A mean-end chain (MEC) lens of quality of care on customer equity, recommendations and revisit intention

Purpose This study aims to investigate how the quality of care (QOC) in terms of structure and process affects the equity customers have with them and their influences on the intention to revisit and recommend health-care providers. Design/methodology/approach The study gathers 200 (pilot) and 400 (mass) data to validate and assess the framework structurally using the means-end chain (MEC) model via AMOS 26.0. Findings Customers with substantial equity derived from QOC are more inclined to revisit and recommend health-care providers. In addition, customers who rely solely on QOC, i.e. disregarding the perceived worth of the brand, value and relationship equity, are less devoted than those who recognise the value offered by health-care providers. Practical implications Hospital management could formulate alternative hospital visit strategies that improve customer access to the health-care system by establishing a treatment charter, akin to informed consent, that explains the instrument and the procedure used for each treatment. It is essential to improve understanding by better communicating the functionalities of the equipment and facilities, as well as the medical benefits customers would gain from using them. Hospital staff, such as check-up assistants, might be trained to convey treatment benefits to customers in a more understandable manner. Originality/value To the best of the authors’ knowledge, this is likely the first study to link flow experience to QOC (structure and process), customer equity and the intention to revisit and recommend. This study contributes to the service literature and the MEC model by providing empirical evidence of QOC in enhancing customer equity and how customers perceive their intention to revisit and recommend.