Healthcare service failure: how dissatisfied patients respond to poor service quality

Service failure is bound to happen: Unraveling the impact of dissatisfaction, complaint behavior and re-travel intention in travel and tourism industry

Service failure is bound to happen, but dissatisfaction has always been undermined by scholars previously. The present study investigates dissatisfaction factors in travel decision-making leading towards re-travel intention with the help of the expectancy disconfirmation theory (EDT) model. Moreover, complaint behavior mediates the relationship between dissatisfaction and re-travel intention concerning the factors involved in it. For the findings, 434 real-time responses were collected through an offline survey following the lifetime value (LTV) approach. Kaiser-Meyer-Olkin (KMO) and Bartlett's tests were conducted to test the sphericity of the variables one by one. Furthermore, structural equation modeling (SEM) was implied to test the measurement and structural models. All the hypotheses supported and accepted the proposed research questions. The findings reveal that the dissatisfaction factors, with their interaction terms (transaction-based and experience-based), help study the variable dissatisfaction and its multifaceted concept in travel and tourism literature. Moreover, complaint behavior is identified as a key mediating factor in the relationship between dissatisfaction and re-travel intention, suggesting that commuters' response to dissatisfaction, including complaints, shapes their future re-travel intentions. The theoretical implications of the study are substantial, as it advances our understanding of commuter behavior in the context of public transport travel and tourism. Practically, the findings offer actionable insights for public transport authorities and service providers. Understanding the specific dissatisfaction factors influencing re-travel intention allows for targeted interventions to improve service quality and customer experience. Recognizing the importance of effective complaint management systems can help organizations better address customer grievances and mitigate the negative effects of dissatisfaction on re-travel intention.

Unveiling the Negative Customer Experience in Diagnostic Centers: A Data Mining Approach

Introduction

This study aims to identify the negative customer experiences reflected in complaints against diagnostic centers using data mining tools.

Methods

Analyzing customer complaints from a consumer complaints website, the Apriori algorithm was employed to uncover frequent patterns and identify key areas of concern. The frequency and distribution of terms used in complaints were also analyzed, and word clouds were generated to visualize the findings.

Results

The study revealed that major areas of unfavorable customer experience included delayed test reports, erroneous test results, difficulties scheduling appointments, staff incivility, subpar service, and medical negligence.

Discussion

These findings and the proposed model can guide diagnostic centers in incorporating data mining tools for customer experience analysis, enabling managers to proactively address issues and view complaints as opportunities for service improvement rather than legal liabilities.

Patient satisfaction and associated factors among insured and uninsured patients in Deder General Hospital, eastern Ethiopia: a facility-based comparative cross-sectional study

Background

Patient satisfaction is a crucial measure of healthcare quality, as dissatisfied patients are more likely to miss appointments, disregard treatment plans, and leave hospitals, leading to poor treatment outcomes. Therefore, the study aimed to compare levels of satisfaction with health services and associated factors among insured and uninsured patients in Deder General Hospital, eastern Ethiopia.

Methods

A comparative cross-sectional study with 532 participants was conducted from December 1-30, 2021. Data was collected through a structured questionnaire, analyzed using SPSS, and predictors assessed using a multivariate logistic regression model. Statistical significance was set at p < 0.05.

Results

Overall, patient satisfaction with health services was 65.6% (95% CI: 61.5-69.5), and the level of patient satisfaction with health services among insured and noninsured patients was 68.8% (95% CI: 62.8-74.4) and 62.4% (95% CI: 56.8-68.0), respectively. In the final model of multivariable analysis, factors such as educational status of secondary school (AOR = 4.90; 95% CI: 2.05-11.76), and a higher level (AOR = 3.08; 95% CI: 1.05-9.03), getting the entire prescribed drugs (AOR = 3.49; 95% CI: 1.43-8.54), getting some of the ordered drugs (AOR = 3.34; 95% CI: 1.61-6.94), paying less than 100 Ethiopian birrs (AOR = 4.85; 1.35-17.40) were significantly associated with patient satisfaction among insured patients. Whereas getting the entire and some prescribed drugs were (AOR = 6.28; 95% CI: 3.26-12.05), and (AOR = 3.40; 95% CI: 1.70-6.78) times more likely to be satisfied with the service among noninsured patients as compared to their counterparts, respectively.

Conclusion

The study found that about six in 10 patients in the study area were satisfied with healthcare services, with insurance patients reporting higher satisfaction. Factors such as receiving prescribed drugs, paying less than 100 Ethiopian birr, having a secondary school education, and having a higher education were associated with satisfaction.

