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International Journal of Trend in Scientific Research and Development (IJTSRD)
Volume 5 Issue 5, July-August 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 842
Service Marketing Mix (7Ps) and
Patient Satisfaction in Clinics: A Review Article
Supaprawat Siripipatthanakul1
, Pattanapong Chana2
1
AeM Center, Singapore
2
Unitar International University, Malaysia
ABSTRACT
This study aims to review the healthcare marketing mix and patient
satisfaction in clinics. The findings indicate that the healthcare
marketing mix (7Ps) in clinics7Ps comprises people, product
(services), process, physical evidence, price, place, and process. The
proposed theoretical framework is shown the relationship between
the service marketing mix in clinics and patient satisfaction.
Managers may adopt the 7Ps of this review article to achieve patient
satisfaction and intended performance levels. The researcher
recommended further study to clarify the relationship in this sector.
KEYWORDS: Healthcare Services, Marketing Mix, 7Ps, Clinics,
Patient satisfaction
How to cite this paper: Supaprawat
Siripipatthanakul | Pattanapong Chana
"Service Marketing Mix (7Ps) and
Patient Satisfaction
in Clinics: A
Review Article"
Published in
International Journal
of Trend in
Scientific Research
and Development
(ijtsrd), ISSN: 2456-6470, Volume-5 |
Issue-5, August 2021, pp.842-850, URL:
www.ijtsrd.com/papers/ijtsrd43944.pdf
Copyright © 2021 by author (s) and
International Journal of Trend in
Scientific Research
and Development
Journal. This is an
Open Access article distributed under
the terms of the Creative Commons
Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)
INTRODUCTION
The Healthcare context is a dynamic changing
industry. Healthcare services face the dual challenges
of being strong in both healthcare management and
expertise. Patient satisfaction is at the forefront of
healthcare and will not go away. (Wooldridge &
Camp, 2019) Quality is what customer needs. In other
words, quality is measured by customer satisfaction.
Customer-focused quality management is one of the
essential ingredients of successful organizations
because the customers are the ultimate judges of
service quality. (D’Cunha & Suresh, 2015). Patients
deserve high-quality healthcare services. The
healthcare quality management efforts should be
focused on patient's needs and experiences. (Balik et
al., 2011 as cited in Pruitt et al., 2020) The marketing
mix has an essential role in influencing consumers to
buy a product or service offered by the company. The
marketing mix elements consist of all the variables
that a company can control to satisfy consumers. The
marketing mix strategy mixes activities marketing to
look for the maximum combination to bring the most
satisfying. The marketing mix is the organizational
elements of a company that can be controlled by the
company in communication with guests and to satisfy
guests. (Kotler & Armstrong, 2012,Alma, 2011,
Zeithaml & Bitner, 2013 and Yoyada&Kodrat, 2017).
In the healthcare industry, the patient perception of
service quality positively influences patient
satisfaction. When a gap exists between expectations
& perceptions of quality attributes and outcomes,
dissatisfaction follows. When expectations are met by
service performance, patients are satisfied. When
performance exceeds expectations, there is a delight
with the service quality. Healthcare providers need to
be aware of how patients perceive healthcare quality.
In identifying patient perceptions, the primary
indicator used to evaluate the quality of care is patient
satisfaction (D’Cunha & Suresh, 2015). Patient
Experience is an essential outcome of medical care
and is related to patient safety and clinical
effectiveness. (Ahmed et al., 2014, Doyle et al., 2013)
Patient experience and patient satisfaction are two
terms often encountered when discussing a patient-
IJTSRD43944
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 843
centered approach. Patient experience is individual
interactions, what happened, and how often, as
opposed to patient satisfaction. Those two terms are
distinguished from the patient outcome, such as when
a known terminal illness may be hospitalized in a
supportive, patient-centric environment with an
overall positive impression despite a poor clinical
outcome. Unlike measuring clinical outcomes, which
are generally objectively defied, accurate assessment
of the patient experience employs subjective patient
satisfaction surveys. Patient expectations vary
depending on the type of clinical encounter. (Jensen
et al., 2016)
Patient satisfaction is related to the patients and their
families. It includes various dimensions ranging from
service aspects to medical aspects and nursing
services. (Al-Qarni et al., 2013)The marketing mix
(7Ps) strategies create value in patient experience and
patient satisfaction (Wooldridge & Camp, 2019).
Patient satisfaction is the standard for healthcare
service quality. The value of service quality of a
health facility is not only determined by the
administrator but also by service consumers.
(D’Cunha & Suresh, 2015).
Figure 1 marketing Mix (7Ps) (Wooldridge & Camp, 2019: 5)
SWOT Analysis
Internal Environment External Environment
Strengths
• The strengths of patient services experience
• Practical services options
• Flexible business model adapts to the
purchasing power of the consumers
• Integrated marketing communication
channels to respond to the patient's needs
Opportunities
• A growing trend in the industry
• Law & Regulations of Social assurance to
promote company employees’ healthcare
Weaknesses
• The capital necessary to grow the business
• Lacks work face to face with the patients for
now
Threats
• The economic forces
• Low purchasing power due to a negative factor
of COVID-19
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 844
Marketing Mix Factors (7Ps)
Patient
Experience
(Factors)
Yoyada&Kodrat (2017) Wooldridge & Camp (2019) Lestari et al. (2020)
People
(Personal)
People are all actors who play
an essential role in presenting
services to affect buyer's
perception. Elements of
people are employees of
companies, consumers, and
other consumers. All
employee attitudes and
actions, how to dress
employees, and employees'
appearance influence the
success of service delivery.
