Influences of Brand on Hospital Performance and Patient Behavioral Expectations

Increasing number of Hospital in Asia at the present triggers hospital to build a marketing strategy. Hospital branding is one of the choosen way for marketing which giving benefits for internal and externals. This study aims to identify the influences of brand on hospital performance and patient behavioral expectations. The research method is literature review with 7 included studies. Research related to branding in the field of healthcare services was searched using valid keywords, including hospital branding, hospital, patient combined with keywords such as the effect dan the influence,dan melalui berbagai database. (mis. Google Scholar, Emerald, Scopus). A total 7 articles were selected to be studied in literature review. From these studies we have managed to categories the influences of brand on hospital performance and patient behavioral expectation and reported on three categories, including the influences of brand on hospital performance, on patient behavioral expectation, and medical team in referral. From these studies we have managed to categorize even practical considerations that is considered as influence of brand on hospital performance and patient behavioral expectation are influence of brand on hospital performance, influence of brand on patient behavioral expectation, Medical team in referral.


INTRODUCTION
found that brand consideration is having a high level of positive relationship with brand preference.Brand image significantly influences patient satisfaction.Brand preference, patient satisfaction and brand image are the factors that highly contributed to brand loyalty.The behavioral intention of the patient is influenced by brand loyalty and brand image.Because of their loyalty, they highly recommend the brand to their friends, relatives and others also.Apart from that, when the need arises, they would like to revisit the same branded hospital.This hospital is loyal in terms of their services, it is a very trusted brand in terms of promised services, and hence patients highly favored this brand.The research confirms the advantage of concepts such as brand identity.Brand image loyalty and satisfaction are the clear insight of the customer's relationship with the brand.The importance of the patient satisfaction, loyalty and trust seems to indicate that patients build their trust on the quality of the brands.In contrast, other dimensions are negligible.Hence, the hospital service providers must take care to build trust in terms of satisfaction.Brand-Customer Relationship relies on every tough point of the hospital services.

THEORETICAL REVIEW
According to research by Khosravizadeh O. et al (2017), key dimensions of healthcare branding Dimensions are a set of variables considered in branding patterns of healthcare in hospitals and medical centers each of which has a series of subfactors that are described in details: 1. Brand equity Brand equity is an important dimension and the final result of a successful branding.The followings are some effective factors for brand equity: brand awareness, transactional/ transformational leadership, ethical dimension, patient's service quality, brand association, brand trust, brand loyalty, authenticity, innovation (product, service, and process), marketing innovation, and brand Jurnal ARSI/Juni 2019 129 image.Moreover, creating healthcare brand equity can affect these factors: hospital image, intention to pursue job opportunity, improving hospital efficiency and productivity, and patient's willingness to revisit the hospital.

Brand loyalty
Brand loyalty is one of the main strategies to create patient's willingness to revisit the hospital.On the other hand, it has a strong positive effect on creating brand equity.The followings are some effective factors for patient loyalty to healthcare brand: brand image, patient's satisfaction, brand attitude, brand trust, advertising, perceived quality, brand association, and relationship commitment.

Brand image
This dimension creates a positive view in patients to choose the right healthcare center for receiving service.In fact, positive image of a hospital affects brand awareness toward revisiting the hospital.It also promotes efficiency and financial performance of a hospital.Some reviewed articles indicated that brand image has an influence on brand loyalty and brand equity.The followings are some effective factors for creating a pleasant brand image: hospitalcreated social media, word-of-mouth, quality medical personnel, tangible and critical service lines, and perceived quality.

Brand awareness
One of the dimensions that affect the success of branding is creating brand awareness.In fact, patients who visit hospitals should know and understand what healthcare branding is and what its features are so that they can get the best services fit their characteristics.Studies indicated the positive impact of brand awareness on brand equity.Perceived service quality, social responsibility, and commercial service are also effective on brand awareness.

Brand trust
Brand trust is known as a guarantee for the performance of a brand.In fact, this dimension is the matter of how successful a brand is in achieving its goals, as well as how honest the brand is in its performance.The effect of brand trust on brand equity, brand loyalty, and brand advocacy.It also brings about a willingness to use a particular service.On the other hand, perceived interactivity, brand satisfaction, and regulatory fit have impact on brand trust.

Search Strategy
The present literature review was carried out between 2010 and 2019, attempting to identify the impact of hospital brand strategy for hospital quality and patient loyalty.Keywords such as hospital branding, hospital, patient, combined with keyword such as the effect dan the influence,dan melalui berbagai database.(mis.Google Scholar, Emerald, Scopus).
Eligibility criteria For the selection of articles related to research area, the inclusion criteria were (1) studies done in the field of healthcare branding during the last 10 years, (2) all sectional descriptive and analytical studies with different methodologies, and (3) only English studies.The exclusion criteria were (1) studies in branding related to other service areas, (2) studies in branding related to pharmaceutical products and public health, and (3) articles whose full text was not easily accessible.

Quality Assessment
After articles were downloaded and extracted in specified databases, they were evaluated using descriptive, analytical study checklist and articles without required quality for reporting were excluded.

Data Extraction
After evaluating the quality of the extracted articles, 7 of them were selected.The required data including author/publication year, setting, topic area, research design, and important results were extracted in the form of a table.

RESULTS AND DISCUSION
Summary of reviewed articles after evaluating the extracted articles and screening in terms of relevance and quality, 7 articles were selected to be studied.These studies were carried out between 2010 and 2019 in different parts of the world.
Regarding target population, 6 of the studies were done in hospitals and 1 of them in all healthcare facilities.In terms of the understudied countries, almost a half of the studies (42,86%) are related to Iran.Moreover, the most frequent research method in the reviewed articles was quantitative study.Almost a half of the studies (42,86%) have been done in 2017.Table 1 provides the data.
Table 2 shows the included studies methodology, variables, analysis and positivenegative results of each articles.A multitude of different methods of analysis had been obtained from the studies.
From these studies we have managed to categorize even practical considerations that is considered as influence of brand on hospital performance and patient behavioral expectation are: A.

