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

Author(s):  
Kofi Osei-Frimpong

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.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gyan Prakash

PurposeThis paper explores the enablers of modular healthcare services.Design/methodology/approachA survey-based approach was adopted with specialised hospitals as the unit of analysis. A structural model was developed based on a literature review and assessed using a cross-sectional research design. A 23-indicator questionnaire was circulated among service providers in the healthcare system across India, and 286 valid responses were received. The data were analysed using partial least squares-structural equation modeling (PLS-SEM).FindingsThe results reveal that professional competence, technological versatility, clear division of tasks, channelised flow of information and professional autonomy act as enablers that may drive modular service delivery.Research limitations/implicationsBy examining service providers' perspectives, this paper highlights the influence of the identified enablers on modular service delivery in healthcare organisations.Practical implicationsFor practitioners, the study provides suggestions for designing patient-centric healthcare services via modular healthcare delivery. The identified structural relationships can facilitate immediate corrective actions and the formulation of future policies. The findings will help practitioners foresee opportunities for patient participation in value co-creation, meet patients' varying needs, decompose service offerings, mix and match components develop sets of rules as interfaces between service modules and design service packages on an ongoing basis.Social implicationsThis study underscores the emergence of patient-centric care and may aid the design of processes that deliver health to the patient as a person.Originality/valueThis paper identifies and empirically validates relationships between healthcare service delivery processes and modular service delivery.


2021 ◽  
Vol 36 (9) ◽  
pp. 1-24
Author(s):  
Sabina De Rosis ◽  
Chiara Barchielli ◽  
Milena Vainieri ◽  
Nicola Bellé

PurposeUser experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.Design/methodology/approach65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.FindingsPatients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.Research limitations/implicationsDifferent features referring to different nursing models make the difference in producing an excellent user experience with the service.Practical implicationsThese findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.Originality/valueThis is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.Highlights This is one of the first studies on the relationship between provision models of nursing care and patient experience.Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.


2019 ◽  
Vol 32 (2) ◽  
pp. 331-347
Author(s):  
Gyan Prakash ◽  
Shefali Srivastava

Purpose The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery. Design/methodology/approach A structural model was developed based on a literature review. Circulation of a 31-indicator questionnaire among service receivers in the healthcare system across India generated 279 valid responses. The research model was assessed using a cross-sectional research design, and the data were analyzed by partial least squares-structural equation modeling. Findings Integrated supply chain performance (ISCP), internal service quality (ISQ) and coordinated care are antecedents of a value-dense environment, which drives patient-centricity. The leagile supply chain strategy strengthens the relationship between ISCP and coordinated care. Employee trust and commitment acts as a moderator between coordinated care and ISQ. Research limitations/implications By adopting the perspective of service receivers, this paper highlights the influence of value-density on patient-centricity in healthcare organizations. Future research should include healthcare professionals’ perceptions of value-dense environment creation. Practical implications The study provides suggestions to practitioners for designing patient-centric healthcare services by leveraging ISCP, coordinated care and ISQ in the value-creation process. Recognizing the relationships among these constructs can aid the timely formulation of corrective actions and future policies. Social implications This study underscores patient-centric care as a basis for effectively delivering healthcare as a social good. Originality/value This paper contributes to the body of knowledge by identifying and empirically validating the relationships between patient-centricity and value co-creation.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Suhail M. Ghouse ◽  
Omar Durrah ◽  
Gerard McElwee

