Abstract
Consumer complaints about dissatisfactory medical services as a method to increase quality and competition in the medical industry are examined by using a block-recursive simultaneous equation model. The probability of complaining about a specific service, the number of complaints made about it, the probability of its resolution, and the probability of subsequently purchasing the same service are estimated. Variables that measure learning, constraints, attitude, and cost/benefits are included. Results indicate that the learning variables, represented by age, education, and gender, are most associated with the process of medical complaints. Overall findings indicate that placing the burden of controlling the costs and quality of medical services on the consumer is not viable given the current structure of the U.S. medical industry.
Zusammenfassung
Verbraucherbeschwerden wegen unzulänglicher ärztlicher Dienstleitungen werden als eine von mehreren Methoden zur Anhebung des Leistungsniveaus und zur Förderung des Wettbewerbs auf diesem Sektor angesehen. Der Beitrag prüft die Eignung dieser Methode anhand von Daten aus einer Stichprobe von 509 Haushalten. Geschätzt wurde dabei die Wahrscheinlichkeit einer Beschwerde über eine bestimmte ärztliche Leistung, die Zahl der Beschwerden, die Wahrscheinlichkeit ihrer befriedigenden Lösung und die Wahrscheinlichkeit einer wiederholten Inanspruchnahme derselben ärztlichen Leistung. Berücksichtigt wurden auΒerdem Variablen, die Lernprozesse, Hemmungen, Einstellungen und Nutzen/Kosten-Aspekte erfassen. Die Ergebnisse zeigen, daΒ die Variablen Alter, Erziehung und Geschlecht am engsten mit dem Vorgang der Beschwerde verbunden sind. Insgesamt zeigt sich, daΒ es angesichts der Struktur des amerikanischen Marktes für ärztliche Leistungen wenig aussichtsreich ist, die Aufgabe der Kontrolle von Kosten und Qualität ärztlicher Leistungen den Konsumenten aufzubürden.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Andreasen, A. R. (1985). Consumer responses to dissatisfaction in loose monopolies.Journal of Consumer Research, 12, 135–141.
Andreasen, A. R. (1988). Consumer complaints and redress: What we know and what we don't know. In: E. S. Maynes & The ACCI Research Committee (Eds.),The frontier of research in the consumer interest, pp. 675–722. Columbia, MO: American Council on Consumer Interests.
Ash, S. B., & Quelch, J. A. (1980). Consumer satisfaction, dissatisfaction, and complaining behavior: A comprehensive study of rentals, public transportation, and utilities. In: H. K. Hunt & R. L. Day (Eds.),Refining concepts and measures of consumer satisfaction and complaining behavior, pp. 120–130. Bloomington, IN: Indiana University, School of Business, Division of Research.
Beisecker, A. (1988). Aging and the desire for information and input in medical decisions: Patient consumerism in medical encounters.The Gerontologist, 28, 330–335.
Berry, L., Zeithaml, V., & Parasuraman, A. (1985). Quality counts in services, too.Business Horizons, 28 (3), 44–52.
Best, A., & Andreasen, A. (1977). Consumer response to unsatisfactory purchases: A survey of perceiving defects, voicing complaints, and obtaining redress.Law and Society, 11, 701–742.
Blackorby, C., Nissen, D., Primont, D., & Russell, R. R. (1973). Consistent intertemporal decision making.Review of Economic Studies, 40, 239–248.
Bryant, W. K. (1988). Consumer complaints and redress: Some directions for future research. In: E. S. Maynes & The ACCI Research Committee (Eds.),The frontier of research in the consumer interest, pp. 723–726. Columbia, MO: American Council on Consumer Interests.
Corrigen, P. (1990). Consumer satisfaction with institutional and community care.Community Mental Health Journal, 26, 151–165.
Council of Better Business Bureaus (1991).Annual inquiry and complaining summary. Arlington, VA: Council of Better Business Bureaus.
Day, R. L., & Bodur, M. (1977). A comprehensive study of satisfaction with consumer services. In: R. L. Day (Ed.),Consumer satisfaction, dissatisfaction, and complaining behavior, pp. 64–74. Bloomington, IN: Indiana University, School of Business, Division of Research.
