Therefore, this study, which aims to analyze the impact of different management variables along with psychological (emotions and subjective well-being) and demographic variables (age and sex) on the satisfaction, perceived value (PV) and future intentions (FI) of 398 users (216 men, aged 18–75, Mean = 35.89 ± 14.53) of a fitness center, intends to fill this gap. In this study, two different methodologies are used, i.e., hierarchical regressions models (HRM) and qualitative comparative analysis (QCA). The data were obtained by means of a self-administered questionnaire composed of 69 items that collected different previously validated scales. Considering HRM, the different models proposed explain 52% of the satisfaction variance, 57% of perceived value and 59% of future intentions. In general, it seems that the management variables are better predictors than subjective well-being, emotions and age or gender since their inclusion does not greatly improve the model’s predictive capacity. As far as QCA analyses are concerned, it seems that none of the conditions are necessary for high or low levels of satisfaction, perceived value or future intentions. On the other hand, based on sufficiency analyses, there seem to be 8 pathways or combinations of conditions leading to high levels of satisfaction and 13 for low levels, 11 combinations leading to high levels of IF and 10 leading to low levels; however, there are 6 combinations of conditions leading to high levels of PV and 5 leading to low levels. In general, some of the pathways consider only the management variables, although many of them consider the importance not only of the management variables but also of the interactions that these may have with emotional aspects and, to a lesser extent, with age and well-being. When comparing both methodologies, it can be observed that the QCA models are more explanatory than the HRM models and that they take into account aspects that seem unimportant when observing linear models (such as emotions or age). However, both methodologies should be considered complementary and used simultaneously since, by focusing on different aspects, enriched results are obtained. The results obtained will enable managers to make more efficient use of available resources to increase user satisfaction.

Perceived Value Influencing the Household Waste Sorting Behaviors in Rural China

Waste sorting is the cardinal measurement to solve the problem of low efficiency of rural environmental governance and to alleviate environmental pollution by reduction, recycling, and harmlessness in rural areas. However, non-excludable and non-rival features of public goods easily cause a wide free-rider problem, which results in a low frequency of participation in the waste sorting of rural people. Based on the theory of the utility maximization of the rational economic man, this paper investigates survey data of 688 farm households in three cities and three counties of Shaanxi Province to explore the effect of the perceived value on the household waste classification behavior based on cost-benefit analysis. The results show that perceived benefit and perceived cost are important perceived value factors affecting farmers’ participation in waste sorting. Specifically, the spiritual benefit of the perceived benefit has a significantly positive impact on classification behavior, while the time cost, physical cost, and material cost of the perceived cost have a negative impact on waste classification behavior. Further study of the heterogeneity of income impact shows that time cost only has a significant impact on the high-income group of farmers’ classification behavior, while spiritual benefit and learning cost only affect the low-income group of farmers’ waste classification behavior. Material cost has different influence directions on high- and low-income groups. In view of the aforementioned findings, this study highlights corresponding policy implications from the perspective of perceived benefit and perceived cost.

Overall Quality of Sporting Events and Emotions as Predictors of Future Intentions of Duathlon Participants

The present study is intended to analyze the effect of global quality, perceived value, general satisfaction, and emotions on future behavior patterns among participants in the European Duathlon Championship. In this sense, a questionnaire was administered (n = 210), composed of four sections: essential demographic and profiling variables, perceived quality, overall quality, and emotions. Consequently, a relational model was designed to be examined by means of structural equation modeling (SEM) and fuzzy set qualitative comparative analysis (fsQCA). Results reveal that global quality and general satisfaction are key dimensions for determining future behaviors of participants, but not so the perceived value. Moreover, up to three combinations of these dimensions together with emotions -pleasure and arousal- emerged as enough for depicting future intentions to a great extent. In this line, a remarkably sufficient combination consists of global quality, general satisfaction, pleasure, and arousal. These findings will guide organizers to design strategies that provide exciting experiences, as well as quality and satisfaction to the participants of sports events.

