The present study aims to perform a segmentation of patients based on their loyalty behaviour. The analysis focuses on Valencia, a region in Spain that features a capitated financing and free-elective framework; such a framework is particularly suitable for this type of study because patient loyalty directly affects the system’s budget and economic viability. Using secondary data from the regional health council, the study focuses on relationships of influence and latent segmentation in answering seven research questions. The two-pronged statistical analysis is designed to analyse relationships of influence, on the one hand, and latent segmentation, on the other. Significant differences were found among the various scales analysed in the three patient loyalty behavioural models (capture, retention and desertion) for each variable within the scope, that is, subjective (gender, age and nationality) and circumstantial (size of the assigned and receiving hospital, location of the province of the assigned hospital). This finding indicates that it may be possible to develop patient profiles based on such variables to analyse different loyalty behaviours in patients and the impact of hospital communication strategies on these behaviours. Patient loyalty is essential to the viability of a capitated health care financing and management system. Likewise, identifying patient profiles would contribute to a better Valencian public health management. Accordingly, it might be applied to evaluate other health care financing systems.
AlcaideJ. C. (2010). Fidelización de clientes. Madrid: ESIC Editorial.
2.
ArberS.CooperH. (1999). Gender differences in health in later life: The new paradox?Social Science & Medicine, 48(1), 61–76.
3.
BagozziR. P.BumkrantR. E. (1979). Attitude measurement and behavior change: A reconsideration of attitude organization and its relationship to behaviour. Advances in Consumer Research, 6, 295–302.
4.
BaldingerA. L.RubinsonJ. (1996). Brand loyalty: The link between attitude and behaviour. Journal of Advertising Research, 36(6), 22–34.
5.
BarrosoC.MartínE. (1999). Nivel de servicio y retención de clientes: el caso de la banca en España [Service level and client retention: The case of the banking sector in Spain]. Revista Española de Investigación de Marketing ESIC, 9, 36.
6.
BellidoC. (2004). Explotación de datos para marketing relacional [Using data for relationship marketing]. En AlfaroM. (coord.). Temas clave en marketing relacional (pp. 107–119). Madrid: McGraw-Hill.
7.
BennetR.BoveL. (2002). Identifying the key issues for measuring loyalty. Australasian Journal of Market Research, 9(2), 27–44.
8.
BloemerJ.RuyterK.WetzelsM. (1999). Linking perceived service quality and service loyalty: A multi-dimensional perspective. European Journal of Management, 33, 1082–1106.
9.
BooraK. K.SinghH. (2011). Customer loyalty and its antecedents: A conceptual framework. Asia Pacific Journal of Research in Business Management, 2(1), 151–164.
10.
CaleroR.GallarzaM. G. (2014). Loyalty behaviour in patients: Applied analysis to the Alzira Model. International Review on Public and Nonprofit Marketing, 12(1), 89–91.
11.
CampoyL. F.SantacreuJ. (2008). La colaboración público-privada en el marco del Sistema Nacional de Salud. El caso especial del modelo valenciano a propósito de la concesión de Denia [Public-private partnership whithin the National Health System: The case of the Valentian model as it regards Denia concession]. Revista de Administración Sanitaria, 6(2), 297–321.
12.
CaviedesR. (2009). Concesiones sanitarias: garantizando la sostenibilidad del sistema [Health concession. Ensuring the sostenibility of the system]. In Informe Social. Santiago de Chile: Libertad y Desarrollo.
13.
CerveraM. (2006). La Agencia Valenciana de Salud [Valencia health agency]. Revista de Administración Sanitaria, 4(1), 33–54.
14.
ChiesaC. (2009). CRM. Las cinco pirámides del marketing relacional [The five pyramids of relationship marketing]. Barcelona: Ediciones Deusto.
15.
ChristensenC. M.BohmerR.KenagyJ. (2007). Will disruptive innovations cure health care? In Harvard Business School (Ed.), Harvard business review on managing health care (pp. 149–173). Boston: Harvard Business School Press.
ClarkeR. N.ShyavitzL. J. (1981). Marketing information and research. Health Care Management Review, 6(1), 73–78.
18.
CodurasA.Llano delJ.RaigadaF.QuecedoL.RodríguezM. J.ArandaI.. (2008). Gestión de tres procesos asistenciales según persona jurídica hospitalaria [Management of three health process acording to their legal form]. Sedisa s.XXI, 8, 44–55.
