The Influence of Relational Marketing and Brand Image on Customer Loyalty Mediated by Patient Experience
DOI:
https://doi.org/10.59188/eduvest.v5i2.50869Keywords:
Relationship Marketing, Brand Image, Customer Loyalty, Patient ExperienceAbstract
Background: Based on a preliminary survey, it was found that there are still problems in: patient loyalty, complaint handling, and suboptimal communication in the outpatient installation service of dr. Sitanala General Hospital Tangerang. Research Objective: aims to analyze the direct and indirect effects of relational marketing and brand image on customer loyalty with patient experience as an intervening variable. Research Method: This quantitative study uses an explanatory method with a cross-sectional design. Data were collected from 119 patients of the Outpatient Installation of dr. Sitanala General Hospital Tangerang, who had been treated at least twice. Data analysis used Structural Equation Modeling - Partial Least Squares (SEM-PLS). Research Results: Shows that the brand image variable is the variable that has the most positive and significant effect on customer loyalty in the outpatient installation of dr. Sitanala General Hospital Tangerang. While patient experience partially mediates (complements) the effect of relational marketing and brand image on customer loyalty. In a managerial context, this study can be a basis and reference for hospitals on the importance of creating and building a positive and strong brand image consistently and continuously in order to form a positive and strong patient perception in order to achieve customer loyalty. In addition, it is also necessary to make efforts to improve the quality of interactions with patients and strive to achieve a positive patient experience.
References
Aaker, AD (2013). Brand Equity Management (Aris Ananda (trans.)). Spectrum Lead Partners.
Adyputra, I., Madjid, R., Ode, L., & Adam, B. (2024). The Role Of Patient Experience And Patient Satisfaction In Mediating The Influence Of Hospital Reputation And Quality Of Service Towards Patient Loyalty. Journalofresearchadmin.Com, 6(2), 37–52. https://journalofresearchadmin.com/index.php/jra/article/view/17
Agency for Healthcare Research and Quality (AHRQ). (2024). What is Patient Experience? https://www.ahrq.gov/cahps/about-cahps/patient-experience/index.html
Amoako, G.K., Kutu-Adu, S.G., Caesar, L.D., & Neequaye, E. (2019). Relationship Marketing and Repurchase Intention in Ghana's Hospitality Industry: An Empirical Examination of Trust and Commitment. Journal of Relationship Marketing, 18(2), 77–107. https://doi.org/10.1080/15332667.2018.1534059
Arslan, T., Çandereli, Z. Ö., Kitapçi, OC, Kitapçi, N. Ş., Kiliç Aksu, P., Köksal, L., Özdamar, E. Ö., Yay, M., Ecevit Alpar, Ş ., & Mumcu, G. (2022). Do Patient Experiences Have a Mediating Role on Patient Loyalty? Journal of Patient Experience, 9, 1–7. https://doi.org/10.1177/23743735221103027
Asmaryadi, A., Pasinringi, SA, Thamrin, Y., & Muis, M. (2020). Influence of patient experience and hospital image on patient loyalty in Meloy Public Hospital of Sangatta, East Kutai Regency. Open Access Macedonian Journal of Medical Sciences, 8(T2), 147–151. https://doi.org/10.3889/oamjms.2020.5213
Asnawi, AA, Awang, Z., Afthanorhan, A., Mohamad, M., & Karim, F. (2019). The influence of hospital image and service quality on patients' satisfaction and loyalty. Management Science Letters, 9(6), 911–920. https://doi.org/10.5267/j.msl.2019.2.011
Assael. (1992). Consumer Behavior. Indonesian Edition. Prentice Hall Inc.
Baker, B. (2018). The Performance of Medicine: Techniques From the Stage to Optimize the Patient Experience and Restore the Joy of Practicing Medicine. Best Job Productions, LLC.
