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Section 1. Marketing
Dr. Anietie Peter Akpan, Department of Business Management University of Uyo Akwa Ibom State E-mail: anietiepakpan@yahoo.com Dr. Samuel George Etuk, Department of Marketing University of Uyo Akwa Ibom State
TANGIBILISATION OF SERVICE AND CUSTOMER SATISFACTION IN HOSPITALS: IMPLICATION FOR MANAGEMENT
Abstract: This study examined the two dimensions of tangibilisation; operations based and marketing based tangibilisation as it affects customer satisfaction in three tertiary hospitals in the Niger Delta region of Nigeria. A sample size of 598 respondents was derived and data collected were subjected to statistical analysis using both descriptive and inferential statistics. Findings from the study shows that both dimensions of tangibilisation of service positively predicts customer satisfaction in the hospitals. Some specific managerial implications that will enhance customer satisfaction were drawn from the study.
Keywords: tangibilisation, intangibility, customer satisfaction.
Introduction been one of the biggest challenges of managers of
Quality of service and the satisfaction of the service-providing firms. consumers of service has been a key research issue According to Webster's Dictionary [2, 1173], inover the years. This is not strange if one takes into tangibility is defined as "the quality or state of some-account that quality is considered a relevant factor thing that cannot be touched or perceived by touch; in explaining the competitiveness and viability of impalpable; imperceptible; the quality or state of the organizations, as well as positive experiences something that cannot be defined or determined of people in their consumption activities. Quality with certainty or precision". Service offering firms of service, through the satisfaction that it is capable need to tackle intangibility and 'tangibilize' their ser-of generating, brings about repeated patronage by vice offerings in order to bring in a better customer customer and influences the economic prosperity of perception towards their offerings, reduce the cli-organizations [1, 180-188]. Therefore, given the fact ent's perceived risk, and enhance the assessment of that service quality influences customer satisfaction, services [3, 292-302].
meeting the challenge of intangibility and confront- What complicates an effective handling of the ing the issue of how best to communicate the 'intan- aforementioned issue is the fact that there has been gible' characteristic of service to the customers has little effort to develop management practices based
on the provision of services. Instead, management of service providing companies borrow ideas from the manufacturing sector, meaning that the frameworks put to use are not necessarily optimized for services [4, 321-335].
As glean from literature, there are two different ways of tangibilization. Operations Based Tangibili-zation (OBT) and Marketing Based Tangibilization (MBT) [5, 747-772]. Operations Based Tangibilization (OBT) works with the intention of decreasing the client's sense of intangibility after the service encounter process and involves all the operational activities that are carried out by the service firms during the service encounter process. On the other hand, Marketing Based Tangibilization (MBT) focuses on raising the potential client's sense of tangibility before the service encounter process, and involves most of the marketing activities carried out by the service-offering firms [5, 747-772]. This study intends look at extent of influence of both ways of tangibilisation.
Theoretical Nexus
Services, generally, require a different managerial approach and elicit a different response from consumers [6, 563). This is generally perceived to be the result of their inherent characteristics; intangibility, variability, perishability and inseparability. Intangibility is often argued to be most important of these generic differences. This is so because tangibility is the basis for determining whether or not an offering is a product or a service [7, 681]. Also, it is generally regarded to be the primary source from which the other three characteristics emerge. Intangibility, as a service characteristics, plays a crucial role in how service-producing organizations are managed and how its strategies are formed [8, 447-469]. It is key to how customers perceive service quality.
Service quality has been defined by several authors in a number of ways. [9, 420-450] defined service quality as global judgement or attitude related to the superiority of service relative to competitive
offerings. To [10, 27-37], service quality is customers' overall impression of the relative inferiority/superiority of the organisation and its offerings. From the above definitions, it can be inferred that service quality is a function of customer satisfaction based entirely on the perception of the customer. This implies that when there are no tangible cues to a service, customers' perception of the service may be misconstrued.
