Development of Customer Value Model for Healthcare Services

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1 96 Developmet of Custome Value Model fo Healthcae Sevices Developmet of Custome Value Model fo Healthcae Sevices Wa-I Lee ad Bih-Yaw Shih Depatmet of Maetig ad Distibutio Maagemet, Natioal Kaohsiug Fist, Uivesity of Sciece ad Techology, Taiwa, ROC, Depatmet of Compute Sciece, Natioal PigTug Uivesity of Educatio, Taiwa, ROC, Abstact The ecoomic ad the livig stadad have bee impoved damatically i Taiwa ove the last decade. People become moe health coscious ad demad fo high quality healthcae sevice cosequetially. Due to the coductio of Natioal Health Isuace ad its impoved policy of isuace paymet, competitio of healthcae sevice becomes fiece day by day. The pupose of the cuet study is to develop a custome model which povides isight ito the custome s fo healthcae istitute maages. Keywods: Custome Value Model, Healthcae Istitute, Custome Value, Custome Attibute. Itoductio The ecoomic ad livig quality of Taiwa has impoved damatically i last decade. People become moe health coscious ad demad high quality healthcae sevice cosequetially. Due to the coductio of Natioal Health Isuace (NHI) ad its evised policy of isuace paymet, competitio of healthcae sevice becomes fiece day by day. Facig the competitive ad complex healthcae eviomet, how to udestad you custome has become a popula topic i elated eseaches (Lode, et al., 008; Ozao, et al., 008; Sute, et al., 007; Rya & Syso, 007; Weg, 006; Zeithaml, et al., 006; Cobi, et al., 00; Kaldebeg, 00). Evey maetig pofessioal i healthcae ows that the most ifluetial fom of advetisig fo physicia ad hospital sevices is wod of mouth (Becham, 00). How do maages of healthcae istitutes detemie what patiets wat (of ew poducts/sevices)? Why the patiet chose to come athe tha aothe? Maages should cae ot oly medical effect but also custome i ode to meet his/he special eeds to etai customes ad ea thei loyalty (Hippel & Katz, 00). Oe way to attact ad etai customes is to esue custome satisfactio. The maages eed to be moe aggessive to set up a pla, which may stad by custome pespective i ode to eseach customes eeds, attact customes ad wi cotacts. Idetifyig ad sustaiig a custome s to build a model is oe of the best ways to ivest i valuable customes. Calculatig the expected futue of the custome base ude alteative sceaios ad selectig the sceaio with the most is/etu pofile ca be used to evaluate a wide age of ivestmet oppotuities (Rust et. al., 004). Theefoe, how to aage the esouce i ode to costuct a dyamic attibute model fo healthcae sevice is impotat. Yet, thee is a death of eseach ito the pocess by which pactitioes idetify custome s s of healthcae istitutes. The pupose of the eseach is to develop a custome model which povides isight ito the custome s fo healthcae istitute maages.. Liteatue Review Custome Hilliad (950) defied custome as a iteactive elativistic pefeece expeiece which efes to the evaluatio of some objective by some customes. The objectives iclude ay poduct, a sevice, a maufactued good, ad a social cause ad so o. Holboo (996) defied thee ey dimesios of cosume : self-oieted, eactive ad extisic. Howeve, Olive (996) poited out that Holboo did ot metioed satisfactio i the typology ad he oted six pesetatios of satisfactio ad. Olive (997) epoted that quality is a impotat iput issue to satisfactio though the compaiso of pefomace to d stadads. Qualities ehace satisfactio ad, which povides additioal satisfactio, the satisfactio deivig fom quality ad the fom as show i Figue. Excellece citeia Pefomace outcomes Quality Satisfactio Cosumptio Figue Value cocepts i cosumptio Exteded Value-based satisfactio Zeithaml(988) utilized