Berry, L.L. (2002). Relationship Marketing of Services Perspectives from 1983 and 2000. Journal of Relationship Marketing, 1(1), 59–77. https://doi.org/10.1300/J366v01n01_05
Biçer, D.F. (2020). Marka İmajı ile Algılanan Kalite, Memnuniyet ve Bağlılık İlişkisinin Yapısal Eşitlik Modeliyle İncelenmesi: Bir Hizmet İşletmesi Örneği. Turkish Journal of Marketing, 5(2), 158–178.
Boyle, B. (2015). The Patient Experience: The Importance of Care, Communication, and Compassion in the Hospital Room. Skyhorse. https: //books.google.co.id/books?id=2S2CDwAAQBAJ
Buttle, F. A. (1996). Relationship Marketing: Theory and Practice. SAGE Publications Ltd.
Chen, X., Zhao, W., Yuan, J., Qin, W., Zhang, Y., & Zhang, Y. (2022). The Relationships Between Patient Experience with Nursing Care, Patient Satisfaction and Patient Loyalty: A Structural Equation Modeling. Patient Preference and Adherence, 16, 3173–3183. https://doi.org/10.2147/PPA.S386294
Chishti, H., Rauf, R., Iram, T., Saddiq, AR, Awaiz, D., Yaqoob, A., Farhan Tabassum, M., & Tabassum, MF (2023). The Impact Of Hospital Brand Image On Patient Loyalty And Patient Behavioral Intention: The Mediating Role Of Patient Satisfaction. Journal of Namibian Studies: History Politics Culture, 37, 614–637. https://www.namibian-studies.com/index.php/JNS/article/view/5492
Christopher, M., Payne, A., & Ballantyne, D. (2001). Relationship Marketing: Creating Shareholder Value. Butterworth-Heinemann.
Day, G.S. (1969). A Two-Dimensional Concept of Brand Loyalty. Journal of Advertising Research, 9(3), 29–35.
Garratt, A. M., Bjaertnes, A., Krogstad, U., & Gulbrandsen, P. (2005). The OutPatient Experiences Questionnaire (OPEQ): Data quality, reliability, and validity in patients attending 52 Norwegian hospitals. Quality and Safety in Health Care, 14(6), 433–437. https://doi.org/10.1136/qshc.2005.014423
Ghozali, I. (2016). Multivariance Analysis Application with IBM SPSS 23 Program, Third Edition. Undip Publishing Agency.
Ghozali, I., & Latan, H. (2012). Partial Least Square: Concept, Technique and Application. SmartPLS 2.0 M3. Diponegoro University Publishing Agency.
Giordano, L.A., Elliott, M.N., Goldstein, E., Lehrman, W.G., & Spencer, P.A. (2009). Development, implementation, and public reporting of the HCAHPS survey. Medical Care Research and Reviews, 67(1), 27–37. https://doi.org/10.1177/1077558709341065
Griffin, J. (2005). Customer Loyalty: How to Earn It, How to Keep It. McGraw Hill.
Grönroos, C. (1994). From Marketing Mix to Relationship Marketing. In Management Decision (Vol. 32, Issue 2). https://doi.org/10.1108/00251749410054774
Hair, J.F., Hult, G.T.M., Ringle, C.M., & Sarstedt, M. (2017). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). Thousand Oaks. SAGE Publications.
Hu, Y., Zhang, Z., Xie, J., & Wang, G. (2017). The outpatient experience questionnaire of comprehensive public hospitals in China: Development, validity and reliability. International Journal for Quality in Health Care, 29(1), 40–46. https://doi.org/10.1093/intqhc/mzw133
Huirse, S. A. H., & Panique, J. C. A. (2024). Relationship Marketing and customer loyalty in the company Saga Falabella SA Cusco. SCT Proceedings in Interdisciplinary Insights and Innovations, 2(206), 1–13.
Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press. https://doi.org/10.1111/j.1945-1474.2002.tb00463.x
Keller, K. L. (1993). Conceptualizing, Measuring, and Managing Customer-Based Brand Equity. Journal of Marketing, 57, 1–22.
