The relationship between perceived justice and its outcomes in the patient complaint process and a taxonomy study

This research aims to assess the complaint process of individuals who have formally lodged complaints, by conducting a thorough examination of the complaint management practices in health services. In this regard, the study has two main objectives. The first is to assess the complaints submitted by patients or their relatives who have experienced errors in healthcare services, examining how perceived justice in the recovery process, as influenced by the emotions and satisfaction levels of complaints with the recovery, impacts patient loyalty, negative word-of-mouth communication, and patient satisfaction with the institution. The second objective is to identify patients' experiences, needs, expectations, and types of complaints, in order to develop a coding taxonomy for an effective complaint management system in hospitals, which will inform healthcare managers in Turkey in accordance with the Regulation on Patient Rights and categorize the profiles of complaining patients. The research is structured around the complaint management practices prescribed by the Ministry of Health in Turkey. Excluded from this study are complaints related to medical malpractice, due to their distinct process and content evaluations. The setting of the study is a teaching and research hospital. For the first objective, a sample that derived from reports of face-to-face complaints submitted to the hospital's patient rights units over the past year was analyzed, ensuring the representativeness of the overall setting. A formula for calculating sample size was used to determine the sample size, based on the total number of applications in the last year. Participants, selected within the framework of purposive sampling method from individuals who used the hospital services during the research period, were first asked if they had submitted a complaint in the last year and data was then collected via face-to-face surveys. The participants were selected using a non-probability convenience sampling method, based on the characteristics described above. A total of 588 surveys were included in the analysis. For coding patient complaints, semi-structured interviews with the hospital's complaint unit staff (n=14) were conducted for the second objective of creating a taxonomy. With respect to the recommendations by relevant literature, the case study design, a qualitative research method, was utilized during the semi-structured interviews. The results of the research indicate that the subcomponents of perceived justice, procedural and interactional justice positively affect patient loyalty, whereas negative word-of-mouth communication has a direct negative effect. No significant effect of justice perception on patient satisfaction was observed. Negative emotions play a mediating role in the relationship between all subcomponents of perceived justice and both patient satisfaction and negative word-of-mouth communication. Additionally, negative emotions were found to have a mediating effect in the relationship between procedural and distributive justice and patient loyalty. Positive emotions also have a mediating role in the relationship between procedural and distributive justice and patient loyalty. Procedural justice affects negative word-of-mouth communication through positive emotions. Service recovery satisfaction plays a mediating role in the relationship between all subcomponents of perceived justice and patient satisfaction and negative word-of-mouth communication. Furthermore, interactional justice affects patient loyalty and patient satisfaction through service recovery satisfaction. Lastly, the research proposes a patient complaint taxonomy comprising six main themes (Medical Malpractice, Support and Quality Services, Administrative and Financial Affairs, Technical Affairs, Communication Problems, Systemic Issues).