Perceptions of Service Quality: Evidence for the Validity and Inseparability of Customer Reported Experiences and True Quality

Marketing researchers have long relied on customer perceptions of service encounters to represent the "true" underlying quality. Researchers and practitioners in healthcare, on the other hand, have long dismissed customer perceptions as a credible measure of service quality. We built a quality framework designed to address this fundamental question: are customer perceptions of service encounters unique, redundant, or wholly flawed measures of actual service quality?

We consistently show customer perspectives reflect a measure of service quality that is both unique from, and complimentary to, the competence with which a service is provided. In fact, we found the explanatory power of either single dimension of process care is completely dependent on the state of the other as they relate to service encounter outcomes. This latter finding may require both management and policy makers to rethink how they approach managing and incenting a balanced approach to investments in improving process care dimensions.

Our research also provides evidence of factors both within, and indirectly outside, the control of management in improving healthcare service quality. In addition, government administrators face a particularly challenging roll in the system; their own policies - whether too punitive or too generous - have the potential to institutionalize lower quality healthcare for the very populations they are most trying to protect.