Kotler, P., & Keller, K. (2016). Marketing management (15th ed.). Pearson Education, Inc.
Kotler, P., Keller, K. L., Brady, M., Goodman, M., & Hansen, T. (2016). Marketing Management 3rd Edition. In Pearson education ltd: Vol. 3rd Editio (Issue Marketing Management). Pearson. www.pearson.com/uk
Levy, M., & Weitz, B. A. (2012). Retailing Management. McGraw-Hill/Irwin.
Lin, W., & Yin, W. (2020). Service Quality, Brand Image, Perceived Value, Patient Satisfaction and Loyalty in China's Private Dental Clinics. Research Square, 1–13.
Liu, S., Li, G., Liu, N., & Hongwei, W. (2021). The Impact of Patient Satisfaction on Patient Loyalty with the Mediating Effect of Patient Trust. Inquiry (United States), 58, 1–11. https://doi.org/10.1177/00469580211007221
Mihardjo, LWW, Sasmoko, Alamsjah, F., & Elidjen. (2019). The influence of digital customer experience and electronic word of mouth on brand image and supply chain sustainable performance. Uncertain Supply Chain Management, 7(4), 691–702. https://doi.org/10.5267/j.uscm.2019.4.001
Morgan, R. M., & Hunt, S. D. (1994). The Commitment-Trust Theory of Relationship Marketing. Journal of Marketing, 58(3), 20. https://doi.org/10.2307/1252308
Mursyid, P., Maidin, A., & Syamsuddin. (2022). The Influence of Price, Service Quality and Relationship Marketing on Patient Satisfaction in the Outpatient Installation of the Haji Hospital, South Sulawesi Province. Journal of Asian Multicultural Research for Medical and Health Science Study, 3(2), 59–68.
Nanggong, A., Mohammad, A., & Sabila, A. (2022). Leveraging Customer Experience, Brand Image and Store Atmosphere for Millennials Loyalty: An Empirical Analysis of Mediation. Management Analysis Journal, 11(4), 349–358. https: //journal.unnes.ac.id/sju/index.php/maj/article/view/56488
NHS. (2011). NHS Patient Experience Framework. Department of Health, 17273, 17273. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215159/dh_132788.pdf
NHS. (2013). The Patient Experience Book: A collection of the NHS Institute for Innovation and Improvement's guidance and support. Institute for Innovation and Improvement. https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/Patient-Experience-Guidance-and-Support.pdf
Nugraha, PG (2023). The Impact of Relationship Marketing and Service Quality on Satisfaction and Its Impact on Patient Loyalty at Hospital: Case Study of a Hospital in Garut Regency. MINISTRATE, 5(3), 451–460.
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), 1–13. https://doi.org/10.4102/sajbm.v54i1.3832
Oliver, R.L. (1999). When is consumer loyalty? Journal of Marketing, 63(Special Issue 1999), 33–44.
Oliver, R.L. (2010). Satisfaction: a behavioral perspective on the consumer. M.E. Sharpe, Inc.
Osei-Frimpong, K., Asante, K., Nkrumah, M., & Owusu-Frimpong, N. (2019). Developing customer loyalty in healthcare. In Health Service Marketing Management in Africa (Issue January). https://doi.org/10.4324/9780429400858-15
Park, HN, Park, DJ, Han, SY, Tae, JY, Jung, KH, Bae, EJ, & Yoon, JY (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
Peck, H., Payne, A., Christopher, M., & Clark, M. (1999). Relationship marketing: strategy and implementation. Butterworth-Heinemann. http: //books.google.co.uk/books?id=kP_DWa07x6MC
Press, I. (2007). Patient Satisfaction Understanding and Managing the Expenditure of Care. In Health Progress (Vol. 8). Health Administration Press.