PurposeThis paper examines the challenges associated with rural women entrepreneurs in Oman. The study is based on women living in rural and highland areas who aim to move beyond their traditional roles in the family seeking avenues for growth and development. It identifies several problems encountered by rural women entrepreneurs and the impact on their future business opportunities.Design/methodology/approachA mixed research approach involving quantitative and qualitative elements was adopted for the study. The research is based on 183 survey responses and personal interviews with 8 rural women entrepreneurs. Partial least squares structural equation modeling (PLS-SEM) was adopted to analyse the quantitative responses and depict a model featuring the intensity of the problems affecting business opportunities. Seven short cases based upon the interviews with rural women entrepreneurs are also detailed.FindingsSeveral problems experienced by rural women entrepreneurs were identified hampering their business ventures, linked to personality, family, educational, socio-cultural, facilities, legal, financial and economic, organizational and geographical, out of which household, organizational and geographical linked problems were most significant. Entrepreneurial opportunities for rural women entrepreneurs are discussed.Practical implicationsThe research suggests that the policymakers should holistically consider how the rural women engaged in informal business for various means can be better supported and sustained by overcoming associated problems, can achieve business opportunities and contribute to regional socio-economic development.Originality/valueThere is a limited literature available on rural women entrepreneurship in an Arab context. The study provides an overview of the challenges and problems experienced by these women and the support areas required to overcome them for their sustainability in this region.


2021 ◽  
Vol 32 (6) ◽  
pp. 1-27
Author(s):  
Elina Jaakkola ◽  
Harri Terho

PurposeThe quality of the customer journey has become a critical determinant of successful service delivery in contemporary business. Extant journey research focuses on the customer path to purchase, but pays less attention to the touchpoints related to service delivery and consumption that are key for understanding customer experiences in service-intensive contexts. The purpose of this study is to conceptualize service journey quality (SJQ), develop measures for the construct and study its key outcomes.Design/methodology/approachThe study uses a discovery-oriented research approach to conceptualize SJQ by synthesizing theory and field-based insights from customer focus group discussions. Next, using consumer survey data (N = 278) from the financial services context, the authors develop measures for the SJQ. Finally, based on an additional survey dataset (N = 239), the authors test the nomological validity and predictive relevance of the SJQ.FindingsSJQ comprises of three dimensions: (1) journey seamlessness, (2) journey personalization and (3) journey coherence. This study demonstrates that SJQ is a critical driver of service quality and customer loyalty in contemporary business. This study finds that the loyalty link is partially mediated through service quality, indicating that SJQ explains loyalty above and beyond service quality.Research limitations/implicationsSince service quality only partially mediates the link between service journey quality and customer loyalty, future studies should examine alternative mediators, such as customer experience, for a more comprehensive understanding of the performance effects.Practical implicationsThe study offers concrete tools for service managers who wish to understand and develop the quality of service journeys.Originality/valueThis study advances the service journey concept, demonstrates that the quality of the service journey is a critical driver of customer performance and provides rigorous journey constructs for future service research.


2018 ◽  
Vol 52 (11) ◽  
pp. 2234-2250 ◽  
Author(s):  
Heini Sisko Maarit Taiminen ◽  
Saila Saraniemi ◽  
Joy Parkinson

Purpose This paper aims to enhance the current understanding of digital self-services (computerized cognitive behavioral therapy [cCBT]) and how they could be better incorporated into integrated mental health care from the physician’s perspective. Service marketing and information systems literature are combined in the context of mental health-care delivery. Design/methodology/approach An online survey of 412 Finnish physicians was undertaken to understand physicians’ acceptance of cCBT. The study applies thematic analysis and structural equation modeling to answer its research questions. Findings Adopting a service marketing perspective helps understand how digital self-services can be incorporated in health-care delivery. The findings suggest that value creation within this context should be seen as an intertwined process where value co-creation and self-creation should occur seamlessly at different stages. Furthermore, the usefulness of having a value self-creation supervisor was identified. These value creation logic changes should be understood and enabled to incorporate digital self-services into integrated mental health-care delivery. Research limitations/implications Because health-care systems vary across countries, strengthening understanding through exploring different contexts is crucial. Practical implications Assistance should be provided to physicians to enable better understanding of the application and suitability of digital self-service as a treatment option (such as cCBT) within their profession. Additionally, supportive facilitating conditions should be created to incorporate them as part of integrated care chain. Social implications Digital self-services have the potential to serve goals beyond routine activities in a health-care setting. Originality/value This study demonstrates the relevance of service theories within the health-care context and improves understanding of value creation in digital self-services. It also offers a profound depiction of the barriers to acceptance.


