BRAND TRUST AND IMAGE: EFFECT ON CUSTOMERS’ SATISFACTION

 

Syeda Jaazba Zehra

Uroosa Arshad

 

Abstract

        Healthcare services are not only treating people, but they are also interconnected with economic condition of the country. Healthcare service sector’s quality is determined by the level of satisfaction they are providing to their customer. This paper determines the impact of brand trust, service quality, and brand image on satisfaction level of customers to use services. Mainly it is describing the impact of service quality on the satisfaction level, while service quality is an independent variable and satisfaction is a mediator which is explaining the importance and their role in the field of healthcare. Furthermore, it also tells us that branding is very much important to gain the trust of customers because satisfaction level of the user shows their interest in a healthcare service. This study solves the problem of service quality related issues in healthcare sector which helps in improving relationships between customers and hospitals as well as impacting the country’s economy in a constructive way. We are targeting every customer related to disease or illness plus the hospital staff. The data is collected through questionnaires and with the help of Excel, Amos, and IBM SPSS. This is helpful for many healthcare organizations to improve their service quality which in return helps in earning profits.

 

Keywords: Service quality, satisfaction, healthcare services, brand trust.

 

Introduction

 

Overview & Background

 

Healthcare sector an economic condition is inter connected with each other and technological advancement in healthcare sector make them to market Their service and brand development crucial (Ramani 2006). Particularly in healthcare sector quality has become a valuable and very concerned part. The aspiration about the quality among the customer has made the company manager around the world too. Think carefully about the quality of service and make it a strategic goal to achieve competitive edge over the other. better services quality help providing more productivity and engaged more customer which in return improves organizational performance and give long term benefits (Glare 1983). Variance high quality services and customer knowledge about choosing service make services provider to provide better and better quality to target customer satisfaction Branding has a significant role in a service sector which increases brand trust (Berry 2000). According to Merriam Webster dictionary 2010 tells quality as the level of greatness quality is not easy due to its subjective characteristic and intangible nature, is hard to explain. It is a subtle concept which has many numerous implication and understanding. (Seawright, 1996). Its explanation differs according to different perspective in which is considered therefore quality cab be explained as “value” (Feigenbaum 1951). “Excellence” (Petter 1982). Healthcare sector is an elusive field that cannot be physically connected or seen (Joss 1995)It is usually not easy to provide constant healthcare sector (Kaluzny 2006).Healthcare sector are among the very critical customized arrangement that patients encounter (Kemd et al, 2014) In firm trust is fundamental for making and keeping up long haul connections (Rousseau et.at 1998).Given auspicious Healthcare sector is critical which can have built customer satisfaction which thusly satisfaction is seen as a crucial and notable factor. According to which satisfaction is a responsiveness resulting from considering what has been gotten versus what was anticipated. (Armstrong 1996) Customer satisfaction is a pre-buying process which represented how many customers like or don’t like the services after gaining it. (Woodsite et.al 1989). Employees’ behavior also has a notable impact on patient’s satisfaction the manner by which worker carry on with patients is an important component. (Andaleeb 1988). 

 

Problem Statement

 

Healthcare Services directly influence economic development for any country. It is not possible to get the good socio-economic position without focusing on healthcare services (Mavlankar, 2006).

 

This research is to determine the influence of service quality on Customer Satisfaction in Healthcare Services to provide patients and customers a better experience. After a deep research we have found that we can further add in service quality’s effect on customer’s satisfaction, in this regard we have gone through several research papers related to healthcare management and services. According to different researches service quality has a great impact over Customer Satisfaction which is considered as a part of customer’s loyalty and customer engagements with the Healthcare service provider. As per it’s definition. Customer Satisfaction is considered as an important area for earning revenues and returns, Consumer Satisfaction can be obtained by providing good quality products which can provide a better life experience and can be obtained from fulfilling the needs and wants of all stake holders. (Oliver 1980). We have included service quality as an independent variable for Customer Satisfaction which is a mediator in between service quality and using healthcare services.

