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Qual Manag Health Care. 2009 Jan-Mar;18(1):48-58. doi: 10.1097/01.QMH.0000344593.40886.b5.

Culture-related service expectations: a comparative study using the Kano model.

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King Fahd National Guard Hospital, Riyadh, Kingdom of Saudi Arabia.



To compare service expectations between Arab and Austrian patients.


We used a Kano model-based questionnaire with 20 service attributes of relevance to the dialysis patient. We analyzed 530, 172, 60, and 68 responses from Saudi, Austrian, Syrian, and UAE patients, respectively. We compared the customer satisfaction coefficient and the frequencies of response categories ("must be," "attractive," "one-dimensional," and "indifferent") for each of the 20 service attributes and in each of the 3 national groups of patients. We also investigated whether any differences seen were related to sex, age, literacy rate, or duration on dialysis.


We observed higher satisfaction coefficients and "one-directional" responses among Arab patients and higher dissatisfaction coefficients and "must be" and "attractive" responses among Austrian patients. These were not related to age or duration on dialysis but were related to literacy rate.


We speculate that these discrepancies between Austrian and Arab patients might be related to underdeveloped sophistication in market competitive forces and to cultural influences.

[Indexed for MEDLINE]

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