ارزش از دیدگاه بیمار: مطالعه کیفی در بیمارستان‌های تامین اجتماعی استان قزوین
محورهای موضوعی : -مدارک پزشکی
زهرا خامدا
1
,
پژمان جعفری
2
,
سید جمال‌الدین طبیبی
3
,
مجید رستمی
4
1 - دانشجوی دکتری مدیریت بازاریابی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 - استادیار، گروه مدیریت بازرگانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
3 - استاد، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
4 - استادیار، گروه مدیریت دولتی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
کلید واژه: ارزش مشتری, ارزش در خدمات مراقبت سلامت, ارزش بیمار,
چکیده مقاله :
مقدمه: خلق ارزش مشتری پیش نیاز بقا و موفقیت سازمان‌ها است. هدف پژوهش تعیین عوامل و ساختار ارزش از دیدگاه بیمار در بیمارستان‌های تامین اجتماعی استان قزوین است. روش پژوهش: از نظر هدف بنیادی با دلالت‌های کاربردی و از نظر گردآوری و تحلیل داده‌ها، کیفی اکتشافی از نوع متوالی و توسعه ابزار است و در سنت پراگماتیسم اجرا شده است. باتوجه به نوبودن موضوع، بمنظور استفاده از تئوری داده بنیاد، با 13نفر از خبرگان و 19نفر از بیماران بیمارستان‌های مورد مطالعه مصاحبه شد. از 533 گزاره شناسایی شده توسط نرم افزار مکس کیودا، 963 مضمون اولیه استخراج، کدگذاری و سپس 35 مفهوم با روایی قابل قبول در 6 مقوله اصلی طبقه بندی شد. یافته‌ها: نتایج نشان می‌دهد که ارزش از دیدگاه بیمار، بر منافع و منابع وی تمرکز دارد. منافع، اثربخشی درمان و مراقبت و منابع شامل پول، زمان و تلاش صرف شده بیمار برای هزینه خدمات، دسترسی به خدمات و مدیریت خطا و خطر می‌گردد. روابط میان کیفیت درمان و مراقبت، ارزش از دیدگاه بیمار، اعتماد بیمار، خدمات تجملی، رضایت بیمار و مقاصد رفتاری بیمار درقالب مدل پارادایمی ارائه شده است. نتیجه‌گیری: پژوهشگران نتیجه می‌گیرند که کیفیت درمان و مراقبت سلامت با میانجی‌گری اعتماد بیمار و تعدیل‌گری امکانات تجملی، بر خلق ارزش از دیدگاه بیمار تاثیر دارد. موازنه میان منافع به دست آمده و منابع صرف شده بصورت ارزش ادراک شده بر رضایت‌مندی بیمار، و رضایت بیمار نیز بر مقاصد رفتاری بیمار موثر است.
Introduction: Creating customer value is a prerequisite for the survival and success of organizations. The purpose of this study is to determine the factors and structure of patient value in Qazvin Social Security Organaization’s hospitals. Methods: This is a fundamental research with applied implications which has been implemented in the tradition of pragmatism. The reseach method is sequential exploration type of qualitative method to develop value scale.The grounded theory was used considering the newly introduced concept of patient value. Interviews were conducted with 13 experts and 19 hospitalized patients in under studied Hospitals. Of the 533 phrase identified by MAXQDA software, 963 primary concept were extracted Results: Findings show that the patient value focuses on his or her benefits and losses. Benefits include the effectiveness of treatment and care; and losses include money, time, resources, and efforts patients spend on services’ cost, accessibility, and error and risk management. The structural relations between the factors of quality of treatment and care, patient value, patient trust, luxury services, patient satisfaction and patient behavioral intentions are proposed as the research paradigmatic model. Conclusion: The quality of treatment and care affects patient value mediated by the patient's trust and moderated by the luxurious services. The balance of interests and expenses as perceived value, has an effect on patient satisfaction that subsequently affects patient behavioral intentions.