2016 ◽  
Vol 28 (2) ◽  
pp. 222-245 ◽  
Author(s):  
Prakash K. Chathoth ◽  
Gerardo R. Ungson ◽  
Robert J. Harrington ◽  
Eric S.W. Chan

Purpose – This paper aims to present a review of the literature associated with co-creation and higher-order customer engagement concepts and poses critical questions related to the current state of research. Additionally, the paper presents a framework for customer engagement and co-creation with relevance to hospitality transactions. Design/methodology/approach – Earlier research on co-production, co-creation, consumer engagement and service-dominant logic are discussed and synthesized. Based on this synthesis, links and contrasts of these varying research streams are presented providing an articulation of key characteristics of each and how these might be applied within a hospitality context. Findings – Modalities in service transactions vary among traditional production, co-production and co-creation based on changes in attitudes, enabling technologies and the logic or ideology supporting the change. Transaction characteristics vary among manufacturing, quasi-manufacturing and services based on several key categories including differences in boundary conditions, enablers, success requirements, sustainability requirements, the dominant logic used and key barriers/vulnerabilities. When creating experiential value for consumers, firms should consider several aspects ex-ante, in-situ and ex-post of the change and during the change process. Research limitations/implications – Firms need to move toward higher-order customer engagement using co-creative modalities to enhance value creation. Current practices in the hotel industry may not in their entirety support this notion. Ex-ante, in-situ and ex-post considerations for creating experiential value need to be used as part of a checklist of questions for firms to pose in order to move toward managing customer experiences using the service-dominant logic as part of the firm’s orientation toward its market. This would give it the required thrust to create superior engagement platforms that use co-creative modalities while addressing the barriers to higher-order customer engagement as identified in the literature. Originality/value – The hospitality and tourism literature on co-creation and higher-order customer engagement is still in its infancy. A synthesis of these early studies provides support for the need for future research on co-creation that more clearly articulates the modality firms could use to move toward co-creation. This paper develops a dynamic framework using characteristics of co-creation that integrate the various stages of value creation (i.e. input, throughput and output).


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hyeongmin Kim ◽  
Chang Huh ◽  
Chanho Song ◽  
Myong Jae Lee

Purpose The purpose of this study was to investigate relationships among the experiential value of hotel apps, the cognitive and affective evaluation of hotel apps users, hotel apps users’ satisfaction and their endorsement for the hotel apps. Specifically, this study examined the relationships that enhance hotel guests’ experiences through hotel apps. Design/methodology/approach The measurement items were developed through extensive literature review. This study used a web-based survey to test an integrated model of the experiential value. With a total of 320 usable samples, partial least squares structural equation modeling was carried out to identify key “driver” constructs and validate the proposed model. Findings A significant relationship was found in the playfulness of hotel apps and hotel guests’ cognitive and affective evaluations of the hotel apps, which positively influence hotel guests’ satisfaction and their endorsement for the hotel apps. Hotel apps should create fun and entertainment features in the hotel apps so that the users of hotel apps can be enjoyable during their usage. In addition, providing hotel apps users with time saving and easy use of the hotel apps can affect their satisfaction and endorsement for the hotel apps. Originality/value This study confirmed the positive links among hotel apps users’ experiential value, their cognitive and affective evaluation of the hotel apps, their satisfaction of using the hotel apps and their endorsement for the hotel apps. This study also revealed that hotel apps can be hotels’ effective communication tool that enhances existing and potential customers’ overall experiences.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Prachi Verma ◽  
Satinder Kumar ◽  
Sanjeev K. Sharma

