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Testing Hirschman’s exit, voice, and loyalty model: citizen and provider responses to decline in public health services
International Public Management Journal ( IF 2.951 ) Pub Date : 2021-03-01 , DOI: 10.1080/10967494.2021.1878314
Oliver James 1 , Peter John 2
Affiliation  

Abstract

Dissatisfied users of public services may choose to voice or exit. But when does voice emerge? To answer this question, we deploy Hirschman’s exit, voice, and loyalty (EVL) model. We set out an ‘available alternatives’ hypothesis—increasing the number of exit options reduces voice—in contrast to an ‘effective voice’ hypothesis where voice is lower when there is no choice. We expect the exit-voice relationship to be moderated by loyalty; and providers that respond to user voice improve satisfaction and reduce exit. We evaluate these hypotheses in a survey experiment on publicly funded doctors’ services in the UK. We find no effects of the number of exit options on voice, nor evidence for loyalty as a moderator. A response by the provider results in higher satisfaction and lower intention to exit, strengthened by loyalty. Providers can promote satisfaction and discourage users moving to alternative providers by responding to voice.



中文翻译:

测试 Hirschman 的退出、声音和忠诚度模型:公民和提供者对公共卫生服务下降的反应

摘要

对公共服务不满意的用户可以选择发声或退出。但是声音什么时候出现呢?为了回答这个问题,我们部署了 Hirschman 的退出、声音和忠诚度 (EVL) 模型。我们提出了一个“可用替代方案”假设——增加退出选项的数量会减少发言权——与“有效发言权”假设相反,即在别无选择时发言权较低。我们预计退出声音关系会受到忠诚度的影响;响应用户声音的提供商提高了满意度并减少了退出。我们在一项关于英国公共资助医生服务的调查实验中评估了这些假设。我们发现退出选项的数量对声音没有影响,也没有证据表明作为主持人的忠诚度。提供者的响应会导致更高的满意度和更低的退出意愿,并通过忠诚度得到加强。

更新日期:2021-03-01
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