 

 Objectives and Significance of the Study

 

Healthcare services are responsible to treat people’s diseases and to maintain health. Healthy human resources are the building blocks of any society and is crucial for the economic development. We desired to examine the effect of service quality on customer satisfaction for using any healthcare services. Major medical progresses and developments reflect distinguishing variances among healthcare centers. Specialists revealed that patients are willing to receive the finest and quick healthcare services. Patients be likely to spend money and time to receive the top treatment, they lean to collect information on healthcare centers and hospitals. Being honest and fulfilling all commitments to patients are among the most crucial factors, that is why hospital staff’s sincerity has a significant and straight connection with patient’s perception. By considering these facts, the governing body of healthcare industry compelled to monitor service standards and commitments towards patients to prevent overstatement by hospital employees.

 

·         Our research is a most important step towards Pakistani hospitals and managers of healthcare centers to grow their brand and achieve patient’s satisfaction.

·         This study shows that service quality in medical field has a significant effect on Pakistani customer satisfaction

·         On the other hand, it helps in improving country’s economy as health is very important for the development.

·         We aim to increase revenues and income of hospitals by showing the effect of service quality on customer satisfaction and brand trust.

 

Outline of Study

 

This research is conducted in numerous hospitals and with various patients to check the effect of service quality on satisfaction level to utilize the healthcare services. Which directed towards the model’s expansion and its influence on the patient’s satisfaction. We examined brand trust, brand image and more specifically service quality to determine their impact over customer satisfaction and satisfaction’s impact over choosing the healthcare service by patients. Furthermore, this research determines that improving service quality can get more patients which yield higher profits. The research that has been done with numerous limitations might be used as the reference to improve upcoming research. New research models might incorporate any additional variable like the corporate social responsibility as the independent variable and customer satisfaction as the mediator. Moreover, it would be a best option to redevelop this research modeling other service sectors as well. Service quality could be the winning factor for achieving competitive edge for any service provider as customers always seek and pay for best quality. The patients and the hospitals of Pakistan are the main subjects of this research that includes every young and old who is ill or having any medical disorders. Additionally, this research is targeting hospital’s managers to make them aware regarding the importance of improving service quality to get attention of more customers.

 

Literature Review

 

Key Constructs:

 

Researcher has designed this model on the healthcare service sector. The following variables are kept in regard like customer satisfaction, brand image, brand trust and service quality. These four factors impact the level of using any healthcare service

 

Customer Satisfaction:

 

Satisfaction is consumers’ judgment that a product or service feature, or the product or service itself, provided (or is providing) a pleasant level of consumption-related self-actualization, containing stages of under or over-fulfillment” (Oliver, 1997). Customer satisfaction viewed as a filling up of consumers’ consumption aims as experienced and described by consumers (Oliver, 2006). An essence of many researches on customer satisfaction showed that the background to satisfaction has a different explanation (Henard, 2001).

 

Brand Image:

 

Brand image as combining name, fame (reputation), design and symbol, it is used by consumers to distinguish products and services from competitors’ as per to Kotler (1991). To buy or select services having a good image, which are unusual, significant and valuable for a person, rapidly enables customer selection. Brand image efficiency can be examined for special services such as healthcare. Good brand image makes consumers trust in product quality and lead consumers to make a selection and to feel relaxed while buying their product (Chih-Chung et al., 2012).

 

Brand Trust:

 

Brand trust is “The willingness of the average consumer to rely on the ability of the brand to perform its stated function” (Holbrook, 2001). Customer brand trust develops after evaluating companies’ services. In case organizations provide beliefs of protection, trustworthiness and consistency about their brands to consumers, brand trust will be created successively (Cannon, 1997).

 

Service Quality:

 

‘Service quality is usually defined as the customer’s impressions of the relative superiority/inferiority of a service provide and its provider’ as per (Bitner, 1994). It is often measured as like the consumer overall attitude towards the company (Bitner, 1990). Researchers have attempted to develop the thought and measure service quality and explain its connection to the whole outcomes of organization.

 

Using Healthcare Services:

 

Health is a main aspect for everyone’s life. Healthy resources generate more productivity and effects economy of the country. Health service is a nonphysical product and cannot physically be viewed, calculated or counted as finished products (Kogan, 1995).

