Shifts In Service Quality Attributes Over The Customer-Provider
Relationship
Tracey S. Dagger, University of Queensland
Jillian C. Sweeney, University of Western Australia
Abstract
Service experiences unfold over a series of consumption episodes, yet customer
perceptions of these experiences are generally treated as static events. As a result, the impact
of temporal change on service perceptions is not well understood. Prior research reveals little
about the variation in the salience of service quality attributes over time or about the effect
service quality and service satisfaction have on behavioral intentions over time. This study
examines these issues within the context of ongoing health care services. The findings have
important implications for managing service processes, for improving the performance of
service providers, and the service received by customers.
Introduction
While the potential for service attributes to vary over time and differentially effect
service quality perceptions has been recognised (e.g., Grönroos, 1993; Rust and Oliver,
1994), empirical research to this effect is limited. Indeed, the impact of time on service
quality perceptions has hardly rated a mention (Palmer and O’Neill, 2003), despite several
calls for the development of dynamic service quality models (e.g., Grönroos, 1993; Rust and
Oliver, 1994). The primary goal of this research, therefore, is to examine the effect of time
on service quality perceptions and in particular whether and how the salience of service
attributes shift over the duration of a service relationship.
Literature Review
As service quality perceptions are likely to be dynamic over the entire life of a
customer’s relationship, successful marketing requires that managers understand how the
formation of customer perceptions change over time (Bolton and Lemon, 1999). Given
increasing emphasis on long-term customer relationships (Grönroos, 1993) and longer
consumption cycles (Mittal and Katrichis, 2000), service firms must understand how
customer needs change throughout the consumption experience. In the current study, we
suggest that the importance of service attributes in determining service quality perceptions
may vary across the consumption experience (Mittal and Katrichis, 2000; Mittal, Kumar and
Tsiros, 1999; Rust and Oliver, 1994). That is, customers may value different attributes at
different times in the consumption process. Moreover, the extent to which a particular
attribute is important to individual consumption goals may change throughout the service
experience. Thus, we suggest that the relationship between individual service quality
attributes and global service quality perceptions may significantly change over time.
Understanding how service attributes jointly contribute to judgments of service
provision, how they interact, and how their relative influence changes as the service script
unfolds makes an essential contribution to theory and practice, especially since prior research
has not examined these issues. While researchers have examined the contribution of service
attributes to quality perceptions (e.g., Dabholkar, Shepherd and Thorpe, 2000) the temporal
ANZMAC 2005 Conference: Services Marketing
31
dependence of these attributes remains unknown. Evidence of temporality can, however, be
found in the product satisfaction literature (e.g., Mittal, Katrichis and Kumar, 2001; Mittal,
Kumar and Tsiros, 1999; Slotegraaf and Inman, 2004). Mittal, Katrichis and Kumar (2001),
for example, found that attribute weights in determining customer satisfaction shift over time
for credit card holders. A similar shift was identified by Mittal, Kumar and Tsiros (1999) for
automobile ownership experiences, these authors offer various possibilities as to why the
salience of product attributes varied over time. Slotegraaf and Inman (2004) also show that
product satisfaction drivers shift asymmetrically over the ownership experience for
automobiles, according to whether the attribute could be remedied/resolved or not. Other
literatures also provide evidence of the dynamic nature of customer perceptions. In the
industrial marketing literature, for example, it is well recognised that retaining clients
requires interacting with customers whose perceptions of value are dynamic and unfolding
(Flint, Woodruff and Gardial, 1997).
While prior studies have focused on examining shifts in product satisfaction, we
believe that the concept of temporal dependence is readily transferable to services and in
particular high involvement, high contact, ongoing services, such as the health setting of this
study. We further suggest that firms failing to acknowledge temporal variability in attribute
weights run the risk of resource misallocation, primarily because firms may need to
emphasize different service attributes at different stages of the customer-provider
relationship. Indeed, understanding the dynamic nature of customer perceptions will assist
firms in developing strategies for customer retention (Mittal and Katrichis, 2000). We
suspect that the attributes that facilitate customer retention differ between newly acquired
customers and longer-term customers. Indeed, we believe that the needs of newly acquired
customers are significantly different from those of more long-term customers. Thus, we
examine the impact time has on the attributes that drive perceptions of service quality, and in
particular, we investigate the direction and magnitude of shifts in attribute weights over time.
