A paradox of service quality in Turkey: The seemingly contradictory relative importance of tangible and intangible determinants of service quality

Purpose – Are there cases or contexts where certain groups of customers who are expected to place a considerable emphasis and importance on the tangible qualities of services end up attributing a greater weight to the intangible qualities? This paper attempts to exemplify the existence of such cases, and explain why such cases are, at times, paradoxical in nature, and how such cases could arise. Design/methodology/approach – The paper employs a structuralequationmodeling approach to theorize about, and empirically examine, the tangible and intangible determinants of service quality. The model and the path developed in the paper also capture the relationship between service quality and customer satisfaction. Using AMOS, the empirical estimation of the model is carried out. Findings – The central finding is that all intangible factors associated with service quality turn out to be unequivocally more important than the tangible ones in the Turkish nonprofit healthcare sector under investigation. In other words, intangible factors appear to play a statistically more significant role compared with tangible factors in determining the overall customer satisfaction and the quality of nonprofit healthcare services. Considering that, in developing countries, tangible factors are expected to be among the most scarce, and hence, most valuable ones, the relative unimportance of tangible factors constitutes a paradox to be explained and resolved. Originality/value – This paper contributes to the literature by bringing to light a striking phenomenon which is largely unnoticed in the literature, namely that, in certain cases, there might exist a fundamental asymmetry and difference between the influences of tangible and intangible factors on service quality, and that difference in certain contexts, as in the case of the Turkish healthcare sector, constitutes a paradox to be explained. The paper demonstrates the possibility of such paradoxical cases and provides cultural and sectorspecific explanations for this seemingly puzzling phenomenon in question. © 2005, Emerald Group Publishing Limite

THE EFFECT OF PATERNALIST LEADERSHIP ON ORGANIZATIONAL CITIZENSHIP BEHAVIOR

The aim of this study is to examine the impact of paternalist leadership behaviors on organizational citizenship behavior. The sample of the study consists of 535 healthcare professionals working in a private hospital in Istanbul. Correlation Analysis and Simple Linear Regression Analysis were used to examine the relationship between the measured variables. As a result of the research, it was found that paternalist leadership has a positive and moderate effect on organizational citizenship behavior (r = 0.427, p <0.01) and 18.3% of the changes in organizational citizenship behavior are explained by paternalist leadership. Our study shows that paternalistic leadership has a significant impact on the organizational citizenship behavior of health workers. By exhibiting paternalistic leadership behavior, health administrators can enable health workers to display more organizational citizenship behavior

The impact of market orientation on NSD and financial performance of hospital industry

Purpose - The principal aim of this study is to determine the critical factors of market orientation (MO) and to measure its effect on new service development (NSD) and financial performance of hospital industry in Turkey. Design/methodology/approach - Drawing on a self-administered questionnaire, the data were collected from a sample of privately-held general hospitals within the city of Istanbul in Turkey. Based on theoretical considerations, a model was proposed to examine the interrelationships among MO, NSD-performance and financial performance. Findings - Data analysis reveals that while MO has a strong and positive effect on NSD-performance, it has no significant effect on financial performance. Also a strong and positive relationship was noted between NSD-performance and financial performance. Finally, the findings also provided evidence for the mediating role of NSD-performance in. the relationship between MO and financial performance in the hospital industry. Research limitations/implications - First, due to relatively small sample size, a caution should be exercised when interpreting the results. Second, the data were collected from hospitals in Turkey, which may restrict to some extent generalizability of findings. Third, we relied on the subjective evaluations of senior, executives. It would therefore be useful to replicate the results with objective measures of performance indicators. Practical implications - Although there is compelling evidence that MO has a positive effect on business performance, it alone may not be able to produce superior performance. Many hospitals are committed to MO and new services development. The framework clearly indicates that a strong commitment to both the NSD-performance and marketing areas is essential for improving the financial performance of hospitals. Also, to remain competitive in today's healthcare industry, hospital managers should all keep pace with the daily changes in the market place and stay attuned to NSD activities and quality management practices. Originality/value - The main thrust of this study is to investigate whether the relationship between MO and financial performance is mediated by NSD-performance in hospital industry. This constitutes the novelty of this research as most prior empirical research investigating a mediating mechanism through which MID affects firm performance largely focused on other factors with no or little emphasis being placed on NSD activities or NSD-performance in healthcare context

System dynamics modeling of a knowledge management process: A case study in Turkish Airlines

Tangible assets like land, machinery and equipment are crucial for an organization, while knowledge and intellectual capital are considered to be the primary source to complete an Organization. Knowledge management is defined as 'any practice of creating, acquiring, capturing, sharing and using knowledge to increase organizations' performance.' Knowledge management aims at managing positive and negative critical knowledge functions in different kinds of operations, identifying new strategies and new products, augmenting human resource management, and accomplishing number of targeted objectives or goals. Knowledge management process consists of four sets. These are creation or generation, storage or retrieval, transfer or sharing, and utilization. The main purpose of this study is to examine how the activities of knowledge management process and the variables excluded from knowledge management process interact with each other and how they affect organization performance by using system dynamics model specific case of Turkish airline. This study indicates that the activities of knowledge management process have a positive relationship with each other. There is also a positive relationship between these activities and organization performance