1- Graf A, Maas, P. Customer Value from a Customer Perspective: a Comprehensive Review. Working Papers on Risk Manag and Insur 2008; (52): 1-37.
2- Gummerus J. Value creation processes and value outcomes in marketing theory: strangers or siblings. Mark Theory 2013; 13(1): 19-46.
3- Khalifa, AS. Customer value: a review of recent literature and an integrative configuration. Manag Decision 2004; 42(5): 645-666.
4- Petrick JF. Development of a multi-dimensional scale for measuring the perceived value of a service. J Leis Res 2002; 34(2): 119-134.
5- Wang Y, PoLo H, Chi R, Yang Y. An integrated framework for customer value and customer-relationship-management performance: a customer-based perspective from China. Manag Serv Qual: An Int J 2004; 14(2/3): 169-182.
6- Smith, JB, Colgate M. Customer value creation: a practical framework. J Mark Theory and Pract 2007; 15(1): 7-23.
7- Sweeney JC, Soutar GN. Consumer perceived value: The development of a multiple item scale. J Retail 2001; 77: 203-220.
8- Park J, Ha S. Co-creation of service recovery: Utilitarian and hedonic value and post-recovery responses. J Retail and Consum Serv 2016; 28: 310-316.
9- Dovaliene A, Masiulyteb A, Piligrimienec Z. The relations between customer engagement, perceived value and satisfaction: the case of mobile applications. Procedia Soc Behav Sci 2015; 659– 664.
10- Popesku M. Clarifying value in use and value creation process. PhD thesis. University of Nottingham; 2015.
11- Karababa E, Kjeldgaard D. Value in marketing: Toward sociocultural perspectives. Mark Theory 2014; 14(1): 119–127.
12- Zhao J, Wang T, Fan X. Patient value co-creation in online health communities: social identity effects on customer knowledge contributions and membership continuance intentions in online health communities. J Serv Manag 2015; 26(1).
13- Hooman HA. A Practical Guide to Qualitative Research. Tehran: Samt; 2006: 105. [Persian]
14- Strauss AL, Corbin MJ. Basics of Qualitative Research: Techniques and producers for Grounded Theory.Tehran: Ney; 2018: 145-155, 219. [Persian]
15- Beheshti SS. Qualitative Data Analysis with MAXQDA. Tehran: Ravesh Shenasan; 2016: 155. [Persian]
16- Pitta DA, Laric MV. Value chains in health care. J Consum Mark 2004; 21(7): 451-464.
17- Walters D, Jones P. Value and value chains in healthcare: a quality management perspective. The TQM Mag 2001;13(5): 319-335.
18- Nelson, DG, Byus K. Consumption Value Theory and the Marketing of Public Health. Health Mark Q 2002; 19(4): 69-85.
19- Rollow W, Cucchiara P. Achieving Value in Primary Care: The Primary Care Value Model. Ann Fam Med 2016; 14(2): 159-165.
20- Atkins JH, Fleisher LA.Value from the Patients’and Payers’ Perspectives. Anesthesiol Clin 2015; 33: 651–658.
21- Biloshapka V, Osiyevskyy O. Three value-focused strategic questions for continuously updating your business model. Strategy and leadersh 2018.
22- Davidson A, Randall RM. Michael Porter and Elizabeth Teisberg on redefining value in health care: an interview. Strategy and Leadersh 2006; 34(6): 48-50.
23- Porter ME, Pabo EA, Lee TH. Redesigning primary care: a strategic vision to improve value by organizing around patients’ needs. Health Aff (Millwood) 2013; 32(3): 516–25.
24- Ranjbar M, Bahrami MA, Baghian N, Izadi R, Eftekhari A, YousefZadeh S. The Reasons of Teaching Hospitals Selection by patients in Yazd Province for Treatment in 2016. J Healthc Manag 2017; 8(1): 81-90.
25- Chang ChSh, Chen SY, Lan YT. Service quality, trust and patient satisfaction in interpersonal-based medical service encounters. BMC Health Serv Res 2013; 13(22): 1-11.
