Customer trust and perceived service quality in the healthcare sector: Customer aggressive behaviour as a mediator

Most healthcare providers experience some form of aggressive behaviour by patients and their relatives (i.e. customers). Customer aggressive behaviour (CAB) is detrimental to customers and healthcare providers, as well as to the overall service quality provided by the healthcare organisation. Drawing on the Social Exchange Theory, the purpose of the study was to examine whether customers' trust in healthcare providers decreases incidents of CAB and in turn improves the perceived service quality of the clinic. Data were collected from 45 primary care clinics of the same organisation, including three sources: Customers (N=579); healthcare providers (N=398); and data provided by the organisation. The data were aggregated and analysed at the clinic level. The results confirmed a mediation model in which customer trust in healthcare providers reduced CAB as experienced by providers, which in turn led to higher levels of clinics' perceived service quality. As CAB in this study was examined as a mediating factor, it was possible to investigate its role within the context of the organisational dynamic. Practically, these findings suggest that healthcare organisations should proactively create and nurture a culture of trust between customers and healthcare providers in order to promote service quality through reducing CAB.