Abstract-With an increasing trend of extended life expectancy and consequential aging society, the demand for health examination is ever heightened. The purpose of this study is to identify the dimensions of health examination service quality and their influence on customer satisfaction and behavioral intention. We utilized a modified SERVPERF model, in which service quality consists of six factors of tangibles, reliability, responsiveness, assurance, empathy, and privacy. Using the structural equation model analysis, we found that six factors of SERVPERF are consolidated into five. Privacy loses its significance, responsiveness and assurance stay valid, and tangibles factor is split into two. Overall, reliability, empathy, and tangibles 1 are found to be the relatively influential to consumer satisfaction.

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During the COVID-19 pandemic, more than twenty percent of the total COVID-19 fatalities in the United States originated in nursing homes. While previous studies underline the shortages of personal protective equipment and staff as potential causes that led to the COVID-19 infection, the generalizability of their findings is limited because they focus on certain states or cross- sectional data. This study empirically investigates these effects using nationwide data spanning 29 weeks. Using longitudinal nursing home-level data and panel regression analyses with fixed effects, this study shows that both shortages led to rise in cases in nursing home residents and staff in the United States. In addition, nursing home quality intensifies the unfavorable effect of staff shortage on staff infection. The results imply that there is a trade-off between improving nursing home quality and preventing staff infection in nursing homes. This study contributes to the literature on the healthcare industry and provides practical implications for stakeholders on how they can mitigate the spread of COVID-19 in nursing homes. First, it suggests nursing home administrators develop contingency plans for personal protective equipment. Second, the study proposes amending the laws on nursing homes’ minimum staffing levels.

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