Providing and perceiving healthcare: A model of medical professional-patient interactivity and service evaluations
Abstract
Patients' perception of the care they receive has become more and more important in terms of not only healthcare quality improvement but also hospital financial management. In addition to medical professionals' clinical performance, their interactions with patients are viewed as critical. This study, therefore, attempted to explore the nature of the medical professional-patient interactivity in an emergency department setting. Specifically, the purpose of this study was to determine: (1) the underlying factors of actual and perceived interactivity in hospital settings; (2) the relationship between actual interactivity, perceived interactivity, overall patient satisfaction, patient loyalty, and patients’ perceptions of emotional care; (3) the relative importance of physician-patient interactivity and nurse-patient interactivity; and (4) the varied effects of different wait-time intervals on patient satisfaction and loyalty. Close observation and patient self-report survey were employed to collect data from the emergency departments of three hospitals. A total of 550 patients were observed. Factor analysis and structural equation modeling were used as the major methods to test the hypotheses. Four constructs (nonverbal connectedness, central communication, rapport formation, and peripheral consideration) were extracted as the underlying factors of actual interactivity, and three constructs (empowerment, respect, and responsiveness) were extracted as the factors of perceived interactivity. The results of the structural model revealed that patients' actual interactivity with nurses was found to indirectly influence overall satisfaction through perceived interactivity, which also had an impact on emotional care perception and patient loyalty. Emotional care perceptions were associated with overall satisfaction and patient loyalty. Additionally, the patient wait time negatively affected overall satisfaction. The current study provided both research and managerial implications. Academically, several important theories in consumer behavior, such as expectancy disconfirmation paradigm, social cognition theory, four loyalty phases, and theories of arousal, were applied to construct a useful theoretical framework with the usage of multiple research methods. Practically, this study suggested that an interaction guideline for behavior and scripts can be established to improve the nonverbal connectedness, peripheral consideration, and central communication of actual interactivity with nurses in order; and that rationally arrange sufficient medical professionals in busy hours to minimize patients’ wait time. These strategies enable the hospitals to enhance the patients’ evaluations of healthcare service and streamline the human resources allocation as well as the training and personnel costs in financial management. The limitations and future research directions were also provided.
Degree
Ph.D.
Advisors
Liu, Purdue University.
Subject Area
Marketing|Health sciences
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