Healthcare is a service delivered
by people for people. Patients
evaluate healthcare based on the
quality and outcome of medical
treatments, how they perceive
they have treated them, and the
quality of interaction delivered
by their healthcare provider. The
quality of the service delivery
will depend upon the skills,
training, experience, and attitude
of the person providing the
service, which can vary
significantly from one provider to
the next.
People indicators are
the doctor in
conveying information
related to the disease
or complaint to the
patient, information
about the officer's
medicine, the staff's
attitude and skilled in
serving patients, and
service procedures that
do not confuse.
Price
Price is the measurement used
in exchange for the buyer and
seller's acquisition of goods
and services. Pricing is
essential to the success of the
business. Thus, an in-depth
analysis of various factors is
used to determine the price
level of goods and services. It
takes to choose the right price
to set that adequately suits the
consumer's satisfaction and
produce utility suitable for the
price.
Price is the amount the customer
has to pay. There are various
health service system values
depends on medical, nursing, or
other medical expenses. There
are many types of disbursement.
Whether it be insurance,
compensation, or personal
expenses, there may be different
payment terms. The service
provider's payment must explain
the service fee details, such as
surgery and any other costs each
patient has to pay or can pay. If
there is an excess payment, how
much more will be required to
pay. These lists should be written
on the receipt.
Price indicators
include the suitability
of the service rates set
for the services
provided, the prices
charged, and drug
prices' affordability.
Place Distribution means all
activities of the company. It is
used to move goods from
business to market to produce
products that consumers want
and need. In contrast, the
distribution channel manages
the movement of goods from
the manufacturer to
consumers both directly and
indirectly by determining the
location and delivery channel
and the scope of distribution
to consumers.
A location is a place where a
product is sold or how the
product is presented to
customers. It could be included
business hours, type, or
presentation of the product in
new channels such as social
media. All of these factors will be
assessed in 7Ps and will
undoubtedly reflect the changes.
Place indicators
include the
convenience of the
clinic locations, room
structure, spacious
parking spaces, clinic’s
cleanliness, and
clinic’s
comfortableness.
Promotion A promotion is a combination
of sales priorities, that is,
advertising, personal selling.
It includes sales channels or
Promotion is the presentation to
consumers about the quality of
the product and what it could do.
Nowadays, there are many ways
Promotion indicators
include three of the
following, the ease of
the clinic promotion to
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 845
other means of selling. to present goods on social media
channels focusing on Word of
Mouth communicating with
consumers. This online and social
media review allows customers
to see more reviews from various
customers who bought the
product. A customer of Positive
WOM health service can perceive
customer feedback. A negative
WOM is negative feedback from
a customer. As a result,
organizations' or institutions'
Services may need to be
improved to satisfy customers.
be known by the
public, the need for
leaflets or brochures
on the clinic
information, and the
clinic's placement is
readily known to the
public.
Physical
Evidence
It is a fact that physical
evidence influences the
consumer's decision to
purchase and use a particular
product or service. Elements
in a physical facility include
environmental or physical
buildings, equipment,
materials, logos, colors, and
other reassuring items that
will impress customers.
Physical Evidence includes
equipment and pharmaceuticals
and the atmosphere and physical
environment. Physical symbols
such as logos, uniforms, and
equipment will be displayed
differently for each organization.
Physical evidence
indicators include
politeness and neatness
of the appearance of
health personnel, the
neatness of the clinic's
room layout, and the
cleanliness of the
clinic always
maintained.
Product Everyone is essential in
delivering a service or
product. That can convince
others to be interested in
products and services,
whether they be those who
have used the service,
corporate employees,
including the image or dress
of the organization will build
on the success of the service.
Products or services or any ideas
are all presented to customers.
There are convenient healthcare
services with a team of doctors,
nurses to provide services to
customers directly. The service
will be standard and will be
controlled not to be expensive.
There is a strategy created. They
are creating value for patients or
service recipients by organizing a
practical assessment.
Product indicators or
patient service
indicators are 1) the
length of service
transactions, 2) the
comfort of the waiting
room, and 3) the ease
of payment
procedures.
Process A process is a mechanism and
flow of activity from start to
finish. This element of the
process means something in
the service to create
satisfaction for consumers.
Care must be taken in every
step how to serve customers
better and make them happy.
Based on these descriptions
of integrated marketing, it can
be concluded that the
marketing mix is the most
influential component of sales
because these elements can
influence consumer interest in
purchasing decisions.
The process is providing services
to the patient from the beginning
until going home and following
up after treatment. An example is
a hospital (The University of
Texas MD Anderson Cancer
Center in Houston, Texas) that
differentiates itself from its
competitors through a process
that uses pager reminders..
