The study showed that expectations were not equal for all three health service providers. For walk‐in‐clinic patrons, the most important influence on expectations was staff friendliness and cost. For private physician patients, they were friendliness and time spent with the customer, treatment explanations and competence. Customers said emergency rooms were the least attractive. The most important influence were physician friendliness, competence, amount of time spent with the customer and the amount of information provided. Both private physician and emergency room patrons placed walk‐in rooms as the referent for their expectations. Staff friendliness, cost and the amount of time the physician spent with them were found to be the three most important considerations/discriminators. With low expectations, emergency rooms generated higher than expected satisfaction levels. The only group where what was received was exactly as what was expected was walk‐in patrons. In the case of private physicians, the performance fell short of expectations, thus generating dissatisfaction.
Healthcare value chain: various actor roles and links that shape patient satisfaction and healthcare quality
According to Pitta and Laric (2004), healthcare delivery value can be described using elements that precede service delivery. The value chain includes five groups:
1. payers – government, employer and individuals;
2. fiscal intermediaries – insurers;
3. providers – hospitals, hospital systems and alternate site facilities;
4. purchasers; and
5. producers.