five factos to model a positive fuctio as show i equatio (), icludig quality, fuctioality(extisic attibute), pleasue(itisic attibute), pesoal s ad peceived sacifice (moetay outlays ad o-moetay costs), whee is a positive fuctio of what is eceived ad a egative fuctio of what is sacificed. Value = f (Receipts/Sacifices).. () Theoetical Custome Value Calculatios Keeey (999, 00) efes to his how do you build model of s by usig qualitative method ad classifies the qualitative modelig of s ito fou steps: Develop a list of s, Covet each that obtais fom customes to a objective, Stuctue objectives, Specifyig measues fo the objectives. Combiig the attibutes

2 Wa-I Lee ad Bih-Yaw Shih 97 A model is defied as a fuctio U, ofte just efeed to as a objective fuctio which assigs to each cosequece x, a umbe U(x) fo eflectig the elative desiability of that cosequece. Theefoe, diffeet types of models ae appopiate fo diffeet decisio cotexts. Oce the fudametal objectives ad attibutes ae specified, the quatitative model ca be costucted by the followig thee steps: () combie the vaious attibutes; () scale the elative of diffeet levels of each attibute ad (3) detemie the tadeoffs betwee diffeet levels of achievemet o diffeet objectives. Thee mai idepedece cocepts ae used fo developig models i the eseach, icludig additive idepedece, pefeetial idepedece ad utility idepedece. These cocepts wee used to deive multiplicative model. Additive model: If all combiatios of attibutes ae additive idepedet, the utility fuctio ca be expessed as equatio ():.. (), whee u is the u( x,... x ) = iui ( xi ) i= valuatio fuctio, x i is the ifeece ad K i is the positive scalig costats summig to oe. Multiplicative model: If each pai of attibutes is pefeetially idepedet of the othes ad if oe attibute is utility idepedet of the othes, the the utility fuctio ca be expessed as equatio (3): + u( x,... x) = [ + iui ( xi )] i=. (3), whee u is valuatio fuctio, x i is the ifeece ad i is the scalig costats ad is a additioal scalig costat. The multi-attibute decisio model (Yoo & Hwag, 98; Woltes & Maeschal, 995) ca be expessed as equatio (4): ϕ = =,, 3,,m (4), ϕ( S ) = ωϕ ( X ) = S, whee ϕ ( S ) is a fuctio of diffeet ω ad ϕ ( ) X ae weight ad fuctio of attibute p, espectively. S = { S, S,..., Sm}: a diect set of m possible alteatives. (,,..., T ω m ω = ω ω ) : the vecto of the elative impotace o weights o the attibutes, whee ω =, ω 0, =,,.., = Futhemoe, the fuctio fo diffeet S ca be expessed as equatio (5): =,, 3,, m (5), ϕ = ω a = whee a is the compaig scale of X afte omalizatio. Let x(t) R, y(t) R m deoted the states of the system. u (t) R p is the cotol iputs. Let u = u(x, t) deote a solutio fo the iitial bouday poblem. Coside a iitial poblem fo the equatio as expessed i equatio (6). Based o additive multi-attibute model, the stuctue of weightig-set ca be eplaced by iitial of equatio because the weight of evey attibutes should be geate tha zeo (Ma, et. al., 00). u = u t i Ω (6) x u (x, 0) = f(x) 0 x ; u (0, t) = u (, t) = 0 0 t T, whee Ω deote the ectagle [0,] [0,T]. If f(x) is ow the u(x, T) ca be computed fo ay positive of T. 3. Methodology The iitial ope-eded questioaie suvey was fist coducted to select paticipats puposefully. The, the method of qualitative i-depth iteviews was applied i the eseach to exploe ad idetify customes (espodets ) attitudes, behavios ad pespective of s. Qualitative i-depth iteviews wee a exploe eseach techique with the ability of givig well-gouded, ich desciptios ad explaatios (Asey & Kight, 999; Godo & Lagmid, 988). Ideed, these methods pemit cocepts ad meaig to be exploed i geate tha questioaies. Futhemoe, the cocept of patial diffeetial equatios is applied o exploed attibutes to