An evaluation of SERVQUAL and patient loyalty in an emerging country context

The growth of the service sector in the US spawned a strong interest and growing body of literature related to the measurement of service quality. SERVQUAL, a multi-item scale first proposed by Parasuraman, Zeithaml, and Berry (1985), has been used for measuring customer perceptions of service quality across a wide variety of service environments including healthcare in the US. There is a dearth of research that relates to an evaluation of SERVQUAL across various cultural and economic environments. This empirical study is an attempt to fill this gap by focusing on the healthcare environment in Istanbul, Turkey. In addition to a rigorous evaluation of SERVQUAL using confirmatory factor analysis, measures of internal consistency and discriminant validity, the relationships between the various dimensions of SERVQUAL, an overall measure of service quality and patient loyalty are evaluated using structural equations modelling and path analysis. A number of hypotheses are developed and tested. The results suggest that SERVQUAL and its dimensions of perceived service quality are reliable and valid across cultural and economic environments in the context of healthcare/hospital albeit some need for adaptation. Path analysis indicates that service quality directly affects both overall quality of and feelings toward hospital services. Overall quality affects customer repatronage intentions and feelings towards hospital services. However, no significant relationship was found between service quality and repatronage intention

A low performance-low quality trap in the non-profit healthcare sector in Turkey and a solution

This paper develops a dynamic model of service performance and service quality and shows that the non-profit healthcare sector in Turkey, which performs a useful function of providing affordable healthcare services to low-income people, is trapped into a stable intertemporal equilibrium characterized by low levels of service performance and service quality. The model enables us to present an empirically demonstrated solution to this problem of low performance-low quality trap. The solution, which stipulates a particular policy for the supplier's provision of services, helps the sector to move from the low performance-low quality equilibrium to a high performance-high quality equilibrium

Sağlık Yöneticilerinin Paternalist (Babacan) LiderlikDavranışlarının Çalışanların İş Doyumu Üzerine Etkisi

Bu araştırma, sağlık yöneticilerinin göstermiş olduğu paternalist liderlik davranışlarının, sağlık çalışanlarının iş doyumu üzerindeki etkisini incelemek amacı ile yapılmıştır ve ilişkisel tarama modelinde betimsel bir çalışmadır. Araştırma, Kastamonu, Çankırı ve Karabük illerinde bulunan kamu ve özel hastanelerde, Temmuz 2016 – Mart 2017 tarihleri arasında yapılmıştır ve araştırmaya toplam 683 sağlık çalışanı katılmıştır. Araştırmaya katılanların %67,9’u kadın (kamu 329, özel 135), %32,1’i (kamu 152, özel 67) erkektir. Verilerin analizinde SPSS16 programı kullanılmıştır. Verilerin analizinde bağımsız örneklemler için t- testi, tek yönlü varyans analizi, pearson korelasyon analizi ve regresyon analizi kullanılmıştır. Yapılan korelasyon ve regresyon analizleri sonucuna göre paternalist liderliğin, iş doyumu üzerinde anlamlı ve yüksek düzeyde pozitif yönlü bir etkisi olduğu saptanmıştır (β=530, t=16,322, p<0,01).Bu araştırma, sağlık yöneticilerinin paternalist liderlik davranışları arttıkça, sağlık çalışanlarında iş doyumunun da arttığını ortaya koymuştur.Job satisfaction is one of the most important requirements so that health workers can be successful in their work. In order to get adequate and quality health services of patients, health workers must be satisfied with the their institution and their work. This study aims to measure the job satisfaction of health workers, to identify factors affecting negatively and positively job satisfaction, to contribute to literature and health administrators. The study population consists 140 health workers working in a public hospital in Kastamonu. The study sampling consists 99 health workers agreed to participate to study. Data collection tool used in the study included a Demographic Information Form and Minnesota Job Satisfaction Scale. Intrinsic job satisfaction average score of health workers is 3,02 and in terms of intrinsic job satisfaction of health workers (achievement, recognition or appreciation, job responsibility) was determined to be satisfactory. Extrinsic satisfaction average score of workers is 2,63. Now that this rating is below 3 neutral score of scale, in terms of extrinsic job satisfaction of workers (agency policy and management, control method, relationships with managers and subordinates, work conditions, wages) was determined to be dissatisfied. It is believed to be useful taking corrective and remedial measures in this issue and review of factors of extrinsic job satisfaction such as agency policy and management, control method, relationships with managers and subordinates, work conditions, wages by managers