• KANAD
  • Contact us
  • E-Submission
ABOUT
BROWSE ARTICLES
EDITORIAL POLICY
FOR CONTRIBUTORS

Articles

Original Article

Causal Relationships Among Perceived Risk, Satisfaction, Switching Cost and Loyalty in Outpatient Health Services

Journal of Korean Academy of Nursing Administration 2011;17(4):516-523.
Published online: December 31, 2011

1Professor, Department of Nursing, Chung-Ang University, Korea.

2Professor, Department of Nursing, Kwandong University, Korea.

Correspondence: Lee, Kyu Eun. Dept of Nursing, College of Medicine, Kwangdong University, 522 Naegok-dong, Gangneung city, Kangwon Province, 210-700, Korea. Tel: 82-33-649-7617, Fax: 82-33-649-7620, lke@kd.ac.kr
• Received: October 11, 2011   • Revised: December 6, 2011   • Accepted: December 6, 2011

Copyright © 2011 Korean Academy of Nursing Administration

  • 22 Views
  • 0 Download
  • 3 Crossref
prev next
  • Purpose
    The purpose of this study was to examine the causal relationships of perceived risk, satisfaction, switching cost and loyalty in outpatient health services.
  • Method
    A survey using a structured questionnaire was conducted with 393 hospital outpatients. The analysis of data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for structural equation model.
  • Results
    The causal model yielded Chi-square=31.44 (p=<.001), df=4, GFI=.98, AGFI=.87, CFI=.97, RMSR=.04, NFI=.96, IFI=.97 and showed relatively good fit indices. Perceived risk had a significant direct effect on customer satisfaction. Customer satisfaction, financial switching cost and relational switching cost had significant direct effects on customer loyalty. Perceived risk and customer satisfaction had significant indirect effects on customer loyalty.
  • Conclusion
    These results suggest that we should decrease the perceived risk and improve the customer satisfaction and switching cost to retain loyal customers. Further study with both a larger sample from various hospitals and a longitudinal design is necessary.
  • 1. Bollen KA. A new incremental fir index for general structural equation models. Sociol Methods Res. 1989;17:303-316.
  • 2. Byun KS, Cho YD, Shin MJ. The effect of perceived value, customer satisfaction, trust, switching costs on customer loyalty in fast food restaurant. Korean J Tourism Res. 2007;22(2):37-58.
  • 3. Burnham TA, Frels JK, Mahajan V. Consumer switching costs: a typology, antecedents, and consequences. J Acad Mark. 2003;31(2):109-126.
  • 4. Choi YJ, Yoo J. The causal relationship among relationship marketing implement factors, satisfaction, trust, switching costs, and customer loyalty in commercial sport centers. Korean J Sport Manage. 2007;12(4):115-136.
  • 5. Cronin JJ, Taylor SA. Measuring service quality: a reexamination and extension. J Mark. 1992;56:55-58.
  • 6. Dowling GR, Staelin R. A model of perceived risk and intended risk-handling activity. J Consum Res. 1994;21(3):119-134.
  • 7. Gremler DD. The effect of satisfaction, switching costs, and interpersonal bonds on service loyalty. 1995;Arizona, Arizona State University. Unpublished doctoral dissertation.
  • 8. Jacoby J, Kyner DB. Brand loyalty vs repeat purchasing behavior. J Mark Res. 1973;10(1):1-9.
  • 9. Jones MA, Mothersbaugh DL, Beatty SE. Switching barriers and repurchase intentions in services. J Retail. 2000;76(2):259-274.
  • 10. Jones TO, Sasser WE. Why satisfied customers defect. Harv Bus Rev. 1995;Nov-Dec;73(2):88-99.
  • 11. Jung Y. Developing customer switching costs model and measuring the effects of switching costs. 2007;Seoul, Yonsei University. Unpublished master's thesis.
  • 12. Kim KS. Analysis structural equation modeling: amos 4. 2001;Seoul, SPSS Academy.
  • 13. Kim SH, Oh SH. The determinants of repurchase intentions in the service industry: customer value, customer satisfaction, switching costs, and attractiveness of alternatives. Korean Mark Rev. 2002;17(2):25-55.
  • 14. Kim SH, Song MS. Analysis of the effects of perceived risk and customer satisfaction on hospital image and customer loyalty. Manag Rev. 2003;12:31-56.
  • 15. Kim YK, Jung KT, Ann YS, Lee SE, Jang YH, Han BR. The influence of dental service qualities on the patient satisfaction and royalty in dental clinics and hospitals. Korean J Hosp Manage. 2003;8(3):49-71.
  • 16. Kim HK. Study on the structural relationship of customers' satisfaction, value, loyalty, and image by utilizing the discordance of service quality and expectation. 2006;Seoul, Kyung Hee University. Unpublished doctoral dissertation.
  • 17. Kim HR. A study on service quality, customer satisfaction, brand recognize and switching cost of customer loyalty in hotel restaurant. Korean J Tourism Res. 2008;23(2):259-281.
  • 18. Kim MJ, Lim YJ. The influence of the quality of service in the beauty industry on customer satisfaction, and the relationship between switching cost and customer loyalty. J Korean Soc Costumes. 2008;58(9):99-113.
  • 19. Ko YK, Kim BJ. The effects of switching cost perceived by patients and negative word of mouth on revisiting intention for hospital patients. J Korean Acad Nurs Adm. 2011;17(1):5-13.
  • 20. Lee SC, Lee HJ, Jung SH. Analysis of relating factors with customer loyalties in medical services. Korean J Health Policy Adm. 2005;15(2):37-52.
  • 21. Lee SH, Kim HM, Kim JH, Ha GY. How are consumers, service and marker factors related to consumer loyalty in medical service?: targeting the medical consumer in a city. J Prev Med Pub Health. 2008;41(5):315-322.
  • 22. Oliver RL. Satisfaction: a behavioral perspective on the consumer. 1997;New York, McGraw-Hill.
  • 23. Prichard MP, Howard DR. The loyal traveler: examining a typology of service patronage. J Travel Res. 1997;Spring;2-10.
  • 24. Reichheld FF, Sasser WE. Zero defection: quality comes to service. Harv Bus Rev. 1990;68(5):105-111.
  • 25. Stone RN, Gronhaug K. Perceived risk: further considerations for the marketing discipline. Eur J Mark. 1993;27(3):39-50.
  • 26. Woodside AG, Frey LL, Daly RT. Linking service quality, customer satisfaction, and behavior intention. J Health Care Mark. 1989;9(4):5-17.
  • 27. Yom YH, Lee IJ. Causal relationships among quality, service value, satisfaction and loyalty. J Korean Acad Nurs Adm. 2010;16(4):497-506.
  • 28. Yoo DK, Suh SW. The effect of medical service quality and perceived risk on customer satisfaction, repurchase intention, and churn intention as to hospital sizes. J Korea Serv Manage Soc. 2009;10(3):97-130.
Figure 1
Conceptual framework.
jkana-17-516-g001.jpg
Table 1
Demographic Characteristics (N=393)
jkana-17-516-i001.jpg
Table 2
Means and Correlations among Variables
jkana-17-516-i002.jpg
Table 3
Standardized Direct Effect, Indirect Effect, and Total Effect in the Modified Model
jkana-17-516-i003.jpg