build qualitative a dyamic attibute model based o Keeey s (999, 00) ad Ma, et al. (00) appoaches. Iteviews Each of the iteviews lasted fom 0-30 miutes ad was ope-eded although stuctued by iteview guides to esue coveage of issues elevat to the eseaches. Duig iteviews, case study paticipats wee ecouaged to thi aloud ad povide why they selected specific s to be impotat ad how it elates to othe compoet that ae liages d. Accodig to the method of Schoefeld, the eseache should iteact with each subject by ecouagig, guidig, questioig, ad seachig duig iteviews. The iteview situatios icluded classificatio of the subject s meaigs by the eseache ad eflectios fom the subjects. The pupose was to help subjects expess thei ideas moe clealy. The questios i idetifyig custome s s ae peseted as Table. All of these issues eed to be cosideed i desigig a objective fom patiets ad developig a set of objectives to the elatioship etwo fo healthcae esouces. Qualitative Value Modelig The modelig pocess icludes a detail discussio fo the model by ecogizig elevat data ad maig them as objectives. The, pocesses fo cogegatig objectives as a objective fuctio ae descibed. A extesio of Keeey s cocepts of -focused thiig would be a moe compehesive mae to develop objectives fom patiets poit of i healthcae sevices. To build a qualitative model of was based o the followig fou steps:

3 98 Developmet of Custome Value Model fo Healthcae Sevices Idetifyig custome s, Compae each that obtais fom customes peceptios to a objective, Idetify desig objective, ad Develop the elatioship etwo. The eseaches ased Why is this impotat? (Glase & Stauss, 967) Each aswe is subjected to the same questio, cotiuig this pocess util a is extacted. A custome s aswe of questioaies, the custome s ca be classified ito diffeet objectives. The goud fo a qualitative dyamic attibute model is based o the basic objectives ad each coespodig attibutes. Table Summay ope-eded questios i idetifyig custome s s Ecouagemet: I believe you ca do this questio.. Explai, i you ow wods, what is a defiitio of. You did a good job o the pevious oe.. What is you coce about the healthcae sevice? Why? 3. How do you feel about the healthcae sevice? 4. What image o chaacteistic comes to you mid whe you choose a hospital? 5. What is the specific that hospital ca offe? 6. How ca hospital maages edesig existig poduct (o stategy) to impove the sevices? 7. How ca the cuet healthcae maetig system sumout the obstacles? Guidace:. What is wog o ight with you hospital?. Is thee ay poblem i cuet healthcae sevice? Give me a example. 3. What eeds to be impoved? Is this eough to guaatee that the situatio becomes well? What do you eally mea by this? Questioig:. What ae you ambitios?. What limitatios ae placed upo you? 3. What specific sevice do customes wat? Seachig:. What s do you have fo you customes ad you employees?. Why is the impotat? 3. What do you mea by this? 4. How valuable ae cetai demogaphic pofile ad diagosis histoy to a custome? 4. Data Collectio ad Aalysis Samplig A total of 47 questioaies wee deliveed ad 49 etued esultig i a 98 pecet esposes ate i the iitial suvey. Of those etued, data fom 406 espodets wee deemed usable fo the study. Based o the esults of iitial suvey, 9 paticipats wee selected ad they wee willig to be iteviewed. Afte idetifyig subjects attibutes of custome s, 6 diffeet subjects icludig 4 physicias ad patiets, wee iteviewed duig the two wees afte teatmet. Categoy Developmet ad Reliability These figues ae espectably high accodig to 9 categoies which ae show i Table. Table Value with healthcae sevice fom the customes poit of view Item Categoies Compoets of objective W Cost. Low pice.. Low co-paymet if illess ca be cued. 3. Hadled i a acceptable mae.. High qualify of medical supplies.. Mode equipmet. W Equipmet 3. Softwae (SOP taiig). 