Process indicators are
the speed and accuracy
of the services
provided, the
friendliness of the
doctor in serving
patients, and the
courtesy and
friendliness of the staff
in assisting patients.
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 846
Patient Satisfaction
Patient
Satisfaction
D’Cunha& Suresh(2015).
Astuti& Nagase
(2014).
Tarihoran et al.
(2020)
Description Patient satisfaction is the standard for
healthcare service quality. The value of
service quality of a health facility is not
only determined by the administrator
but also by service consumers. When a
gap exists between perceptions &
expectations of quality attributes and
outcomes, dissatisfaction follows.
When expectations are met by service
performance, patients are satisfied.
Customer satisfaction
refers to a specific
evaluation of the
overall services
provided. It must be
assessed based on the
experience during the
service delivery
process. (Astuti &
Nagase, 2014)
The factor influencing
patient satisfaction
and one that would
increase service visits
is an outstanding
service, easy access to
services, reasonable
price, and the service
process is convenient
without confusion.
A review concludes the definitions of terms as follows:
People refer to the doctor in conveying information about the disease or complaint to the patient, information
about the officer's medicine, the staff's attitude and skilled in serving patients, and service procedures that do not
confuse. (Lestari et al., 2020)
Price refers to the suitability of the service rates set for the services provided, the fees charged, and drug prices'
affordability. (Lestari et al. (2020)
Place refers to the location, business hours, type, or presentation of the product in new channels such as social
media. All of these factors will be assessed in 7P and will undoubtedly reflect the changes. (Wooldridge &
Camp, 2019)
Promotion refers to a combination of sales priorities, that is, advertising, personal selling. and includes sales
channels or other means of selling. (Yoyada&Kodrat, 2017)
Physical Evidence refers to equipment and pharmaceuticals and the atmosphere and physical environment.
Physical symbols such as logos, uniforms, and equipment will be displayed differently for each organization.
(Wooldridge &Camp, 2019)
Product (Services) refers to creating value for patients or service recipients by organizing an adequate
assessment. (Wooldridge & Camp, 2019)
Process refers to the speed and accuracy of the services provided, the friendliness of the doctor in serving
patients, and the courtesy and friendliness of the staff in assisting patients. (Lestari et al., 2020)
Patient satisfaction refers to a gap that exists between expectations & perceptions of quality attributes and
outcomes; dissatisfaction follows. When expectations are met by service performance, patients are satisfied
(D'Cunha & Suresh, 2015).
The link between healthcare service marketing and patient satisfaction is based on Naidu, 2008; Sreenivas et al.,
2013; Ofili, 2014; Thawalyawichachit, 2014, Al-Qurni et al. (2014). Thus, this study identifies the relationship
between healthcare service marketing mix (7Ps) and patient satisfaction. The implications could improve
healthcare service quality in the private healthcare sector (clinics), Thailand.
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 847
Figure 1. Theoretical Framework
Instrumentation of Marketing Mix (7Ps) Measurements
Original Questions Modified Questions
Product/Service (Srrenivas et al., 2013)
1. the services provides at hospital are attractive
2. Equipment is latest
3. The hospital is having good patient care
4. Reception services are good
5.This hospital is capable in developing new services
Product (Service)
1.the services provides at clinic are attractive
2. Equipment is latest
3. The clinic is having good patient care
4. Reception services are good
5.This clinic is capable in developing new
services
Prices (Srrenivas et al., 2013)
1. Prices are affordable
2. Treatment quality depends on price
3. The charges in hospital are reasonable
1. Prices are affordable
2. Treatment quality depends on price
3. The charges in clinic are reasonable
Place/Location (Srrenivas et al., 2013)
1. Patients are from all places
2. Hospital is well reputed
3. Hospital have place convenience
4. Hospital is located at a right place
1. Patients are from all places
2. The clinic is well reputed
3. The clinic has place convenience
4. The clinic is located at a right place
Promotion (Srrenivas et al., 2013)
1. Hospital promotional campaigns are gaining the
attention of the needy
2. Special campaigns at concession rates are getting good
response from patients
3. This hospital have brand image
1. Clinic’s promotional campaigns are gaining
the attention of the needy
2. Special campaigns at concession rates are
getting good response from patients
3. Theclinic has brand image
People (Srrenivas et al., 2013)
1. Doctors with excellent knowledge
2. Doctors treat all the patients alike
3. The supporting staff and nurses are qualified
4. The staff is sympathetic towards patients
1. Doctors with excellent knowledge
2. Doctors treat all the patients alike
3. The supporting staff and nurses are qualified
4. The staff is sympathetic towards patients
Product (Services)
Process
Physical Evidence
Promotion
Place (Location)
Price
People
Patient Satsifaction
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 848
Physical Evidence (Srrenivas et al., 2013)
1. The interior decoration is very good
2. Lighting and ventilation is good
3. Sewerage facilities are good
4. Communication facilties are good
1. The interior decoration is very good
2. Lighting and ventilation is good
3. Sewerage facilities are good
4. Communication facilties are good
Process
1. Treatment process is lengthy and time consuming
(Srrenivas et al., 2013)
2. Bill settlement process is simple
(Srrenivas et al., 2013)
3. Service counters are sufficient
(Srrenivas et al., 2013)
4.Waiting time is reasonable (Srrenivas et al., 2013)
5. Safety of the dental clinic
(Saub et al., 2019)