Exploring the Key Antecedents Influencing Consumer's Continuance Intention toward Bike-Sharing Services: Focus on China

This study investigates the key antecedents affecting consumers' continuance intention toward bike-sharing services in China. The theoretical framework clarifies the role of perceived value and trust in a service provider in enhancing customer's continuance intention toward bike-sharing services. Perceived usefulness, perceived ease of use, and perceived enjoyment are considered vital factors in forming perceived value and trust in a service provider. Financial risk and privacy risk serve as inhibitors to consumers' continuance intention. Our research model is validated using data from 224 bike-sharing consumers in China. Both perceived value and trust in a service have a significant impact on consumers' continuance intention. However, financial risk significantly affects customer's continuance intention, although privacy risk does not have a significant impact on it. The analysis results show that perceived usefulness has no significant effect on both perceived value and trust in a service provider. The results demonstrate that perceived ease of use and perceived enjoyment play a significant role in enhancing both perceived value and trust in a service provider. Our results are expected to provide academic and practical implications for bike-sharing services.

Gastronomic Motivations and Perceived Value of Foreign Tourists in the City of Oruro (Bolivia): An Analysis Based on Structural Equations

The continuous dynamism that tourism suffers makes the motivations of tourists change, making them search for new experiences. In this sense, gastronomy is positioned as a key element of union between tourism and culture, thus developing gastronomic tourism. The analysis presented here will address gastronomic motivations and their influence on the value perceived by foreign tourists in Oruro (Bolivia), based on a total sample of 370 and through a covariance-based structural equation modelling (CB-SEM). Among the main results, it is worth highlighting the positive influence of gastronomic motivations on the value perceived by tourists. These results are also very useful for public and/or private entities for the creation of new strategies to promote local gastronomy.

The Influence of Continuous Improvement of Public Car-Sharing Platforms on Passenger Loyalty: A Mediation and Moderation Analysis

Public car-sharing is a growing business model that contributes to sustainable transportation and urban development. The continuous improvement of public car-sharing platform to garner passenger loyalty is vital for a car-sharing platform’s success. This study applied perceived value theory, trust theory, and transaction cost theory to construct a structural equation model in order to explain passenger loyalty. Data from 755 surveys were collected using stratified sampling in mainland China. The estimated results of the theoretical model show that the relationship between continuous improvement and passenger loyalty is mediated by passenger perceived value, passenger trust, and transaction costs. Consequently, a multi-group analysis is conducted to analyze the moderation effects of passenger’s license and car-sharing experience on the theoretical model. The results show that some of the path coefficients are significantly different between these sub-groups. This indicates that platforms should provide differentiate services for passengers based on the purpose of using car-sharing and usage experience. This study provides new theoretical insights into understanding passenger loyalty with respect to public car-sharing and provides policy recommendations for the sustainable development of public car-sharing.

Assessing the Effects of Information System Quality and Relationship Quality on Continuance Intention in E-Tourism

The advance of electronic commerce has resulted in successful e-travel services. Through the development of e-travel information, consumers can plan their trip without time and space limitations. This study proposes a model regarding the formation of the relationship quality (customer satisfaction and trust), information system quality, perceived value, and customers’ intention to continue in the e-tourism environment. The study is based on 351 e-travel users in Taiwan. The result shows that customer satisfaction has a positive effect on continuance intention. Information system quality has a positive relationship with customer satisfaction, trust, and customer continuance intention. Furthermore, the perceived value has an effect on customer satisfaction and trust. However, the perceived value is partially related to customer continuance intention through customer satisfaction. The managerial implications of this study are discussed.

Snowball Effect of User Participation in Online Environmental Communities: Elaboration Likelihood under Social Influence

Ecological preservation and sustainable development depend on active public involvement. The emergence of online environmental communities greatly facilitates people’s participation in green endeavors. The population penetration of such platforms accelerates as existing users persuade people around them and media coverage further attracts public attention. This snowball effect plays an important role in the user base expansion, but the specific mechanism of social influence involved is yet to be examined. Based on the social influence theory, cognitive response theory, and elaboration likelihood model, this study establishes a research model depicting the relationship between persuasion in terms of social influence and outcomes in terms of behavioral intention and actual participation through the mediation of cognitive responses in terms of perceived value and perceived risk. Empirical results from survey observations show that social influence has both moderated (by education) and mediated (through perceived risk) effects on behavioral intention, which leads to actual participation. Meanwhile, social influence shapes the perceived value, which has a direct and strong impact on actual participation. These central and peripheral routes through which social influence affects individual participation yield useful theoretical and practical implications on human behavior with online environmental communities.

