Purpose The purpose of this paper is to explore marketing analysis by developing a customer loyalty approach for small- and medium-sized enterprises (SMEs) in the service sector, based on customer relationship management (CRM) in the context of an emerging economy. Design/methodology/approach This study analyzes different models of CRM in the literature and defines a loyalty approach for SMEs in the service sector. It is characterized as exploratory research, with a qualitative approach. A systematic review of the literature is undertaken as the starting point for achieving the main objective of the study. Findings The need to develop a framework for an approach to customer loyalty for SMEs based on CRM and to make it operational. Research limitations/implications It is a qualitative and exploratory study, applied only to a company’s two main clients. Practical implications The contribution of this study is that it offers SMEs consistent guidelines on how best to conduct relationship management with their customers by using a systemic methodology that can be adapted to the requirements of more effective interaction between a company and its customers. It also provides coherence to the purpose of meeting customers’ needs. This is an action strategy that focuses especially on the use of tools, such as SERVQUAL, Kano and SWOT analysis, and thereby increases the competitive profile of organizations in this sector. Originality/value This study is a new approach to customer loyalty for SMEs in the service sector, which integrates elements of CRM strategy and implementation.

BackgroundThe current economic and social context has required health systems to provide top quality services and to be efficient in controlling costs. An obstacle to achieve these goals is the inappropriate health services demand. This study aims to present these inappropriate health service demand determinants from data on telephone calls made to a medical advice call centre.MethodsThis study used a Brazilian medical advice call centre data sample in the period of November and December 2012 (n = 19690), which supplied data on the user’s initial request, the physician’s recommendation, information on the patient and circumstances (the day and time of the day of the telephone call). The convergence between user intent and medical recommendation consists in adequate demand; otherwise the divergence consists in an inadequate one. In this way, using a logistic regression model, the critical factors that determine inappropriate health services request could be estimated.ResultsIn general, the user’s initial intent is the most critical for the inappropriate health system demand occurrence: the greater the complexity of the patient’s initial intent, the greater the chance the intent is wrong: (OR: 1.160; 95% CI: 1.113-1.210). With regard to the social characteristics, men are more likely to make inappropriate requests (OR: 1.102; 95% CI: 1038-1169); as well as youngsters are more likely to use the system incorrectly (OR = .993; 95% CI: .992 - .994). Regarding the circumstances (day and time of the call), requests in the final hours of the day and on days close to the weekend are more likely to be the inappropriate ones (OR: 1.082 for each six hour increase; 95% CI: 1.049-1.116) and weekday (OR: 1.017 for each day increase; 95% CI: 1.002-1.032).ConclusionsThe critical profile for the inappropriate use occurrence consists of males and youngsters, who use the health service in the final hours of the day and at weekends, and mainly want to use more complex services. A practical implication of this research is to provide health systems managers, supporting information to the most critical users in order to assist them in making a decision when asking for health care.

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O programa de Produção Mais Limpa tem sido aplicado com sucesso na indústria manufatureira, entretanto, esta ferramenta está longe de ser adotada por empresas de prestação de serviço. Este artigo tem como principal contribuição caracterizar o desenvolvimento e a aplicação da Produção Mais Limpa na prestação de serviço, a partir da utilização da Metodologia de Checkland para estruturação de problemas. Essa metodologia objetiva a comparação entre sistema real (como a empresa se encontra hoje) e conceitual (como a empresa iria funcionar se adotasse a Produção Mais Limpa) no sentido de traçar cenários de mudanças e auxiliar os gestores na tomada de decisão sobre adotar ou não adotar este programa.