1. Treatment process is lengthy and time
consuming
2. Bill settlement process is simple
3. Service counters are sufficient
4. Waiting time is reasonable
5. The safety of the clinic is appropriate
Original Questions (Al-Qarni et al., 2013) Modified Questions
1. Our patients are satisfied with the quality of our
service
2. Our patients are satisfied with the price of our service
3. Our patients are satisfied with the promotion of our
service
4. Our patients are satisfied with the physical evidence of
our service
5. Our patients are satisfied with the process of our
service
1. I am satisfied with the quality of services.
2. I am satisfied with the prices.
3. I am satisfied with the clinic’s promotion.
4. I am satisfied with the clinic’s
environment.
5. I am satisfied with the process of services.
Demographic Profile (Thawalyawichachit, 2014)
Gender Female
Male
Age <20 years old or lower
21-30 years old
31-40 years old
41-50 years old
51-60 years old
61-70 years old
71-80 years old
80 or over
Marital Status Single
Married
Divorced
Education <Bachelor degree
Bachelor degree
Master degree
Doctor degree
Occupation Students
Civil Servant/ State Owned Enterprise
Private Sector Employees
Business Owners
Freelance
Homemakers
Retired
Others
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 849
Income 5,000 THB or lower
5,001-10,000 THB
10,001-20,000 THB
20,001-30,000 THB
30,001-40,000 THB
40,001-50,000 THB
50,001-70000 THB
70,001-100,000 THB
Freqeuncy of Visits Over 8 times a month
8 times a moth
4 times a month
Twice a month
Once a month
Below once a month
Conclusion
In healthcare marketing, many factors affecting the
brand choices of choosing the clinics and influencing
the target market segmentation and the market share
to the healthcare providers. To adapt the business
model as smoothly as possible, the clinic's manager
would focus on marketing concepts and management
services because they impact patients' perceptions and
decisions to use the clinics. The service marketing
mix (7Ps principle) values the customers (patients) in
the healthcare context system. Therefore, healthcare
quality management is essential to produce quality
results for patients to reach the highest satisfactory
level and intention to revisit the clinics.
References
[1] Ahmed, F., Burt, J., & Roland, M. (2014).
Measuritng patient experience: concepts and
methods. The Patient-Patient-Centered
Outcomes Research, 7(3), 235-241.
[2] Alma, Buchari. (2011) ManajemenPemasaran
dan Pemasaran Jasa. Bandung :Penerbit
Alfabeta.
[3] Al-Qarni, A. A., Alsharqi, O. Z., Qalai, D. A.,
& Kadi, N. (2013). The impact of marketing
mix strategy on hospitals performance
measured by patient satisfaction: an empirical
investigation on Jeddah private sector hospital
senior managers perspective. International
Journal of Marketing Studies, 5(6), 210.
[4] Astuti, H. J., & Nagase, K. (2014). Patient
loyalty to healthcare organizations:
Relationship marketing and satisfaction.
International Journal of Management and
Marketing Research, 7(2), 39-56.
[5] D’Cunha, S., & Suresh, S. (2015). The
measurement of service quality in healthcare: a
study in a selected hospital. International
Journal of Health Sciences and Research, 5(7),
333-345.
[6] Doyle, C., Lennox, L., & Bell, D. (2013). A
systematic review of evidence on the links
between patient experience and clinical safety
and effectiveness. BMJ open, 3(1).
[7] Jensen, J. D., Allen, L., Blasko, R., & Nagy, P.
(2016). Using quality improvement methods to
improve patient experience. Journal of the
American college of radiology, 13(12), 1550-
1554.
[8] Kotler, P., G. Armstrong. (2012) Principles of
Marketing, 14th edition, Pearson Internation
Education. New Jersey, USA: Pearson Prentice
Hall.
[9] Lestari, E. N., Adi, S., &Puspitasari, S. T.
(2020, December). The Effort to Increase
Patient Visits with Marketing Mix Strategies at
Sekarpuro Medical Clinic Malang. In The 1st
International Scientific Meeting on Public
Health and Sports (ISMOPHS 2019) (pp. 185-
189). Atlantis Press.
[10] Pruitt, Z., Smith, C. S., & Pérez-Ruberté, E.
(2020). Healthcare Quality Management: A
Case Study Approach. Springer Publishing
Company.
[11] Saub, R., Jaapar, M., Musa, G., &Moghavvemi,
S. (2019). DENTAL
TOURISTS'SATISFACTION AND
LOYALTY INTENTION WITH DENTAL
CARE SERVICES IN MALAYSIA. Malaysian
Dental Journal, (1).
[12] Sreenivas, T., Srinivasarao, B., & Rao, U. S.
(2013). 7Ps in corporate hospitals
Administrators perspective. African Journal of
Business Management, 7(43), 4363-4379.
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 850
[13] Tarihoran, U., Girsang, E., R. Nasution, S.
Ginting, C (2020). Marketing Mix 7P
[14] Application to Increase Patient Re-
visits.International Conference on Health
Informatics, Medical, Biological Engineering,
and Pharmaceutical, 73-79.