 

Relationship among variables

 

Image V/S Satisfaction:

 

Delivering on time healthcare services is significant, because that could rise customer satisfaction level, that results an optimistic image. Good brand image convinces consumers to believe in service quality and lead consumers to choose and to feel good during investing in their services/products (Chih-Chung et al., 2012). Customer satisfaction is measured as significant and crucial factor in re-buying a finished good or getting a service. Satisfaction is a feeling resultant from assessing the received services as compared to what was anticipated, involving the buying choice itself, wants and needs relate to buying (Kotler, 1996). Patient satisfaction is amongst the utmost broadly studied field in the last fourth and semi decades (Puri et al., 2012). Satisfaction, which is a concerning difference between preceding hopes as well as post-performance, drives patients to obtain services for the different or same health related issues from the different or same Medical Centre (Sardana, 2003).

 

Brand trust V/S Satisfaction:

 

A few aspects comprising consumer attitudes to the brand and some other factors including customer-The capability to generate customer’s trust is vital. Numerous researches talk about this topic (Morgan & Hunt 1994). Trust is the desire to depend upon others (Moorman et al. 1993). Trust in a healthcare service is compelled through oriented emotions. Healthcare-related brand trust involves faith and dependence as well as having assurance in the hospital. Loyalty to any service means being dependent on its services (Kemp et al. 2014) long-term commitments are the outcomes of relations categorized through trust (Hrebiniak, 1974).

 

Service Quality V/S Satisfaction:

 

Quality has been a point of discourse since decades. In writing, quality has been characterized in various diverse ways (Campbell et al., 2000) what's more, with regards to characterizing social insurance quality alternate points of view on, and measurements of, the quality make it encourage hard to have an accord on a general definition (Piligrimienė and Bučiūnienė, 2008). There are diverse approaches to characterize and operationalize the build of patient desires for administration nature of social insurance division on account of the nonattendance of measures meaning of "human services benefit quality" and nearness of various measurements of administration quality in writing. Persistent fulfillment is an evaluation of particular human services measurements (Naidu, 2009). According to Naidu (2009), these measurements could be center administrations, customization, proficient believability, fitness, correspondences, affirmations, release, nursing care, nourishment, housekeeping and specialized administrations. Blend of these highlights can fundamentally and emphatically impact quiet discernment and hence fulfillment. It can make such a "quality ordeal" for a doctor's facility's patients that can't be duplicated by its rivals effortlessly along these lines can make a wellspring of upper hand/edge for the clinic. This may likewise make the hierarchical capacity to make a quality ordeal as one of the wellsprings of upper hand for an association (healing facility). Effective administration/association of measurements or highlights of a medicinal services benefit quality, along these lines, is critical in controlling patients' recognitions. Different develops of administration quality that is significant as well

 

Satisfaction V/S Using Health Care Services:

 

Persistent fulfillment is corresponded with vital results, for example, predominant consistence, diminished usage of medicinal administrations, less misbehavior suit and better visualization Patient fulfillment is a vital proportion of human services quality as it offers data on the supplier's prosperity at meeting the desires for most pertinence to the customer (Huang JA., 2004, Aug) furthermore, a key determinant of patients' point of view social aim (Al-Refaie A., 2011) The nonappearance of a strong theoretical premise and predictable estimation device for buyer fulfillment has driven, in the course of recent years, to a multiplication of reviews that attention only on patient experience, i.e., parts of the consideration experience, for example, holding up times, the nature of essential pleasantries, and correspondence with social insurance suppliers, all of which help recognize unmistakable needs for quality change (Bleich SN 2009) A few scientists have recommended that characterizing quality change from patients' viewpoint gives better an incentive to their cash with enhanced security, availability, value, and breadth of consideration, while from a supplier's perspective, quality change might be more proficient, giving more compelling administrations to a more noteworthy number of buyers with a sensible level of fulfillment, with the last being sufficient for client maintenance (Patwardhan. A 2012). Though the points of viability and security of human services are about widespread, social orders and societies around the globe vary in the amount they underline the extra points of patient-centeredness, convenience, effectiveness and value. Social insurance measures – including process measures– are created for differed groups of onlookers who may wish to utilize them for human services buying, usage, or execution change (Rubin HR 2001) For every one of these reasons it is basic that are important, experimentally stable, generalizable, and interpretable (McGlynn EA 1998).