26- Wong A, Sohal A. Service quality and customer loyalty perspectives on two levels of retail relationships. The J Serv Mark 2003; 17(5): 495–513.
27- Josep MR, Velilla M. Loyalty and trust as the ethical bases of organizations. J Bus Ethics 2003; 44(1):49–59.
28- Singh J, Sirdeshmukh D. Agency and trust mechanisms in consumer satisfaction and loyalty judgments. J Acad Mark Sci 2000; 28: 150–167.
29- Savage SV. Patients, Trust, and Patient Participation: Factors Influencing Whether Patients Want to be Active Health Care Participants. In Access to Care and Factors that Impact Access, Patients as Partners in Care and Changing Roles of Health Providers. Res Sociol Health Care 2015; 29: 149–171.
30- Gorji D, Vafaee Najjar A, Staji R, Hooshmande E. A Systematic Reviews of Healthcare Complaints in the Hospital of Iran Since 2006 to 2016. J Healthc Manag 2016; 7 (3): 71-80. [Persian]
31- Rasheed FA, Abadi MF. Impact of service quality, trust and perceived value on customer loyalty in Malaysia services industries. Procedia Soc Behav Sci 2014; 164: 298-304.
32- Sardar S. Causal Structure Model of Service Quality and Perceived Value on Repurchase Intention, Mediated by Customer’s Satisfaction (the Case of Pharmacies in Tehran). J Healthc Manag 2017; 8(1): 37-45. [Persian]
33- Bahrami MA, Aghily M, Montazerolfaraj R, Eshrati B. Assessing Level of Public Relations Hospital and its Relation with Patients Loyalty in Governmental Hospitals in Yazd and Arak. J Healthc Manag 2015; 5 (4): 45-54.
34- Hanaysha JR. Customer retention and the mediating role of perceived value in retail industry. World J Entrep, Manag Sustain Dev 2018; 14(1): 2-24.
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1- Graf A, Maas, P. Customer Value from a Customer Perspective: a Comprehensive Review. Working Papers on Risk Manag and Insur 2008; (52): 1-37.
2- Gummerus J. Value creation processes and value outcomes in marketing theory: strangers or siblings. Mark Theory 2013; 13(1): 19-46.
3- Khalifa, AS. Customer value: a review of recent literature and an integrative configuration. Manag Decision 2004; 42(5): 645-666.
4- Petrick JF. Development of a multi-dimensional scale for measuring the perceived value of a service. J Leis Res 2002; 34(2): 119-134.
5- Wang Y, PoLo H, Chi R, Yang Y. An integrated framework for customer value and customer-relationship-management performance: a customer-based perspective from China. Manag Serv Qual: An Int J 2004; 14(2/3): 169-182.
6- Smith, JB, Colgate M. Customer value creation: a practical framework. J Mark Theory and Pract 2007; 15(1): 7-23.
7- Sweeney JC, Soutar GN. Consumer perceived value: The development of a multiple item scale. J Retail 2001; 77: 203-220.
8- Park J, Ha S. Co-creation of service recovery: Utilitarian and hedonic value and post-recovery responses. J Retail and Consum Serv 2016; 28: 310-316.
9- Dovaliene A, Masiulyteb A, Piligrimienec Z. The relations between customer engagement, perceived value and satisfaction: the case of mobile applications. Procedia Soc Behav Sci 2015; 659– 664.
10- Popesku M. Clarifying value in use and value creation process. PhD thesis. University of Nottingham; 2015.
11- Karababa E, Kjeldgaard D. Value in marketing: Toward sociocultural perspectives. Mark Theory 2014; 14(1): 119–127.
12- Zhao J, Wang T, Fan X. Patient value co-creation in online health communities: social identity effects on customer knowledge contributions and membership continuance intentions in online health communities. J Serv Manag 2015; 26(1).
