Multidimensional Analysis of Overall Service Quality in Aesthetic Clinics as a Predictor of Recommendation Intentions
DOI:
https://doi.org/10.37385/ijedr.v4i6.6869Keywords:
Overall service quality, Aesthetic Clinics, Intention to Recommend, Higher Order ConstructAbstract
This study investigates the impact of overall service quality on patient satisfaction and their intention to recommend aesthetic clinics, emphasizing the role of six quality dimensions measured as a higher-order construct (HOC). Understanding the influence of comprehensive service quality is crucial in aesthetic clinics, where patients seek more hedonic experiences rather than medical treatment. A survey was conducted among patients visiting aesthetic clinics, and Partial Least Squares - Structural Equation Modeling (PLS-SEM) with a disjoint two-stage approach was used to examine the relationships between the six reflective dimensions of service quality as lower order construct (LOC), namely technical, procedural, interactional, personnel, infrastructural, and social support with the outcomes of patient satisfaction and intention to recommend. The findings reveal the dimensionality of the service quality model in the aesthetic clinic context. In particular, overall service quality, measured as HOC, significantly influences patient satisfaction, which in turn positively affects the intention to recommend. Among the dimensions, technical quality and social support were critical in shaping patient perceptions and driving satisfaction. The model demonstrates robust explanatory and predictive power, with an R² value of 0.745 and Q²_predict of 0.679 for intention to recommend. A cross-validated predictive ability test confirms the model's predictive accuracy. Novel to this research is the comprehensive inclusion of quality dimensions, reflecting the complexity of service delivery in aesthetic clinics. The disjoint two-stage approach provides enhanced insights into the relative contributions of LOCs, highlighting technical quality, social support quality, and interactional quality as critical drivers of overall service quality. These findings offer actionable recommendations for managers to optimize service quality and encourage clinic recommendations.
References
Abbasi-Moghaddam, M. A., Zarei, E., Bagherzadeh, R., Dargahi, H., & Farrokhi, P. (2019). Evaluation of service quality from patients’ viewpoint. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-3998-0
Alghonaim, Y., Arafat, A., Aldeghaither, S., Alsugheir, S., & Aldekhayel, S. (2019). Social media impact on aesthetic procedures among females in Riyadh, Saudi Arabia. Cureus. https://doi.org/10.7759/cureus.6008
Amarat, M., Akbolat, M., & Dizlek, K. (2022). The mediating role of patient satisfaction in the effect of corporate reputation on patient loyalty. International Journal of Health Management and Tourism. https://doi.org/10.31201/ijhmt.1076913
Apostol, E. M., & Matchimura, M. V. (2024). Bridge the gap: A modified Gronroos model approach to guests’ satisfaction and service quality perception in small and medium-sized hotels (SMSH). American Journal of Multidisciplinary Research and Innovation, 3(4), 1–12. https://doi.org/10.54536/ajmri.v3i4.2605
Batbaatar, E., Dorjdagva, J., Luvsannyam, A., Savino, M. M., & Amenta, P. (2016). Determinants of patient satisfaction: A systematic review. Perspectives in Public Health, 137(2), 89–101. https://doi.org/10.1177/1757913916634136
Becker, J.-M., Cheah, J.-H., Gholamzade, R., Ringle, C. M., & Sarstedt, M. (2022). PLS-SEM’s most wanted guidance. International Journal of Contemporary Hospitality Management, 35(1), 321–346. https://doi.org/10.1108/ijchm-04-2022-0474
