Exploring Consumers’ Negative Electronic Word-of-Mouth of 5 Military Hospitals in Taiwan Through SERVQUAL and Flower of Services: Web Scraping Analysis
Authors: Huang Ching-Yuan , Lee Po-Chun , Chen Long-Hui 
Published: April 2024

Background
In recent years, with the widespread use of the internet, the influence of electronic word-of-mouth (eWOM) has been increasingly recognized, particularly the significance of negative eWOM, which has surpassed positive eWOM in importance. Such reviews play a pivotal role in research related to service industry management, particularly in intangible service sectors such as hospitals, where they have become a reference point for improving service quality.

Objective
This study comprehensively collected negative eWOM from 5 military hospitals in Taiwan that were at or above the level of regional teaching hospitals. It aimed to investigate service quality issues before and after the pandemic. The findings provide important references for formulating strategies to improve service quality.

Methods
In this study, we used web scraping techniques to gather 1259 valid negative eWOM, covering the period from the inception of the first review to December 31, 2022. These reviews were categorized using content analysis based on the modified Parasuraman, Zeithaml, and Berry service quality (PZB SERVQUAL) scale and Flower of Services. Statistical data analysis was conducted to investigate the performance of service quality.

Results
The annual count of negative reviews for each hospital has exhibited a consistent upward trajectory over the years, with a more pronounced increase following the onset of the pandemic. In the analysis, among the 5 dimensions of PZB SERVQUAL framework, the “Assurance” dimension yielded the least favorable results, registering a negative review rate as high as 58.3%. Closely trailing, the “Responsiveness” dimension recorded a negative review rate of 34.2%. When evaluating the service process, the subitem “In Service: Diagnosis/Examination/Medical/Hospitalization” exhibited the least satisfactory performance, with a negative review rate of 46.2%. This was followed by the subitem “In Service: Pre-diagnosis Waiting,” which had a negative review rate of 20.2%. To evaluate the average scores of negative reviews before and during the onset of the COVID-19 pandemic, independent sample t tests (2-tailed) were used. The analysis revealed statistically significant differences (P<.001). Furthermore, an ANOVA was conducted to investigate whether the length of the negative reviews impacted their ratings, which also showed significant differences (P=.01).

Conclusions
Before and during the pandemic, there were significant differences in evaluating hospital services, and a higher word count in negative reviews indicated greater dissatisfaction with the service. Therefore, it is recommended that hospitals establish more comprehensive service quality management mechanisms, carefully respond to negative reviews, and categorize significant service deficiencies as critical events to prevent a decrease in overall service quality. Furthermore, during the service process, customers are particularly concerned about the attitude and responsiveness of health care personnel in the treatment process. Therefore, hospitals should enhance training and management in this area.