Customer attachment and its role in patienthealthcare provider relationships
Establishing, maintaining and enhancing long-term, profitable patient relationships are essential for hospitals in the competitive South African healthcare market. Hospitals have to focus on customer attachment as a key differentiator to competition. Attachment consolidates the bond between customer and organisation, a prerequisite for building a reciprocal long-term relationship with profitable customers. Relationship marketing literature acknowledges this, but shows limited understanding of developing and maintaining attached customers. Long-term patient relationships are crucially important, but attachment in the South African hospital industry remains peripheral. This study determines the interrelationships in the South African hospital industry among respondents' attachment and the key relationship marketing constructs (consumption emotions, loyalty, involvement, satisfaction, relationship value, fear of relationship loss and forgiveness). The study population was comprised of 303 patients from the Gauteng, KwaZulu-Natal and North West provinces of South Africa. The respondents' attachment to their hospitals and their services was generally positive, as was the relationship between the respondents' attachment and their positive consumption emotions. There was a negative relationship between the respondents' attachment and their negative consumer emotions. Hospitals should therefore identify attached patients whose positive consumption emotions would probably increase during service delivery, as opposed to their negative consumption emotions, which would decrease, especially with the activation of their internal working models of attachment especially when encountering emotional experiences like service failure. The results also indicated that the respondents' involvement and relationship value significantly influenced attachment, while the latter influenced their loyalty, fear of relationship loss and forgiveness. Statistically, loyalty significantly influenced the respondents' involvement. Ultimately, two prospective mediating effects were possible. The results revealed that the indirect effect of attachment on the relationship between relationship value and forgiveness was significant. Further, the indirect effect of attachment on the relationship between relationship value and fear of relationship loss was significant. South African hospitals were therefore advised to employ strategies that would encourage patients to become more involved and add value to the relationship, thereby improving their efforts at attachment and loyalty. To gain the benefits of patients' loyalty, fear of relationship loss, and willingness to forgive, hospitals are advised to establish patient attachment by nurturing the bonds between them. They should also emphasise the importance of attachment in the relationship between relationship value and forgiveness and relationship value and fear of relationship loss. Lastly, after considering the various findings, it can be inferred that hospitals should apply the same strategies, and focus on the same factors cited in the study (consumption emotions, involvement, relationship value, forgiveness, loyalty and fear of relationship loss) which would generally improve their efforts to encourage and strengthen attachment. This study makes theoretical and practical contributions, enhancing marketing researchers' and managers' understanding of the antecedents and outcomes of patients' attachment to their hospitals. This research also contributes to the investigations into customer attachment. In addition, it is the sole study in the South African hospital industry to focus specifically on the antecedents and outcomes of patients' attachment to their hospitals.
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