The Impact of Relationship Quality on Electronic Word-of-mouth Referral Behavior in Big Data Era

Consumer through their referral behavior could be an effective mechanism for marketers in promoting their products in today’s big data era. In order to explore the ways that the electronic word-of-mouth referral (e-WOM) comprehensively and effectively influence on the film market in the current media ecological environment in China, this research selects Douban, an outstanding representative of China’s online film evaluation platform as the research object and combines the related theories of relationship quality and e-WOM referral behavior to investigate the significant positive influence of the four dimensions of relationship quality (satisfaction, credibility, affection and commitment) on e-WOM referral behavior.

Availability and Accessibility of Primary Care for the Remote, Rural, and Poor Population of Indonesia

Background: Adopting Universal Health Coverage for implementation of a national health insurance system [Jaminan Kesehatan Nasional (JKN)/Badan Penyelenggara Jaminan Sosial or the Indonesian National Social Health Insurance Scheme (BPJS)] targets the 255 million population of Indonesia. The availability, accessibility, and acceptance of healthcare services are the most important challenges during implementation. Referral behavior and the utilization of primary care structures for underserved (rural/remote regions) populations are key guiding elements. In this study, we provided the first assessment of BPJS implementation and its resulting implications for healthcare delivery based on the entire insurance dataset for the initial period of implementation, specifically focusing on poor and remote populations.Methods: Demographic, economic, and healthcare infrastructure information was obtained from public resources. Data about the JKN membership structure, performance information, and reimbursement were provided by the BPJS national head office. For analysis, an ANOVA was used to compare reimbursement indexes for primary healthcare (PHC) and advanced healthcare (AHC). The usage of primary care resources was analyzed by comparing clustered provinces and utilization indices differentiating poor [Penerima Bantuan Iur (PBI) membership] and non-poor populations (non-PBI). Factorial and canonical discrimination analyses were applied to identify the determinants of PHC structures.Results: Remote regions cover 27.8% of districts/municipalities. The distribution of the poor population and PBI members were highly correlated (r2 > 0.8; p < 0.001). Three clusters of provinces [remote high-poor (N = 13), remote low-poor (N = 15), non-remote (N = 5)] were identified. A discrimination analysis enabled the >82% correct cluster classification of infrastructure and human resources of health (HRH)-related factors. Standardized HRH (nurses and general practitioners [GP]) availability showed significant differences between clusters (p < 0.01), whereas the availability of hospital beds was weakly correlated. The usage of PHC was ~2-fold of AHC, while non-PBI members utilized AHC 4- to 5-fold more frequently than PBI members. Referral indices (r2 = 0.94; p < 0.001) for PBI, non-PBI, and AHC utilization rates (r2 = 0.53; p < 0.001) were highly correlated.Conclusion: Human resources of health availability were intensively related to the extent of the remote population but not the numbers of the poor population. The access points of PHC were mainly used by the poor population and in remote regions, whereas other population groups (non-PBI and non-Remote) preferred direct access to AHC. Guiding referral and the utilization of primary care will be key success factors for the effective and efficient usage of available healthcare infrastructures and the achievement of universal health coverage in Indonesia. The short-term development of JKN was recommended, with a focus on guiding referral behavior, especially in remote regions and for non-PBI members.

Sort and Sift, Think and Shift: Let the Data Be Your Guide An Applied Approach to Working With, Learning From, and Privileging Qualitative Data

The Sort and Sift, Think and Shift qualitative data analysis approach is an iterative process where analysts dive into data to understand its content, dimensions, and properties, and then step back to assess what they have learned and to determine next steps. Researchers move from establishing an understanding of what is in the data (“Diving In”) to exploring their relationship to the data (“Stepping Back”). This process of “Diving In” and “Stepping Back” is repeated throughout analysis. To conclude, researchers arrive at an evidence-based meeting point that is a hybrid story of data content and researcher knowledge. To illustrate core tenets of Sort and Sift, Think and Shift, we analyzed three focus group transcripts from a study of postnatal care referral behavior by traditional birth attendants in Nigeria; these transcripts came from Syracuse University’s Qualitative Data Repository and were unfamiliar to the analytic team prior to this exercise. We focused on letting the data be our guide into not only the explicit purpose of the interviews, but also into the unexpected discoveries that arise when inquiring about people’s lived experiences. Situating our efforts within an Initial Learning Period, each member of the team closely read each transcript, and then identified powerful quotations that made us pause and take note. We documented what we learned from each transcript in an episode profile which contained diagrams and memos. Episode profiles were shared and discussed across the team to identify key points of interest, such as the role of faith in women’s decision-making processes related to their pregnancy and delivery preferences, and concepts of who bears what knowledge about reproductive health. Our engagement in this analytic exercise demonstrates the applicability of qualitative inquiry and Sort and Sift as flexible approaches for applied research.

