Satisfaction and Value: A Meta-Analysis in the Healthcare Context

Affect and cognition as antecedents of patients’ trust in the dentist

Aim: to evaluate the association of the patients’ perception about dentist’s affect and cognition on trust and, consequently, on intention to return and patient satisfaction with life. Methods: Analytical cross-sectional study conducted in patients’ adults and elderly at of two dentistry clinics in the south of Brazil. Patients had to have a previous relationship with the dentist (at least one previous consult) and 18 years of age or older. The data were collected through self-administrated questionnaire using measures adapted from other research, using structural equation modeling. We test using a chi-square difference test (p-value<0,05). Results: The mean age of the 197 patients was 37.0 years (σ = 15.5). The affect perceived by the patient at the dentist had a positive effect (β = .53) on the trust that the patient develops in relation to the dentist. The same is true for the effect of the rational or cognitive aspects perceived by the patient at the dentist (β = .41). The trust positively influences the patient’s intention to return to that dentist (β = .82). In addition, the intention to return to the dentist positively influences the patient’s satisfaction with life (β = .49). Conclusions: Affective and cognitive aspects positively influenced the patient’s trust in the dentist. The greater the patient’s trust in the dentist, the greater the intention to return to that dentist. Furthermore, a good relationship with the dentist improve the patient’s satisfaction with life.

From good to great: nonlinear improvement of healthcare service

Purpose

Increasing consumer choices in health care results in keener competition faced by providers. The existing nonlinear and asymmetric impact of patient perceived quality of care to their choices should provide insights for hospitals to deploy limited resources to areas that produces most significant and positive outcomes. This study aims to develop an algorithm for examining the nonlinear and asymmetrical relationships in the health-care domain with the hope to provide a more precise indication as to how specifically addressing patient experience with meaningful improvements of service quality.

Design/methodology/approach

Data were obtained through telephone surveys of 2,000 inpatients who had been hospitalized in a health system in 2006. After coding the original data, the authors conducted regression analysis and Z-test to investigate the nonlinear and asymmetrical relationship between patient recommendation and perceived hospital attributes.

Findings

“Spiritual care” is considered as a “delight” for patients. “Procedure efficiency”, “Compassionate care” and “Mutual communication” linearly related to patients’ likelihood to recommend the hospital (LTR) in the positive domains, but increasingly sensitive to LTR in negative domain.

Practical implications

Examining the asymmetry and the nonlinear relationship can detect diminishing effect of certain drivers for patient satisfaction. An emphasis on patients’ spiritual needs can provide the hospital with a unique opportunity to differentiate itself from other health-care providers which usually compete within the ordinary domain of services. The absence of “Procedure efficiency”, “Compassionate care” and “Mutual communication” will result in extremely negative word-of-mouth.

Originality/value

This study has developed an algorithm to examine the asymmetry and the nonlinear relationship between perceived hospital performance and patient satisfaction. The insights generated should help providers determine specific sets of priorities for improving services and hence strategize for optimal deployment of limited resources.

Exploring consumers’ experiences of spiritual value in healthcare services

Purpose

This paper aims to explore consumer experiences of spiritual value and investigates whether it is distinct from ethical value within a large and growing private sector health-care setting. Understanding consumers’ experiences of spiritual value versus ethical value has important implications for corporate social responsibility as increasingly, consumers want their spiritual needs met.

Design/methodology/approach

The research adopts an exploratory case study approach using in-depth interviews with 16 consumers who use complementary and alternative medicine health-care services. Drawing on consumer value frameworks, a thematic analysis identified dimensions of spiritual and ethical values co-created during their consumption experiences.

Findings

From a consumer’s perspective, spiritual value is distinct from ethical value. The key finding is that participants talked about spiritual value predominantly in reactive terms (apprehending, appreciating, admiring or responding), whereas ethical value was referred to as active (taking action).