 

Research Methodology

 

Methods of Data Collection:

 

Research topic that we have selected for our study is using Healthcare services for this purpose we have collected data from various sources like various journals from internet related to our topic as well as involvement of online Google docs we have made a questionnaire which has to be filled among the individuals.

 

Sampling:

 

Sampling there are different ways to collect the data but our preference was to collect the data online and from the questionnaires we have distributed this question among the patients of JSMU. We have distributed about 350 forms from which we have selected 230 forms, those were successful, and we got our perceived results. However, the questionnaire was submitted in order to ensure the validity for the study. We have selected 230 sample size because our questions were 23. The result of multiplication of 23 into 10 is 230.

 

Statistical Technique:

 

 

The model which we have selected is a mediation model in which customer satisfaction is the mediator and brand trust brand image service quality independent variables and using Healthcare services is the dependent variable we have got the help from Excel to test data we have taken the help from Google scholar we have also used SPSS for testing the data.

 

The results model of using Healthcare services has been taken from “International Journal of Healthcare quality assurance” from the paper of Brand trust and image effects on customer satisfaction. This model analyzes the effects of customer satisfaction on using Healthcare services in the sector of health care and medicines. The goal was to determine the effect of satisfaction level of the patients on using the health care service of any hospital or Medical Centre and also to help organizations in Healthcare services to increase their profits margins.

 

Results & Interpretation

 

Demographics

 

Table no 1: Gender:

Demographics	Frequency	%percentage	Total
Male	147	64%	230
Female	83	36%

 

 

 

 

The idea which has selected for this study is the effect of customer satisfaction on using Healthcare service. For this research we have determined the data from various resources like different journals from internet associated to our research topic and the participation of online Google medium. In this regard we have spread questionnaires among the people related to our research topic. A total of 470 questionnaires were distributed from which 230 was selected from which we got our perceived results. The frequency was 64% of males and 36% of females. The number of male’s respondents is greater than the number of female respondents just because we found more male patients than the female.

 

Table no 2: Age:

 

This table demonstrates the age of the male and female respondents. The highest ratio is 65.2% that is the age group from 21 to 30 years. However, the least ratio is 2% that is the result of 51 onwards. The topic which we have selected for our research is using healthcare services. For this purpose, we have determined the data from various sources like different journals from internet related to our topic including online Google forms. We have made a questionnaire which has to be filled among the individuals. There are different sources from which we can collect data but according to our suitability we have taken this data from online medium and by distributing print forms among students of KASBIT and patients of JSMU. A total of 470 forms were distributed from which the successful forms are 230 in which 50 are collected from KASBIT and 180 are collected from JSMU.

 

Table no 3: Qualification:

 

Demography	Frequency	% Percentage	Total
Matric	16	7%	230
Intermediate	9	4%
Bachelors	120	52.2%
Masters	60	26.1%
Others	25	10.7%

 

There are different sources from which we can collect data but according to our suitability we have taken this data from online medium and by distributing print forms among students of KASBIT and patients of JSMU. A total of 470 forms were distributed from which the successful forms are 230 in which 50 are collected from KASBIT and 180 are collected from JSMU. The results from the above demographic table chart shows the qualification of the respondents. The highest ratio is 52.2% that accounts for the bachelors group, then 26.1 accounts for the masters group and the 7% for the Matriculation.

 

Table no 4: Construct Reliability & Validity:

 

 

Table no 5 Model Fit Test:

 

MODEL FIT	VALUES
CHI SQUARE	2.442
P.VALUE	0.00
GFI	.87
AGFI	.862
CFI	.828
TLI	.7900
RMSEA	.052

 

Explanation:

 

For the purpose of measuring the model, we have used these standards. The values of Chi square and othe standards  tells us that our model is significant or not. In this table Chi square, P value, GFI, AGFI, CFI, TLI, RMESEA, all values are accepted because they all are meeting the threshold. The Model Fit Test is fit as all the values are significant as per criteria.

 

 

Hypothesis Testing:

 

Direct/Indirect Effects – Two Tailed Significance (Bc) (Group No 1 – Default Mode)

 

Indirect Effects - Two Tailed Significance (BC) (Group number 1 - Default model)

 

 

The indirect effect of BT to HS is 0.002 that is accepted threshold value. The indirect effect of BI and HS is 0.043 which is also accepted. The indirect effect of CS on HS is 0.003 that is also accepted. The indirect effects must be accepted for true mediation and we have found the true mediation.