4. Hadwae (e.g. locatio, decoatio). Physicia. Physicias expetise. W3 Bacgou. Physicia s techological sill. d 3. Outstadig physicia. W4 W5 W6 W7 W8 W9 Physicia Cae Eviome t Timig Aageme t Relatioshi p Bad Image Additioal (Diffeetia te). Coutesy of physicia.. Amout of time the physicia spet with patiet. 3. Commuicatio sill (e.g. laguages baies).. Good suoudig.. Patiets eceatio oom o wad (e.g. libay, coffee oom).. Equitable diagosis timig to each custome.. Equitable teatmet timig to each custome. 3. Timig of patiet s dischage fom hospital. 4. Time fo talig about patiet s feelig o woies.. Guidace ad suppot patiets.. Tust (e.g. empathy, sympathy, wod of mouth). 3.Commitmet (e.g. complait feedbac--cae cete/ /-800 umbes).. LOGO.. Bad idetifies (e.g. fee medical teatmet/ oal hygiee guidace. 3. Bad awaeess.. Pofessioal maagemet (e.g. iteal custome--expeiece iheits/specific labo divisio/occupatioal taiig).. Cliic diffeet chaacteistics (e.g. health isuace). Fidigs The poposed custome model is pope to hospital maages ad offes a fittig way of coceptualizig the elatioships amog the coe

4 Wa-I Lee ad Bih-Yaw Shih 99 elemets (e.g. custome satisfactio, custome elatioship, loyalty, health sevice pefomace). Accodig to categoies hieachy of Table, the objective etwo of healthcae sevices is developed as show i figue. Custome Value Custome Satisfactio Custome Relatioship Custome Loyalty Healthcae Sevice Pefomace Additioal Value Commitmet Tust Mode Equivalet Employee Sevice Health educatio's publicity Bette medical teatmet Comfotable eviomet Sevice quality (Complait Feedbac / Appeals the pipelie / Physicias expetise) Commuicatio Empathy / Sympathy Figue Majo s of healthcae sevices Buzz---Buzz Maetig (Advetisig / Wod of Mouth) Alliace---Chai Reactio Bad---Bad Awaeess/Bad Image (Bad Idetify/LOGO) 5. Value modellig Combiig the Attibutes A pimay fuctio of qualitative dyamic attibute model is to cotibute diectly ad powefully to the decisio situatio. Upo buildig up the espective model, it was based o customes pespectives, icludig thei paticula eeds o i-depth satisfactio/dissatisfactio (Table ) that will evetually povide a pefect sevice. Defiitio. A bouday umbe B is defied o R (-,+ ) to be a umbe. Coside a iitial poblem fo equatio (6) ad f(x) epesets a give fuctio of x.: Let the of u(x, t) at the time be deoted by g(x) =u(x, t) whee the g(x) deotes the dyamic attibute model. The g(x) is elated to f by = g(x) = fsi( Πx)exp[-( T] T >0, =,,..(7) Theefoe, diffeet custome ca be calculated accodig to diffeet peiod of time (T). The seies fo g(x) coveges uifomly o [0, ] to g(x) by Weiestass M test f si( Πx)exp[-( T] f exp[-( T] = = Moeove, fo evey itege m, the seies (d/dx) coveges uifomly o [0, ] = m f si( Πx)exp[-( T] to g (m) (x). Theefoe, g(x) must be a C fuctio idepedet of how sooth f(x) is. The g(x) =u(x, T) depeds cotiuously o the iitial time. Idividual custome may show distiguish attibutes. Accodig to categoies as show i Table 3, a weightig fuctio w is defied to epeset the ie categoies fo adjustmet o custome model. The weightig fuctio W is expessed as w =, 0, if the categoy exists Othewise The oveall dyamic custome of healthcae sevice ca be ewitte as 9 G = w g ( x) =, =, m, whee epesets each idividual custome. 6. Coclusios Nie categoies of with healthcae sevice fom the customes poit of view wee developed i the eseach. Meawhile, the objective etwo of these categoies hieachy fo custome with healthcae sevice was costucted. Based o the above fidigs, the qualitative dyamic attibute model is successfully. The custome of the cuet istace ca be used to tavese the oigial custome attibutes via the model. Meawhile, the model of the same clealy idetified types of customes ca be used o diffeet depatmet fo sevice shae. Evetually, decisios ae made quicly fo povidig satisfied sevice ad impovig custome loyalty. 