How to develop emotional attachment amongst patients towards hospitals? A qualitative investigation in the context of emerging Indian market
| Pages | 213-229 |
| Date | 01 August 2016 |
| Published date | 01 August 2016 |
| DOI | https://doi.org/10.1108/JABS-05-2015-0058 |
| Author | Abhigyan Sarkar,Juhi Gahlot Sarkar,K.S. Venu Gopal Rao |
| Subject Matter | Strategy,International business |
How to develop emotional attachment
amongst patients towards hospitals? A
qualitative investigation in the context of
emerging Indian market
Abhigyan Sarkar, Juhi Gahlot Sarkar and K.S. Venu Gopal Rao
Abhigyan Sarkar is
Assistant Professor
(Marketing) at Institute of
Management Technology,
Ghaziabad, India.
Juhi Gahlot Sarkar is
Research Scholar at IBS
Hyderabad, Hyderabad,
India. K.S. Venu Gopal
Rao is Professor at the
Marketing Department,
IBS Hyderabad,
Hyderabad, India.
Abstract
Purpose –The purpose of this qualitative study is to explore the antecedents and consequences of
hospital brand attachment and associated intervening factors amongst patients and attendants in the
context of the emerging Indian market where the hospital industry has a heterogeneous structure
consisting of state-owned and private hospitals.
Design/methodology/approach –Semi-structured in-depth interviews were conducted to collect
data. Data were coded using the grounded theory method to explore and validate interrelationships
between the constructs that emerged.
Findings –Based on the data analysis, a grounded theory framework has been developed, which
recognizes hospital brand attachment as the central construct, and depicts its related antecedents,
consequences and intervening or moderating factors.
Originality/value –The study contributes to the existing body of healthcare marketing research by
having discovered actionable antecedents of hospital brand attachment that could help healthcare
marketers in emerging markets to formulate branding strategies that strengthen the patient–hospital
brand attachment relationships. Based on the concepts explored in this qualitative study, it has been
put forth that the concept of brand love or brand attachment that is well-researched in the case of
general consumer brands is also applicable in the case of hospital brands, without ignoring the specific
idiosyncrasies of the hospital industry.
Keywords Brand trust, Hospital brand attachment, Brand ethicality, Accommodation environment,
Foreign collaboration, Empathetic interaction
Paper type Research paper
Introduction
Attachment is an emerging area of research in the context of brand consumption. The
concept of brand attachment has been borrowed from the interpersonal attachment
literature (Thomson et al., 2005). The basic assumption of the interpersonal attachment
theory is that human infants’ attachment behaviour evolves from how adult caregivers
maintain proximity with infants, which subsequently shapes those infants’ future proximity
maintenance behaviour with regard to attachment objects (Hazan and Shaver, 1994). So,
attachment is a psychological system that functions to maintain proximity to an attachment
object. Shimp and Madden (1988) have stated that individuals can have emotional
relationships with consumption objects, and the structure of such consumer–consumption–
object relationships is largely analogous to that of interpersonal love relationships as
proposed by Sternberg (1986).Thomson et al. (2005) developed a psychometrically
reliable scale to measure emotional brand attachment. The scale has three intercorrelated
dimensions – affection, passion and connection. It is very important for marketers in any
industrial sector to enhance the levels of consumers’ brand attachments, as brand
Received 13 May 2015
Revised 19 July 2015
19 September 2015
Accepted 23 September 2015
DOI 10.1108/JABS-05-2015-0058 VOL. 10 NO. 3 2016, pp. 213-229, © Emerald Group Publishing Limited, ISSN 1558-7894 JOURNAL OF ASIA BUSINESS STUDIES PAGE 213
attachment helps producers predict desirable marketing outcomes, such as conative
brand loyalty and intentions to pay price premiums (Thomson et al., 2005).
Individuals tend to go to hospitals only in cases of illness, and under normal situations, they
generally do not show a willingness to consume hospital services. Hence, it ought to be
important to understand how consumers might develop strong brand attachments for
hospital services, as the basic nature of healthcare provision is different from that of most
other types of service industry.
Individuals normally visit hospitals in highly negative emotional states and suffering from
stress, including mental distress, created by chronic or severe illnesses. Under the
conditions of such stress, individuals will ardently seek care, and thus perceive hospitals as
caregivers more prominently than they perceive other organizations in other sectors as
providers of consumer goods and services. It is necessary to investigate emotional brand
attachment in the hospital industry, as prior empirical research has shown that stress is a
significant trigger of searches for attachment objects that act as safe havens because they
are perceived to offer protection from stress (Thomson et al., 2005). Still, a review of the
extant literature reveals that investigations of the concepts of emotional brand love (Carroll
and Ahuvia, 2006) and brand attachment (Thomson et al., 2005) have largely been
undertaken in relation to various goods and services that are unrelated to hospitals, and
prior studies of brand attachment have largely ignored the healthcare industry. The current
study intends to bridge this gap by investigating the nature of consumers’ emotional brand
attachments in the context of Indian hospitals. It should be noted, as per definitions, that
Carroll and Ahuvia’s (2006) “brand love” is conceptually the same as “brand attachment”
discussed by Thomson et al. (2005). So, this article will use brand love and brand
attachment interchangeably.
The hospital sector in India was considered to be appropriate as a study context. Recent
statistics have shown that the medical tourism sector in India is currently experiencing
significant growth compared to those of other Asian countries (https://en.wikipedia.org/
wiki/Medical_tourism_in_India). Medical tourism is defined as a special kind of tourism by
which consumers elect to travel to different places and foreign destinations to receive
healthcare treatment (Lunt and Carrera, 2010). Indian hospitals should take advantage of
this opportunity by exploiting the strategically actionable factors that can enhance the
attachments felt by consumers towards hospitals.
To address the above-mentioned research gaps related to brand attachment, the objective
of this qualitative study has been to explore the possible factors that might determine
conative hospital brand loyalty and foster consumers’ intentions to make repeat visits to
particular state-owned and private hospitals in India, in cases of any future illnesses. Then,
the article discusses the theoretical background for brand attachment, satisfaction, loyalty
and other related concepts in the context of hospital services. The literature review is
followed by a qualitative exploration of the antecedents of hospital brand attachment and
the desirable outcomes resulting from it. Grounded theory methodology (Strauss and
Corbin, 1990) has been used to analyse the data. While explaining the findings, theoretical
supports have been given wherever possible, following Strauss and Corbin’s (1990)
suggestion of sensitising the grounded theory data analysis and findings via prior literature
reviews. In this way, Strauss and Corbin’s (1990) grounded theory approach is partly
inductive and partly deductive. Finally, a grounded theory framework has been developed
based on the findings of this study, which has formed the basis for discussing its theoretical
and managerial implications.
Theoretical background
Interpersonal attachment theory
John Bowlby is regarded as the father of interpersonal attachment theory. Bowlby (1944,1951)
asserted that mental deprivation, because of parental separations, put children at increased
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