Abstract
Patient loyalty is crucial within a capitation payment scheme, especially when patients are granted freedom to choose among alternative providers, e.g., in Taiwan. A service provider can take the part of the amount paid as profit if the patient uses few services, and has to absorb the excessive expenses if the patient consumes services the cost exceeding the reserved. As a result, the success of the capitation payment scheme needs to tackle two major issues patient loyalty and the information asymmetry between patients and the hospital. This dissertation includes three main themes organized as follows. First, we explain the proposed conceptual model along with relevant research pertaining to patient loyalty, patient experience, service encounter and patient co-creation behavior. The aim of the second theme is to justify the role played by each encounter of perceived service quality and hospital image in the explanation of co-creation behavior in the context of the healthcare services offered by a hospital. We collected data about patients of different clinics in a regional hospital (Cardinal Tien Hospital: CTH) in northern Taiwan for the first and second theme. Finally, in the third theme, through the scenario-based survey method, we investigate patients’ revisit intention to a hospital after they know about their affiliation with the specified hospital via the capitation system. This research discovered that patients’ experiences in different healthcare service encounters with different patient citizenship behaviors affect the loyalty to the corresponding service providers (e.g., hospitals). Patients’ perceived value and trust from different service encounters also affects their value co-creation behaviors. From the scenario-based survery, we identified that siganaling instittuionalized service information and the patient-centered care service information policy significantly affect patients’ intention to use the service provided by the healthcare service provider comparing with signialing no or either one information item. The results imply that a healthcare service provider such as a hospitial can allocate resources for different service encounters in order to maintain patients’ loyalty and value co-creation behaviors. The provision of the information in institutationlized service (e.g., capitation payment scheme) and the patient-centered service (e.g., e-healthcare service) could increase patients’ intention to use the services provided the healthcare service provider. In summary, this research contributes not only to the academic literature but also to the managerial implications to healthcare service. However, the findings of this study are obtained only in a snapshot of a time flow. There is a need for longitudinal studies to develop patient behavior model in future.