Asymmetric Effects of Expectation Disconfirmation and Evaluability of Hospital Service Attributes on Consumer Satisfaction

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This study examines the determinants of consumer satisfaction of cancer patients with Dutch hospitals on the basis of perceived service attribute performance and disconfirmation of service attribute expectations. Evaluability theory argues that easy-to-evaluate attributes have a larger effect on consumer satisfaction than difficult-to-evaluate attributes. Predictions of asymmetric evaluations of gains and losses from prospect theory are combined with those from evaluability theory. Even though evaluability theory and expectancy-disconfirmation theory are not directly comparable, this study examines how evaluability influences the effects of asymmetric evaluations of positive and negative disconfirmation of service attribute expectations on consumer satisfaction. Furthermore, this study analyses the effect of patients’ hospital experience on evaluability and the effect of the overall health status of patients on satisfaction. This research was conducted by means of an online survey filled in by 198 Dutch cancer patients. Results showed a positive and significant effect of expectation disconfirmation on satisfaction. Additionally, negative disconfirmation had a larger effect on satisfaction than positive disconfirmation, supporting loss aversion theory. We did not find results supporting evaluability theory, as easy-to-evaluate attributes of hospital service did not have a significantly stronger effect on satisfaction than difficult-to-evaluate attributes. We found that patients who considered themselves to be experienced regarding hospitals would more easily view attributes as being easy-to-evaluate than non-experienced patients. No significant effect on this matter was found for the frequency of visits to the hospital. Strong evidence has been found for a positive correlation between self-reported health status and satisfaction, indicating that healthier people tend to be more satisfied with the hospital. We discuss both theoretical and managerial implications of our findings.
Faculteit der Managementwetenschappen