7. Acowledgemet This wo patially suppoted by the Natioal Sciece Coucil, Taiwa, R.O.C. ude Gat NSC96--E Refeeces []. Asey, H. & Kight, P. (999). Iteviewig fo Social Scietists, Lodo: Sage. []. Becham, J. D.(00). 0 yeas of health cae maetig, Health Foum Joual, July, [3]. Cobi, C. L., Kelley, S. W., & Schwatz, R. W. (00). Cocepts i sevice maetig fo

5 00 Developmet of Custome Value Model fo Healthcae Sevices healthcae pofessioals, The Ameica Joual of Sugey, 8, -7. [4]. Glase, B. G. & Stauss, A. L. (967). The discovey of gouded theoy: Stategies fo qualitative eseach. Chicago: Aldie. [5]. Godo, W. & Lagmaid, R. (988). Qualitative Maete Reseach, Aldeshot: Gowe. [6]. Hilliad, A. L. (950). The Foms of Value: The Extesio of Hedoistic Axiology. New Yo: Columbia Uivesity Pess, pp. 4. [7]. Hippel, E. ad Katz, R. (00). Shiftig iovatio to uses via toolits. Maagemet Sciece, 48, [8]. Holboo, M. B. (996). Custome -A famewo fo aalysis ad eseach. i K. P. cofma ad J. G. Lych, J. (eds.) Advaces i Cosume Reseach, 3, Povo, UT: Associatio fo Cosume Reseach, [9]. Keeey, R. L. (999). The of iteet commece to the custome. Maagemet Sciece, 45 (4), [0]. Keeey, R. L. (00). Modelig s fo telecommuicatios maagemet. IEEE Tasactios o Egieeig Maagemet, 48 (3), []. Kaldebeg, D. O. (00). Patiet satisfactio ad health status. Health Maetig Quately, 8, 8-0. []. Lode, A., Coustasse, A. & Sigh, K. P. (008). The balaced scoecad famewo-a case study of patiet ad employee satisfactio: What happes whe it does ot wo as plaed?. Health Cae Maagemet Review, 33(), [3]. Ma, J., Fa, Z. ad Wei, Q. (00). Existece ad costuctio of weight-set fo satisfyig pefeece odes of alteatives based o additive multi-attibute model. IEEE Tasactios o Systems, Ma ad Cybeetics, 3 (), [4]. Olive, R. L. (996). Vaieties of Value i the Cosumptio Satisfactio Respose. i K. P. Cofma ad J.G. Lych, J. (eds.) Advaces i Cosume Reseach, 3, Povo, UT: Associatio fo Cosume Reseach, pp [5]. Olive, R. L. (997). Satisfactio: A Behavioal Pespective o the Cosume, New Yo: Iwi/McGaw-Hill. [6]. Ozao, A. J., McIeey, C. R., Tallia, A. F., Schaf, D. & Cabtee, B. F. (008). Family medicie pactice pefomace ad owledge maagemet. Health Cae Maagemet Review, 33(), -8. [7]. Rust, R. T.; Lemo, K. N.; Zeithaml, V. A. (004). Retu o Maetig: Usig Custome Equity to Focus Maetig Stategy. Joual of Maetig, 68(), [8]. Rya, J. ad Syso, J. (007). The cotigecy of patiet pefeeces fo ivolvemet i health decisio maig. Health Cae Maagemet Review, 3(), [9]. Schodfeld, A. H. (983). Episodes i mathematical poblem solvig. I R. Lesh & M. Ladau (Eds.), Acquisitio of Mathematics Cocepts ad Pocesses, New Yo: Academic Pess, [0]. Sute, E., Hyma, M. & Oele, N. (007). Measuig ey itegatio outcomes: A case study of a lage uba health cete. Health Cae Maagemet Review, 3(3), []. Weg, H. (006). Cosume Empowemet Behavio ad Hospital Choice. Health Cae Maagemet Review, 3(3), []. Zeithaml, V. A. (988). Cosume peceptios of pice, quality ad : A mea-ed model ad sythesis of evidece. Joual of Maetig, 5 (July), -. [3]. Zeithaml, V. A., Bolto, R. N., Deighto, J., Keiigham, T. L., Lemo, K. N. & Petese, J. A. (006). Fowad-Looig Focus: Ca Fims Have Adaptive Foesight?. Joual of Sevice Reseach, 9(), Copyight 008 by the Iteatioal Busiess Ifomatio Maagemet Associatio. All ights eseved. No pat o all of this wo should be copied o epoduced i digital, had, o ay othe fomat fo commecial use without witte pemissio. To puchase epits of this aticle please

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