Antecedents of service outcome among Malaysian private medical clinics

Abstract

In health care services, achieving high performance is of utmost importance as it relates to human life. The main purpose of this research is to extend and consolidate knowledge about the outcome of customer’s experience of consuming the attributes of services and the impact on business performance. Previous researchers investigated the health care services from social medical services perspective, in hospital and inpatient setting. Outpatient and private medical clinic setting was not the focus. Furthermore the researchers measured the performance of the services isolatedly and did not relate them to the business outcomes. Therefore this research aims to measure the service outcome from services marketing perspective, at the private medical clinic setting. This research fills the empirical gap through the measuring process of the service attributes of the private medical clinic by the customers. Private medical clinic is a business entity that provides services to customers who are the patients in an open market. Competition is part of the game and satisfying customers is an important agenda. The importance of this research relates to the nature of the private medical clinic itself that is a profit making entity, which reputation and customer loyalty are among the important measures. The whole framework was develop based on the marketing theory and marketing mix model that specifically tailored to services business. The conceptual framework was adapted into the private health care business. The service attributes were constrained to the extended Ps of the marketing mix strategies for services business, i.e. the physical evidence of the clinic (consultation and treatment) and people (physician). Patient satisfaction and enablement were treated as the outcome measures that mediate the relationship and the impact was measured on two performance traits that are relevant to the nature of the case, that are patient loyalty and patient appraisal on reputation. Two moderation variables: the categorical factor; patient category and the psychometric factor; patient health consciousness were tested on their effect towards the relationship. In the data collection process, questionnaire was used as the instrument. Data were collected at the private medical clinics on patients who went through the consultation before they consumed the medicine. 500 questionnaires were distributed, 358 were collected, and 201 were treated as completed questionnaire. The data were analyzed on the measurement model and the structural model namely the confirmatory factor analysis, composite reliability and discriminant reliability. Hypotheses bootstrapping test was done using SmartPLS 2. The key finding shows that doctor professionalism is the most critical factor that contributes to the performance. In addition satisfaction partially mediates the relationship but does not enablement. All paths tested were significant except enablement to performance, but health consciousness and patient category show insignificant effect on the relationship. Theoretically, this research proven that the extended ‘P’ that is People in services marketing is significant and the importance is obvious. In practical perspective, this research contributes to the development of ‘people’ and ‘product’ strategy in the marketing mix model in professional service business. It is recommended that in professional service business, the element of ‘People’ and ‘Product’ to be integrated since the ‘product’ in professional services business is reliant to the knowledge, skills and ability of the ‘people’ who deliver the service. Therefore all aspects of ‘product’ including brand, packaging and guarantee are to be developed in ‘people’ element itself.