Consumer expectation formation in health care services: A psycho-social model

A psycho-social model of consumer expectation formation in a health care services context was developed and tested. A field study involving obstetrical patients (n=171) at a large women's specialty hospital in the southeast was conducted. Initial support for the structural model which posits that consumer expectations in health care services are multidimensional involving role, process, outcome, and service quality was found. Furthermore, the research identified that the uncertainty of a health service encounter may cause certain consumer segments to choose coping strategies and expectation processes based on their locus of control orientation from along a continuum ranging from "approach-active" to "avoidance-passive". High internal locus of control was associated with greater amounts of internal search, the formation of more accurate process expectations, and higher service quality expectations. External locus of control was associated with greater amounts of external information search with medical professionals (powerful others) and the formation of higher service quality expectations. The linkage of external locus of control to social support was not supported. However, social support was associated with higher levels of bolstering---an affect based coping strategy in which consumers minimize the risks of a chosen alternative and maximize the risks of non-chose health service alternative. Seventy percent of the variance in the model was explained by the structural model. The model provides a useful basis for segmentation in health care services to improve consumer satisfaction based on designing integrated marketing communications and service offerings which meet unique psycho-social needs and consumer expectations.