The Perceived Value of Reducing Sedentary Behavior in the Truck Driving Population

Purpose: To conduct rapid qualitative analysis early in the intervention design process to establish the perceived value of reducing sedentary behavior in the truck driver population.

Methods: A rapid assessment process for qualitative data collection was used to examine managerial and employee perceptions quickly and iteratively to inform intervention design. Managerial insights were collected during semi-structured interviews and employee insights were collected via an online survey and focus group. Thematic analyses were guided by the constructs of the Health Belief Model to establish; (a) perceived susceptibility to the health problem; (b) perceived severity of the health problem; (c) perceived benefits of the potential solutions; (d) perceived barriers to adopting the recommended solution; (e) cues to action; and (f) self-efficacy.

Results: Three managers (2 females; 1 male) participated in semi-structured interviews. Seven truck drivers (1 female; 6 males) took part in a focus group. Sixteen survey responses (all male, mean age 49.8 ± 12.4 years, 86% white Caucasian) were collected in total (11 paper based; 6 online). The most important managerial motivators for engagement in an intervention included; improved sleep, alertness and quality of life. The most important employee motivators included; stress reduction (3.3 ± 1.3), improved quality of life (3.3 ± 1.3) and alertness (3.2 ± 1.4). Managerial and employee perspectives indicated that sedentary behavior may be of lower priority than diet and exercise, and may not resonate with the truck driving population as a health risk.

Conclusion: Application of the Health Belief Model indicated a disconnect between the researcher, managerial and employee perspective and the perceived value of a sedentary behavior reduction intervention. Within the truck driving population, researchers should endeavor to include safety as well as health outcomes, use multi-level strategies, design for outcomes of high perceived value and leverage health communication strategies to communicate benefits that resonate with the end-user.

Factors Influencing the Intention to Use the Common Ticketing System (Spider Card) in Thailand

The Common Ticket, locally called the “Spider Card” is a contactless smartcard ticket used for public transportation systems in Thailand. The card is used for all modes of transportation and increases the convenience of public transit passengers while increasing public transport ridership. This research aimed to identify the determinant factors that impact passengers’ intention to use the Spider Card based on the unified theory of acceptance and use of technology (UTAUT) model by integrating perceived convenience and perceived sacrifice as part of the perceived value. A survey of public transit users in the Bangkok metropolitan area was conducted. The Partial Least Square-Structure Equation Modelling (PLS-SEM) technique was employed to examine the data. The results showed that perceived value, performance expectancy, and facilitating conditions are all significant factors. Perceived convenience and perceived sacrifice are significant antecedents for perceived value. Surprisingly, effort expectancy and social influence did not impact passengers’ intentions to use the Spider Card. The results also offer beneficial information for public transit authorities in order to comprehend what passengers desire from using these kinds of technology service systems.

Empirical Evaluation of a Conceptual Model for the Perceived Value of Health Services

INTRODUCTION

Perceived value and its antecedents and consequences have been claimed to be important in industries with higher customer involvement. The aim of this paper is therefore to empirically assess the conceptual model, with perceived service value as its central component. It also investigates how it affects loyalty and satisfaction, how it is influenced by its antecedents, and to compare with other studies investigating partial relationship between variables.

METHODS

A total of 800 patients were enrolled in the main study, and the data was analysed using exploratory and confirmatory factor analyses. By modelling linear structural equations, we assessed reliability and established the convergent and discriminant validity of the questionnaire in the same way as in the pilot study.

RESULTS

In the conceptual model for testing our hypotheses, we also included the relationship between patient satisfaction and loyalty. In this manner, the fitting of data to the model was significantly improved. After including the additional relationship, global fit indices had the following values: Chi-square=349.6 (sig.=0.00), df=143, RMSEA=0.05, NFI=0.96, CFI=0.97. All relationships between the constructs were statistically significant, thus confirming all our hypotheses.

CONCLUSIONS

The major conclusion of this paper is that an especially higher reputation and higher perceived service quality can contribute to perceived service value and therefore to more satisfied patients. The research approach has a few limitations. In the future, the model of perceived service value can be extended with variables such as emotions, patient trust, and commitment as well.

