Effect of Hospital Digital Advertising on Patient Loyalty

Nia Murniati

Program Pendidikan Vokasi, Universitas Indonesia, Depok, Indonesia

Keywords: Marketing Communication, Intention to Return, Health Industry.

Abstract: Digital marketing is widely used by various industries, including the health industry, such as hospitals. Digital

marketing is a favourite for millennials. People have even abandoned conventional forms of marketing such

as banners, television, newspapers, and of the kind to move entirely to digital marketing because more

effective in reaching potential buyers at a much cheaper cost. This study aims to determine the effect of hospital

digital advertising on patient loyalty as measured by the intention to return to the same hospital in the future.

Through a purposive sampling method, using a sample of 100 hospital patient respondents X. Logistic

regression analysis with scaled-dependent binary variables is used to predict customer loyalty consisting of

quality, public image, and hospital digital advertising. The results of logistic regression analysis with binary

scale indicate that three dimensions of service that have the most significant effect in creating customer

loyalty. But the results of Exp (B) testing show that the contribution given by the hospital digital advertising

variables in creating customer loyalty is actually smaller than the other variables. The number of respondents

in this study is quite small, only 100 respondents. This means that the data obtained does not yet reflect the

actual market conditions.

1 INTRODUCTION

In competitive times like now, creating and

maintaining customer satisfaction and loyalty is very

important for the company. Consequently, it is an

obligation for companies to find out how customer

preferences affect their loyalty. Although customers

tend to be more demanding and less loyal to products

or services, companies must be sure that building

lasting relationships with customers is very important

because loyal customers are more comfortable to

serve, buy more, pay for a membership, and spread

positive influence from mouth to mouth

(Palamidovska-Sterjadovska & Ciunova-Shuleska,

2017).

Consumer loyalty is the final effect of purchasing,

which is defined as the attitude and intention to

behave in the future, and expressed through a

commitment to give recommendations to others, the

desire to say positive things about the company, and

willingness to pay dearly. The concept of customer

loyalty includes five factors, namely overall

satisfaction experienced by the customer when

making a purchase, willingness to build relationships

with the company, willingness to buy back,

willingness to recommend the company to others and

not switching to competing products (Mulyana &

Sugeng, 2018).

Customer loyalty often expresses loyalty as a

commitment to attitude or behaviour towards the

brand. loyalty is created when there is a favourable

belief in the brand (Zhang, Dixit & Friedmann, 2010).

2 MANUSCRIPT PREPARATION

A satisfied customer is the basis of a successful

business because he will repurchase it. Positive word

of mouth influence will lead to customer loyalty.

Customer satisfaction is one of the critical strategies

that can be used to retain existing customers even

though there is no consensus in the literature about

the relationship between satisfaction and loyalty

(Sandada & Matibiri, 2015).

The competitive advantage of marketing must be

able to detect customer needs that change rapidly

because losing customers is a price that must be paid

handsomely. Maintaining sustainable and mutually

beneficial relationships with customers is the centre

of attention of contemporary marketing strategies and

is considered a significant competitive advantage for

the company. Companies have shifted their focus

Murniati, N.

Effect of Hospital Digital Advertising on Patient Loyalty.

DOI: 10.5220/0010705000002967

In Proceedings of the 4th International Conference of Vocational Higher Education (ICVHE 2019) - Empowering Human Capital Towards Sustainable 4.0 Industry, pages 567-571

ISBN: 978-989-758-530-2; ISSN: 2184-9870

567

from transaction-based strategies that can be easily

copied by competitors, to those that are more

relational based. When customers develop

relationships with companies, they usually spend

more, give positive influence by word of mouth,

recommend to family and friends and continue to

support the profitability of the company. Research

has shown that the quality of relationships can even

replace service quality and customer satisfaction as

the main drivers of superior performance. On the

other hand, various recent studies have questioned the

linear effects of strong relationships with customer

loyalty and positive influence by word of mouth

(Giovanis, Athanasopoulou & Tsoukatos, 2015).

Now, customers are not just consumers. They will

become intellectual partners in the company’s

business success. Recent research has proven that

customer loyalty is the result of individual attention

to customer expectations in all aspects. Loyal

customers create a comfortable situation for other

customers. Customer retention and loyalty are

considered to be profitable investments in the long

run. An important focus that must be considered by

companies is that attracting new customers is more

expensive than retaining existing customers. Thus

loyal customers are invaluable assets for the company

(Komejani & Mohaghegh, 2017).