 

Direct Effects - Two Tailed Significance (BC) (Group number 1 - Default model)

 

 

The direct relation between HS and CS is 0.167 which is greater than 0.005 and that is rejected. The direct relation between HS and Bi is 0.046 that is also rejected, the direct relation between HS and BT is 0.368 which is also rejected and the relation between HS and SQ is 0.002 that is also rejected.

 

Discussion and Conclusion

 

This study highlights the importance of providing customer satisfaction through the service quality, brand trust and brand image to use any health care service. This research examines how service quality plays their crucial role in building good relationships with the customers and patients. The model that is proposed in this study is based on providing service quality in the field of Healthcare. The independent variables are brand trust, brand image, and service quality which revolves around the customer satisfaction which is being the mediator. The dependent variable is using Healthcare service. This research also focuses on the brand image and the brand trust and their roles in developing best customer relationships as well as engaging more and more patients to a Healthcare service. In literature review we have studied many well-known authors’ discussions on these variables and they have defined importance of customer satisfaction in the Healthcare services. Central objective of this study is to examine the extent to which service quality influences the customer satisfaction and how it effects the level of using Healthcare services. Our model is fit and acceptable because we have found true mediation. Indirect relations are strong and significant and indirect relations are weak and insignificant which is good for any model to be accepted.

 

Limitations and Future Recommendations

 

This research determines that improving service quality can get more patients which helps in getting higher profits. The research has been done with many limitations which can be used as the reference to expand future researches. New research models could include any other variable like the corporate social responsibility as the independent variable and customer satisfaction as the mediator. Furthermore, it is a best option to re-create this model in other service sectors as well. Service quality could be the winning factor for achieving competitive edge for any service provider as customers always seek and pay for best quality. Due to financial and time constraints we only have collected the data through printed questionnaires and google docs with the sample size of 230. We could have brought in more variables if we have more time and financials. Furthermore, healthcare service sector is a vast field and there are too many hospitals and medical centers situate in Pakistan so due to financial constraints we could not go to every hospital. We have just chosen Jinnah Hospital for our sample data. We could also do this research in whole Pakistan if we had more financials.

 

References

 

Al-Refaie A. A structural model to investigate factors affect patient satisfaction and revisit intention in Jordanian hospitals. Int J Artif Life Res. 2011;2(4):43–56. 10.4018/jalr.2011100105

 

Andaleeb, S. (1988), “Determinants of customer satisfaction with hospitals: a managerial model”, International Journal of Health Care Quality Assurance, Vol. 11 No. 6, pp. 181 187.

 

Armstrong, G. and Kotler, P. (1996), Principles of Marketing, 7th ed., Prentice Hall, London.

 

Berry, L.L. (2000), “Cultivating service brand equity”, Journal of the Academy of Marketing Science, Vol. 28 No. 1, pp. 128-137

 

Bitner, M.J. and Hubbert, A.R., 1994. Encounter satisfaction versus overall satisfaction versus service quality: the consumer’s voice. In: R.T. Rust and R.L. Oliver, eds. Service quality: new directions in theory

        and practice. Thousand Oaks, CA: Sage Publications, 72–94.

 

Bitner, M.J., 1990. Evaluating service encounters: the effects of physical surroundings and employee responses. Journal of Marketing, 54 (4), 69–82

 

Bleich SN, Özaltin E, Murray CJL. How does satisfaction with the health-care system relate to patient experience? Bull World Health Organ. 2009;87(4):271–278. doi: 10.2471/BLT.07.050401.

 

Campbell, S. M., Roland, M. O., and Buetow, S. A. (2000). Defining quality of care. Social science medicine, 51(11), 1611-1625.

 

Chih-Chung, C., Chang, C., Wei-Chun, L. and Yau-Nang, L. (2012), “The effect of advertisement frequency on the advertisement attitude the controlled effects of brand image and spokesperson’s credibility”, Procedia – Social and Behavioral Sciences, Vol. 57, pp. 352-359.