Self-Assessment of Competence and Referral Behavior for Musculoskeletal Injections among Dutch General Practitioners

General practitioners (GPs) are qualified and trained to administer therapeutic musculoskeletal injections when indicated. However, it is unknown to what extend Dutch GPs feel competent to administer these injections in clinical practice. Reluctance among GPs to inject might lead to unnecessary and costly referral to secondary care. An online and offline questionnaire was spread among Dutch GPs, querying demographics, GPs’ self-assessment of injection competence, the number of administered/referred injections and management strategy for musculoskeletal injections. A total of 355 GPs responded. In total, 81% of the GPs considered themselves competent in administering musculoskeletal injections. Self-assessed incompetent GPs performed less injections the last month than self-assessed competent GPs (1.2 ± 1.4 vs 4.8 ± 4.6 injections, P < 0.001). Additionally, they referred four times more often to a colleague GP (0.4 ± 1.0 vs 0.1 ± 0.6 injections per month, P < 0.001) and twice as often to secondary care (1.0 ± 1.3 vs 0.5 ± 0.9 injections per month, P = 0.001). Self-assessed incompetence was associated with female sex (OR [95% CI] = 4.94 [2.39, 10.21]) and part-time work (OR [95% CI] = 2.58 [1.43, 4.66]). The most frequently addressed barriers were a lack of confidence in injection skills, lack of practical training, and uncertainty about the effectiveness and diagnosis of musculoskeletal injections. Although most GPs considered themselves competent to administer musculoskeletal injections, the referral rate to secondary care for several injections was strikingly high. To decrease secondary care referrals, addressing some of the most frequently indicated barriers is highly recommended.

The role of customer engagement facets on the formation of attitude, loyalty and price perception

Purpose This study aims to investigate the influence of customer satisfaction on four facets of customer engagement: customer influencer behavior, knowledge behavior, referral behavior and purchase behavior. Furthermore, its (in)direct influence on affective attitude, price perception and loyalty is investigated. Design/methodology/approach Two studies were conducted. First, an experimental scenario design was set up to investigate the hypothesized relations between customer engagement; customers’ affective attitude and their loyalty; and their price perceptions. Second, a survey at a national forest park center helped to secure external validity. Findings The results indicate that engaged customers develop a more positive affective attitude, which leads to increased future loyalty and positive price perceptions. In addition, the results suggest that assessing cognitive approaches exclusively is not sufficient for understanding customers’ price perceptions. Research limitations/implications Future research should investigate antecedents of customer engagement behaviors (CEBs) other than satisfaction, and extend this research by taking into account further mediators that might be cognitive rather than affective. Practical implications The results are of superior importance for services or tourism destinations. Fostering CEB can help in improving a destinations’ performance. Originality/value This research expands the current state of literature by investigating several dimensions of CEB at one time, as well as by examining customers’ affective attitude toward the organization as a potential mediator, extending previous research approaches.

Ignored or Rejected: Retail Exclusion Effects on Construal Levels and Consumer Responses to Compensation

Among the top customer complaints regarding retailers are experiences of exclusionary treatment in the form of explicit condescension or implicit disregard. However, little is known about how consumers respond to different instances of exclusion in retail or service settings. This research focuses on how customers respond cognitively and emotionally when frontline staff reject or ignore them and on how retailers can recover from such service failures. Findings from six studies using exclusion as a hypothetical scenario or a real experience demonstrate that direct negative feedback leads customers to feel rejected and to form concrete low-level mental construals, while a lack of attention leads customers to feel ignored and to form abstract high-level construals. Explicit rejection (implicit ignoring) causes consumers to form more (less) vivid mental imagery of the exclusionary experience and to activate a concrete (abstract) mindset, resulting in preferences for tangible (intangible) and visual (textual) compensation options. Retailers are advised to align their compensation with construal levels to increase post-recovery customer satisfaction, customer reviews, intended loyalty, and brand referral behavior.