Customers who feel satisfied with the quality of a

product or service are more likely to act as an

intermediary for companies in promoting word of

mouth to friends, relatives, and other potential

customers to try various products or services

(Andriyansah, Kusumawardhani & Suharto, 2019).

The factor that determines the level of success and

quality of the company is the company’s ability to

provide services to customers, achieve high market

share, and increase profits. Service quality is defined

as the customer’s assessment of overall excellence or

the privilege of a product or service (Dapas et al,

2019).

2.1 Customer Loyalty

Customer loyalty is expressed as a systematic

purchase made from time to time by the customer.

Based on these definitions, it can be concluded that

loyalty is directed towards behaviour, which is

indicated by regular purchases, based on customer

decision making. Customer loyalty has a vital role in

a company; maintaining it means improving company

performance. This is the main reason for companies

to attract and retain customers (Puspaningrum, 2018).

Creating customer loyalty is a challenge for marketers

who are very important and exciting. The focus of

consumer perceptions about quality, marketing

activities and brand loyalty creates customer value

(Subram, Khan & Srivastava, 2018).

2.2 Satisfaction and Loyalty

Satisfaction is a pleasant mood, which is generated by

knowledge and experience, usually associated with

satisfying some special interests. If individuals

achieve the desired goals of a product or service, and

as a result, ultimately feel satisfied, they feel a

pleasant mood, which can be called satisfaction. As a

result of this satisfaction will lead to repeated

purchases of the same brand according to situational

factors and practical marketing efforts towards

changes in consumer behaviour. Loyalty is a deep and

ongoing commitment to buy back the desired product

or service in the future. One effective factor in the

relationship between satisfaction and loyalty is the

transfer of costs. Companies can retain their

customers without increasing their satisfaction.

Transfer costs are economical and psychological

costs, which will be felt by consumers through

changes from one alternative (brand) to another

alternative (brand). Before 1990, satisfaction criteria

were concentrated on specific products or services

and were defined as evaluative assessments after

choosing individual purchasing decisions. The new

concept states that satisfaction is the overall impact of

a series of services provided or transactions with

service providers, over a period of time. It seems that

overall customer satisfaction is a better predictor of

their expectations and behaviour (Kabiri et al., 2013)

2.3 Digital Advertising

The internet and the world wide web (www) are

viable channels for distributing various digital media

services to consumers. There are several reasons why

companies can embrace online channels as a

marketing medium, as technology advances, notably

broadband and digital media have made it easier for

consumers to get a variety of services and save a lot

of time. Digital technology and high-speed internet

have fundamentally changed the way companies

distribute their products. How, where, with what kind

of content is the focus of the company in sending

service messages through channels that customers

like (Fan, Kumar & Whinston, 2007).

Despite the strong interest, marketers’ beliefs

about the effectiveness of digital media do not seem

harmful. Marketers still intend to continue to look for

ways to use digital advertising effectively. Many

marketers report only achieving moderate success or

ICVHE 2019 - The International Conference of Vocational Higher Education (ICVHE) “Empowering Human Capital Towards Sustainable

4.0 Industry”

568

results that are not consistent with digital advertising.

Various factors can trigger the success or failure of

marketing, such as the ad itself and the media channel

where the ad is placed (Bart, Stephen & Sarvary,

2014).

2.4 Social Marketing

The effectiveness of traditional marketing

instruments has declined in many markets, while the

effects of social interactions between consumers and

buying behaviour have increased. As a result,

marketers are required to display optimal

performance to drive customer behaviour. The

increase in social media activity has created keen

interest and influence. Clearly, this development

poses new challenges for marketing practitioners

(Risselada, Verhoef & Bijmolt, 2014).

Social marketing is currently in the growth phase

of their life cycle. The most significant developments

in this phase have agreed that the primary purpose of

social marketing is not promoting ideas but changing

behaviour. In general, social marketing competes

with lethargy and habits. There are many programs,

organizations, and people who do not believe in the

need for an organized and organized approach to

bring about change. Social marketing can be applied

in any situation where the behaviour of individuals

who are socially critical needs to be addressed as the

target audience. The approach can also be applied to

produce behavioural changes that require cooperative

action to make the program successful (Andreasen,

2002).