Bidmon, S., Elshiewy, O., Terlutter, R., & Boztug, Y. (2020). What patients value in physicians: Analyzing drivers of patient satisfaction using physician-rating website Data. Journal of Medical Internet Research, 22(2). https://doi.org/10.2196/13830
Bonell, S., Austen, E., & Griffiths, S. (2022). Australian women’s motivations for, and experiences of, cosmetic surgery: a qualitative investigation. Body Image, 41, 128-139. https://doi.org/10.1016/j.bodyim.2022.02.010
Brady, M. K., & Cronin, J. J. (2001). Some new thoughts on conceptualizing perceived service quality: A hierarchical approach. Journal of Marketing, 65(3), 34–49. https://doi.org/10.1509/jmkg.65.3.34.18334
Brook, R. H., McGlynn, E. A., & Cleary, P. D. (1996). Measuring quality of care. New England Journal of Medicine, 335(13), 966–970. https://doi.org/10.1056/nejm199609263351311
Chahal, H., & Kumari, N. (2010). Development of Multidimensional Scale for Healthcare Service Quality (HCSQ) in Indian context. Journal of Indian Business Research, 2(4), 230–255. https://doi.org/10.1108/17554191011084157
Cham, T.H., Lim, Y.M., Aik, N.C. and Tay, A.G.M. (2016). Antecedents of hospital brand image and the relationships with medical tourists’ behavioral intention, International Journal of Pharmaceutical and Healthcare Marketing, Vol. 10 No. 4, pp. 412-431. https://doi.org/10.1108/IJPHM-02-2016-0012
Chen, K., Congiusta, S., Nash, I. S., Coppa, G. F., Smith, M. L., Kasabian, A. K., Thorne, C., & Tanna, N. (2018). Factors influencing patient satisfaction in plastic surgery: A nationwide analysis. Plastic & amp; Reconstructive Surgery, 142(3), 820–825. https://doi.org/10.1097/prs.0000000000004658
Chen, M.-H., Tai, P.-N., & Chen, B. H. (2015). The relationship among Corporate Social Responsibility, consumer-company identification, Brand Prestige, and purchase intention. International Journal of Marketing Studies, 7(5). https://doi.org/10.5539/ijms.v7n5p33
Clemes, M. D., Ozanne, L. K., & Laurensen, W. L. (2001). Patients’ perceptions of service quality dimensions. Health Marketing Quarterly, 19(1), 3–22. https://doi.org/10.1300/j026v19n01_02
Cotofana, S., Sattler, S., Frank, K., Hernandez, C., Pavicic, T., Green, J. B., Kerscher, M., Peng, P., Gold, M., & Pooth, R. M. (2022). Aesthetic Medicine—Quo Vadis? Journal of Cosmetic Dermatology, 21(11), 6526–6527. https://doi.org/10.1111/jocd.15334
Dagger, T. S., & Sweeney, J. C. (2007). Service quality attribute weights. Journal of Service Research, 10(1), 22–42. https://doi.org/10.1177/1094670507303010
Devgan, L., Singh, P., & Durairaj, K. (2019). Minimally invasive facial cosmetic procedures. Otolaryngologic Clinics of North America, 52(3), 443–459. https://doi.org/10.1016/j.otc.2019.02.013
Diaz, J., Lorenzo, R., Mag-aso, C., & Akilan, B. S. (2023). Factors influencing customer loyalty among optical clinics in the City of Koronadal, South Cotabato, Philippines. Journal of Applied Management and Business, 4(2), 80–92. https://doi.org/10.37802/jamb.v4i2.434
Dickons, G. (2016). Client retention is central to the future success of your medical aesthetic clinic. Journal of Aesthetic Nursing, 5(5), 252–253. https://doi.org/10.12968/joan.2016.5.5.252
Dio, R., Dermawan, A. A., & Putera, D. A. (2023). Application of market basket analysis on beauty clinic to increasing customer’s buying decision. Sinkron, 8(3), 1348–1356. https://doi.org/10.33395/sinkron.v8i3.12421
Duggirala, M., Rajendran, C., & Anantharaman, R. N. (2008). Patient?perceived dimensions of total quality service in Healthcare. Benchmarking: An International Journal, 15(5), 560–583. https://doi.org/10.1108/14635770810903150