Theoretically, service quality is divided into two school of thoughts, namely, the European school of thought and the American school of thought. The European school of thought led by [11, 964] is based on the fact that customers evaluate service quality from two perspective; the functional and technical perspectives. However, the European school overlooked the physical environment of the place where the service is being delivered and /or exchanged [12, 26-38]. The American school fills this gap by conceptualising service quality as the difference between the overall gap between the customers' perception and expectation of service delivery [13, 41-50; 14, 21-240; 9, 420-450 and 15, 111-124].
The American school of thought gave birth to the SERVQUAL scale of measuring service quality. This scale was made up of10 dimensions which was later reduced to five dimensions, namely, reliability, tangibility, responsiveness, assurance and empathy. Of these five dimensions, four (i.e. reliability, responsiveness, assurance and empathy) emphasized social/interpersonal interaction between employee of the service delivery organisation and the customer. Parasumaran and colleagues pointed out that social/ interpersonal interaction in services is more important than the physical (tangible) aspect of services [13, 41-50]. They confirmed this idea through the study of the expectations of customers and observing that the tangible aspects occupied a secondary place in their interests [16, 1-12].
However, this predominance of social/interpersonal interaction does not have to occur in all service organizations. This is so based on typologies
of service organisation, where it is assumed that each type of service has peculiarities that should be taken into account in research [17, 90-99]. A critical factor is the presence of the customer in service organizations. There are services that are provided while the user is at home or at work and not physically present at any facilities of the service providers while service is being delivered (e.g. telephone line), but others are delivered and/or consumed in the organization's facilities (for example, hospital). The results obtained by Parasuraman et al., with respect to the scarce importance attributed to the tangible aspects, have to do with the types of service organizations studied. They focused on the banking services and insurance services. In these type of services, what contribute to customer satisfaction is how the customers perceive their interaction with the employee and not the physical conditions of the facilities. Aspects such as the provision of adequate security, employee's ability to solve problems or the trust, confidence and competence the employees transmit in the course of the interaction are important.
There are indications that tangibilisation of service are relevant in sectors where the services delivered and/or consumed in the organization's facilities such as hospitals. However, it has not been specifically tested the extent to which tangibilisation can predict customer satisfaction. This study seeks to establish the extent to which tangibilisation predicts customer satisfaction and the managerial implication of this influence in hospitals using Operations Based Tangibilization (OBT) and Marketing Based Tangibilization (MBT). Against this backdrop, this study attempts to provide answers to the following research questions:
i. To what extent does tangibilisation of services predicts customer satisfaction in tertiary hospitals in the Niger Delta region of Nigeria?
ii. What are the managerial implications of tangibilisation of services in tertiary hospitals in the Niger Delta region of Nigeria?
Methodology
The study was conducted in three public tertiary hospitals located in the Niger Delta region of Nigeria. The target population of the study comprised all the patients that visit the General Outpatient Departments (GOPD) of the three hospitals for medical treatment. Available records in the respective hospitals were used to compute the average weekly population of patients visiting the General Outpatient Departments (GOPD) of these hospitals over a one year period. From the average weekly population of patients computed, a sample size of 598 was derived for this study by applying the Taro Yamane formula for sample size determination. For this study, the Service Tangibilisation and Customer Satisfaction Questionnaire (STCSQ) was used as the instrument for data collection. The STCSQ was subjected to face and content validity through a pilot study using 20 patients. The pilot study helped in fine-tuning the items in the questionnaire and enhanced the validation process. Cronbach Alpha reliability statistics was adopted to test the reliability of the instrument. A reliability coefficient of 0.76 was obtained.
The copies of questionnaire were administered to the respondents in the general outpatients department of respective hospitals during official hours. The questionnaire was administered and retrieved the same day. Judgment sampling was adopted due for this study. Descriptive statistics such as frequency distribution and percentage analysis was used to describe the demographic characteristics of respondents. Regression analysis was used to determine the extent to which the independent variable (tangibilisation) predicts the dependent variable customer satisfaction. The regression model for this study was stated implicitly as: 7 = F X X) + e.