19.
DabholkarP. A.WallsS. (1999). Service evaluation and switching behaviour for experiential services: An empirical test of gender differences within a broader conceptual framework. Journal of Consumer Satisfaction, Dissatisfaction and Complaining Behavior, 12, 123–137.
20.
DickA. S.BasuK. (1994). Customer loyalty: Toward an integrated conceptual framework. Journal of the Academy of Marketing Science, 22, 99–113.
21.
DillonW. R.KumarA. (1994). Latent structure and other mixture models in marketing: An integrative survey and overview. In BagozziR. P. (Ed.), Advanced methods of marketing research (pp. 352–388). Cambridge: Blackwell.
22.
FottlerM. D.FordR. C.RobertsV.FordE. W. (2000). Creating a healing environment: The importance of the service setting in the new consumer-oriented healthcare system. Journal of Healthcare Management, 45(2), 91–106.
23.
FreemanG.HjortdahlP. (1997). What future for continuity of care in general practice?British Medical Journal, 314(7098), 1870–1873.
24.
GadeaS. (2009). Flujos de pacientes entre Departamentos de Salud de la Comunidad Valenciana [Patients fluxes among Departments in the Valencia health system] (Trabajo de Fin de Máster). Universidad Católica de Valencia.
25.
GallarzaM. G.Gil-SauraI. (2008). The concept of value and its dimensions: A tool for analysing tourism experiences. Tourism Review, 63(3), 4–20.
26.
García-ArmestoS.Abadía-TairaM. B.DuránA.Hernández-QuevedoC.Bernal-DelgadoE. (2010). Health systems in transition: Spain: Health system review. Copenhagen: European Observatory on Health Systems and Policies.
27.
GilliganC.LoweR. (1995). Marketing and health care organizations. New York, NY: Radcliffe Medical Press.
28.
HaferJ. C. (1987). Developing and operationalizing a product/service classification system for health care providers. Journal of Health Care Marketing, 7(3), 25–36.
29.
HagenaarsJ. (1993). Loglinear models with latent variables. Newbury Park, CA: SAGE Publications.
30.
HalowellR. (1996). The relationships of customer satisfaction, customer loyalty, and profitability: An empirical study. International Journal of Service Industry Management, 7(4), 27–42.
31.
HanX.KwortnikR. J.WangC. (2008). Service loyalty: An integrative model and examination across service contexts. Journal of Service Research, 11(1), 22–42.
32.
HeskettJ. L.SasserW. E.SchlesingerL. A. (1997). The service profit chain. New York, NY: The Free Press.
33.
HolbrookM. B. (1999). Consumer value. A framework for analysis and research. London: Routledge.
34.
HueteL. M. (1997). Servicios & beneficios. Bilbao: Ediciones Deusto.
35.
JacobyJ.ChesnutR. W. (1978). Brand loyalty measurement and management. New York: Wiley.
36.
JonesT. O.SasserW. E. (1995). Why satisfied consumers defect. Harvard Business Review, Nov–Dec, 88–99.
37.
JonesT. O.TaylorS. F. (2007). The conceptual domain of service loyalty: How many dimensions?Journal of Services Marketing, 21(1), 36–51.
38.
KolbA. Y.KolbD. A. (2005). Learning styles and learning spaces: Enhancing experiential learning in higher education. Academy of Management Learning and Education, 4(2), 193–212.
39.
KotlerP.ClarkeR. N. (1987). Marketing for health care organizations. Englewood Cliffs, NJ: Prentice Hall.
40.
LópezE.FindlingL.AbramzonM. (2006). Desigualdades en salud: ¿es diferente la percepción de morbilidad de varones y mujeres? [Inequalities in health: Is morbidity perception of men and women different?] Salud colectiva, 2(1), 61–74.
41.
McCutcheonA. L. (1987). Latent class analysis (Quantitative applications in the social sciences). Newbury Park, CA: SAGE Publications.
42.
McHughR. B. (1956). Efficient estimation and local identification in latent class analysis. Psychometrika, 21(4), 331–347.
43.
McLachlanG. J.BasfordK. E. (1988). Mixture models. Inference and applications to clustering. New York, NY: Statistics: Textbooks and Monographs.
44.
MorenoE. (2007). Ventajas e inconvenientes del copago en la financiación y gestión de la atención sanitaria urgente [Pros and Cons of copayment for financying and managing emergency health attention]. Emergencias, 19, 32–35.