13- Hooman HA. A Practical Guide to Qualitative Research. Tehran: Samt; 2006: 105. [Persian]
14- Strauss AL, Corbin MJ. Basics of Qualitative Research: Techniques and producers for Grounded Theory.Tehran: Ney; 2018: 145-155, 219. [Persian]
15- Beheshti SS. Qualitative Data Analysis with MAXQDA. Tehran: Ravesh Shenasan; 2016: 155. [Persian]
16- Pitta DA, Laric MV. Value chains in health care. J Consum Mark 2004; 21(7): 451-464.
17- Walters D, Jones P. Value and value chains in healthcare: a quality management perspective. The TQM Mag 2001;13(5): 319-335.
18- Nelson, DG, Byus K. Consumption Value Theory and the Marketing of Public Health. Health Mark Q 2002; 19(4): 69-85.
19- Rollow W, Cucchiara P. Achieving Value in Primary Care: The Primary Care Value Model. Ann Fam Med 2016; 14(2): 159-165.
20- Atkins JH, Fleisher LA.Value from the Patients’and Payers’ Perspectives. Anesthesiol Clin 2015; 33: 651–658.
21- Biloshapka V, Osiyevskyy O. Three value-focused strategic questions for continuously updating your business model. Strategy and leadersh 2018.
22- Davidson A, Randall RM. Michael Porter and Elizabeth Teisberg on redefining value in health care: an interview. Strategy and Leadersh 2006; 34(6): 48-50.
23- Porter ME, Pabo EA, Lee TH. Redesigning primary care: a strategic vision to improve value by organizing around patients’ needs. Health Aff (Millwood) 2013; 32(3): 516–25.
24- Ranjbar M, Bahrami MA, Baghian N, Izadi R, Eftekhari A, YousefZadeh S. The Reasons of Teaching Hospitals Selection by patients in Yazd Province for Treatment in 2016. J Healthc Manag 2017; 8(1): 81-90.
25- Chang ChSh, Chen SY, Lan YT. Service quality, trust and patient satisfaction in interpersonal-based medical service encounters. BMC Health Serv Res 2013; 13(22): 1-11.
26- Wong A, Sohal A. Service quality and customer loyalty perspectives on two levels of retail relationships. The J Serv Mark 2003; 17(5): 495–513.
27- Josep MR, Velilla M. Loyalty and trust as the ethical bases of organizations. J Bus Ethics 2003; 44(1):49–59.
28- Singh J, Sirdeshmukh D. Agency and trust mechanisms in consumer satisfaction and loyalty judgments. J Acad Mark Sci 2000; 28: 150–167.
29- Savage SV. Patients, Trust, and Patient Participation: Factors Influencing Whether Patients Want to be Active Health Care Participants. In Access to Care and Factors that Impact Access, Patients as Partners in Care and Changing Roles of Health Providers. Res Sociol Health Care 2015; 29: 149–171.
30- Gorji D, Vafaee Najjar A, Staji R, Hooshmande E. A Systematic Reviews of Healthcare Complaints in the Hospital of Iran Since 2006 to 2016. J Healthc Manag 2016; 7 (3): 71-80. [Persian]
31- Rasheed FA, Abadi MF. Impact of service quality, trust and perceived value on customer loyalty in Malaysia services industries. Procedia Soc Behav Sci 2014; 164: 298-304.
32- Sardar S. Causal Structure Model of Service Quality and Perceived Value on Repurchase Intention, Mediated by Customer’s Satisfaction (the Case of Pharmacies in Tehran). J Healthc Manag 2017; 8(1): 37-45. [Persian]
33- Bahrami MA, Aghily M, Montazerolfaraj R, Eshrati B. Assessing Level of Public Relations Hospital and its Relation with Patients Loyalty in Governmental Hospitals in Yazd and Arak. J Healthc Manag 2015; 5 (4): 45-54.
34- Hanaysha JR. Customer retention and the mediating role of perceived value in retail industry. World J Entrep, Manag Sustain Dev 2018; 14(1): 2-24.