SKILLED physicians examining a patient may disagree regarding the findings. Such disagreements reflect the imperfect reliability of clinical methods and data. A decade ago, Fletcher1 urged physicia...

The Reliability of Clinical Methods, Data and Judgments

The reliability of clinical methods, data and judgments (second of two parts).

Many service interactions require customers to actively participate, yet customers often do not participate at levels that optimize their outcomes, particularly in health care. To gain insight into how customers shape a service experience with highly uncertain outcomes, we construct a model on the broaden-and-build theory of positive emotions. The model is used to empirically assess how situation-specific emotions and customer participation during a health care service experience affect perceptions of the service provider. The model is tested using data from 190 medical clinic customers. Consistent with theory, results reveal that as customers’ relative affect levels become more positive, levels of participation increase as well. In turn, higher levels of positivity and participation improve customer perceptions of the quality of the service provider and satisfaction with the co-produced service experience. Implications of this research focus managers on designing services to help clients manage their emotions in ways that facilitate positivity and participation and thus improve service perceptions.

Customer positivity and participation in services: an empirical test in a health care context

This is a literature review of theoretical and methodological issues on health care evaluation of research and technical reports. Conceptual frameworks, approaches, subject matter, strategies, and study designs are identified and analyzed. Evaluative research designs are compared with epidemiological ones. A diverse terminology was encountered, and many methodological problems in the literature were examined. The incorporation of evaluative procedures in health planning or health policy-making and administration is still limited in Brazil, particularly at the local level. Recent implementation of projects for the reorganization of the health services system based on the administrative autonomy of Local Health Units raises the need for more appropriate strategies aimed at health care evaluation. Perspectives for the development of alternative strategies are indicated.

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Avaliação em saúde: limites e perspectivas

Purpose – The purpose of this paper is to validate an empirically derived measure for assessing perceived service quality in the business‐to‐business (b2b) context. In doing so, the SERVQUAL scale is evaluated against the alternative measure.Design/methodology/approach – A questionnaire was mailed to 1,285 companies from different industries. Respondents were identified by approaching companies from four service industries, namely consultants offering middle and senior management training and recruitment services, banks offering corporate banking, software development and maintenance houses and freight shipping providers in Athens, Greece.Findings – SERVQUAL appears to suffer from significant methodological problems when applied to b2b services. This comes hardly as a surprise since the instrument has been developed using consumer markets as a frame of reference.Practical implications – For practitioners, the major implication is that the developed instrument allows them to make the most out of their effo...

/pdf/measuring-service-quality-in-b2b-services-an-evaluation-of-3kcrrrhlr4.pdf

Measuring service quality in b2b services: an evaluation of the SERVQUAL scale vis‐à‐vis the INDSERV scale

Evaluation of health care is equated with the intent to continuously improve rather than to control its quality. Quality is seen as being affected by and therefore embracing 1) patient's health status and attitudes on entry to care, 2) suitability of the delivery machinery (structure), 3) application of care (process), and 4) outcomes of application to care. It is suggested that analysis in depth at two points of this paradigm, the entry to care and the outcomes of care, are the most likely to reveal the basis of failures. These may largely reside with the patient, the health care delivery structure, or the inability of the patient and care deliverer to perform together appropriately. These suggest the kind of interventions most likely to provide good results in the future. Such interventions or changes are very likely to call for significant changes in many social institutions, including that of the health care delivery machinery. Focusing on process is seen as contributing to professional education but less likely to result in meaningful changes because it works on the assumption that what the professional in a given illness cycle offers is the main factor in achieving better quality care.

Henrik L. Blum

Papers

Evaluating health care.