Role of the xenocentrizm, cosmopolitanism and price in the effect of country image on health service quality and behavioral intentions

Country of origin is a concept that has been used in the field of international marketing for the purpose of determining, explaining, and predicting the attitudes and behaviors of the consumers. The effect of country-of-origin image have been investigated in such sectors as automobile, food-beverage, tourism, education etc.in the goods and services markets. Studies that investigate whether or not this effect prevails in the health sector, if so, the extent of the direction and magnitude of this effect and the roles of the certain variables that moderate it have not encountered. Based on the research gap aforementioned, the main purpose of this study is to determine the roles of certain socio-psychological and price factors in the effect of country image on health sector. It was identified that the debates on the literature suggest that the concept of country image have been measured in a cognitive-oriented way, ignoring the importance of the affective country image. Based on this gap and criticism determined about the measurement of the country image, it was meant to develop a new measurement tool on country image as a secondary purpose in order to accurately reach the main purpose of this study. In this context, reliability, and various validity types of the developed scale have been ensured through expert views, and a qualitative and two quantitative data collected. Upon the completion of the scale development, the findings of the research model had been discussed. Findings of the study imply that country image has a direct effect and an indirect effect through perceived service quality on a set of behavioral intentions such as purchase intent for both oneself and others, suggestion to others, positive word-of-mouth. The magnitudes and directions of the effects of country image differ in accordance with price and the variables determining out-group behaviors such as xenocentrism and cosmopolitanism. When price sensitivity and cosmopolitanism levels of the consumers are low and xenocentism level is high, country image turns more effectively to the behavioral intentions.