A Comparative Study of Positive and Negative Electronic Word-of-Mouth on the SERVQUAL Scale under the COVID-19 epidemic -Taking a Regional Teaching Hospital in Taiwan as an Example (preprint)

Background In recent years, studies have disclosed that electronic WOM (eWOM) more directly reflects consumers' post-purchase psychological perception, and directly affects repurchase behavior, which is valued by institutions in various fields. Within the scope of service characteristic evaluation, medical service is the most invisible and difficult to evaluate service attribute. They are service organizations that must have high trust attributes. Therefore, the eWOM review will significantly influence people's decision-making process for choosing a healthcare provider. The purpose of this research is to combine eWOM reviews with the SERVQUAL scale in a comparative study of positive and negative eWOM reviews of a certain regional teaching hospital in Taiwan.Methods This research obtained data of eWOM reviews publicly available on Google maps from a Regional Teaching hospital in Taiwan in the past 10 years (from June 24, 2011, to December 31, 2021) by using website scraping technology. The semantic content analysis method was used in this study to classify WOM reviews according to the revised PZB SERVQUAL scale.Results Statistical analysis is then conducted. During the COVID-19 pandemic, the positive reviews have shown a downward trend. Among the five determiners of SERVQUAL of PZB, positive WOM reviews performed best in “Assurance”, with a positive review rate of 60.00%, followed by 42.11% of “Reliability”. In negative WOM reviews, “Assurance” performed the worst, with a positive rate of 72.34%, followed by “Responsiveness” at 28.37% and “Reliability” at 26.95%.Conclusion Since the onset of the COVID-19 in 2020, negative eWOM has increased significantly and exceeded the numbers of positive eWOM. Regardless of the positive and negative reviews, what patients care most about is “Assurance” of the professional attitude and skills of the medical staff, which needs to be strengthened most urgently. In addition, good “Reliability” will help to build up positive eWOM. However, the "Responsiveness" of poor service waiting time can easily lead to the spread of negative eWOM. This study suggests that the hospital management should focus on these few service-oriented qualities.

Covid-19 mortality is associated with test number and government effectiveness (preprint)

Objectives: A question central to the Covid-19 pandemic is why the Covid-19 mortality rate varies so greatly across countries. This study aims to investigate factors associated with cross-country variation in Covid-19 mortality.Methods: Covid-19 mortality rate was calculated as number of deaths per 100 Covid-19 cases. To identify factors associated with Covid-19 mortality rate, a multivariable linear regression model was applied to a cross-sectional dataset comprising 78 countries and 1,790,550 patients infected by Covid-19. We retrieved data from the Worldometer website and the Worldwide Governance Indicators and World Development Indicators databases.Results: Covid-19 mortality rate was negatively associated with Covid-19 test number per 1,000 population (RR=0.97; 95% CI 0.96 to 0.99, P=0.013) and government effectiveness indicator (RR=0.96; 95% CI 0.93 to 0.98, P=0.001). Covid-19 mortality rate was positively associated with number of critical cases per 100 Covid-19 cases, Covid-19 case number per 10,000 population, proportion of population aged 65 or older and proportion of deaths attributable to communicable diseases in previous years (all with P<0.05). Predicted mortality rates were highly associated with observed mortality rates (r = 0.74; P<0.001).Conclusions: Multiple factors were associated with Covid-19 mortality rates. Increasing Covid-19 testing and improving government effectiveness may have the potential to attenuate Covid-19 mortality.Authors Li-Lin Liang and Chun-Ying Wu contributed equally to this work.