Research limitations/implications

This paper enhances the understanding of spiritual value and provides evidence that people want their spiritual needs met in a private health-care context. Furthermore, this study provides insights into the consumption experience of spiritual value that can be considered, with further research, in other health-care and service contexts.

Originality/value

This paper offers a new view on corporate social responsibility by taking a consumer’s perspective, and identifying that consumer experiences of spiritual value are important and distinct from ethical value.

Healthscape role towards customer satisfaction in private healthcare

Purpose - The purpose of this paper is to identify the motives that enforce consumers to find out the major determinants that frame healthscape in private healthcare service that leads to their satisfaction in a developing country like India. Design/methodology/approach - The generic motive dimensions are identified using an exploratory factor analysis. Next the reliability and validity of the factors are established followed by regression analysis using SPSS 20.0 s/w. Findings - This paper identifies six healthscape motives in the private healthcare sector named as service personnel conduct and cleanliness, service delivery and facilities, ambience, location and look, appealing decoration, and upgraded safety service, out of which only service delivery, ambience, location, and decorations contribute the most to build customer satisfaction as per their significance value. Research limitations/implications - The various dimensions of healthcare motives should be viewed as the levers of improving hospitals' service quality in the minds of its present and future customers. This finding can offer valuable insight to the forthcoming as well as existing developer who are planning to have their healthcare service presence in India. Practical implications - This study suggests some important strategic guidelines for service positioning and market segmentation of healthcare services as per customer requirements. In the recent past, availing services from hospitals were purely utilitarian in nature. Customers were more inclined to get proper and timely services and cared more about the service quality of the healthcare service provider. Originality/value - This paper is among the few works done on understanding private healthcare service delivery process in India and customer satisfaction level from those Hospitals. This study addresses the gap by identifying a set of dimensions that are relevant to customers for a unique healthcare experience.

Explaining public satisfaction with health-care systems: findings from a nationwide survey in China

OBJECTIVE

To identify factors associated with health-care system satisfaction in China.

CONTEXT

Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction.

DESIGN

Stratified nationwide survey sample analysed using multilevel logistic regression.

SETTING AND PARTICIPANTS

3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013.

MAIN OUTCOME MEASURE

Satisfaction with the way the health-care system in China is run.

RESULTS

We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical.

CONCLUSIONS

To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices.

Developing a framework of service convenience in health care: An exploratory study for a primary care provider

From retail health clinics and online appointment scheduling to (mobile) kiosks that enable patient check-in and automate the collection of copays and open balances, convenience has become an important topic in the health care sector over the last few years. While service convenience has also gained much interest in academia, one common limitation is that authors have adopted a "goods-centered" perspective focusing primarily on retail settings. Results of this exploratory study reveal that health care service convenience encompasses seven different dimensions: decision, access, scheduling, registration and check-in, transaction, care delivery, and postconsultation convenience. Implications and future research suggestions are discussed.

The missing path to gain customers loyalty in pharmacy retail: The role of the store in developing satisfaction and trust

BACKGROUND

An evolution led to community pharmacies experiencing increased competition both between themselves and with new entrants in the sector, for example, grocery retailers. Applying certain retail marketing strategies aimed at developing store loyalty may be an appropriate strategic path for pharmacies wanting to compete in this new arena.

OBJECTIVES

This study aimed to develop and test a two-step model to identify the determinants of store loyalty for community pharmacies in Italy.

METHODS

Based on the retail literature, qualitative research was conducted to identify key variables determining loyalty to community pharmacies. The model was then tested by means of a phone survey. A total of 735 usable questionnaires was collected.

RESULTS

The study highlights the key role of the relationship between pharmacists and their customers in the loyalty-building path; trust in pharmacists is the first driver of satisfaction and a direct and indirect (through satisfaction) driver of trust in pharmacies, which leads to store loyalty. Retail-level levers, such as the store environment, assortment, and communication, influence trust in pharmacies.