PurposeThis article initially aims to explore the factors of every quality construct of the 5Qs model of service quality and, second, identify the significant factors affecting the total quality of e-healthcare services and its association with consumer satisfaction using a multidimensional hierarchical 5Qs model of e-healthcare service quality.Design/methodology/approachQuestionnaire-oriented research was performed at three public hospitals of Punjab and Chandigarh. In total, 53 variables were covered in all quality constructs for data collection from the designated public hospitals. The respondents who agreed to have knowledge regarding e-Healthcare services and were availing these services were included in the study. The analysis comprised structural equation modeling technique using AMOS 21.FindingsThe outcomes suggest that the 5Qs model is more comprehensive and can be used to evaluate service quality perceptions using e-Healthcare services. The research identified 11 sub-dimensions for the five quality constructs of the 5Qs model, representing total quality, which is primary to consumer satisfaction. “Overall objectivity” and “technical objectivity” defined the quality of object. The quality of process of e-Healthcare services was characterized by “functionality,” “timeliness” and “responsiveness.” Quality of infrastructure was defined by “technical infrastructure,” “physical infrastructure,” “manpower skills” and “organizational infrastructure.” “Manner of interaction” and “timely interaction” defined the quality of interaction. The atmosphere was represented by only one factor. The results also suggest that quality of infrastructure, quality of interaction and quality of atmosphere play the most significant role in total quality leading to consumer satisfaction.Research limitations/implicationsTheoretical implications: The multidimensional hierarchical model will help the researchers study the e-Healthcare service quality in a more organized manner, and the outcomes of this study can be linked with that of future studies for more generalized application in other public hospitals. The sub-dimensions of each quality construct of the 5Qs model can be applied in private hospitals, and the hierarchical model can be tested in different industries to measure service quality perceptions of the consumerPractical implicationsThe outcomes of the study can be applied in various public sector hospitals to redesign the e-Healthcare services based on consumers' perception for better consumer satisfaction and quality services. This paper identifies the role of each quality construct in e-Healthcare services for improvement in the total quality, which in turn will lead to higher satisfaction for the consumers.Originality/valueIn this study, the original 5Qs model has been used for the first time in a new instrument to understand better and design quality e-Healthcare services. The paper explores the sub-factors of each quality construct and its significance in measuring the total quality.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elizabeth H. Manser Payne ◽  
James Peltier ◽  
Victor A. Barger

Purpose The purpose of this study is to investigate the relationships that influence the value co-creation process and lead to consumer comfort with artificial intelligence (AI) and mobile banking (AIMB) service platforms. Design/methodology/approach A conceptual model was developed to investigate the value-in-use perceptions of AI-based mobile banking applications via five antecedents: baseline perceptions of current bank service delivery; service delivery configuration benefits; general data security; safety perceptions of specific mobile banking services; and perceptions of AI service delivery. Data were collected from 218 respondents and analyzed using structural equation modeling. Findings This study highlights the role and importance of the sequential relationships that impact the assessment of AIMB. The findings suggest that service delivery and the customer’s role in value co-creation change as AI is introduced into a digital self-service technology channel. Furthermore, AIMB offers transaction-oriented (utilitarian) value propositions more so than relationship-oriented (hedonic) value propositions. Research limitations/implications The sample consisted on digital natives. Additional age cohorts are needed. Practical implications As financial institutions redirect their business models toward digital self-service technology channels, the need for customers to feel comfortable while interacting with an AI agent will be critical for enhancing the customer experience and firm performance. Originality/value The authors extend the service-dominant logic (SDL) literature by showing that value co-creation is a function of both firms’ technologies and consumers’ value-in-use, a finding that appears to be unique in the literature. The authors advance the digital transformation literature by evaluating AIMB as an interactive process that requires an understanding of key technology constructs, including perceptions of baseline service relationships, desired service configurations, security and safety issues and whether AI is useful for value co-creation. To the best of the authors’ knowledge, this is the first SDL framework that investigates interactive and structural relationships to explain value-in-use perceptions of AIMB.


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