 

Feigenbaum, A.V. (1951), Quality Control: Principles, Practice, and Administration, McGraw Hill, New York, NY

 

Glare, P.G.W. (1983), Oxford Latin Dictionary, Oxford University Press, Oxford

 

Henard, D.H. (2001), “Customer satisfaction: a meta-analysis of the empirical evidence”, Journal of the Academy of Marketing Science, Vol. 29 No. 1, pp. 16-35.

 

Hrebiniak, L.G. (1974), “Effects of job level and participation or employee attitudes and perceptions of influence”, Academy of Management Journal, Vol. 17 No. 4, pp. 649-662.

 

Huang JA, Lai CS, Tsai WC, Hu WH, Yang DW. Determining factors of patient satisfaction for frequent users of emergency services in a medical center. J Chin Med Assoc. 2004;67(8):403–10. 

 

Joss, R. and Kogan, M. (1995), Advancing Quality: Total Quality Management in the National Health Service, Open University Press, Buckingham.

 

Kemp, E., Jillapalli, R. and Becerra, E. (2014), “Healthcare branding: developing emotionally based consumer brand relationships”, Journal of Services Marketing, Vol. 28 No. 2, pp. 126-137.

 

Kotler, P. (1991), Marketing Management: Analysis, Planning, Implementation, and Control, 7^th ed., Prentice Hall, NJ.

 

Kotler, P. and Zaltman, G. (1970), “Social marketing: an approach to planned social change”, Journal of Marketing, Vol. 35 No. 3, pp. 3-12.

 

McGlynn EA. Choosing and evaluating clinical performance measures. Jt Comm J Qual Improv. 1998;24(9):470–9

 

Moorman, C., Deshpande, R. and Zaltman, G. (1993), “Factors affecting trust in market research relationships”, Journal of Marketing, Vol. 57 No. 1, pp. 81-101

 

Morgan, R.M. and Hunt, S.D. (1994), “The commitment-trust theory of relationship marketing”, Journal of Marketing, Vol. 58 No. 3, pp. 20-38

 

Naidu, A. (2009). Factors affecting patient satisfaction and healthcare quality. International Journal of Health Care Quality Assurance, 22(4), 366-381

 

Oliver, R.L. (1997), Satisfaction: A Behavioral Perspective on the Consumer, McGraw-Hill, New York, NY

 

Oliver, R.L. (2006), “Customer satisfaction research”, in Grover, R. and Vriens, M. (Eds), The  Handbook of Marketing Research, Chapter 27, Sage, Thousand Oaks, CA.

 

Patwardhan A, Spencer CH. Are patient surveys valuable as a service-improvement tool in health services? An overview. J Health Leadership. 2012; 4:33–46. doi: 10.2147/JHL.S23150

 

Peters, T. and Waterman, R. (1982), In Search of Excellence: Lessons from America’s Best Run Companies, Harper and Rowe, New York, NY

 

Piligrimienė, Ž., and Bučiūnienė, I. (2008). Different perspectives on health care quality: Is the consensus possible? Engineering Economics, 56(1).

 

Puri, N., Gupta, A., Aggarwal, A.K. and Kaushal, V. (2012), “Outpatient satisfaction and quality of healthcare in North Indian medical institute”, International Journal of Healthcare Quality Assurance, Vol. 25

        No. 8, pp. 682-697.

 

Ramani, K.V. and Dileep, R. (2006), “Health system in India: opportunities and challenges for improvements”, Journal of Health Organization & Management, Vol. 20 No. 3, pp. 560 572.

 

Rubin HR, Pronovost P, Diette G. The advantages and disadvantages of process-based measures of health care. Int J Qual Health Care. 2001;13(6):469–474. doi: 10.1093/intqhc/13.6.469.

 

Sardana, G.D. (2003), “Performance grading of hospitals: a conceptual framework”, Productivity, Vol. 44 No. 3, pp. 450-465.

 

Seawright, K.W. and Young, S.T. (1996), “Quality definition continuum”, INTERFACES, Vol. 26 No. 3, pp. 107-13.

 

Woodside, A.G., Frey, L.L. and Daly, R.T. (1989), “Linking service quality, customer satisfaction, and behavioral intention”, Journal of Healthcare Marketing, Vol. 9 No. 4, pp. 5-17.

 

 

 

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