Conclusion
From these studies we have managed to categorize even practical considerations that is considered as influence of Analyze significant components of service brand equityi.e.perceived service quality, brand loyalty, and brand imageand analyze relationships among the components of brand equity and also their relationship with brand equity, which is still to be theorized and developed in the healthcare literature.
(+):The study findings reveal certain significant outcomes relating to brand loyalty and perceived quality.First, brand loyalty is linked with indicators associated with attitudinal loyalty and behavioral loyalty (i.e.consequences of consumer satisfaction).Second, to strengthen perceived service quality, patients indicate that hospital management should focus on staff behavior, assurance, and tangibility.Specifically, communication quality, prescription quality, promptness in response to queries, and caring attitude of the staff are considered by patients as important characteristics of staff behavior that contribute to perceived service quality .3.tangible factor items such as adequate stock of medicine, availability of state of art technology equipments and availability of parking facility also adds to perceived service quality.Oganizations with high degree of service brand equity will be efficient in sustaining competitive performance 4.
Brand trust and image: effects on customer satisfaction (2017)

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marketing and branding to attract and satisfy customers.
(-) Brand trust was not significant with customer satisfaction and had no effect on healthcare service use.

5.
Comparative Analyze effective components on branding in selective hospitals that have influence for improving strong points, outcomes and titles earned by hospital.
(+) Subject public hospitals have done branding and were successful in this field.(+)Mainly in these hospitals objective efforts have been done for improving strong points, outcomes and titles earned by hospital.(+)Each of the subject hospitals use a strategy for hospital branding (+) Preserving brand positioning among customers and in the market as the effective factor in hospital branding, relates to improving the relationship between brand and customers and market.(+) recently hospital brand image has turned into an important factor for comparing hospitals by customers.(+) Success of branding projects among public hospitals relies on competitive ability.Hospitals tendency towards offering distinguished quality and according to customers' needs helps them be superior and valuable among customers.This also increases personality and serf confidence.In subject hospitals in the present study competitive policies have been observed, which are a way of improving the level of performance and service acceptance.competitive activities leads the organization to more profit and chances for developing brand and this confirms the importance of competitive positioning of the brand Brand strategy improves the organization brand with recognizing customer favorableness and unique identity for the services and products and this Way brings value for the customer and identity for the organization.(+)Desired relationship of the organization with customer is a solution for long term customer satisfaction it even starts before direct contact with the customer and continues after the contact, subject hospitals tried to improve their brand using branding strategies 6 Antecedents of hospital brand image and the relationships with medical tourists' behavioral intention (2016) The work provides a comprehensive analysis of how the organization is designed, promoted, and a successful marketing plan is implemented using positioning and branding strategies to effectively penetrate a market and foster ongoing patient/healthcare provider relationships.
(+) The improvementof Patient satisfaction reflects the advancements made with patient care pertaining to both their in-hospital experience and surgical outcome.
(+)the improvement patient satisfaction reflects the advancements made with patient care pertaining to both their in-hospital experience and surgical outcome (+)a decline in patient length of stay conveys improved patient care and more rapid recovery.These factors contribute to decreased costs for patients, hospitals, and insurance carriers.total inpatient case net revenue declined by 24% and outpatient case net revenue decreased by 5%

Yuliani,
Influences of Brand on Hospital Performance and Patient Behavioral Expectations Jurnal ARSI/Juni 2019 130 Sharma (2017) O. et al(2017)analyze the factors that affect the success of hospital branding , which have many dimensions, such as brand equity, brand loyalty, brand image, brand awareness, brand trust, brand mark, brand promise, brand positioning, brand advocacy, brand attitude, brand personality, brand satisfaction, brand resonance, brand choice, and brand performance.It was very complex research and the result was very valuable, which can conclude the many dimensions of the success of branding and suitable with the reseach bySharma (2017)that findingthe major factors affecting patients's satisfaction and loyalty at a health-care organization in India is a good brand image.This study can reflect the extent to which the current quality systems are effective in building a good brand image for India, such as: quality of objects, quality of process, quality of infrastructure, quality of interaction.
Influence of Brand on Hospital Performance -Improving quality of objectsThe technical quality of the treatment that the patient receives during a hospital visit.improving quality of process,

Table 1 . Descriptive characteristics of the selected articles
brand on hospital performance and patient behavioral expectation are influence of brand on hospital performance, influence of brand on patient behavioral expectation, Medical team in referral.But we have to consider the factors that affect the success of hospital branding , which have many dimensions, such as brand equity, brand loyalty, brand image, brand awareness, brand trust, brand mark, brand promise, brand positioning, brand advocacy, brand attitude, brand personality, brand satisfaction, brand resonance, brand choice, and brand performance.

Table 2 . Analysis of the Included Studies
)service quality has a positive impact on re-visit intention, but this hypothesis was not supported The results reveal that hospital brand image has both direct and indirect effects on patient loyalty.It means that a positive hospital brand image not only increases patient loyalty directly, but it also improves patient satisfaction through the enhancing of perceived service quality, which in turn increases the re-visit intention of patients.Hospital brand image indeed serves as a lead factor in enhancing service quality, patient satisfaction, and patient loyalty.In addition, the results imply that the path from service quality to patient satisfaction is a key avenue for the impact of hospital brand image on patient loyalty.