[15] Thawalyawichachit, S. (2014). Factors
Affecting Satisfaction of Patients of
Physiotherapy Clinics in Bangkok. TNI Journal
of Business Administration and Languages,
2(2), 9-16.
[16] Yoyada, N., &Kodrat, D. S. (2017). Effect Of
Marketing Mix (7p) On Decision Of Consumer
Selection In Ny Dental Clinic Of Surabaya
City.
[17] Wooldridge & Camp (2019) Healthcare
Marketing: Strategies for Creating Value in the
Patient Experience Zethaml, Valarie, Mary Jo
Bitner, Dwayne D. Gremler. (2013) Service
Marketing. McGraw-Hill International Edition.

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Service Marketing Mix 7Ps and Patient Satisfaction in Clinics A Review Article

  • 1. International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 5 Issue 5, July-August 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 842 Service Marketing Mix (7Ps) and Patient Satisfaction in Clinics: A Review Article Supaprawat Siripipatthanakul1 , Pattanapong Chana2 1 AeM Center, Singapore 2 Unitar International University, Malaysia ABSTRACT This study aims to review the healthcare marketing mix and patient satisfaction in clinics. The findings indicate that the healthcare marketing mix (7Ps) in clinics7Ps comprises people, product (services), process, physical evidence, price, place, and process. The proposed theoretical framework is shown the relationship between the service marketing mix in clinics and patient satisfaction. Managers may adopt the 7Ps of this review article to achieve patient satisfaction and intended performance levels. The researcher recommended further study to clarify the relationship in this sector. KEYWORDS: Healthcare Services, Marketing Mix, 7Ps, Clinics, Patient satisfaction How to cite this paper: Supaprawat Siripipatthanakul | Pattanapong Chana "Service Marketing Mix (7Ps) and Patient Satisfaction in Clinics: A Review Article" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5, August 2021, pp.842-850, URL: www.ijtsrd.com/papers/ijtsrd43944.pdf Copyright © 2021 by author (s) and International Journal of Trend in Scientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0) INTRODUCTION The Healthcare context is a dynamic changing industry. Healthcare services face the dual challenges of being strong in both healthcare management and expertise. Patient satisfaction is at the forefront of healthcare and will not go away. (Wooldridge & Camp, 2019) Quality is what customer needs. In other words, quality is measured by customer satisfaction. Customer-focused quality management is one of the essential ingredients of successful organizations because the customers are the ultimate judges of service quality. (D’Cunha & Suresh, 2015). Patients deserve high-quality healthcare services. The healthcare quality management efforts should be focused on patient's needs and experiences. (Balik et al., 2011 as cited in Pruitt et al., 2020) The marketing mix has an essential role in influencing consumers to buy a product or service offered by the company. The marketing mix elements consist of all the variables that a company can control to satisfy consumers. The marketing mix strategy mixes activities marketing to look for the maximum combination to bring the most satisfying. The marketing mix is the organizational elements of a company that can be controlled by the company in communication with guests and to satisfy guests. (Kotler & Armstrong, 2012,Alma, 2011, Zeithaml & Bitner, 2013 and Yoyada&Kodrat, 2017). In the healthcare industry, the patient perception of service quality positively influences patient satisfaction. When a gap exists between expectations & perceptions of quality attributes and outcomes, dissatisfaction follows. When expectations are met by service performance, patients are satisfied. When performance exceeds expectations, there is a delight with the service quality. Healthcare providers need to be aware of how patients perceive healthcare quality. In identifying patient perceptions, the primary indicator used to evaluate the quality of care is patient satisfaction (D’Cunha & Suresh, 2015). Patient Experience is an essential outcome of medical care and is related to patient safety and clinical effectiveness. (Ahmed et al., 2014, Doyle et al., 2013) Patient experience and patient satisfaction are two terms often encountered when discussing a patient- IJTSRD43944
  • 2. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 843 centered approach. Patient experience is individual interactions, what happened, and how often, as opposed to patient satisfaction. Those two terms are distinguished from the patient outcome, such as when a known terminal illness may be hospitalized in a supportive, patient-centric environment with an overall positive impression despite a poor clinical outcome. Unlike measuring clinical outcomes, which are generally objectively defied, accurate assessment of the patient experience employs subjective patient satisfaction surveys. Patient expectations vary depending on the type of clinical encounter. (Jensen et al., 2016) Patient satisfaction is related to the patients and their families. It includes various dimensions ranging from service aspects to medical aspects and nursing services. (Al-Qarni et al., 2013)The marketing mix (7Ps) strategies create value in patient experience and patient satisfaction (Wooldridge & Camp, 2019). Patient satisfaction is the standard for healthcare service quality. The value of service quality of a health facility is not only determined by the administrator but also by service consumers. (D’Cunha & Suresh, 2015). Figure 1 marketing Mix (7Ps) (Wooldridge & Camp, 2019: 5) SWOT Analysis Internal Environment External Environment Strengths • The strengths of patient services experience • Practical services options • Flexible business model adapts to the purchasing power of the consumers • Integrated marketing communication channels to respond to the patient's needs Opportunities • A growing trend in the industry • Law & Regulations of Social assurance to promote company employees’ healthcare Weaknesses • The capital necessary to grow the business • Lacks work face to face with the patients for now Threats • The economic forces • Low purchasing power due to a negative factor of COVID-19