Where Y = customer satisfaction
X = operations based tangibilisation;
X2 = market based tangibilisation.
Results and Interpretation
Table 1. - Respondents' Profile
S/N Sample Characteristics Number of Respondents Respondents (%)
1 Sex
Male 304 50.7
Female 294 49.3
2 Age
Less than 20 4 0.7
20-30 51 8.5
31-40 234 39.1
41-50 283 47.5
Above 50 23 3.7
3 Education
No formal education 17 2.8
Primary education 149 24.9
Secondary education 206 34.4
Tertiary education 226 38.8
Table 1 shows that male and female respondents constituted 50.7% and 49.3% respectively; 0.7% were less than 20 years of age, 8.5% were aged between 21 and 30 years and 39.1% of the respondents were aged
From the result in Table 2, the adjusted R-square ofthe regression analysis is 0.728. This finding suggest that tangibilisation of services predicts 72.8% of the variance in customer satisfaction in tertiary hospitals in the Niger Delta region of Nigeria. The analysis of variance (ANOVA) result [i.e. F = 122.825, p < 0.005] confirmed that tangibilisation of services significant-
between 31 and 40 years. Those between the age of 41 and 50 were 47.5% and 8.4% were above 50 years of age. Also, a good majority of them 97.2% have one form of education or the other.
ly influence customer satisfaction. This result implies that tangibilisation of services in tertiary hospitals in the Niger Delta region of Nigeria predicts customer satisfaction to a high extent.
Furthermore, from the standardized coefficient of the beta weights, it can be observed that all dimensions of tangibilisation yielded significant impact on
Table 2.- Multiple regression analysis tangibility and customer satisfaction
Variable Beta Estimate (ß) Standard Error T score P value Remark
Constant (a 11.035 7.521 1.467 0.083 -
Marketing based tangibilisation 0.412 0.100 4.120 0.001 Significant
Operations based tangibilisation 0.432 0.065 6.646 0.000 Significant
R2 0.804
Adjusted R2 0.728
Std Error of Estimate 0.01505
F- Statistics 122.825
Dependent variable: customer satisfaction
organizational performance (p < 0.05). However, "operations based tangibilisation" made the highest significant contribution towards predicting customer satisfaction in tertiary hospitals in the Niger Delta region of Nigeria (p = 0.432, t = 6.646, p < 0.05). This implies that a unit increase in operations based tan-gibilisation by tertiary hospitals in the Niger Delta region of Nigeria will result in 0.432 unit increase in customer satisfaction in those hospitals. This result is consistent with (Vargo and Lusch, 2004) whose contribution established a positive relationship between tangibilisation of service and customer satisfaction. This also agrees with Tarn (2005) and Santos (2002) whom in their respective studies suggested tangibilisation of services as a way of enhancing customer satisfaction derived from services rendered or delivered.
Managerial Implications
This paper has several managerial implications. The general implication is that managers should be aware of the importance ofboth dimensions (i.e. operations based and marketing based) of tangibilisation of services. More specifically, continuous investment in tangibilisation of services in tertiary hospital in the Niger Delta region of Nigeria can greatly en-
hance customer satisfaction and play a critical role in sustaining competitive advantage. This means setting long-term goals for tangibilisation of services and bringing to bear innovation in this regard which could positively influence customer perception of service delivery in these hospitals and add to their satisfaction.
Also, this study indicates that operation based tangibilisation contributes more to customer satisfaction in tertiary hospitals in the Niger Delta Region of Nigeria, therefore managers of health facilities in this region should make efforts to improve upon the application of the different operations based tangibilisation in order to reap the benefits thereof. Futhermore, different hospitals may need to vary the degree of combination of the two dimensions of tangibilisation in order to bring a balance to customers' experience of their service delivery and enhance customer satisfaction. Therefore, managers of hospitals need to understand the level or degree of tangibilisation needed for their organisations in order to bring about the right mix of the two dimensions that will lead to customer satisfaction with regards to their service offerings.
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