Consumers' perceptions of sacrifice, service quality, and value in the health care industry

The concepts of price, quality, and value have received considerable attention in the marketing discipline in recent years. These concepts were adapted to a health care services context in an attempt to investigate what influences they had on consumers' behavioral intentions (defined here as customer loyalty and willingness of the consumer to recommend the service). In developing a perception of value, the patient considers what is sacrificed (defined as both monetary and nonmonetary costs) in exchange for what is received (in this case service quality). If the perception of value is high, the patient is more inclined to develop loyalties to the health care provider and may be willing to recommend the services to other potential patients. An examination of prior research in both the marketing and health care fields reveals that the assessment of behavioral intentions has traditionally been linked to consumer satisfaction.;This dissertation proposed and tested a theoretically based model of sacrifice, service quality, and value in a hospital setting. The findings were based on a mail-survey sample of 427 respondents who were former patients of a local hospital. LISREL was used to test the hypothesized relationships of the model.;The proposed model was generally supported and the findings indicate that both service quality and sacrifice influence the patients' perceptions of value. A surprising aspect of the findings, however, was the positive relationship between sacrifice and value. Although the monetary and nonmonetary sacrifices for the respondents are substantial, their perceptions of value are also high. This result may be context specific and is theoretically supported by the consumer behavior complex decision making, high involvement paradigm. This paradigm suggests that a number of contingency factors, including patient involvement, seriousness of the patient's health condition, and the outcome of the hospital procedure could be influencing patients' perceptions of sacrifice and value and provides direction for future research. Of note to health care managers, the linkage between perception of value and behavioral intentions was strongly supported and suggests the importance of patient loyalty and the willingness of former patients to recommend the hospital to potential customers.