Endeshaw, B. (2020). Healthcare Service Quality-Measurement Models: A Review. Journal of Health Research, 35(2), 106–117. https://doi.org/10.1108/jhr-07-2019-0152
Fatima, I., Humayun, A., Iqbal, U., & Shafiq, M. (2019). Dimensions of service quality in Healthcare: A systematic review of literature. International Journal for Quality in Health Care, 31(1), 11–29. https://doi.org/10.1093/intqhc/mzy125
Ferdinand, M., & Ciptono, W. S. (2022). Indonesia’s cosmetics industry attractiveness, competitiveness and critical success factor analysis. Jurnal Manajemen Teori Dan Terapan |Journal of Theory and Applied Management, 15(2), 209–223. https://doi.org/10.20473/jmtt.v15i2.37451
Fook, T. N., Peng, L. M., & Mun, Y. W. (2024). Hospital brand image and Trust leading towards patient satisfaction: Medical tourists’ behavioural intention in Malaysia. Healthcare in Low-Resource Settings. https://doi.org/10.4081/hls.2024.12276
Grönroos, C. (1984). A service quality model and its marketing implications. European Journal of Marketing, 18(4), 36–44. https://doi.org/10.1108/eum0000000004784
Hair, Joseph F, Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2022). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) (3rd ed.). SAGE Publications, Inc.
Handini, N. S., & Antonio, F. (2023). Patients’ tendency to recommend plastic surgery clinics is shaped by appearance consciousness. Health SA Gesondheid, 28. https://doi.org/10.4102/hsag.v28i0.2320
Henseler, J., Ringle, C. M., & Sarstedt, M. (2014). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115–135. https://doi.org/10.1007/s11747-014-0403-8
Kang, G., & James, J. (2004). Service quality dimensions: An examination of grönroos’s service quality model. Managing Service Quality: An International Journal, 14(4), 266–277. https://doi.org/10.1108/09604520410546806
Kim, M., Koo, D.-W., Shin, D.-J., & Lee, S.-M. (2017). From servicescape to loyalty in the medical tourism industry: A Medical Clinic’s Service Perspective. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 004695801774654. https://doi.org/10.1177/0046958017746546
Ladhari, R. (2010). A review of 20 years of Servqual Research. International Journal of Quality and Service Sciences, 2(3). https://doi.org/10.1108/ijqss.2010.41002caa.001
Lee, J.-Y., & Park, Y.-H. (2019). Hospital selection factors and satisfaction, intention to revisit and recommend by recognition of Specialized Hospital?: Based on Joint Specialized Hospital Inpatients. The Korean Journal of Health Service Management, 13(2), 39–54. https://doi.org/10.12811/kshsm.2019.13.2.039
Lin, W., & Yin, W. (2022). Impacts of service quality, brand image, and perceived value on outpatient’s loyalty to China’s private dental clinics with service satisfaction as a mediator. PLOS ONE, 17(6). https://doi.org/10.1371/journal.pone.0269233
Marcela B, D., Montoya C, K., & Tavera-Mesías, J. F. (2017). Correlational study of the factors that influence in the recommendation and loyalty of patients of Aesthetic Medicine Medellín Colombia, 2014. Cuadernos de Administración, 33(58), 3–17. https://doi.org/10.25100/cdea.v33i58.4527
Memon, M. A., Ting, H., Cheah, J.-H., Thurasamy, R., Chuah, F., & Cham, T. H. (2020). Sample Size For Survey Research: Review and recommendations. Journal of Applied Structural Equation Modeling, 4(2), i–xx. https://doi.org/10.47263/jasem.4(2)01
