health tourism, customer satisfaction and quality of life: the role of specialty hospitals dina...

HEALTH TOURISM, CUSTOMER SATISFACTION AND QUALITY OF LIFE:

THE ROLE OF SPECIALTY HOSPITALS

Dina Lončarić, PhDFaculty of Tourism and Hospitality Management, Opatija

Damir Lončarić, M. A.Thallassotherapia, Crikvenica

Suzana Marković, PhDFaculty of Tourism and Hospitality Management, Opatija

ToSEE - Tourism in South East Europe 3rd International Scientific Conference Sustainable Tourism, Economic Development and Quality of LifeUniversity of Rijeka, Faculty of Tourism and Hospitality Management Opatija

CONTENTS

Purpose of the study Theoretical background Research objectives and hypotheses Methodology Research results Conclusion Limitations and suggestions


PURPOSE OF THE STUDY

To assess the impact of health services on physical quality of life and customer satisfaction in the health tourism sector

with special emphasis on the role of specialty hospitals which are part of the health system of the Republic of

Croatia.


THEORETICAL BACKGROUND HEALTH TOURISM

… "the provision of health facilities utilizing the natural resources of the country, in particular mineral water and climate“ (IUOTO, 1973)

… “tourism that is linked with travel to health resorts or other destinations, the primary purpose of which is to improve the physical condition of tourists through a regime of physical exercises and therapy, and controlled nutritional and medicinal services relevant to health maintenance” (National Strategy of Health Care Development, 2012)


THEORETICAL BACKGROUND HEALTH TOURISM

4 segments of health tourism in Croatia (Kesar and Rimac, 2011) : • sanatorium/hospital "tourism" • spa/thermal/thalassotherapy tourism • wellness tourism • medical tourism

SPECIALTY HOSPITAL … “is a health care institution engaged in the specialist-consiliary and

hospital treatment of specific diseases and specific age-groups and possessing the facilities, in terms of beds, diagnostics, etc., required to carry out such treatment (Health Protection Act, 2008).


THEORETICAL BACKGROUND QUALITY OF LIFE (QOL) … “an individual’s perception of their position in life in the context of the

culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns”, (WHOQOL Group, 1994)

LIFE SATISFACTION (LS) … “is the degree to which a person positively evaluates the overall

quality of his/her life as a whole. In other words, how much the person likes the life he/she leads”, (Veenhoven, 1996)

LIFE DOMAIN The domain of health is one of the most important determinants of QOL

and LS (Andrews and Withey, 1976 ; Cummins, 1996; Alber and Fahey, 2004)


THEORETICAL BACKGROUND CUSTOMERS … patients of medical institutions (Altsech, 2012; Han, 2013; Zaim,

Bayyurt and Zaim, 2010)

CUSTOMER SATISFACTION … the customer's evaluation of a product or service in terms of whether

that product or service has met their needs and expectations (Zeithaml and Bitner, 2003)

CUSTOMER LOYALTY … “commitment to re-buy or re-patronize a preferred product or service

consistently in the future… “ (Oliver, 1997)


RESEARCH OBJECTIVES

to study the correlation between the perception of physical quality of life and the life satisfaction of patients who have stayed in a specialty hospital for medical rehabilitation;

to establish the correlation between the perception of physical quality of life after staying in a hospital and customer satisfaction;

to study the correlation between customer satisfaction and life satisfaction after using the hospital’s services;

to establish the correlation between customer satisfaction and customer loyalty.


HYPOTHESES

H1 Physical quality of life is positively related to life satisfaction.

H2Physical quality of life is positively related to customer satisfaction in a specialty hospital.

H3 Customer satisfaction is positively related to life satisfaction.

H4:There is a positive relationship between customer satisfaction and customer loyalty in a specialty hospital.


