A paradox of service quality in Turkey

Abstract

Purpose -Are there cases or contexts where certain groups of customers who are expected to place a considerable emphasis and importance on the tangible qualities of services end up attributing a greater weight to the intangible qualities? This paper attempts to exemplify the existence of such cases, and explain why such cases are, at times, paradoxical in nature, and how such cases could arise. Design/methodology/approach -The paper employs a structural-equation-modeling approach to theorize about, and empirically examine, the tangible and intangible determinants of service quality. The model and the path developed in the paper also capture the relationship between service quality and customer satisfaction. Using AMOS, the empirical estimation of the model is carried out. Findings -The central finding is that all intangible factors associated with service quality turn out to be unequivocally more important than the tangible ones in the Turkish non-profit health-care sector under investigation. In other words, intangible factors appear to play a statistically more significant role compared with tangible factors in determining the overall customer satisfaction and the quality of non-profit health-care services. Considering that, in developing countries, tangible factors are expected to be among the most scarce, and hence, most valuable ones, the relative unimportance of tangible factors constitutes a paradox to be explained and resolved. Originality/value -This paper contributes to the literature by bringing to light a striking phenomenon which is largely unnoticed in the literature, namely that, in certain cases, there might exist a fundamental asymmetry and difference between the influences of tangible and intangible factors on service quality, and that difference in certain contexts, as in the case of the Turkish health-care sector, constitutes a paradox to be explained. The paper demonstrates the possibility of such paradoxical cases and provides cultural and sector-specific explanations for this seemingly puzzling phenomenon in question.

Hospital service quality measurement models: patients from Asia, Europe, Australia and America

“…A comparison of the healthcare dimensions identified with those evident in the marketing literature indicates a considerable overlap, that is, both literatures identify the importance of the technical, functional, environment, administrative and personnel dimensions of the service experience. The application of SERVQUAL in health service quality analysis showed that intangible elements tend to be more influential than tangible ones (Kara, Lonial, Tarim, & Zaim, 2005), although one should always consider adapting the scale in specific situations. It is noticeable that the majority of studies about service quality in healthcare do not provide a comprehensive outcome element, which could be due to difficulties in measuring the results in healthcare service quality.…”

Customer Perceptions of Health Examination Service Quality: An Empirical Investigation in South Korea

“…As a result, we extracted 32 items from literature study and made adjustment for the health examination service context. We utilized results of [29], [36], and [55] as major references. Since the health examination service provider of our choice offers service with no charge, items regarding cost ( [22], [29], [36], [54], [59]) have been removed.…”

“…Also, since consumers of health examination service are treated as outpatients, the items pertinent to inpatients have been excluded. These include discharge process [19], [36] and meal ( [19], [36], [55]). The finalized items and their references are depicted in Table V Review of measurement items was based on the pre-test and responses from professionals.…”

“…The importance of privacy attribute has been pointed out in various contexts such as primary care [52], and emergency room [51], [53]. Privacy also appears as a tangibles factor in other healthcare literature [36], [54], [55].…”

The Relationship of Service Quality on Consumer Satisfaction in Shipyard Industry

“…While Kara, Lonial, Tarim, and Zaim (2005) stated that intangible factors turn out to be among the most decisive ones in determining the service quality.…”