SMC =squared multiple correlations.

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • A Study on the Structural Relationship between Quality of Medical Service, Perceived Risk, Reputation and Customer Satisfaction in Small and Medium Hospitals
      Ae-Jun Park
      Journal of Industrial Distribution & Business.2019; 10(4): 67.     CrossRef
    • Factors Influencing Chinese Customers' Loyalty to Korean Medical and Tourism Services
      Young-Hee Yom, Myoung Ae Kim, Jung Hee Han
      Journal of Korean Academy of Nursing Administration.2015; 21(3): 317.     CrossRef
    • Influence Factors on Acculturative Stress among Chinese Students Studying in Korea: Focusing on Spiritual Well-Being
      Hye-Sun Jeong
      Journal of the Korea Academia-Industrial cooperation Society.2015; 16(7): 4768.     CrossRef

    Download Citation

    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

    Format:

    Include:

    Causal Relationships Among Perceived Risk, Satisfaction, Switching Cost and Loyalty in Outpatient Health Services
    J Korean Acad Nurs Adm. 2011;17(4):516-523.   Published online December 31, 2011
    Download Citation
    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

    Format:
    • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
    • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
    Include:
    • Citation for the content below
    Causal Relationships Among Perceived Risk, Satisfaction, Switching Cost and Loyalty in Outpatient Health Services
    J Korean Acad Nurs Adm. 2011;17(4):516-523.   Published online December 31, 2011
    Close

    Figure

    • 0
    Causal Relationships Among Perceived Risk, Satisfaction, Switching Cost and Loyalty in Outpatient Health Services
    Image
    Figure 1 Conceptual framework.
    Causal Relationships Among Perceived Risk, Satisfaction, Switching Cost and Loyalty in Outpatient Health Services

    Demographic Characteristics (N=393)

    Means and Correlations among Variables

    Standardized Direct Effect, Indirect Effect, and Total Effect in the Modified Model

    SMC =squared multiple correlations.

    Table 1 Demographic Characteristics (N=393)

    Table 2 Means and Correlations among Variables

    Table 3 Standardized Direct Effect, Indirect Effect, and Total Effect in the Modified Model

    SMC =squared multiple correlations.

    TOP