Press, I. (2014). Concern for the patient's experience comes of age. Patient Experience Journal, 1(1), 4–6. https://doi.org/10.35680/2372-0247.1001
Rahayu, C. (2023). The Influence of Relationship Marketing on Patient Loyalty Mediated by the Value Co-Creation Behavior of Patients at the Dental and Oral Education Hospital in Jakarta. Journal of Social Research, 2(3), 781–802. https://doi.org/10.55324/josr.v2i3.737
Reeves, R., Coulter, A., Jenkinson, C., Cartwright, J., Bruster, S., & Richard, N. (2002). Development and Pilot Testing of Questionnaires for Use in the Acute NHS Trust Inpatient Survey Programme. Picker Institute Europe.
Robinson, S., & Etherington, L. (2006). Customer loyalty: A guide for time travelers. Palgrive Macmillan.
Sekaran, U., & Bougie, R. (2016). Research Methods For Business: A Skill Building Approach. John Wiley & Sons, Inc.
Shimp, T. A., & Andrews, J. C. (2018). Advertising, Promotion, and other aspects of Integrated Marketing Communications (10th ed.). Cengage Learning.
Snyder, R. (2015). A Physician Guidebook to the Best Patient Experience. ACHE Management.
Soen, RCJ, & Kristaung, R. (2023). The Influence Of Service Quality And Hospital Image For Patient Satisfaction And Loyalty Dental And Oral Hospital In Jakarta. Journal of Social Research, 2(8), 2679–2687. https://doi.org/10.55324/josr.v2i8.1323
Sofia, T. A. (2023). The Effect of Patient Satisfaction on Patient Loyalty Mediated by Patient Trust and Hospital Brand Image at the Jakarta Education Dental and Oral Hospital. Journal of Social Research, 2(3), 765–780. https://doi.org/10.55324/josr.v2i3.727
Steine, S., Finset, A., & Laerum, E. (2001). A new, brief questionnaire (PEQ) developed in primary health care for measuring patients' experience of interaction, emotion and consultation outcome. Family Practice, 18(4), 410–418. https://doi.org/10.1093/fampra/18.4.410
Sugiyono. (2017). Quantitative, Qualitative and R&D Research Methods. Alfabeta.
Sukartini, & Indrawati, RL (2018). Analysis of the Influence of Service Quality and Hospital Image on Inpatient Loyalty with Patient Satisfaction as Intervening Variable. Iarjset, 5(9), 75–83. https://doi.org/10.17148/iarjset.2018.5911
Tashtoush, L. (2023). Impact of Relationship Marketing on Customer Loyalty in Banking Sector. 2023 4th International Conference on Data Analytics for Business and Industry (ICDABI) New, 224–232. https://doi.org/10.34260/jbt.v2i2.38
Tsai, T.I., Liu, K.N., Xiao, Q., & Hu, C. (2021). The impact of experience on brand loyalty: Mediating effect of images of Taiwan hotels. Journal of China Tourism Research, 17(3), 395–414. https://doi.org/10.1080/19388160.2020.1777238
Tüfekçi, Z., & Eser, Z. (2023). Importance of relationship marketing and service quality on patient loyalty. International Dental Journal, 73, S15–S16. https://doi.org/10.1016/j.identj.2023.07.226
The 1945 Constitution.
Law Number 17 of 2023. (2023). Concerning Health.
Vimla, & Taneja, U. (2020). Navigating from Brand Image to Patient Loyalty: Mediating Effect of Service Quality and Patient Satisfaction. Journal of Health Management, 22(3), 430–445. https://doi.org/10.1177/0972063420937940
Webster, F.E., & Keller, K.L. (2004). A roadmap for branding. Brand Management, 11(5), 388–402.
Wolf, J. A. (2013). The patient experience: strategies and approaches for providers to achieve and maintain a competitive advantage. The Beryl Institute.
Zakkar, M. (2019). Patient experience: determinants and manifestations. International Journal of Health Governance, 24(2), 143–154. https://doi.org/10.1108/IJHG-09-2018-0046
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