This study develops three alternative models of academic library Web site usage based on the Technology Acceptance Model (TAM). The three alternative models depict relationships among various intrinsic and extrinsic determinant factors of an academic library's Web site usage. The four factors included in the models are perceived ease-of-use, perceived usefulness, service functionality, and task functionality. These four factors are hypothesized to affect directly or indirectly both factors of satisfaction and intention-to-use. LISREL analysis using survey data shows that the best-fit model is the "Dual Mediation Impact" Model. Research and managerial implications for the academic library are discussed. Future research directions and limitations also are provided.

This paper aimed to examine a conceptual model for the relationships between hospital service quality, patient satisfaction, hospital utilization, and hospital financial performance. A total of 176 hospitals was selected from California State for this study. The standardized performance measures were used together with precisely defined specifications and standardized data-collection protocols. First, an exploratory factor analysis with Varimax rotation was performed. The measurement properties were then assessed in a confirmatory factor analysis (CFA). The analysis results show that quality had a significant effect on satisfaction, which, in turn, affected the financial performance. The results provide support for the previous findings indicated that service quality was positively associated with patient satisfaction and that satisfaction and utilization had a significant positive effect on financial performance. The analysis results provide support for the previous findings that hospital service quality is positively related to patient satisfaction. The findings also show that patient satisfaction and hospital utilization have a significant positive effect on hospital financial performance.

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