The Dimensions of Pet-Owner Loyalty and the Relationship with Communication, Trust, Commitment and Perceived Value

Loyalty is one of the greatest intangible assets that any organization can possess and improving client loyalty is a primary marketing goal that can have a significant financial impact on any business. This quantitative study examined the mediating role of communication on the relationship between satisfaction and loyalty (attitudinal and behavioral) in veterinary clinics, along with the moderating roles of trust, commitment, perceived value, and relational characteristics. Responses collected from 351 pet-owners through social media were analyzed using descriptive and inferential statistics. The results show that attitudinal loyalty (AL) has a strong positive relationship with communication at multiple points in a veterinary clinic, whereas the relationship with behavioral loyalty (BL) was not as clear. Additional findings suggest that AL, which is influenced by trust in the veterinarian, communication from staff members and commitment, has a strong positive relationship with behavioral intentions, increases the number of products and services that a pet-owner consumes at his or her primary veterinary clinic, and attenuates the role of cost in receiving veterinary care. These findings can help veterinary clinic owners and managers in developing and implementing relationship strategies that improve pet-owner loyalty.

Sport Activity for Health!! The Effects of Karate Participants' Involvement, Perceived Value, and Leisure Benefits on Recommendation Intention

This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that karate participants from different places of residence do not display significant differences in involvement, perceived value, leisure benefits, and recommendation intention. Furthermore, “attraction” in the involvement category reveals the highest mean, “paid spirit and energy being worthy” in perceived value appears as the highest mean, and “physiological benefits” in leisure benefits shows the highest mean. The Pearson correlation analysis result presents significant strong positive correlations between involvement, perceived value, leisure benefits, and recommendation intention. Finally, multiple regression analysis reveals that leisure benefits, except “physiological benefits”, show notably positive effects on recommendation intention. According to the research results, suggestions are proposed for the reference of karate teaching business managers, participants, and future research.

Perceived Value of Health Insurance and Enrollment Decision among Low-Income Population

The individual mandate is one of the key features of the Affordable Care Act (ACA) and has contributed to a substantial decrease in the overall uninsured rate. We examined the relationship between the individual's insurance status and his/her attitude towards risk and uncertainty among the nonelderly adults, without employer-sponsored insurance (ESI) sources and who are most likely to benefit from the ACA. A descriptive, cross-sectional study was conducted using the 2014 full-year consolidated data file from the Household Component of the Medical Expenditure Panel Survey-Household Component (MEPS-HC). This study included 4,848 individuals, aged 18-64 years, with incomes between 138-400 % of the Federal Poverty Level (FPL), and without access to public coverage or ESI. We examined the factors associated with the likelihood of being uninsured using a logit model. We found that the proportion of the uninsured among the low-income nonelderly adults without ESI (31.1%) was much higher than the one among the nonelderly adults (14.3%). The uninsured adults were likely to have lower demand for insurance and perceived value of insurance and were less likely to visit a doctor or to fill prescription drugs. More rigorous outreach efforts focusing on increasing perceived value of health insurance could contribute to an increased insurance coverage among low-income populations.

Smoking cessation: Exploration of perceived technology-related information value

This study describes a unique approach to information transfer affecting the perceived value of this information and related impact on smoker behavior. Data were collected via survey, sampling approximately 120 participants. An online survey tool was used for the survey creation, data collection and monitoring. Another online tool was used by participants to create short animation videos as a means of increasing their engagement with information in an experiential fashion. Study findings included that the process experienced by the test group was influential and facilitated participants' change of mind regarding enrollment in a smoking cessation workshop. This was partly attributable to the IKEA effect. The study provides evidence that a change in habits crucial to improve health and enhance positive lifestyle choices can be stimulated through active engagement with artifact creation in a technology-mediated environment.

Burnout among psychosocial oncologists in Israel: The direct and indirect effects of job demands and job resources

OBJECTIVE

Psychosocial oncologists may be particularly vulnerable to burnout. This study aimed to assess burnout among Israeli psychosocial oncologists in relation to the Job Demands-Resources model and the coping strategies model.

