Customer loyalty in health care relationship marketing

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Ross, Mitchell J
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Surachartkumtonkun, Jiraporn
Thaichon, Park
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Relationship marketing stands at the frontline of marketing study and practice, in which the concept of customer loyalty is dominant. Likewise, health care, a human-centric form of service, is at the forefront of service sectors that warrant the enduring development of individuals, society, economy, and nation. Customer loyalty within the health care industry is explored by this research through the lens of relationship marketing. Transferring the marketing concepts into the health care domain requires the process which is complicated for many reasons due to the complexity of the context, as well as being a form of service that is highly personalized to suit the individual’s medical conditions, requirements, and expectations. Consequently, health care remains a unique area for marketing studies. Although a great deal of research has examined customer loyalty and health care marketing, the patient loyalty phenomenon has not been comprehensively conceptualized. This study explores customer loyalty in the health care context, viewing through the lenses of relationship marketing approach. The research aims to understand and conceptualize the phenomenon of patient loyalty. Since health care services are complex and highly personalized, the context is recognized as a fertile field for conducting the research. The objectives of this research are: (1) to interpret and conceptualize the authentic perceptions of customer loyalty, (2) to explore the service attributes relating to the presence of patient loyalty, and (3) to identify the implications and impacts of customer loyalty in the health care domain. A qualitative method, inductive approach, through the in-depth interview, was adopted to collect data from patients and medical personnel, reflecting perspectives and perceptions toward customer loyalty and relationship marketing in the health care industry. Data were collected from 30 patients and 22 medical personnel in Thailand.The patient interviewees were both inpatient and outpatient, in which the duration of hospitalizations and medical conditions were diverse. The medical personnel respondents were specialists, nurses, and pharmacists. Thematic analysis was conducted to analyze the interview transcripts using qualitative data analysis software in conjunction with manual coding. The findings indicate that the presence of customer loyalty in the health care context is subject to the pre-existence of patient’s faith and trust, which are perceived as the robust definition of patient loyalty. Exclusively, this research uncovers the perception of customer loyalty in health care as the degree of faith that a patient has in health care providers. In the context of this study, individuals’ faith is representative of attitudinal loyalty, including intention to revisit and intention to recommend. Additionally, the concept of faith demonstrates the positive impact on the effectiveness of medical treatment. This research discovers that the perception of faith is also a determinant of patient loyalty to the health care provider. The results also unveil that attitudinal loyalty is impacted by a series of service attributes evaluated by customers during the use of medical services, including experience, service mind, patient care, and favorable feelings. This exploratory research enlightens that an engagement in customer loyalty and relationship marketing benefits patients and health care providers from both medical and managerial perspectives. The results also reveal the significant implications of customer loyalty and relationship marketing, impacting theoretical and practical contributions, based on both managerial and medical perspectives. This study concludes that the concept of customer loyalty and relationship marketing orientation are highly relevant and generate numerous desirable outcomes in the health care industry which benefit both service provider and recipient.The outcome of this study produces both theoretical and practical contributions. Theoretically, this thesis enhances the knowledge of customer loyalty by integrating the concept of faith into marketing literature to explain the patient loyalty phenomenon, in which the service attributes affecting customer evaluation are rationalized. Furthermore, the exploration of customer loyalty is conducted two-dimensionally from both health care providers’ and patients’ perspectives, which ensures the robustness of this research. Therefore, this study resulted in three theoretical contributions. First, customer loyalty in health care is conceptualized by informing a clear description of the concept. In the health care industry, customer loyalty, a form of emotional attachment, is different from a generic loyalty that applies to both goods and services. Another theoretical contribution involves clarifying a series of service attributes that customers assess throughout the health care journey with the model of the patient buying decision process which represents an empirical effort to capture the considerations of customers during the entire service journey. Third, this study clarifies the impacts and implications of patient loyalty and relationship marketing orientation in the health care industry. As demonstrated in this thesis, customer loyalty has important implications, including preferable medical outcomes and other impacts relating to the financial benefits of providers and the wellbeing of patients. Practically, this study encourages managerial implications for key stakeholders of the industry, including health care providers, public organizations (i.e., government-owned organizations), patients, and the overall service sector. The findings illustrate the benefits from long-term relationship orientation, which sustain the relationship between service provider and customer. This thesis provides informative findings which appropriately justify the cruciality of customer loyalty in health care relationship marketing.

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Thesis (PhD Doctorate)
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Doctor of Philosophy (PhD)
Dept of Marketing
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The author owns the copyright in this thesis, unless stated otherwise.
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Customer loyalty
Relationship marketing
Health care
Health care marketing
Patient loyalty
Service marketing
Service industry
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