The conceptual framework guiding this study is shown in Figure 1 and summarises the
discussion thus far.
Figure 1
The Temporal Dependence of Service Quality Attributes
Service Attributes
Relationship
Interaction
Atmosphere
Tangibles
Outcome
Expertise
Timeliness
Operation
Support
ANZMAC 2005 Conference: Services Marketing
t1 t2
Perceived Service
Quality
32
Method
The healthcare industry was selected as the context for this research. Oncology
clinics located at major metropolitan hospitals were specifically selected as they provide
service over an extended period of time, thus, allowing examination of service experiences
over time. Our investigation began with an exploratory qualitative study involving
participants from two oncology clinics located at different metropolitan hospitals. Data was
collected using four focus group sessions, which were segmented on the basis of the length of
time customers had been attending the clinic (<6mths and >1year). The procedures used to
form the focus groups were in accordance with the guidelines used in traditional marketing
research (e.g., Morgan, 1997). Respondents ranged from 18 to 72 years of age, both genders
being equally represented. Data from the sessions was initially analysed using a manual
content analysis system and then using QSR NUD*IST 4 (Qualitative Solutions and
Research, 1995) to enhance the rigor of the research findings. Data analysis was undertaken
using a standardized approach (e.g., Denzin and Lincoln 1994).
While a detailed discussion of the qualitative findings is beyond the scope of this
paper, we did notice several differences in participant attitudes toward service in the two time
frames. Experienced customers were more likely than inexperienced customers to question
the advice given to them by the service provider and were also more likely to actively
participate in the service process. Moreover, it became apparent that different attributes were
more or less salient depending on the length of time a customer had been attending the clinic.
Experienced customers were, for example, more likely to discuss issues of technical quality
such as the technical competence of the provider in achieving service outcomes, than less
experienced customers. In fact, inexperienced customers were more likely to mention
elements of the physical environment such as design, layout and décor. This suggests that
inexperienced customers may rely more heavily on aspects of the service that are easy to
evaluate (e.g., physical environment), than those aspects that are more difficult to evaluate
(e.g., expertise) when assessing service quality.
Our main study involved a mail survey of 2875 oncology consumers across five
health care clinics located at different metropolitan hospitals in two Capital cities. This
represented a census of each participating clinics database during the past twelve months. Of
these questionnaires, 1118 useable surveys were returned, which equates to a response rate of
38.9%. Analysis of a sample of questions revealed no evidence of non-response bias
(Armstrong and Overton, 1977). The measures applied in our main study were developed
from the focus group sessions as well as the service quality scales of Parasuraman, Zeithaml
and Berry (1988), Brady and Cronin (2001), and McDougall and Levesque (1994). Each
scale comprised at least three items that were adapted to suit the research context. The
service attributes identified as appropriate to the study setting are given in Table 1. The
global perceived service quality scale, which comprised four items, was also adapted from
the literature (e.g., Brady and Cronin, 2001; Cronin and Taylor, 1992; Parasuraman, Zeithaml
and Berry, 1988). A seven point Likert response format was used where 1 represented
strongly disagree and 7 strongly agree. The survey was pre-tested on a sample considered
representative of the survey population.
ANZMAC 2005 Conference: Services Marketing
33
Table 1
Attributes Used in Study
Attribute
Interaction
Relationship
Outcome
Expertise
Atmosphere
Tangibles
Timeliness
Operation
Support
Definition
the interaction, manner and communication between the provider and customer
the closeness and strength of the relationship between the provider and customer
what the consumer receives as a result of their interactions with the service firm
the provider’s competence, knowledge, qualifications, or skill
the intangible background characteristics of the service environment
physical elements of the service environment that exist at the forefront of awareness
the factors involved in arranging to receive medical services such as waiting time
aspects which facilitate core service production through administration of the clinic
Augmented service elements that add value to the core service
Analysis and Results
The research model was assessed through structural equation modelling using Amos
4. Based on a two-step approach to structural equation modelling, the measurement model
was estimated and validated using confirmatory factor analysis prior to analysis of the
structural model (Anderson and Gerbing, 1988). The measurement model was found to have
good fit to the data and the observed indicators served as strong measures of their latent
construct (Garver and Mentzer, 1999). High levels of construct reliability and average
variance extracted were found for all latent variables (Fornell and Larcker, 1981). Moreover,
all pairs of constructs had discriminant validity (Fornell and Larcker 1981; Anderson and
Gerbing 1988).
To examine whether the effect of the service quality attributes on service quality
perceptions was temporally dependent we compared the weight of each attribute for
inexperienced customers who had a relatively short relationship with the service provider
(time period t1), with more experienced customers (time period t2). Our goal was to
determine if there was a significant shift across time. To do this, we split our database
(n=1118) into two groups (Mittal and Katrichis, 2000); clients who had been attending the
clinic for less than six months (t1 n=320) and greater than three years (t2 n=315). Our focus
group sessions led to the choice of these two time points. We tested for invariance by
comparing the fit of a constrained model in which attribute weights were set to be equal in
both time periods with the fit of an unconstrained model in which the weights were allowed
to be different for both time periods (Byrne, 2001). We then assessed the statistical
significance of the decrement in model fit between the constrained and unconstrained model.
To facilitate this analysis we first assessed the overall service attribute model for
invariance before examining each individual path (Byrne, 2001). The results of this process
indicated that the overall service attribute model was indeed noninvariant. That is, fit
statistics of the constrained model was significantly larger than that for the unconstrained
model (2diff=30.04, dfdiff =9, p=0.000), which suggests that the impact of the service
attributes shifted over time. Given evidence of noninvariance at the overall model level we
then tested for the invariance of each service attribute by comparing the weight of each
attribute at t1 with its weight in t2. The results of this analysis are shown in Table 2.
ANZMAC 2005 Conference: Services Marketing
34
Table 2
Shifts in Service Quality Attribute Weights Across Time
Weight
Mean(s.d)
1
2
1
T
t
t
t2
Interaction Service quality
6.12(1.07) 6.11(1.13) 0.16*
0.18*
Relationship Service quality
5.36(1.54) 5.47(1.68)
0.06
-0.06
Outcome Service quality
6.27(1.01) 6.27(1.07)
0.07
0.20*
Expertise Service quality
6.37(0.87) 6.44(0.85) 0.37*
0.64*
Atmosphere Service quality
5.49(1.34) 5.65(1.30) -0.10
0.19*
Tangibles Service quality
5.61(1.24) 5.71(1.25) 0.16*
-0.03
Timeliness Service quality
5.04(1.88) 5.14(1.73)
0.07
0.09*
Operation Service quality
6.05(1.12) 6.11(1.09) 0.27*
0.16*
Support Service quality
5.06(1.72) 4.81(1.82)
0.01
0.00
Overall service quality
6.28(0.97) 6.32(1.03)
Note: ***p<0.001; **p<0.01; * p<0.05. t1=<6mths; t2>3yrs
Attribute Relationships
2diff(dfdiff) Signif.
Shift/
0.06 (1) No
1.44(1) No
4.24(1) Yes*
14.07(1) Yes***
6.39(1) Yes**
3.48(1) Yes*
0.61(1) No
15.57(1) Yes***
0.01(1) No
-
As can be seen, attribute weights remained statistically unchanged for four attributes, namely,
interaction, relationship, timeliness and support. The salience of these attributes, therefore,
appears to remain constant over time. That is, they are equally important or unimportant to
customer perceptions of quality throughout the consumption experience. Interaction, for
example, appears to be equally important to service quality perceptions throughout the
service relationship, whereas relationship appears to be equally unimportant. The weight of
the outcome attribute increased significantly across the time points (t1=0.07; t2=0.20), as
did the weights for expertise (t1=0.37; t2=0.64) and atmosphere (t1=-0.10; t2=0.19). This
suggests that the importance of these attributes increases over time. The longer the customer
has been in the consumption relationship the more important these attributes become in
driving service quality perceptions. Thus, these attributes are particularly relevant to
customer retention strategies. The tangibles (t1=0.16; t2=0.-03) and operation (t1=0.27;
t2=-0.16) attribute weights, in contrast, decreased over time. This suggests that the
importance of these attributes decays over the consumption experience. Indeed, these
attributes appear most relevant to new customers and thus customer acquisition strategies.
Discussion
Companies spend billions of dollars annually in an attempt to create repeat patronage,
positive word-of-mouth communications and customer loyalty. As the service sector
becomes more competitive, service providers are increasingly looking to service quality to
achieve market leadership (Brady and Cronin 2001). The results of this study show that
attribute weights in determining overall service quality perceptions shift over time.
Specifically, the findings suggest that the importance of service attributes in driving service
quality perceptions varies greatly. The salience of the interaction, relationship, timeliness
and support attributes, for example, remained constant over time, thus suggesting that these
attributes are important or unimportant drivers of service quality perceptions irrespective of
relationship maturity. The attributes of outcome, expertise and atmosphere on the other hand
increased in importance as drivers of service quality perceptions as the relationship matured.
The attributes of tangibles and operation, in contrast, became less important as the
relationship matured. This suggests that customers may rely more heavily on attributes that
are largely search based when evaluating service quality in the initial stages of the service
ANZMAC 2005 Conference: Services Marketing
35
experience. Ultimately, our study shows that service quality attributes differentially impact
on customer perceptions of overall service quality throughout the entire consumption
experience.
The idea of a dynamic consumption relationship has implications for service firms in
the areas of customer retention, resource management, segmentation, and employee training
and relationship management. For example, it was found that tangibles and operation are
more important to newly acquired customers whereas expertise and outcome are of greater
relevance to loyal customers. These findings suggest that service firms cannot treat newly
acquired and loyal customers in the same manner, as the needs and consumption goals of
these customer groups are vastly different. Service firms must, therefore, recognise that
attribute importance is dynamic, changing as the customers’ relationship with the firm
unfolds. Firms that fail to acknowledge this run the risk of resource misallocation, and more
seriously, failing to retain customers. Service firms should use customer experience as a
behavioral segmentation variable in customising service strategies across segments. Firms
will need to invest in employee training if this strategy is to be effective, for example
demonstrating to staff that different aspects of the service need to be emphasized, depending
on the customer’s stage in the service consumption experience. Such strategies should assist
firms in determining the lifetime value of their customers and in retaining a highly loyal
customer base. Given that customer loyalty has been linked to customer retention and
ultimately to profitability (Koska 1990; Rust, Zahorik, and Keiningham 1995), understanding
how service attribute importance changes over time is essential to many service firms.
In terms of future research directions, our research focused on two time points, less than
six months and greater than three years of service relationship. Research could also examine
the process of service evaluation in more detail. It would be helpful for example, to see at
what point in the consumption experience customer perceptions begin to change and how this
change occurs. Similarly, it would be useful to focus on service encounter frequency and
intensity as a determinant of attribute shifts. A final research agenda could focus on
determining how temporal shifts in the service quality drivers influence sales and profits,
especially given that service quality improvements have been linked to profitability and
market performance (Koska 1990; Rust, Zahorik, and Keiningham 1995; Zeithaml 2000).
ANZMAC 2005 Conference: Services Marketing
36
References
Anderson, J.C., and Gerbing, D.W., 1988. Structural equation modelling in practice: a review
and recommended two-step approach. Psychological Bulletin 103 (3), 411-423.
Armstrong, J.S., and Overton, T.S., 1977. Estimating nonresponse bias in mail surveys.
Journal of Marketing Research 14 (August), 396-402.
Bolton, R.N., and Lemon, K.N., 1999. A dynamic model of customers’ usage of services:
usage as an antecedent and consequence of satisfaction. Journal of Marketing Research
XXXVI (May), 171-186.
Brady, M.K., and Cronin, J.J., 2001. Some new thoughts on conceptualizing perceived
service quality: a hierarchical approach. Journal of Marketing, 65 (July), 34-49.
Byrne, B.M., 2001.Structural equation modeling with AMOS: basic concepts, applications,
and programming, Lawrence Erlbaum Associates: Mahwah, New Jersey.
Cronin, J.J., and Taylor, S.A., 1992. Measuring service quality: a reexamination and
extension. Journal of Marketing, 56 (July) 55-68.
Dabholkar, P.A., Shepherd, D.C., and Thorpe, D.I., 2000. A comprehensive framework for
service quality: an investigation of critical conceptual and measurement issues through a
longitudinal study. Journal of Retailing, 72 (2), 139-173.
Denzin, N.K., and Lincoln, Y.S., 1994. Handbook of Qualitative Research. Sage
Publications, Thousand Oaks.
Flint, D.J., Woodruff, R.B., and Gardial, S.F., 1997. Customer value change in industrial
marketing relationships. Industrial Marketing Management, 26, 163-175.
Fornell, C., and Larcker, D.F., 1981. Evaluating structural equation models with unobserved
variables and measurement error. Journal of Marketing Research, 28 (February), 39-50.
Garver, M.S., and Mentzer, J.T., 1999. Logistics research methods: employing structural
equation modeling to test for construct validity. Journal of Business Logistics, 20 (1), 33-57.
Grönroos, C., 1993. Toward a third phase in service quality research: challenges and future
directions. In Swartz, T.A., Bowen, D.E., and Brown, S.W. (Eds.), Advances In Services
Marketing And Management: Theory And Practice, JAI Press, Greenwich, CT, pp. 65-85.
McDougall, G.H.G., and Levesque, T.J., 1994. A revised view of service quality dimensions:
an empirical investigation. Journal of Professional Service Marketing, 11 (1), 189-209.
Mittal V., and Katrichis, J.M., 2000. New and loyal customers. Marketing Research, Spring,
26-32.
ANZMAC 2005 Conference: Services Marketing
37
Mittal V., Katrichis, J.M., and Kumar, P., 2001. Attribute performance and customer
satisfaction over time: evidence from two field studies. Journal of Services Marketing, 15 (5),
343-356.
Mittal, V., Kumar, P., and Tsiros, M., 1999. Attribute-level performance, satisfaction, and
behavioral intentions over time: a consumption-system approach. Journal of Marketing, 63
(April), 88-101.
Morgan, D.L., 1997. Focus Groups as Qualitative Research, Sage Publications, Thousand
Oaks, California.
Palmer, A., and O,Neill, M., 2003. The effects of perceptual processes on the measurement of
service quality. Journal of Services Marketing, 17 (3), 254-274.
Parasuraman, A., Zeithaml, V.A., and Berry, L.L., 1988. SERVQUAL: a multiple-item scale
for measuring consumers perceptions of service quality. Journal of Retailing, 64 (1), 12-37.
Qualitative Solutions and Research. 1995. QRS NUD*IST: User Guide, Sage Publications
Software, La Trobe.
Rust, R.T., and Oliver, R.L., 1994. service quality: insights and managerial implications from
the frontier. In Rust, R.T., and Oliver, R.L. (Eds), Service Quality: New Directions in Theory
and Practice. Sage Publications, Thousand Oaks, CA, pp. 1-19.
Slotegraaf, R.J., and Inman, J., 2004. Longitudinal shifts in the drivers of satisfaction with
product quality: the role of attribute resolvability. Journal of Marketing Research, XLI
(August), 269-280.
ANZMAC 2005 Conference: Services Marketing
38