Nowadays, consumers are actively looking for

brands they know; their preferences are strongly

influenced by prices. With this growing behaviour

and expectations, companies need to optimize their

marketing content. Advertise strategically, and

competitive prices allow high-value prospects and

loyal consumers (Global Data Point, 2019).

3 METHOD

This study used a purposive sample with the criteria

of respondents in the last three months, periodically

making purchasing decisions for hospital X services

and having moved to another hospital more than once.

In addition, respondents plan to purchase hospital

services in the future. The subjects of this study were

100 patients in hospital X. Questionnaires with a five-

point Likert Scale for Service Quality (SQ) variables,

Public Image (PI), and Digital Advertising (DA). As

for consumer loyalty using a two-point Binary Scale.

In this study, Consumer Loyalty (CL) is a variable

used to measure the extent to which consumers want

to use the latest hospital services or move to another

hospital. Data analysis using Multiple Logistic

Regression which aims to show the pattern of

relationships between the dependent variables that are

binary (0 = stop buying or 1 = repurchase) with more

than one independent variable (service quality, public

image, and digital advertising).

4 RESULTS

The results of data collected from 100 respondents

obtained information that all respondents had used

services more than one hospital and 60 per cent had

used the services of more than three hospitals.

The results of testing the validity and reliability of

9 items are all valid. This is evidenced by the results

of the Pearson correlation analysis in which each item

produces p <0.05. Reliability testing with Cronbach

alpha analysis of all instruments was declared reliable

according to Nunally’s criteria, namely Alpha> 0.6.

Based on binary logistic regression analysis with the

SPSS program, the results are as shown in table 1.

Table 1. Results of the Binary Logistic Regression Model.

Variabel B Wald Sig Exp(B)

SQ 0,807 11,745 0,001 2,242

PI 0,724 11,473 0,001 2,063

DA 0,642 6,061 0,014 1,900

Konstanta = -26,268

The results of testing the binary logistic regression

model are obtained by the equation: CL = -26,268 +

0,807SQ + 0,724PI+ 0,642DA +



The above equation can be interpreted that the

three independent variables namely Service Quality

(SQ), Public Image (PI), and Digital Advertisements

(DA) have a positive effect on consumer loyalty

manifested in the intention to repurchase.

Seeing the expectation value B or Exp value (B)

of each predictor, shows that the service quality

variable (Exp (B) = 2,242) has a greater influence on

repurchase intention than the public image variable

(Exp value (B) = 2,063) and digital advertising (Exp

value (B) = 1,900). This shows, that in predicting

consumer loyalty that is realized from the intention to

repurchase digital advertising variables make the

smallest contribution compared to other variables.

Effect of Hospital Digital Advertising on Patient Loyalty

569

5 DISCUSSION

In the service process provided by the hospital, the

thing that really stands out is how to create quality

services that can enforce the hospital branding

concept. Hospital branding is not just raising a

“hospital name” or “doctor’s name”, but also having

to be able to make the patient’s emotional attachment

to the health services provided by the hospital.

Patients as health care users will be able to feel the

value and trust in a hospital brand so that it can create

patient loyalty to the health services offered by the

hospital. The online marketing strategy chosen by

hospitals is a form of excellent advertising that is a

sophisticated and renewable communication tool that

can raise prestige, create positive images branding

and also bring prospective patients (Sullivan, 2014).

In the results of this study, it has been revealed

that service quality, public image or hospital branding

and digital advertising positively influence consumer

decisions to repurchase hospital services. But

statistically, the effect of digital advertising ranks last

in this relationship. This proves that digital

advertising is only one of the media that hospitals can

choose in promoting their services, so there is no need

to over-allocate funds for the implementation of this

form of promotion. Often marketers forget that word

of mouth advertising is actually cheaper, but the

impact is significant because it reflects the quality of

hospital services. And this is priceless. People are

more likely to listen to friends’ suggestions than to

pay attention to the guidelines of some online reviews

or advertisements (Alon & Brunel, 2018).

6 CONCLUSION

Service quality, public image and digital advertising

significantly influence the loyalty of users of hospital

services. Given that the digital advertising

statistically has the smallest influence compared to

service quality and public image, hospital marketers

are expected to continue to improve the content and

features of digital advertising so that they can make

the same contribution as other variables in satisfying

customers.

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