Munawaroh, S. M., Nurhayati, H., Sudarmono, A., Dhony, E. F., Veibiani, N. A., Krisnawati, H., Puspita, W. H., Handayani, D., Dianika, B., & Sumarah, K. C. (2021). Meta analysis on the effect of the quality of health services with the level of patient satisfaction. Journal of Health Policy and Management, 6(2), 107–115. https://doi.org/10.26911/thejhpm.2021.06.02.03
Nguyen, C. Q., Tran, P., & Nguyen, M. (2020). Factors that motivate young people’s intention to undergo cosmetic surgery in Vietnam. International Journal of Pharmaceutical and Healthcare Marketing, 14(3), 395–407. https://doi.org/10.1108/ijphm-07-2018-0035
Nyadzayo, M. W., & Khajehzadeh, S. (2016). The antecedents of customer loyalty: A moderated mediation model of Customer Relationship Management Quality and Brand Image. Journal of Retailing and Consumer Services, 30, 262–270. https://doi.org/10.1016/j.jretconser.2016.02.002
Octaviani, S., Antonio, F., & Andy, A. (2023). The antecedents of patient experience of Aesthetic Clinic and its impact on revisit intention. South African Journal of Business Management, 54(1). https://doi.org/10.4102/sajbm.v54i1.3832
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1994). Reassessment of expectations as a comparison standard in measuring service quality: Implications for further research. Journal of Marketing, 58(1), 111–124. https://doi.org/10.1177/002224299405800109
Park, H. N., Park, D. J., Han, S. Y., Tae, J. Y., Jung, K., Bae, E. J., & Yoon, J. Y. (2022). Effect of inpatient experiences on patient satisfaction and the willingness to recommend a hospital: The mediating role of patient satisfaction: A cross?sectional study. Health Science Reports, 5(6). https://doi.org/10.1002/hsr2.925
Ringle, C M, Wende, S., & Becker, J. M. (2024). SmartPLS 4. SmartPLS. https://www.smartpls.com/
Sarstedt, M., Hair, J. F., & Ringle, C. M. (2022). “PLS-SEM: Indeed a silver bullet” – retrospective observations and recent advances. Journal of Marketing Theory and Practice, 31(3), 261–275. https://doi.org/10.1080/10696679.2022.2056488
Sarstedt, M., Hair, J. F., Cheah, J.-H., Becker, J.-M., & Ringle, C. M. (2019). How to specify, estimate, and validate higher-order constructs in PLS-SEM. Australasian Marketing Journal, 27(3), 197–211. https://doi.org/10.1016/j.ausmj.2019.05.003
Singhal, S., Radha, M., & Vinjamoori, N. (2022, March 24). The next frontier of care delivery in Healthcare. McKinsey & Company. https://www.mckinsey.com/industries/healthcare/our-insights/the-next-frontier-of-care-delivery-in-healthcare
Swain, S., & Kar, N. C. (2018). Hospital service quality as antecedent of patient satisfaction – A conceptual framework. International Journal of Pharmaceutical and Healthcare Marketing, 12(3), 251–269. https://doi.org/10.1108/ijphm-06-2016-0028
Swain, S., & Singh, R. K. (2021). Measuring the impact of perceived service quality on insured and uninsured patients’ satisfaction. Measuring Business Excellence, 25(3), 346–367. https://doi.org/10.1108/mbe-06-2020-0095
Wirtz, J., & Lovelock, C. (2021). The Services Marketing Framework. Services Marketing, 104–105. https://doi.org/10.1142/9781944659806_others02
Woo, S., & Choi, M. (2021). Medical Service Quality, patient satisfaction and intent to revisit: Case study of public hub hospitals in the Republic of Korea. PLOS ONE, 16(6). https://doi.org/10.1371/journal.pone.0252241
Yahanda, A. T., Lafaro, K. J., Spolverato, G., & Pawlik, T. M. (2015). A systematic review of the factors that patients use to choose their surgeon. World Journal of Surgery, 40(1), 45–55. https://doi.org/10.1007/s00268-015-3246-7
Zeithaml, Valarie A., Berry, L. L., & Parasuraman, A. (1996). The behavioral consequences of service quality. Journal of Marketing, 60(2), 31–46. https://doi.org/10.1177/002224299606000203