Punitive switching costs and behavioral responses in the context of contractual services

Purpose

Contractual services are characterized by features such as termination fees, long-term commitment, and complex terms. When customers find better deals from other providers, they may want to switch, but contractual obligations prevent them from doing so. Thus, this study aims to draw upon the stimulus-organism-response paradigm and theories of emotion regulation to examine how punitive switching costs (PSCs) can evoke negative emotions (NEs) from customers and, consequently, lead to negative behavioral responses in contractual service settings.

Design/methodology/approach

This study collected data from 395 customers of telecommunications companies, fitness centers, tutoring firms/centers, and house leasing companies in Taiwan. We tested the hypotheses using partial least squares structural equation modeling via SmartPLS 3.0.

Findings

The results show that NEs partially mediate the relationship between PSC and customers’ switching intention and negative word-of-mouth. This study also finds alternative attractiveness (AA) and service recovery (SR) do not moderate the PSCs–NEs relationship, but AA does directly influence NEs.

Originality/value

First, this study contributes to the literature on switching costs by exploring how PSC exerts a detrimental impact on behavioral responses. Second, this study adds to the literature on service failures by identifying the mediating role of NEs in such a relationship.

Adoption of Digital Vaccination Services: It Is the Click Flow, Not the Value—An Empirical Analysis of the Vaccination Management of the COVID-19 Pandemic in Germany

This research paper examines the adoption of digital services for the vaccination during the COVID-19 pandemic in Germany. Based on a survey in Germany’s federal state with the highest vaccination rate, which used digital vaccination services, its platform configuration and adoption barriers are analyzed to understand existing and future levers for optimizing vaccination success. Though technological adoption and resistance models have been originally developed for consumer-goods markets, this study gives empirical evidence especially for the applicability of an adjusted model explaining platform adoption for vaccination services and for digital health services in general. In this model, the configuration areas of personalization, communication, and data management have a remarkable effect to lower adoption barriers, but only functional and psychological factors affect the adoption intention. Above all, the usability barrier stands out with the strongest effect, while the often-cited value barrier is not significant at all. Personalization is found to be the most important factor for managing the usability barrier and thus for addressing the needs, preferences, situation, and, ultimately, the adoption of the citizens as users. Implications are given for policy makers and managers in such a pandemic crisis to focus on the click flow and server-to-human interaction rather than emphasizing value messages or touching traditional factors.

Service quality in health care: empathy as a double-edged sword in the physician–patient relationship

Purpose

As one of the five major dimensions of service quality, empathy has been and continues to be regarded as a requirement for a successful service encounter. This paper focuses on the highly customer-centric service industry of health care. The purpose of this paper is to shed light on the potential negative effects of empathy on both the physician and the patient.

Design/methodology/approach

Building on an in-depth review of literature and well-established service quality models, the authors propose a new model for understanding the complex role of physician empathy in the physician–patient encounter. The trait, emotional intelligence (EI), is presented as a moderator for physician empathy levels.

Findings

The Health Care Optimal Physician Empathy (HOPE) model enables further characterization and analysis of the tradeoffs between patient satisfaction and physician burnout and determining when empathy optimally works to the benefit of both the physician and the patient to maximize service quality. The HOPE model provides a systematic way to understand and determine the appropriate level of physician empathy that results in optimal outcomes for both physicians and their patients by demonstrating the tradeoffs between physician burnout and patient satisfaction.

Originality/value

The authors highlight the potential detrimental effects on physicians themselves, and, in turn, on service quality. The theoretical and practical implications in this paper provide insights into the development and implementation of empathy-focused interventions and best practices to optimize service quality in the physician–patient interaction. The HOPE model is the first of its kind in shedding light on the manifestation of physician empathy.

The satisfaction of the undergraduate nursing classroom teaching quality based on the Kano model in China

Objectives

To investigate the satisfaction of the undergraduate nursing classroom teaching quality based on the Kano model and provide a reference for improving the overall quality of educational services.

Methods

A total of 621 sophomores and juniors of nursing at Hubei University of Medicine were selected to conduct questionnaires based on the Kano model using convenient sampling.

Results

The 16 items are all a one-dimensional factor. The satisfaction and importance are 0.77 to 0.86 and -0.58 to -0.80, respectively. In the quadrant analysis chart, there are four items in the dominant area, three items for improvement, three in the observation area, and six in the retention area.

Conclusion

Analyzing the satisfaction of nursing undergraduates' classroom teaching quality can help us effectively understand the intrinsic needs of students and improve the overall quality of nursing undergraduates' curriculum teaching services.

