Healthcare service quality: what really matters to the female patient?

Influence of Physical Attractiveness and Gender on Patient Preferences in Digital Doctor Consultations: Experimental Study

BACKGROUND

The rise of digital health services, particularly digital doctor consultations, has created a new paradigm in health care choice. While patients traditionally rely on digital reviews or referrals to select health care providers, the digital context often lacks such information, leading to reliance on visual cues such as profile pictures. Previous research has explored the impact of physical attractiveness in general service settings but is scant in the context of digital health care.

OBJECTIVE

This study aims to fill the research gap by investigating how a health care provider's physical attractiveness influences patient preferences in a digital consultation setting. We also examine the moderating effects of disease severity and the availability of information on health care providers' qualifications. The study uses signal theory and the sexual attribution bias framework to understand these dynamics.

METHODS

Three experimental studies were conducted to examine the influence of health care providers' physical attractiveness and gender on patient preferences in digital consultations. Study 1 (n=282) used a 2×2 between-subjects factorial design, manipulating doctor attractiveness and gender. Study 2 (n=158) focused on women doctors and manipulated disease severity and participant gender. Study 3 (n=150) replicated study 2 but added information about the providers' abilities.

RESULTS

This research found that patients tend to choose attractive doctors of the opposite gender but are less likely to choose attractive doctors of the same gender. In addition, our studies revealed that such an effect is more prominent when the disease severity is high. Furthermore, the influence of gender stereotypes is mitigated in both the high and low disease severity conditions when service providers' qualification information is present.

CONCLUSIONS

This research contributes to the literature on medical information systems research and sheds light on what information should be displayed on digital doctor consultation platforms. To counteract stereotype-based attractiveness biases, health care platforms should consider providing comprehensive qualification information alongside profile pictures.

Examining the behavioural intention of inpatients in Indian government hospitals

PURPOSE

The purpose of this research is to examine the impact of perceived service quality (PSQ) on the behavioural intention (BI) of patients in Indian government hospitals. The underlying mechanism of trust and patient satisfaction (SAT) is examined as multiple mediating effect.

DESIGN/METHODOLOGY/APPROACH

Data from 510 respondents were collected using structured questionnaires. Six government hospitals, namely, S.M.S. Hospital, J.L.N. Hospital, New Medical College Hospital, Maharana Bhupal Medical Hospital, Mathuradas Hospital and P.B.N. Hospital, were selected from the cities of Jaipur, Ajmer, Kota, Udaipur, Jodhpur and Bikaner, respectively. The data were collected from adult patients (>18 years old) who spent at least two nights in a government hospital between 1 October, 2020 and 30 December, 2020. PSQ formed as a reflective-formative model was analysed using the repeated indicator approach. Structural equation modelling (SEM) using SMART-PLS software was used to test the hypothesised model(s) derived deductively from literature.

FINDINGS

The findings support the following conclusions: (1) the positive relationship between PSQ and BI is significant; (2) SAT mediates the PSQ and BI relationship; (3) trust mediates the PSQ and BI relationship; (4) the mediation effect of SAT is stronger than that of trust.

PRACTICAL IMPLICATIONS

The results indicate that, in order to enhance the positive BI of patients towards government hospitals, it is necessary for the hospitals to work on strategies to enhance the service quality provided to patients. The outcome of this study will enable state government hospitals to get a better understanding of the different dimensions of service quality and will help in observing the factors that contribute to patients' satisfaction and trust in building long-term relationships by encouraging a positive BI.

ORIGINALITY/VALUE

There is a dearth of research in India that evaluates the relationships between the constructs PSQ, trust, BI and SAT in the context of healthcare service. This empirical study is an attempt to fill this gap by focussing on the government hospitals in India.

Brand image to loyalty through perceived service quality and patient satisfaction: A conceptual framework

Brand image (BI) is a relatively new concept in the healthcare sector and its value is important for healthcare organizations to survive in this competitive era. Extant research in academics shows the diversity in determinants of patient satisfaction (PS), perceived service quality (PSQ), loyalty and brand image (BI) in the healthcare sector. The large numbers of existing studies mainly emphasize constructs such as PS, PSQ or the relationship between these two, taking into consideration other factors like cost and loyalty. The purpose of this study is to systematically review and summarize current research as well as propose a conceptual model of hospital brand image and its impact on patient loyalty through PSQ and PS. We provide a research framework for future theoretical and empirical studies on the impact of BI on patient loyalty.