  • 3. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 844 Marketing Mix Factors (7Ps) Patient Experience (Factors) Yoyada&Kodrat (2017) Wooldridge & Camp (2019) Lestari et al. (2020) People (Personal) People are all actors who play an essential role in presenting services to affect buyer's perception. Elements of people are employees of companies, consumers, and other consumers. All employee attitudes and actions, how to dress employees, and employees' appearance influence the success of service delivery. Healthcare is a service delivered by people for people. Patients evaluate healthcare based on the quality and outcome of medical treatments, how they perceive they have treated them, and the quality of interaction delivered by their healthcare provider. The quality of the service delivery will depend upon the skills, training, experience, and attitude of the person providing the service, which can vary significantly from one provider to the next. People indicators are the doctor in conveying information related to the disease or complaint to the patient, information about the officer's medicine, the staff's attitude and skilled in serving patients, and service procedures that do not confuse. Price Price is the measurement used in exchange for the buyer and seller's acquisition of goods and services. Pricing is essential to the success of the business. Thus, an in-depth analysis of various factors is used to determine the price level of goods and services. It takes to choose the right price to set that adequately suits the consumer's satisfaction and produce utility suitable for the price. Price is the amount the customer has to pay. There are various health service system values depends on medical, nursing, or other medical expenses. There are many types of disbursement. Whether it be insurance, compensation, or personal expenses, there may be different payment terms. The service provider's payment must explain the service fee details, such as surgery and any other costs each patient has to pay or can pay. If there is an excess payment, how much more will be required to pay. These lists should be written on the receipt. Price indicators include the suitability of the service rates set for the services provided, the prices charged, and drug prices' affordability. Place Distribution means all activities of the company. It is used to move goods from business to market to produce products that consumers want and need. In contrast, the distribution channel manages the movement of goods from the manufacturer to consumers both directly and indirectly by determining the location and delivery channel and the scope of distribution to consumers. A location is a place where a product is sold or how the product is presented to customers. It could be included business hours, type, or presentation of the product in new channels such as social media. All of these factors will be assessed in 7Ps and will undoubtedly reflect the changes. Place indicators include the convenience of the clinic locations, room structure, spacious parking spaces, clinic’s cleanliness, and clinic’s comfortableness. Promotion A promotion is a combination of sales priorities, that is, advertising, personal selling. It includes sales channels or Promotion is the presentation to consumers about the quality of the product and what it could do. Nowadays, there are many ways Promotion indicators include three of the following, the ease of the clinic promotion to
  • 4. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 845 other means of selling. to present goods on social media channels focusing on Word of Mouth communicating with consumers. This online and social media review allows customers to see more reviews from various customers who bought the product. A customer of Positive WOM health service can perceive customer feedback. A negative WOM is negative feedback from a customer. As a result, organizations' or institutions' Services may need to be improved to satisfy customers. be known by the public, the need for leaflets or brochures on the clinic information, and the clinic's placement is readily known to the public. Physical Evidence It is a fact that physical evidence influences the consumer's decision to purchase and use a particular product or service. Elements in a physical facility include environmental or physical buildings, equipment, materials, logos, colors, and other reassuring items that will impress customers. Physical Evidence includes equipment and pharmaceuticals and the atmosphere and physical environment. Physical symbols such as logos, uniforms, and equipment will be displayed differently for each organization. Physical evidence indicators include politeness and neatness of the appearance of health personnel, the neatness of the clinic's room layout, and the cleanliness of the clinic always maintained. Product Everyone is essential in delivering a service or product. That can convince others to be interested in products and services, whether they be those who have used the service, corporate employees, including the image or dress of the organization will build on the success of the service. Products or services or any ideas are all presented to customers. There are convenient healthcare services with a team of doctors, nurses to provide services to customers directly. The service will be standard and will be controlled not to be expensive. There is a strategy created. They are creating value for patients or service recipients by organizing a practical assessment. Product indicators or patient service indicators are 1) the length of service transactions, 2) the comfort of the waiting room, and 3) the ease of payment procedures. Process A process is a mechanism and flow of activity from start to finish. This element of the process means something in the service to create satisfaction for consumers. Care must be taken in every step how to serve customers better and make them happy. Based on these descriptions of integrated marketing, it can be concluded that the marketing mix is the most influential component of sales because these elements can influence consumer interest in purchasing decisions. The process is providing services to the patient from the beginning until going home and following up after treatment. An example is a hospital (The University of Texas MD Anderson Cancer Center in Houston, Texas) that differentiates itself from its competitors through a process that uses pager reminders.. Process indicators are the speed and accuracy of the services provided, the friendliness of the doctor in serving patients, and the courtesy and friendliness of the staff in assisting patients.