The role of service quality in fostering different types of perceived value for student blended learning satisfaction

The present study aims to conceptualize service quality and perceived value in the context of blended learning by redefining and modifying the existing SERVQUAL model, reviewing prior marketing literature on perceived value, and examining the relationships between service quality, perceived value, and student satisfaction. The sample was restricted to colleges in South Korea, where blended learning programs have started to receive much attention. We examined our hypotheses by using regression analysis via the statistical programs Amos 22.0 and SPSS 23.0. The following results are produced. First, the conceptualization of service quality and perceived value was confirmed. Second, the different effects of online and offline service quality on each perceived value are confirmed. Offline service quality is more effective in generating perceived epistemic value, perceived social value, and perceived emotional value than online service quality, whereas online service quality is more effective in triggering perceived conditional value than offline service quality. Finally, perceived emotional value and perceived conditional value are the important determinants of student satisfaction. We address the theoretical implications that (1) service quality and perceived value are conceptualized through modification, refinement, and empirical testing and develop a multidimensional scale for service quality and perceived value, and (2) the sequential and causal relationships among service quality, perceived value, and student satisfaction are confirmed. Practically, we expect that our measurement scales for service quality and perceived value, which have high validity and reliability, can serve as diagnostic tools for blended learning program evaluation from students' perspective.

Is Hospital Service Quality Relevant During COVID-19 Pandemic?

The study captures hospital service quality expectations during the COVID-19 crisis and compares the same before the onset of COVID-19. The study also highlights which dimensions of service quality attenuate during a medical crisis. The authors used a service quality measurement instrument based on SERVQUAL to capture service quality expectation from patients between June 2019 and May 2020. A sample of 700 was obtained (pre COVID-19 sample size 350 and during COVID-19 sample size 350). The data was analysed using partial least squares, structural equation modelling (PLS-SEM) and ANOVA. Service quality and its dimensions of assurance, empathy, reliability, responsiveness and tangibility remain relevant during COVID-19 pandemic, however, there is a drop in service quality expectation in India in all the five dimensions of service quality. Service quality expectations in tangibility dropped by 11.59%, reliability dropped by 8.82%, responsiveness dropped by 11.56%, assurance dropped by 9.82% and empathy dropped by 12.29%. From a practical standpoint, the study also identifies service quality dimensions that hospitals need to focus on during a crisis. In India, hospitals handling COVID-19 patients need to pay special heed to reliability and responsiveness to improve their service quality and better manage care during the pandemic situation.

The Impact of Healthcare 4.0 on the Healthcare Service Quality: A Systematic Literature Review

Healthcare 4.0 is inspired by Industry 4.0 and its application has resulted in a paradigmatic shift in the field of healthcare. However, the impact of this digital revolution in the healthcare system on healthcare service quality is not known. The purpose of this study is to examine the impact of healthcare 4.0 on healthcare service quality. This study used the systematic literature review methodology suggested by Transfield et al. to critically examine 67 articles. The impact of healthcare 4.0 is analyzed in-depth in terms of the interpersonal, technical, environmental, and administrative aspect of healthcare service quality. This study will be useful to hospitals and other stakeholders to understand the impact of healthcare 4.0 on the service quality of health systems. Besides, this study critically analyses the existing literature and identifies research areas in this field and hence will be beneficial to researchers. Though there are few literature reviews in healthcare 4.0, this is the first study to examine the impact of Healthcare 4.0 on healthcare service quality.

Operations-oriented strategies and patient satisfaction: the mediating effect of service experience

Purpose

The purpose of this study is to explore the direct and indirect effects of perceived provider professionalism and service recovery in enhancing patient satisfaction in a developing country.

Design/methodology/approach

This study used a survey method to investigate satisfaction among health-care consumers. This study used data collected from 210 health-care consumers to empirically test the hypotheses via structural equation modeling

Findings

This study found that service recovery has a significant direct effect on patient satisfaction. Though this study did not find perceived provider professionalism to have a direct effect on patient satisfaction, it found an indirect effect in the relationship via service experience. Thus, service experience fully/completely mediates the relationship between perceived provider professionalism and patient satisfaction, while partially mediating the significant relationship between service recovery and patient satisfaction.

Originality/value

The results further underscore the need for health-care organizations in developing countries to focus on mindfully developing operations-oriented strategies that lead to the delivery of memorable service experiences for patients.