HYPOTHESES Figure 1. The conceptual model

H1

H2

H3

H4

LIFE SATISFACTION

CUSTOMER LOYALTY

PHYSICAL

QOL

CUSTOMER SATISFACTION


METHODOLOGYResearch instrument Questionairre, 7-point Likert-type scale, 15 items:

• Physical Quality of life, 7 items (WHOQOL-BREF quality of life assessment, Skevington, S. et al., 2004)

• Life satisfaction, 3 items• Customer satisfaction, 3 items• Customer loyalty, 2 itemsDemographics characteristics

Sample Convenient sample of patients of a specialty hospital for medical rehabilitationN = 82

Response rate 68.33 % ( N=120, n=82)

Data collection July and August of 2014

Data analysis Descriptive statistics Partial Least Squares Structural Equations Modelling (PLS-SEM)


RESEARCH RESULTS

CHARACTERISTICS RESPONDENTS

Gender 53.7% females, 46.3% males

Age 62.1% more than 56 years old

Occupation 50.0 % retired, 30.5 % employed

Level of education 63.4 % secondary school

Purpose of visit 92.7 % medical and health programs

Previous hospital stays

15.9% first time visitors

Table 1. Socio-demographic profile of respondents (N=82)

Source: Research results

CONSTRUCTS ITEMS MEAN SD

PHYSICAL QUALITY OF LIFE

Reduced physical pain 5.93 1.54

Reduced addiction to medication 5.36 1.99

Increased energy levels 5.89 1.56

Increased ability to relax and sleep 5.83 1.61

Increased ability to carry out everyday activities 5.91 1.55

Increased ability to work 5.70 1.71

Enhanced mobility 6.02 1.42

LIFE SATISFACTION

Satisfaction with health 5.19 1.89Satisfaction with quality of life 5.40 1.79General life satisfaction 5.66 1.67

CUSTOMER SATISFACTION

Satisfaction with overall hospital services 6.29 1.20Satisfaction with health care services 5.81 1.67Satisfaction with accommodation and food and beverage services 5.57 1.81

CUSTOMER LOYALTY

Intention to recommend to friends 6.35 1.24Intention to repeat hospital stay 6.48 1.09


Table 2: Constructs, measurement items and results of descriptive analysis (N=82)

Figure 2. PLS-SEM model with indicator loadings and structural coefficients



RESEARCH RESULTS

Path Path coefficients t values p values Effect size Hypotheses

PQOL LS 0.422 3.169 0.002* 0.224 Supported

PQOL CSAT 0.499 5.104 0.000* 0.332 SupportedCSAT LS 0.307 2.494 0.013** 0.119 SupportedCSAT CLOY 0.403 2.943 0.003* 0.194 Supported

* p<0.01** p<0.05Source: Research results

Table 3. Significance testing of the structural model path coefficients


CONCLUSION The patients using the services of the specialty hospital expressed a

positive attitude towards hospital services.

Medical rehabilitation services helped to improve the physical quality of their lives.

A positive effect on their life satisfaction.

A postive effect on the customer satisfaction and loyalty.


CONTRIBUTIONTHEORETHICAL CONTRIBUTION

the WHOQOL-BREF quality of life assessment scale (Skevington, Lotfy and O’connell, 2004) previously used to study the impact of tourism on quality of life (Carneiro and Eusébio, 2012), and in the field of health care (Skevington, Lotfy and O’connell, 2004), can be successfully applied in the area of health tourism.

PRACTICAL CONTRIBUTION is evident in proving the connection between the perception of the

influence of health services on the improvement of health and satisfaction with hospital services, and their influence on the patients’ satisfaction and loyalty to the hospital.


LIMITATIONS AND SUGGESTIONSLIMITATION OF THE RESEARCH

A small convinient sample of patients in only a single specialty hospital.

Only the construct of physical quality of life was applied, while social, psychological and environmental quality of life constructs were not studied.

SUGGESTIONS FOR FUTURE RESEARCH To conduct the research on representative sample of patients in

larger number of speciality hospitals. Social, psychological and environmental quality of life constructs

should be included. This study - a platform for similar research in the field of health

tourism and quality of life.

Thank you for your attention!

Dina Lončarić Faculty of Tourism and Hospitality Management, OpatijaE-mail: [email protected]

health tourism, customer satisfaction and quality of life: the role of specialty hospitals dina...

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