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productivity and economic growtha re now widely recognised (Ellis & Singh, 2010). Markets characterised bym ore competition, with more players, more dynamic entry and exit, andmore intense rivalry for customers (e.g. through price promotions, specialoffers, and marketing campaigns etc.) tend to deliver better marketoutcomes. The se outcomes include lower prices and better access toservices for consum ers (Ellis & Singh, 2010). The introduction ofcompetition or indeed even th e prospect of increased competition canhave a significant and immediate i mpact on prices and other outcomes thatare of interest to the consumer. According to Rivers and Saundra (2008), within the health care industry,co mpetition impacts several relational perspectives; with numerous studiesre porting the impact of increased competition. For example, several studiesh ave examined the relationships between competition and quality of healthc are (Zwanziger and Melnick, 1996); and between competition and patientsa tisfaction (Miller, 1996). These studies show that competition is capableof i ncreasing value for customers over time. Quality and processimprovements lead to decreased costs, which in turn results in increasedcustomer satisf action Customer service and sevice quality have become distinct components ofb oth product and service sectors and with the developments in informationt echnology many businesses find demanding and knowledgeablecustomers . The worldwide trend toward service quality was initiated in the1880s when businesses realized that a quality product, in itself, is notguaranteed to ma intain competitive advantage (Van der Wal et al., 2002).Many researchers r ecognize that service quality can bring an organization alasting competitive advantage (Lewis, 1989). Quality of services can be thedifference betwee n success and failure in both service and manufacturingfirms. Service quality, customer satisfaction and customer value have become th emain concern of both manufacturing and service organizations in the incr easingly intensified competition for customers in today's customer-centere dera (Wang et al., 2004). As a result, many organizations are payingincreas ing attention to improve service quality. In some manufacturingindustries "s ervice quality" is considered a more important order winnerthan "product q uality" (Ghobadian et al., 1994). In addition, service qualityimprovements le ad to customer satisfaction and cost management thatresult in improved pr ofits. Contemporary service sector firms are compelledby their nature to pr ovide excellent service in order to prosper inincreasingly competitive dome stic and global marketplaces (Sultan andSimpson, 2000). As service firms f ind themselves in an increasinglycompetitive and complex business enviro nment, they are inevitably drivento examine their service delivery processes critically. The focus of suchinternal analysis is ultimately about customer s atisfaction, and how bottom-line results can be actualized through deliveri ng quality services tocustomers via flawless interface platforms.
Customer satisfactionis consider ed a prerequisite of customer retention and loyalty. In p articular. They investigated Taylor andBaker's (1994) a ssertion that satisfaction judgements moderate the quality-purchase intenti on relationship by testing the research model in both for-profit and not-for -profit hospital settings. in themo dern.Service quality is commonly noted as a critical prerequisite and determinan tof competitiveness for establishing and sustaining satisfying relationships with customers. highly competitive business world. Chernew.Attention to service quality can make an organisation different from otherorganisatio ns and gain a lasting competitive advantage (Boshoff and Gray. A model of the relationship amongthes e variables was developed. However differnces in the effect of competion seem to exist for variousind ustries. It has become adistinct and impor tant aspect of the product and service offering (Caruana. as shown in Baker and Taylor's (1997) study of the relationshipbet ween quality perceptions and satisfaction judgements in the formationof fu ture purchase intentions may be very different in health servicesettings rela tive to other service settings. Rajendran & Anantharaman (2002). appears to bedifferent for health services. market share and return on investment. healthcare system costs and customer satisfaction in health care were examinedi n a competitive health care market. the nature of service quality. lead to satisfied customers. in turn. Swaminathan & Lee(200 6) which investigated a range of data issues related to the measures ofheal th insurance competition used in empirical studies published from 1994-20 04. The literature relies exclusively on market structure and penetrationvaria . The results of this study firstsupport the growing v iew that satisfaction judgements are more closelyrelated to outcome behav iors than quality perceptions in hospital settings. (2002) examined in detail the relationship betweenservice quality and customer satisfaction in a competitive market and theyfound a positiv e relationship. such as future purchase intentions.Sureshcha ndar et al. The model depicts customer satisfaction asan outcome measure directly dependent on competition. Another potential source of variability in findings in competition studiesacro ss industries is highlighted by Scanlon. while also directly dependent on competition. According to Brady and Robertson (2001) service quality helps tocreate the necessary competitive advantage by being an effectivedifferentiating factor According to Sureshchandar.are considered as determinants of customer satisfaction as well.2004). 1996).The results further support the assertion that the formation of importantconsumer outcomes.2002). In a study by Asoh and Rivers (2007). In their study. Previous studying suggests that service quality is animport ant indicator of customer satisfaction (Spreng and Mackoy. Quality of careand h ealth care system costs. and can helpto boost p rofitability. 2002). consumers prefer service quality when the price andother cost ele ments are held constant (Turban. the key to sustainablecompetitive advantage lies in delivering high quality service in the insuranceindustry tha t will.
