From good to great: nonlinear improvement of healthcare service

Abstract

Purpose: Increasing consumer choices in health care results in keener competition faced by providers. The existing nonlinear and asymmetric impact of patient perceived quality of care to their choices should provide insights for hospitals to deploy limited resources to areas that produces most significant and positive outcomes. This study aims to develop an algorithm for examining the nonlinear and asymmetrical relationships in the health-care domain with the hope to provide a more precise indication as to how specifically addressing patient experience with meaningful improvements of service quality. Design/methodology/approach: Data were obtained through telephone surveys of 2,000 inpatients who had been hospitalized in a health system in 2006. After coding the original data, the authors conducted regression analysis and Z-test to investigate the nonlinear and asymmetrical relationship between patient recommendation and perceived hospital attributes. Findings: “Spiritual care” is considered as a “delight” for patients. “Procedure efficiency”, “Compassionate care” and “Mutual communication” linearly related to patients’ likelihood to recommend the hospital (LTR) in the positive domains, but increasingly sensitive to LTR in negative domain. Practical implications: Examining the asymmetry and the nonlinear relationship can detect diminishing effect of certain drivers for patient satisfaction. An emphasis on patients’ spiritual needs can provide the hospital with a unique opportunity to differentiate itself from other health-care providers which usually compete within the ordinary domain of services. The absence of “Procedure efficiency”, “Compassionate care” and “Mutual communication” will result in extremely negative word-of-mouth. Originality/value: This study has developed an algorithm to examine the asymmetry and the nonlinear relationship between perceived hospital performance and patient satisfaction. The insights generated should help providers determine specific sets of priorities for improving services and hence strategize for optimal deployment of limited resources.