Day, R. L., & Landon, E. L. (1975). Collecting comprehensive complaint data by survey research. In: B. B. Anderson (Ed.),Advances in Consumer Research, 3, pp. 263–268. Provo, UT: Association for Consumer Research.
Fornell, C., & Wernerfeit, B. (1987). Defensive marketing strategy by customer complaint management: A theoretical analysis.Journal of Marketing Research, 24, 337–346.
Gilly, M. (1987). Postcomplaint processes: From organizational response to repurchase behavior.Journal of Consumer Affairs, 21, 293–313.
Health Insurance Association of America (1991).Sourcebook of health insurance data. Washington, D.C.: Health Insurance Association of America.
Heath, B., Hultberg, J., Ramey, J., & Reis, C. (1984). Consumer satisfaction: Some new twists to a not so old evaluation.Community Mental Health Journal, 20, 123–134.
Hirschman, A. O. (1970).Exit, voice, and loyalty. Cambridge, MA: Harvard University Press.
Kendall, C. L., & Russ, F. (1975). Warranty and complaint policies: An opportunity for marketing management.Journal of Marketing, 39 (2), 36–43.
Kolodinsky, J. (1992). A system for estimating complaints, complaint resolution, and subsequent purchases of professional and personal services.Journal of Satisfaction, Dissatisfaction, and Complaining Behavior, 5, 36–44.
Kolodinsky, J., & Aleong, J. (1990). An integrated model of consumer complaint action applied to services: A pilot study.Journal of Satisfaction, Dissatisfaction, and Complaining Behavior, 3, 61–67.
Lazenby, H. C., & Letsch, S. W. (1990). National health expenditures 1961–1989.Health Care Financing Review, 12 (2), 1–26.
Liefeld, J. P. (1980). Urban/rural consumer expectations and evaluations of their consumer realities. In: H. K. Hunt & R. L. Day (Eds.),Refining concepts and measures of consumer satisfaction and complaining behavior, pp. 95–101. Bloomington, IN: Indiana University, School of Business, Division of Research.
Maddala, G. S. (1983).Limited dependent and qualitative variables in econometrics. Cambridge: Cambridge University Press.
Maddala, G. S., & Lee, L.-F. (1976). Recursive models with qualitative endogeneous variables.Annals of Economic and Social Measurement, 5, 525–544.
Marketing Science Institute (1985).Consumer attitude questionnaire. Cambridge, MA: Marketing Science Institute.
Pauly, M. (1988). Primer on competition in the medical industry. In H. E. Fresch (Ed.),Health care in America, pp. 27–60. San Francisco, CA: Pacific Research Institute for Public Policy.
Pauly, M., & Satterthwaite, M. (1981). Pricing of primary care physicians' services: A test of the role of consumer information.Bell Journal, 12, 488–506.
Pollak, R. (1970). Habit formation and dynamic demand functions.Journal of Political Economy, 78, 745–762.
Sharp, A., Register, C., & Leftwich, R. (1988).Economics of social issues. Plano, TX: Business Publications.
Singh, J. (1989). Determinants of consumers' decisions to seek third party redress: An empirical study of dissatisfied patients.Journal of Consumer Affairs, 23, 329–363.
Singh, J. (1991). Industry characteristics and consumer dissatisfaction.Journal of Consumer Affairs, 25, 19–56.
U.S. Bureau of the Census (1991).Population profile of the United States. Washington, DC: U.S. Government Printing Office. Special Studies, Series P-23, No. 173.
von Weizsäcker, C. C. (1971). Notes on endogeneous changes in tastes.Journal of Economic Theory, 3, 345–372.
White-Means, S. (1989). Consumer information, insurance, and doctor shopping: The elderly consumer's perspective.Journal of Consumer Affairs, 23, 45–64.
Zeithaml, V. (1981). How consumer evaluation processes differ between goods and services. In: J. Donnelly & W. George (Eds.),Marketing of services, pp. 186–190. Chicago: American Marketing Association.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kolodinsky, J. Complaints, redress, and subsequent purchases of medical services by dissatisfied consumers. J Consum Policy 16, 193–214 (1993). https://doi.org/10.1007/BF01418376
Issue Date:
DOI: https://doi.org/10.1007/BF01418376