45.
NaiduG. M.ParvatiyarA.ShethJ. N.WestgateL. (1999). Does relationship marketing pay? An empirical investigation of relationship marketing practices in hospitals. Journal of Business Research, 46, 207–218.
46.
OliverR. L. (1999). Whence consumer loyalty?Journal of Marketing, 63, 33–44.
47.
Pérez SomaloF. (2008). Marketing en tecnología sanitaria [Marketing in health technology]. Madrid: ESIC Ediciones.
48.
PetersonR. A.WilsonW. R. (1992). Measuring customer satisfaction: Fact and artifact. Journal of the Academy of Marketing Science, 20(1), 61–71.
49.
PettersonP. G. (2007). Demographic correlates of loyalty in a service context. Journal of Service Marketing, 21(2), 112–121.
50.
PhillipsL. W.SternthalB. (1977). Age differences in information processing: A perspective on the aged consumer. Journal of Marketing Research, 14(4), 444–457.
51.
Picón-PradoE.Lévy-ManginJ. P.Voces-LopezC. (2006). Modelización con estructuras de covarianzas en ciencias sociales: temas esenciales, avanzados y aportaciones especiales [Modeling with covariance structures in social sciences: Essential, advanced topics and special contributions]. Coord. Jean Pierre Lévy Mangin; Jesús Varela Mallou (Dir.) (pp. 403–417).
52.
PorterM. E.TeisbergE. (2006). Redefining health care. Boston, MA: Harvard Business Review Press.
53.
QuintanoM. (2004). La dinámica de la lealtad del cliente: un acercamiento teórico [Customer loyalty dynamics. A theoretical approach]. En AlfaroM. (coord.). Temas clave en marketing relacional [Key topics in relationship marketing] (pp. 27–48). Madrid: McGraw-Hill.
54.
RamblaV. (2005). La oportunidad perdida: la financiación sanitaria [The missed opportunity: Health financing]. Revista de Administración Sanitaria, 3(4), 553–565.
55.
RobinsonS.EtheringtonL. (2006). Customer loyalty: A guide for time travellers. New York, NY: Palgrave Macmillan.
56.
Rosa-JiménezF.MontijanoA. M.HerráizC. I.ZambranaJ. L. (2005). Solicitan las mujeres más consultas al área médica que los hombres?Anales de medicina interna, 22(11), 515–519.
57.
Rundle-ThieleS.Russell-BennettR. (2010). Patient influences on satisfaction and loyalty for GP services. Health Marketing Quarterly, 27(2), 195–214.
58.
ShethJ. N.ParkC. W. (1974). A theory of multidimensional brand loyalty (Faculty Working Papers). Illinois: College of Commerce and Business Administration, University of Illinois at Urban-Champaign.
59.
SlamaM. E.TashchianA. (1985). Selected socioeconomic and demographic characteristics associated with purchasing involvement. Journal of Marketing, 49(1), 72–82.
60.
SpakeD. F.BishopJ. S. (2009). The impact of perceived closeness on the differing roles of satisfaction, trust, commitment, and comfort on intention to remain with a physician. Health Marketing Quarterly, 26(1), 1–15.
TorresE.Vasquez-ParragaA. Z.BarraC. (2009). The path of patient loyalty and the role of doctor reputation. Health Marketing Quarterly, 26(3), 183–197.
63.
VerhoefP. C.DonkersB. (2005). The effect of acquisition channels on customer loyalty and cross-buying. Journal of Interactive Marketing, 19(2), 31–43.
64.
VermuntJ. K.MagidsonJ. (2003). A nontechnical introduction to latent class models. DMA Research Council Journal. Retrieved from statisticalinnovations.com
65.
VertinskyI. B.ThompsonW. A.UyenoD. (1974). Measuring consumer desire for participation in clinical decision making. Health Services Research, 9(2), 121–134.
66.
ZhangX.-x.LiuL.ZhaoX.ZhengJ.YangM.ZhangJ.-q. (2015). Towards a three-component model of fan loyalty: A case study of Chinese youth. PLOS One, 10(4), e0124312. DOI:10.1371/journal.pone.0124312
67.
ZinsA. H. (1998). Antecedents of satisfaction and customer loyalty in the commercial airline industry. Proceedings of the 27 EMAC Conference, 327–421.