CONCLUSIONS

This model is a first step toward investigating loyalty-building by applying the retail management literature's concepts to the community pharmacy sector.

Determinants of parental satisfaction with ultrasound hip screening in child health care

Prior research has shown ultrasound (US) screening for developmental dysplasia of the hip (DDH) in preventive child health care to be more effective than the current screening method. In the present study, 3-month-old infants were screened for DDH with US. The objective of this study was to examine parental satisfaction with the screening and determinants that affect satisfaction. Parental satisfaction was measured using a questionnaire. Independent variables included socio-demographic determinants, structure, process and outcome-related determinants and the meeting of expectations. Satisfaction with the screening was high. Parents who perceived the screener as competent, had enough time to ask questions, perceived the proceeding as fluent, perceived a low burden on their infant and whose expectations were met, were more likely to be satisfied. Satisfaction was influenced by process-related factors and not by factors related to the structure and the outcome of the screening. Good information provision before the screening and communication during the screening are means by which parental satisfaction can be influenced positively.

Improving quality of medical treatment and care: are surgeons' working conditions and job satisfaction associated to patient satisfaction?

BACKGROUND

Over the last decades, surgeons, researchers, and health administrators have been working hard to define standards for high-quality treatment and care in Surgery departments. However, it is unclear whether patients' perceptions of medical treatment and care are related and affected by surgeons' perceptions of their working conditions and job satisfaction. The aim of this study was to evaluate patients' satisfaction in relation to surgeons' working conditions.

METHODS

A cross-sectional survey with 120 patients and 109 surgeons working in Surgery hospital departments was performed. Surgeons completed a survey evaluating their working conditions and job satisfaction. Patients assessed quality of medical care and treatment and their satisfaction with being a patient in this department.

RESULTS

Seventy percent of the patients were satisfied with performed surgeries and services in their department. Surgeons' job satisfaction and working conditions rated with moderate scores. Bivariate analyses showed correlations between patients' satisfaction and surgeons' job satisfaction and working conditions. Strongest correlations were found between kindness of medical staff, treatment outcome and overall patient satisfaction.

CONCLUSION

This study demonstrates strong associations between surgeons' working conditions and patient satisfaction. Based on these findings, hospital managements should improve work organization, workload, and job resources to not only improve surgeons' job satisfaction but also quality of medical treatment and patient satisfaction in Surgery departments.

[Perception of health care quality by patients with chronic conditions]

BACKGROUND

Patient opinion is becoming ever more important when considering healthcare quality and the reforms required to improve healthcare quality. The main aim of this study was to explore factors determining perceived healthcare quality among patients with chronic diseases.

METHODS

Data are drawn from the survey carried out in 2008 by the Commonwealth Fund, in partnership with the French Superior Health Authority (Haute Autorité de santé). The prospective telephone survey targeted adults in eight countries who had serious health problems (chronic or severe disease, declared poor state of health, hospital admission or major surgery). Of the 1202 French respondents, 851 had at least one diagnosed chronic disease. A multinomial logistic model was used to identify the relationship between perceived healthcare quality and patients' recent experience with the healthcare system.

RESULTS

People with chronic disease in general perceived that healthcare quality was excellent (45%) or good (44%). Only 11% of respondents judged it to be average or poor. There was a hint of "could do better", for example when considering podology and ophthalmology follow-up in diabetes or the management of multiple medications. The explanatory model revealed a positive correlation between excellent perceived healthcare quality and a strong doctor-patient relationship, taking into account both the length of this relationship and the ability of the doctor to involve the patient at all stages of decision-making concerning therapeutic management. There was no major link between the perceived quality of care and objective care quality, the quality of procedures, the cost of care to the patient or how frequently patients access the healthcare system.

CONCLUSION

The quality of the relationship between the patient and his/her doctor is a determining factor in the patient's judgement of the quality of healthcare he/she receives.