R. Healthcare service quality: a methodology for servicescape re-design using Taguchi approach

Purpose

The purpose of this paper is to identify major healthcare service quality (HSQ) dimensions, their most preferred service levels, and their effect on HSQ perceptions of patients using a Taguchi experiment.

Design/methodology/approach

This study adopted a sequential incidence technique to identify factors relevant in HSQ and examined the relative importance of different factor levels in the service journey using Taguchi experiment.

Findings

For HSQ, the optimum factor levels are online appointment booking facility with provision to review and modify appointments; a separate reception for booked patients; provision to meet the doctor of choice; prior detailing of procedures; doctor on call facility to the room of stay; electronic sharing of discharge summary, an online payment facility. Consultation phase followed by the stay and then procedures have maximum effect on S/N and mean responses of patients. The appointment stage has a maximum effect on standard deviations.

Research limitations/implications

Theoretically, this study attempted to address the dearth of research on service settings using robust methodologies like Taguchi experiment, which is popular in the manufacturing sector. The study implies the need for patient-centric initiatives for better HSQ through periodic experiments that inform about the changing priorities of patients.

Practical implications

The trade-off between standardization and customization create challenges in healthcare. Practically, a classification of processes based on standardization vs customization potential is useful to revamp processes for HSQ.

Originality/value

This study applied the Taguchi approach to get insights in re-designing a patient-centric healthcare servicescapes.

Verifying alternative measures of healthcare service quality

PURPOSE

The purpose of this paper is to determine the best measure among several alternatives (SERVQUAL, weighted SERVQUAL, SERVPERF, weighted SERVPERF) and develop a scale which healthcare providers can use for measurement of healthcare service quality.

DESIGN/METHODOLOGY/APPROACH

The study involved two phases. The first phase was through a series of in-depth interviews with experts and patients followed by a pilot study. Subsequently, the second phase involved a quantitative phase through surveys with 384 patients. Alternative measures were analyzed using coefficient (Cronbach) α, composite reliability, factor analysis and logistic regression analysis.

FINDINGS

Findings confirmed "Weighted SERVPERF" using an interactive methodology as the most appropriate for measurement of healthcare service quality.

ORIGINALITY/VALUE

Using the model and scale developed, healthcare providers will be able to measure healthcare service quality and identify areas of shortfall and act accordingly to improve delivery through allocating resources in service areas that would generate the greatest returns in customer satisfaction. Enhancing satisfaction will ultimately generate patient loyalty and positive recommendation behavior.

Examining the effects of patient characteristics and prior value needs on the patient-doctor encounter process in healthcare service delivery

Purpose

Considering the increasing conceptualization of value creation, this paper aims to empirically examine the influence of pre-encounter value needs of patients on the clinical encounter process and how this impacts on their perceived experiential value, and contributes to the patient’s role in value creation in healthcare service delivery.

Design/methodology/approach

A model is proposed to suggest the antecedent and consequences of key elements of the patient–doctor encounter process. Following survey design approach, data collected from 332 outpatients from two clinics in Accra, Ghana, are examined through structural equation modeling using AMOS 23.0.

Findings

The findings reveal that patient pre-encounter value needs significantly influence key elements of the patient–doctor encounter process (care delivery approach, level of trust and shared-decision making approach). This in turn affects patient’s perceived experiential value and satisfaction evaluation. The results also suggest that patient characteristics (e.g. educational background and frequency of visit) had no significant effect on the encounter process leading to perceived experiential value; however, patient’s age had significant influence on the encounter process.

Research limitations/implications

This study empirically establishes a need to understand patient’s pre-encounter value needs, which fundamentally influence the patient-doctor encounter process and their perceived experiential value. However, the research only focused on the patient, which could limit the findings considering the multi-actors involved in the service delivery.

Practical implications

Creating value with patients suggests a need for providers to understand patient value needs or goals and adopt an approach to engage in a holistic manner that would result in positive experiences. This would empower and increase confidence of patients in consultations.

Originality/value

Using a quantitative research approach, this research engages in a highly focused investigation of the influence of patient’s pre-encounter value needs on key elements of the patient–doctor encounter process, which has received limited attention in the extant literature. The study also furthers our understanding of the effects of fundamental patient characteristics on encounter process and how this influence actor perceived experiential value.