& Taylor. A. . "ServiceQuality: Conceptsa nd Models". (1996). Spreng.. & Singh. C. (2004). Assessing the economic impact ofcompetition . F. Miller. Swaminathan. & Rivers. & Robertson. 8. (2007). A. (2010).Health Affairs Summer. 27–37 Caruana. Chernew. (2002). The Relationships between Service Quality. & Lee. thedegr ee of correlation is modest.European Journal of Marketing. Brady.Medical Care Research Review. & Gray.828. S. R. S. K.Journal of Retailing. An Empirical Examination of aMode l of Perceived Service Quality and Satisfaction. 43 . R.etc.ODI research report commissioned by DFID Ghobadian. 4-12. M. B.InternationalJour nal of Bank Marketing. J.320 Scanlon.. & Jones. (1996). suggesting that choice of measure couldinflue nce empirical results. Number 1. M.1. certain measurement issues such asthe la ck of data on the treatment of small firms. (2001).. 53-60 Boshoff.2.... & Simpson. A. P.g. S. L. Lewis.bles to measure competition. C. "Service loyalty: The effects of service quality andthem ediating role of customer satisfaction". A. 6.“Patient satisfaction and service quality in the formation of patient’s future purchase intentions in competitive health care settings. D. 7.Health Servicing ManagementResearch. theavailability of informatio n on price and outcomes. REFERENCES Asoh. Customer Satisfaction and Buying Intentions in the Private Hospital Industry . 15. 15. D.72.. International service variants: airlinepa ssenger expectations and perceptions of service quality.. (2000). but t heir impact on market outcomes has not beenwidely studied.Importantly.South African Journal of Business Management..Competiti on in health insurance markets: limitations of current measures forpolicy an alysis.9. 35. 4. 811 .36. & Mackoy. A.. 5. H. Speller. other types of measures related to competition (e. M.. (2006). 20 1 . T. K. (1997). 1-16.Health Marketing Quarterly.7. P. R. 11. R. Ellis. (1989). A research model of health-carecompe tition and customer satisfaction. 63. “Searching for a consensus onthe antecedent role of service quality and satisfaction: An exploratorycross-n ational study. C. . and omitted marketcharacteristi cs also could affect the conclusions in empirical studies. International Journal of Quality & Reliability Management. B. A. Competition in the health system: good news and bad news.) are important.. 244-252 Baker.2. 37-55.214 Sultan.66. 51. D. W. Moreover. 312 .”Journal of Business Research. M..Journal ofService . 4. While these measures are correlated. R. (1994). degree of entry barriers. Quality in the service secto: A review.
satisfaction: Evidence from China'stelecommunicatio n industry. 189 . Service quality ince llular telecommunications company: A South-African experience.W..2.A Van der Wal. (2002). (1996). 14. Can managed care plans controlhea lth care costs. 16.E. & Bond.4.Health Affairs. (2002) "There lationship between service quality and customer satisfaction &ndash. S. Pampallis. customer value.Journal of Retailing . & Anantharaman. C.Journal of Services Marketing.379 Taylor. Lo H.S. Y. Y. & Yang. A. A. E. Zwanziger. 323-35 Wang. Rajendran. U. J. 325-340. 188-216. Turban. R.. 363 .3.199 .Prentice Hall.Managing Service Quality. (2002). C. (1994). 4 . Sureshchandar.Electronic Commerce a Managerial Perspective. An integrated framework for servicequ ality.Information Systems Fromtiers 6. 5. and Baker.2. & Melnick..afacto r specific approach". N. 70. (2004).Marketing. A. "An Assessment of the relationshipb etween service quality and customer satisfaction in the formation ofconsu mers' purchase intentions". 12... 15. L. R. G. S. T .. G. 163-78.
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