  • 5. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 846 Patient Satisfaction Patient Satisfaction D’Cunha& Suresh(2015). Astuti& Nagase (2014). Tarihoran et al. (2020) Description Patient satisfaction is the standard for healthcare service quality. The value of service quality of a health facility is not only determined by the administrator but also by service consumers. When a gap exists between perceptions & expectations of quality attributes and outcomes, dissatisfaction follows. When expectations are met by service performance, patients are satisfied. Customer satisfaction refers to a specific evaluation of the overall services provided. It must be assessed based on the experience during the service delivery process. (Astuti & Nagase, 2014) The factor influencing patient satisfaction and one that would increase service visits is an outstanding service, easy access to services, reasonable price, and the service process is convenient without confusion. A review concludes the definitions of terms as follows: People refer to the doctor in conveying information about the disease or complaint to the patient, information about the officer's medicine, the staff's attitude and skilled in serving patients, and service procedures that do not confuse. (Lestari et al., 2020) Price refers to the suitability of the service rates set for the services provided, the fees charged, and drug prices' affordability. (Lestari et al. (2020) Place refers to the location, business hours, type, or presentation of the product in new channels such as social media. All of these factors will be assessed in 7P and will undoubtedly reflect the changes. (Wooldridge & Camp, 2019) Promotion refers to a combination of sales priorities, that is, advertising, personal selling. and includes sales channels or other means of selling. (Yoyada&Kodrat, 2017) Physical Evidence refers to equipment and pharmaceuticals and the atmosphere and physical environment. Physical symbols such as logos, uniforms, and equipment will be displayed differently for each organization. (Wooldridge &Camp, 2019) Product (Services) refers to creating value for patients or service recipients by organizing an adequate assessment. (Wooldridge & Camp, 2019) Process refers to the speed and accuracy of the services provided, the friendliness of the doctor in serving patients, and the courtesy and friendliness of the staff in assisting patients. (Lestari et al., 2020) Patient satisfaction refers to a gap that exists between expectations & perceptions of quality attributes and outcomes; dissatisfaction follows. When expectations are met by service performance, patients are satisfied (D'Cunha & Suresh, 2015). The link between healthcare service marketing and patient satisfaction is based on Naidu, 2008; Sreenivas et al., 2013; Ofili, 2014; Thawalyawichachit, 2014, Al-Qurni et al. (2014). Thus, this study identifies the relationship between healthcare service marketing mix (7Ps) and patient satisfaction. The implications could improve healthcare service quality in the private healthcare sector (clinics), Thailand.
  • 6. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 847 Figure 1. Theoretical Framework Instrumentation of Marketing Mix (7Ps) Measurements Original Questions Modified Questions Product/Service (Srrenivas et al., 2013) 1. the services provides at hospital are attractive 2. Equipment is latest 3. The hospital is having good patient care 4. Reception services are good 5.This hospital is capable in developing new services Product (Service) 1.the services provides at clinic are attractive 2. Equipment is latest 3. The clinic is having good patient care 4. Reception services are good 5.This clinic is capable in developing new services Prices (Srrenivas et al., 2013) 1. Prices are affordable 2. Treatment quality depends on price 3. The charges in hospital are reasonable 1. Prices are affordable 2. Treatment quality depends on price 3. The charges in clinic are reasonable Place/Location (Srrenivas et al., 2013) 1. Patients are from all places 2. Hospital is well reputed 3. Hospital have place convenience 4. Hospital is located at a right place 1. Patients are from all places 2. The clinic is well reputed 3. The clinic has place convenience 4. The clinic is located at a right place Promotion (Srrenivas et al., 2013) 1. Hospital promotional campaigns are gaining the attention of the needy 2. Special campaigns at concession rates are getting good response from patients 3. This hospital have brand image 1. Clinic’s promotional campaigns are gaining the attention of the needy 2. Special campaigns at concession rates are getting good response from patients 3. Theclinic has brand image People (Srrenivas et al., 2013) 1. Doctors with excellent knowledge 2. Doctors treat all the patients alike 3. The supporting staff and nurses are qualified 4. The staff is sympathetic towards patients 1. Doctors with excellent knowledge 2. Doctors treat all the patients alike 3. The supporting staff and nurses are qualified 4. The staff is sympathetic towards patients Product (Services) Process Physical Evidence Promotion Place (Location) Price People Patient Satsifaction
