Academic journal article International Journal of Marketing Studies

Perceptions of Service Quality and Behavioral Intentions: A Mediation Effect of Patient Satisfaction in the Private Health Care in Malaysia

Academic journal article International Journal of Marketing Studies

Perceptions of Service Quality and Behavioral Intentions: A Mediation Effect of Patient Satisfaction in the Private Health Care in Malaysia

Article excerpt


This study attempts to examine the mediation effect of satisfaction on service quality perception and intentions behavior of private hospital outpatients in Malaysia. 300 hospital outpatients were selected as the sample size. Regression analysis was run to test the hypotheses. Based on the 273 completed data, the results provide support for the association between perceived service quality dimensions (tangibles, assurance, and empathy) and behavioral intentions. The results also confirm that service quality perception is an antecedent of intentions. In addition, tangibility, reliability and assurance are important predictors of satisfaction, and satisfaction has a strong positive relationship with intentions. In short, service quality drives satisfaction which in turn drives behavioral intentions. The finding also indicates that satisfaction partially mediates the relationship between perceived service quality and behavioral intentions. As a result, the strength of the perceived service quality-behavioral intentions relationship becomes weaker when satisfaction is considered. Theoretical and managerial implications of the findings are also discussed.

Keywords: service quality dimensions, customer satisfaction, behavioral intentions, mediation effect

1. Introduction

Malaysia is positioning itself as the hub of medical tourism in Southeast Asia (Navid et al., 2010). As a result of this, healthcare travel, often referred to as medical tourism, is now recognized as a potential foreign exchange earner for Malaysia. The Malaysian medical tourism industry has been experiencing consistent growth at a rate of 15% throughout 2008 to 2009 (Frost & Sullivan, 2010). For the first six months of the year 2012, the revenue has reached RM300 million (Harían Metro, 2012).

The number of medical tourists visiting the country for medical tourism has hit approximately 425,500 in 2009, and Malaysia received 583,000 medical tourists in 2011. The majority of the visitors are from neighboring countries such as Indonesia (60 percent) and the remaining are from Singapore, Japan, India, United Kingdom, Iran, Nepal, and Bangladesh who came to seek more affordable medical treatment (Harían Metro, 2012).

In January 2010, the Prime Minister launched the Malaysia Healthcare Travel Council (MHTC) with the responsibility to formulate strategic plans in promoting healthcare travel. Malaysia is fast becoming the destination of choice for healthcare tourists behind established medical tourism locations such as Singapore and Thailand. Many local private hospitals now offer a variety of medical packages and special arrangements for foreign patients (Frost & Sullivan, 2010).

Among the factors that make Malaysia the preferred healthcare travel destination are friendly and highly professional medical staff; internationally accredited hospitals, world-class hospitals with state-of-the-art medical facilities; affordable costs of procedures; English-speaking population, a safe and friendly environment for visitors (Liow, 2010) and short waiting period (Frost & Sullivan, 2010). By Jun 2010, six of Malaysian healthcare facilities have obtained international accreditation from the Joint Commission International (JCI) and the government has to date identified 72 private hospitals for the purpose of healthcare tourism promotion (Harían Metro, 2012).

Past research, has linked service quality to customer satisfaction (Taylor & Baker, 1994) and purchase intentions (Zeithaml, Berry & Parasuraman, 1996). A few researchers have suggested that patients' perception of service quality is a key determinant of a health care organization's success due to its primary role in achieving patient satisfaction and hospital profitability (Donabedian, 1996). Other researchers went a step further by investigating the mediating effect of customer satisfaction on perceived service quality-behavioral intentions (Bou-Llusar, Camison-Zornoza, & Escrig-Tena, 2001; Brady & Robertson, 2001; Bigne & Blesa, 2003; Choi, Lee, Kim, & Lee, 2005; Mpingajira, 2008; Alrubaiee & Alkaa'id, 2011). …

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