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theses

One of the most effective ways to improve access, and in turn service usage, is by reducing barriers to access and strengthening enablers to access. Drawing from social exchange theory, relationship marketing theory, service-dominant logic and behavioral model of health service utilization, I examine customer access in the context of health care. To explore this issue, I conduct two studies to examine the likelihood of customer-initiated missed service encounters and the likelihood of customer’s usage of preventive care services. In my first essay, I explore the following questions: How does a customer’s value of their relationship with a provider influence the likelihood of missed service encounters? How will incurring a service failure by a provider influence missed service encounters? How does the effect of loyalty to a provider influence the effect of service failures on future missed service encounters? Logistic regression results show that a customer’s met service history is critical to the success of customer-provider relationships and can have positive spillover effects to other relationships within the organization. Further, the results indicate that customer-provider relationships are reciprocal in nature. Provider-initiated service failures are found to weaken the value of the relationship between the customer and scheduled provider but can be buffered by a customer’s loyalty to their scheduled provider. In my second essay, I explore the following questions: How does a customer’s need for service, enabling factors and pre-disposing characteristics influence future preventive service usage? How do different groups of customer’s respond to the effect of enabling factors on future preventive service usage? Logistic regression results show that preventive service usage is influenced by the degree of need for a service, insurance coverage and type, and demographic variables. Of key interest are the findings that 1) the degree to which insurance coverage and type of coverage matters varies amongst different demographic cohorts, and 2) the type of insurance a customer carries influences the customer’s need for services. This research offers a novel account of the service encounter phenomenon and offers management frameworks to improve service usage. I conclude by offering theoretical and practical implications for marketers and public policy.

ETD_5769

Ph.D.

Includes bibliographical references

Includes vita

by Genevieve Elizabeth O’Connor

doi:10.7282/T3G44RXJ

ETD doctoral

The author owns the copyright to this work.