The Ramifications of COVID‐19 in Education: Beyond the Extension of the Kano Model and Unipolar View of Satisfaction and Dissatisfaction in the Field of Blended Learning

With the emergence of COVID‐19 worldwide, interest in blended learning in higher education is rapidly increasing. Despite the fact that the unipolar view that satisfaction and dissatisfaction are measured separately has been emphasized in higher education, fewer efforts have been made in a blended learning context. Therefore, this study attempts to document the unipolar view of satisfaction and dissatisfaction in a blended learning context by adopting the Kano model. More specifically, the objectives of this study is to (1) conceptualize online and offline service dimensions in blended learning, (2) examine the asymmetric effect between satisfaction and dissatisfaction, and (3) apply those results to the Kano model. The following results are reported: (1) system quality and assurance are symmetric, functioning as a satisfier; and (2) information quality, responsiveness, and tangibility are asymmetric, functioning as a delighter. Theoretical and practical implications are addressed.

Innovation resistance theory perspective on the use of food delivery applications

Purpose

The current study tries to better understand the resistance toward food delivery applications (FDAs). This study has adapted the existing criteria to measure different consumer barriers toward FDAs. It also examined the relationships between various consumer barriers, intention to use FDAs and word-of-mouth (WOM).

Design/methodology/approach

This study utilized the innovation resistance theory (IRT) and a mixed-method approach comprised of qualitative essays submitted by 125 respondents and primary surveys (N = 366) of FDA users.

Findings

Tradition barrier (trust) shared a negative association with use intention, while image barrier (poor customer service) shared a negative association with WOM. The intention to use was positively associated with WOM. Additionally, the study results reveal that image barrier (poor customer experience) and value barrier (poor quality control) were, in fact, positively related to WOM. This study also discusses the managerial and theoretical implications of these findings and the scope for further research on FDAs.

Originality/value

FDAs have revolutionized the food delivery industry and made it more comfortable and convenient for the consumers. However, FDA service providers are facing challenges from both customers and restaurants. Although scholars investigated customer behavior toward FDAs, no prior study has focused on consumer barriers toward FDA usage.

Whose experience is it anyway? Toward a constructive engagement of tensions in patient-centered health care

Purpose

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

Design/methodology/approach

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

Findings

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

Originality/value

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

The Antecedents of Poor Doctor-Patient Relationship in Mobile Consultation: A Perspective from Computer-Mediated Communication

This study aims to understand the underlying reasons for poor doctor-patient relationships (DPR). While extant studies on antecedents of poor DPR mainly focus on the offline context and often adopt the patients' perspective, this work focuses on the mobile context and take both doctors' and mobile consultation users' perspectives into consideration. To fulfill this purpose, we first construct a theoretical framework based on the Computer-Mediated Communication (CMC) literature. Then we coded 592 doctor-user communication records to validate and elaborate the proposed theoretical model. This work reveals that characteristics of mobile technologies pose potential challenges on both doctors' and patients' information providing, informative interpreting, and relationship maintaining behaviors, resulting in 10 and 6 types of inappropriate behaviors of doctors and users, respectively, that trigger poor DPR in the mobile context. The findings enrich the research on online DPR and provide insights for improving DPR in the mobile context.

Gender in service quality expectations in hospitals

Purpose

Despite evidence largely confirming gender-based differences in service quality perceptions in healthcare, little research has considered patients’ expectations. This study aims to examine the gender-based differences in both the affective and cognitive components of customers’ service quality expectations.

Design/methodology/approach

Data were collected through random sampling from three outpatient hospitals in the UAE. Hypothesized relationships between the cognitive and affective components (moderated by gender) were tested by means of CFA and ANOVA.

Findings

The results indicate that the differences between male and female expectations of overall service quality as a singular construct were not statistically significant, except for the empathy dimension. However, when measured as affective and cognitive, the results confirm that significant differences do exist between male and female patients.

Research limitations/implications

The research was limited to the UAE. However, identifying gender differences in patients’ expectations would enable healthcare providers to engage and manage patients’ expectations.

Originality/value

This paper provides theoretical and practical implications on how the male and female are different in the cognitive and affective components of service quality expectations.

Can Leadership Enhance Patient Satisfaction? Assessing the Role of Administrative and Medical Quality

This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and medical quality on the relationship between participative leadership and patient satisfaction. The data was obtained from 123 public sector hospitals in Pakistan. We employed confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques to test the structural model. From the study results, we found significant and positive relationships between participative, administrative quality, medical quality, and patient satisfaction. In addition, our research found administrative quality and medical quality as potential mediators on PL-PS relation. Adopting participative leadership as an exogenous factor, and both administrative and medical quality as potential mediators of patient satisfaction, provided new insights into MBNQA criteria.