Patient Context: A New Concept for Gap Model to Understand Patient Satisfaction



The purpose of this paper is to propose a new concept named patient context, which is developed by restructuring findings from sociology related to health and medicine. Patient context consists of trigger(s) by which a person is induced to contact medical service. Triggers are situations that evoke utility of medical service to the person. Patient context should play a crucial role in understanding patient satisfaction by the gap model because trigger should be reflected in expectations. In this paper, (1) what kind of triggers forms patient context and (2) how patient context contributes to a deeper understanding of patient satisfaction are described.


Context Gap model Healthcare service Patient satisfaction 


  1. 1.
    Donabedian A (1966) Evaluating the quality of medical care. Milbank Memorial Fund Q 44(3):166–206CrossRefGoogle Scholar
  2. 2.
    Donabedian A (1980) Explorations in quality assessment and monitoring, vol 1. Health Administration Press, Ann ArborGoogle Scholar
  3. 3.
    Parasuraman A, Zeithaml V, Berry L (1985) A conceptual model of service quality and its implications for future research. J Mark 49:41–50CrossRefGoogle Scholar
  4. 4.
    Lovelock C, Wright L (1999) Principles of service marketing and management. Prentice Hall, Upper Saddle RiverGoogle Scholar
  5. 5.
    Brown S, Swartz T (1989) A gap analysis of professional service quality. J Mark 53:92–98CrossRefGoogle Scholar
  6. 6.
    Parsons T (1951) The social system. Free Press, GlencoeGoogle Scholar
  7. 7.
    Suchman E (1965) Stages of illness and medical care. J Health Hum Behav 6:114–128CrossRefGoogle Scholar
  8. 8.
    Rosenstock I (1974) The health belief model and preventive health behavior. Health Educ Behav 2(4):354–386Google Scholar
  9. 9.
    Barsky J (1981) Hidden reasons some patients consult doctors. Ann Intern Med 94(part 1):492–498CrossRefMathSciNetGoogle Scholar
  10. 10.
    Rosenstock I (1966) Why people use health services. Milbank Memorial Fund Q 44(3):94–127CrossRefGoogle Scholar
  11. 11.
    Cornford CS (1998) Why patients consult when they cough: a comparison of consulting and non-consulting patients. Br J Gen Pract 48(436):1751Google Scholar
  12. 12.
    Armstrong D (1984) The patient’s views. Soc Sci Med 18:737–744CrossRefGoogle Scholar
  13. 13.
    Anderson JAD, Buck C, Danaher K, Fry J (1977) Users and non-users of doctors: implications for self-care. J Roy Coll Gen Pract 27(176):155Google Scholar
  14. 14.
    Fadem B (2012) Behavioral science in medicine. Wolters Kluwer Health/Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  15. 15.
    Friedson E (1970) Professions of medicine: a study of the sociology of applied knowledge. University of Chicago Press, ChicagoGoogle Scholar
  16. 16.
    Kleinman A (1980) Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine and psychiatry. University of California Press, BerkeleyGoogle Scholar
  17. 17.
    van de Kar A et al (1992) Why do patients consult the general practitioner? Determinants of their decision. Br J Gen Pract 42(361):313Google Scholar
  18. 18.
    Rosenstock I (1974) The health belief model and preventive health behavior. Health Educ Monogr 2(4):354–386Google Scholar
  19. 19.
    Kasl SV, Cobb S (1966) Health behavior, illness behavior and sick-role behavior. I. Health and illness behavior. Arch Environ Health 12:246–266, II 12:534–541CrossRefGoogle Scholar
  20. 20.
    Sigerist H (1945) Civilization and disease. Cornell University Press, IthacaGoogle Scholar
  21. 21.
    Foucault M (1963) The birth of the clinic (translated from the French by A.M. Sheridan Smith). Routledge, LondonGoogle Scholar
  22. 22.
    Achkerknecht E (1967) Medicine at the Paris hospital 1794–1848. Johns Hopkins University Press, BaltimoreGoogle Scholar
  23. 23.
    The Japan Sociological Society, Editorial Committee on Encyclopedia of Sociology (2010) Encyclopedia of sociologyGoogle Scholar
  24. 24.
    Armstrong D (1995) The rise of surveillance medicine. Sociol Health Illness 17(3):393–404CrossRefMathSciNetGoogle Scholar
  25. 25.
    Japanese Ministry of Health, Labor and Welfare (2009) Comprehensive survey of living conditions. Ministry of Health, Labor and Welfare, JapanGoogle Scholar
  26. 26.
    Zeithaml V, Berry L, Parasuraman A (1993) The nature and determinants of customer expectations of service. J Acad Mark Sci 21:1–12CrossRefGoogle Scholar
  27. 27.
    Maslow AH (1970) Motivation and personality, 2nd edn. Harper & Row, New YorkGoogle Scholar
  28. 28.
    Gnoth J (1997) Tourism motivation and expectation formation. Ann Tour Res 24(2):283–304CrossRefGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  1. 1.Tokyo Institute of TechnologyTokyoJapan

Personalised recommendations