  • 7. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 848 Physical Evidence (Srrenivas et al., 2013) 1. The interior decoration is very good 2. Lighting and ventilation is good 3. Sewerage facilities are good 4. Communication facilties are good 1. The interior decoration is very good 2. Lighting and ventilation is good 3. Sewerage facilities are good 4. Communication facilties are good Process 1. Treatment process is lengthy and time consuming (Srrenivas et al., 2013) 2. Bill settlement process is simple (Srrenivas et al., 2013) 3. Service counters are sufficient (Srrenivas et al., 2013) 4.Waiting time is reasonable (Srrenivas et al., 2013) 5. Safety of the dental clinic (Saub et al., 2019) 1. Treatment process is lengthy and time consuming 2. Bill settlement process is simple 3. Service counters are sufficient 4. Waiting time is reasonable 5. The safety of the clinic is appropriate Original Questions (Al-Qarni et al., 2013) Modified Questions 1. Our patients are satisfied with the quality of our service 2. Our patients are satisfied with the price of our service 3. Our patients are satisfied with the promotion of our service 4. Our patients are satisfied with the physical evidence of our service 5. Our patients are satisfied with the process of our service 1. I am satisfied with the quality of services. 2. I am satisfied with the prices. 3. I am satisfied with the clinic’s promotion. 4. I am satisfied with the clinic’s environment. 5. I am satisfied with the process of services. Demographic Profile (Thawalyawichachit, 2014) Gender Female Male Age <20 years old or lower 21-30 years old 31-40 years old 41-50 years old 51-60 years old 61-70 years old 71-80 years old 80 or over Marital Status Single Married Divorced Education <Bachelor degree Bachelor degree Master degree Doctor degree Occupation Students Civil Servant/ State Owned Enterprise Private Sector Employees Business Owners Freelance Homemakers Retired Others
  • 8. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 849 Income 5,000 THB or lower 5,001-10,000 THB 10,001-20,000 THB 20,001-30,000 THB 30,001-40,000 THB 40,001-50,000 THB 50,001-70000 THB 70,001-100,000 THB Freqeuncy of Visits Over 8 times a month 8 times a moth 4 times a month Twice a month Once a month Below once a month Conclusion In healthcare marketing, many factors affecting the brand choices of choosing the clinics and influencing the target market segmentation and the market share to the healthcare providers. To adapt the business model as smoothly as possible, the clinic's manager would focus on marketing concepts and management services because they impact patients' perceptions and decisions to use the clinics. The service marketing mix (7Ps principle) values the customers (patients) in the healthcare context system. Therefore, healthcare quality management is essential to produce quality results for patients to reach the highest satisfactory level and intention to revisit the clinics. References [1] Ahmed, F., Burt, J., & Roland, M. (2014). Measuritng patient experience: concepts and methods. The Patient-Patient-Centered Outcomes Research, 7(3), 235-241. [2] Alma, Buchari. (2011) ManajemenPemasaran dan Pemasaran Jasa. Bandung :Penerbit Alfabeta. [3] Al-Qarni, A. A., Alsharqi, O. Z., Qalai, D. A., & Kadi, N. (2013). The impact of marketing mix strategy on hospitals performance measured by patient satisfaction: an empirical investigation on Jeddah private sector hospital senior managers perspective. International Journal of Marketing Studies, 5(6), 210. [4] Astuti, H. J., & Nagase, K. (2014). Patient loyalty to healthcare organizations: Relationship marketing and satisfaction. International Journal of Management and Marketing Research, 7(2), 39-56. [5] D’Cunha, S., & Suresh, S. (2015). The measurement of service quality in healthcare: a study in a selected hospital. International Journal of Health Sciences and Research, 5(7), 333-345. [6] Doyle, C., Lennox, L., & Bell, D. (2013). A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ open, 3(1). [7] Jensen, J. D., Allen, L., Blasko, R., & Nagy, P. (2016). Using quality improvement methods to improve patient experience. Journal of the American college of radiology, 13(12), 1550- 1554. [8] Kotler, P., G. Armstrong. (2012) Principles of Marketing, 14th edition, Pearson Internation Education. New Jersey, USA: Pearson Prentice Hall. [9] Lestari, E. N., Adi, S., &Puspitasari, S. T. (2020, December). The Effort to Increase Patient Visits with Marketing Mix Strategies at Sekarpuro Medical Clinic Malang. In The 1st International Scientific Meeting on Public Health and Sports (ISMOPHS 2019) (pp. 185- 189). Atlantis Press. [10] Pruitt, Z., Smith, C. S., & PĂ©rez-RubertĂ©, E. (2020). Healthcare Quality Management: A Case Study Approach. Springer Publishing Company. [11] Saub, R., Jaapar, M., Musa, G., &Moghavvemi, S. (2019). DENTAL TOURISTS'SATISFACTION AND LOYALTY INTENTION WITH DENTAL CARE SERVICES IN MALAYSIA. Malaysian Dental Journal, (1). [12] Sreenivas, T., Srinivasarao, B., & Rao, U. S. (2013). 7Ps in corporate hospitals Administrators perspective. African Journal of Business Management, 7(43), 4363-4379.
  • 9. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD43944 | Volume – 5 | Issue – 5 | Jul-Aug 2021 Page 850 [13] Tarihoran, U., Girsang, E., R. Nasution, S. Ginting, C (2020). Marketing Mix 7P [14] Application to Increase Patient Re- visits.International Conference on Health Informatics, Medical, Biological Engineering, and Pharmaceutical, 73-79. [15] Thawalyawichachit, S. (2014). Factors Affecting Satisfaction of Patients of Physiotherapy Clinics in Bangkok. TNI Journal of Business Administration and Languages, 2(2), 9-16. [16] Yoyada, N., &Kodrat, D. S. (2017). Effect Of Marketing Mix (7p) On Decision Of Consumer Selection In Ny Dental Clinic Of Surabaya City. [17] Wooldridge & Camp (2019) Healthcare Marketing: Strategies for Creating Value in the Patient Experience Zethaml, Valarie, Mary Jo Bitner, Dwayne D. Gremler. (2013) Service Marketing. McGraw-Hill International Edition.