METHOD

Participants included 85 of 128 listed psychosocial oncologists currently working with cancer patients. They completed a questionnaire assessing emotional exhaustion, depersonalization, job demands, job resources, work engagement, overcommitment, and perceived value of work.

RESULTS

The mean level of burnout was low, whereas 16.3% experienced high levels of emotional exhaustion and only 2.4% experienced high levels of depersonalization. According to mediation analysis, overcommitment, partially mediated job demands-burnout associations, and work engagement mediated the perceived value-burnout association. Job resources and burnout were not related, either directly or indirectly.Significance of resultsThe study extended the Job Demands-Resources model to include perceived value as an additional resource, and work-engagement and overcommitment as coping strategies. Two distinct patterns of associations were found between work characteristics and burnout: the positive-protective pattern (perceived value and work engagement) and the negative pattern (job demands and overcommitment). These two patterns should be considered for further research and for implementing preventive interventions to reduce burnout in the workplace setting.

How public reporting of prescription quality indicators influence prescribing practices? A survey of general practitioners

RATIONALE, AIMS AND OBJECTIVES

Public reporting of performance data is one of the most popular topics in health care field. The aim of this study was to investigate the transparency mechanism, that is, how public reporting influenced general practitioners' (GPs) prescribing practices.

METHOD

GPs who had the license to prescribe medicine of all 10 primary care institutions were surveyed. Data were collected by an instrument, which exhibited satisfactory reliability and validity (Cronbach's alpha > 0.7; average variance extracted > 0.5; composite reliability > 0.7). Data analysis was conducted by structural equation model.

RESULTS

The results showed that GPs' perceived value (GP's overall assessment of the worth of the public reporting) and attitude (the psychological reaction to public reporting) had a significantly direct effect on behavioural intention (r = 0.28; r = 0.36), and were affected by information accessibility (r = 0.63; r = 0.32). Attitude had a significant effect on perceived value(r = 0.45). Perceived risk (the perceptions of the possible loss due to public reporting, e.g. decreasing their income) did not have a significant relationship with information accessibility, attitude and behavioural intention(r = -0.09; r = 0.01; r = -0.07).

CONCLUSION

The information accessibility, perceived value and attitude have strong effects on prescribing practices of GPs, whereas perceived risk did not play a role in influencing the prescribing practices. Policymakers need to improve the accessibility of prescription quality indicators and pay attention to the perceived values and attitudes of GPs. Policymakers also need to strengthen the risk education of GPs and attach incentives to transparent regulation.

Patient preferences and willingness to pay for innovations in intermittent self-catheters

BACKGROUND

Intermittent catheterization is the gold standard for bladder management in Europe in people with spinal cord injuries. The aim of the present study was to identify and investigate individuals' preferences regarding intermittent self-catheterization (ISC) devices and furthermore investigate the willingness to pay for attributes in ISC devices in the UK, France, and the Netherlands.

METHODS

A discrete choice experiment survey was conducted to evaluate the patients' perceived value of catheter features. Attributes were selected based upon a literature review of the most important characteristics of catheters and the survey was developed and validated with input from patients and medical experts. Data were analyzed using the conditional logit model whereby the coefficients obtained from the model provided an estimate of the (log) odds ratios of preference for attributes. Willingness to pay was estimated for all levels of the attributes.

RESULTS

Two-hundred and eighty-three participants completed the questionnaire and were included in data analysis. Risk of infection had the highest odds ratios as preferred important attribute for all three countries followed by ease of insertion. "Pre-coated catheters" was found to be valued as the most preferred coating technology across all countries. Out of pocket cost was a significant influence on patients' choice.

CONCLUSION

Users of ISC perceive the value of convenience (size of catheter), ease of insertion, and reduced risk of infection as the most important features attached to an intermittent catheter. These results are applicable both for the "classic" ISC user as well as for another broad group of catheter dependent individuals.

Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long-term care institution residents

OBJECTIVE

To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions.

DESIGN

The five-point Likert scale questionnaire administered through facetoface interviews.

SETTING

Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population.

PARTICIPANTS

One hundred and eighty long-term institutional care residents.

MAIN OUTCOME MEASURES

Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction).

RESULTS

Student's t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a resident's level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residents' overall satisfaction.

CONCLUSION

The primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of in-depth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents.