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The Impact Of Customer Satisfaction And Perceived Value On Loyalty Among Dental Patients

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Background of Study

The researcher will explore the concept of patient loyalty particularly within the area of dental industry, its significance for practices and practitioners. This study will examine how the concept of loyalty will be measured and show its impact with customer satisfaction and perceived value which play a determinant role in dentistry as well as in other industries. Moreover, the study will highlight the association or relationship of both satisfaction and perceived value on loyalty and be able to fully understand how it can be more effective at ensuring customer retention at Bayside Dental Centre.

Different strategies are created to retain patients and one of this is through repeat visits. The repeated visits present the foundation of any company as it enhances market share and create a positive word of mouth to attract more patients. Moreover, it is argued that repeated revisits of patients are also extremely important for service industries such as airline, insurance banking, but also within professional practices like dentists to survive.

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Literature Review

Many studies conducted previously have shown relationship of customer satisfaction and perceived value towards loyalty. Loyalty has been regarded as an important goal in a study on consumer marketing community. But professionals and academics seek to reveal the most important antecedent of it. Preceding studies indicate that there are two effective ways to generate customer loyalty first, by delighting customers second, by delivering excellent value from quality products and excellent services.

In context of dentistry, only moderate amount of study has been conducted for practitioners to fully understand the concepts of satisfaction and perceived value its effect and relationship towards loyalty. These constructs have been regarded in various service situation but a lesser extent in dental practice. No research study was conducted to investigate the mentioned constructs in a single framework.

The ability to comprehend customers’ perceived value and be able to deliver it is one of the foundations of successful marketing performance. Four consumer definitions have been defined by the researcher for perceived value these are: (1) low price, (2) whatever I want in a product, (3) the quality I get for the price I pay and (4) what I get for what I give with this definition perceived value was described according to the perceptions of what is obtained and what is provided. Consumers acquire value from the utility provided and will pay a final price. Customer satisfaction has explained by Oliver (1997) as the fulfillment response of a consumer. A model demonstrated by Oliver (1980) was used to explain customer satisfaction. Four constructs enclose the model: performance, expectations, disconfirmation and satisfaction (Oliver, 1980). Discrepancies between prior expectations and actual performance arises from disconfirmation and there are three possibilities: zero disconfirmation results when as expected the product performs; while positive disconfirmation when better than expected the product performs and negative disconfirmation is when below expectation and dissatisfaction sets in product performance (Oliver, 1980). Hence, as described above it is possible for a customer to be particularly satisfied but not satisfied completely due to negative experiences.

A lot of studies have been considering loyalty in so many ways, like repurchase intention, positive word of mouth and many more. Da Silva & Alwi (2008) describe it as a positive propensity for an organization or brand. While Dick & Basu (1994) argue that it can be conceptualized as a two-dimensional construct such as attitude and behavior. According to East, Sinclair, and Gendall, (2000) it is closer to behavioral intention rather than an intention which was argued by Buttle and Burton (2002) the other around. Despite these arguments more studies conceptualized loyalty as behavioral response or intention. With this, patient loyalty is more appropriately described as behavioral response. In spite of whether patient loyalty focuses in the context of health care or within general context as customer loyalty, the same applies as to any health care practice as they do retail business. Therefore, patient loyalty represents as an asset for dental practices.

Research Problem Section

Background of the Organization

Bayside Dental Centre Bayside Dental Centre was established by Dr. Zena Bayan in 2012, who is the owner and dentist of the dental clinic. It is conveniently located at the heart of Browns Bay on Auckland’s North Shore. It is one of the trusted dental clinics in Browns Bay area. The practice is committed to deliver exceptional patient health care. They provide invasive treatment procedures such as implant placement, cosmetic dentistry and complex mouth rehabilitation. A team of expert practitioners which includes a dentist, associate dentist, dental hygienist, a practice manager and a dental nurse were the internal stakeholders while their patients, dental suppliers such as Henry Schein, dental laboratory companies like OralArt, New Zealand Dental Association and Council and some colleges and companies who partners with Bayside Dental Centre like White Flower Café. Bayside Dental is honored to have a group comprise of an experienced dental practitioner in the area of cosmetic dentistry and a hygienist who is a recipient of an academic prize of excellence.

Research Problem

The owner of Bayside Dental Centre perceive that they were facing decrease in loyalty which is shown within their patient’s records. Their financial records show that the company’s income has been decreasing because some of their patients defect to other dental practice. She believed that the loyal patients they have the more likely they will to try new products or services than new patients. Since long term patients has already built relationship with the practice therefore they show trust more than new patient. Therefore, the researcher finds it reasonable to investigate the relationship of perceived value and customer satisfaction towards patient loyalty how it produces patient retention and trust but will also increase the profit of the company as well.

Research Purpose

This research proposes to examine the relationship of perceived value and customer satisfaction in ensuring loyalty and customer retention. With this in mind, the researcher wants to understand the patient’s behavior and be specific, the patient’s commitment to remain loyal in a specific dental office. Hence, the objective is to determine the relationship of perceived value and customer satisfaction as major antecedents of patient loyalty.

Methodology Section

The research paradigm the study will utilize is a positivist approach. The dependent and independent variables were presented on Figure 1, the need to examine these quantifiable elements through quantitative approach and evaluate the formulated hypothesis through a scientific method (Bougie & Sekaran, 2010). A descriptive study will be carried out to further describe the characteristics of the identified variables. Moreover, the developed theoretical framework will be examined by providing empirical evidence to test the hypothesis and identify instrument used on perceived value, satisfaction and loyalty. As discussed on the literature section each instrument was carefully chosen to ensure the concept was considered.

Research Design and Methods

In identifying the methodology approach, a research design is created as the general plan of the research project on how to achieve the research objectives and questions. Its contents and functions will include the research philosophy (quantitative method), techniques in data collection and developing empirical evidence by way of survey questionnaires and statistical analysis (using SPSS) for data interpretations to test the hypothesis emanated from the theoretical framework.

Data Collection

A cross sectional method will be used to collect data from patients of Bayside Dental Centre. Furthermore, the researcher chooses to employ cross sectional method since it is the fastest way and less costly to pursue (Levin, 2006). The primary data collection will use survey questionnaires on perceived value, customer satisfaction and loyalty in the context of dental practice. A total of 100 questionnaires with a cover letter explicating the study’s academic nature will be provided. Data collection will be conducted from week 2 until week 6.


Sampling of this study will be taken from Bayside Dental Centre’s patients. The researcher opts to use convenience sampling method in gathering its data. Convenience sampling (also known as Haphazard Sampling or Accidental Sampling) is a type of nonprobability or non-random sampling where members of the target population that meet certain practical criteria, such as easy accessibility, geographical proximity, availability at a given time, or the willingness to participate are included for the study. The researcher finds this sampling method more effective since it enables to achieve the sample size in a fast and inexpensive way.

Development of Survey

The instruments for survey questionnaire where carefully selected to make certain that the study will capture the concept discussed in literature review. Final questionnaire for this study composed of 19 items, (1) 5 items which consist of measurement from Dobbs, Monroe & Grewal (1991) for perceived value (2) 6 items taken from Oliver (1980) on customer satisfaction (3) 4 items on loyalty from Oliver (1997). Demographic variables for gender, education, marital status and age will be collected to allow cross tabulations and comparison of results. Hence, the survey should convey and produce reliable response from respondents from the questionnaire.

Data Analysis

The collected data will then be analyzed and interpreted using statistical means, specifically through SPSS to determine the data reliability. Each instruments reliability will be test through Cronbach Alpha.

Research Ethics

Ethical guidelines and code of conduct should be taken into consideration in conducting research. This should be applicable to the respondents who will participate, host organization and researcher who will gather data. The most important aspect of this research is the agreement between the researcher and host organization to safeguard the confidentiality and anonymity and privacy of its respondents and ensure that any information remains within the organization. It is of utmost important that the researcher convey the information and content remain anonymous and confidential during the process the research. The respondents survey questionnaires are used solely in achieving the objectives of the research. Moreover, while conducting the survey a high level of integrity and professionalism is exercised to ensure that personal boundaries and privacy concerns are addressed in a respectful manner.

Significance of the Research

This research study will benefit the company, in creating potential sales and profit that will create value to the business and maximizes the practice sustainable growth. The owner together with the employees will be able to gather information and be able to come up with methods and theories that will support the company in developing loyalty. The research hopes to contribute also to areas related to perceived value and customer satisfaction relationship towards loyalty.


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