Özet:

LITERATURE RESEARCH SUBJECT Recently, many scientific and technological developments have occurred in the health sector as in all sectors. Thanks to these developments, the new methods and practices revealed provide extra advantages and convenience to patients and practitioners. (Bozkurt, 2020). Nowadays, people have become more searching and questioning. By gaining a comparative quality with the opportunity to access information more efficiently, they have become more sensitive about the personalization and quality of the service. Besides, the number of private hospitals and health centres has also increased (Zor and Biçer, 2020). Thus, in order to survive in the sector and the sustainability of the service between all public and private healthcare enterprises, intense competition has been entered. In this context, the brand concept, which is considered to be the determinant of the prestige, character and relations of the enterprise, which shapes and affects the purchasing decisions of consumers and the increase in competition between businesses and consumers (Demirgüneş & Avcılar, 2014) draws attention. Brands can create an emotional bond and relationship between consumers and institutions. Especially with the formation of this emotional attachment in healthcare, consumers can identify with the healthcare provider's brand. A brand is a promise by the hospital to provide its customers with the care they need. Health service branding requires the institution to reach the expected standards with its products and services and to prioritize how to manage consumer perceptions and emotions (Mangini, 2002). Continuous preference of healthcare institutions in order to meet the health service needs of all internal and external customers in the intensely competitive environment, and positive communication efforts by the customers and becoming the "advocate" of the brand will provide significant advantages. RESEARCH PURPOSE AND IMPORTANCE   This study aims to examine the impact of customer-oriented behaviour of institutions operating in the healthcare sector on the brand prestige, brand trust and brand advocacy behaviours of the patient. Considering the scarcity of studies on branding and marketing efforts of hospitals, which are important actors of health services, and the relationships observed between variables examined in the study, it is thought that the results obtained will contribute to the relevant literature academically. Healthcare institutions and organizations will be able to make significant contributions to marketing and brand managers by creating strong brands to gain a competitive advantage.   CONTRIBUTION of the ARTICLE to the LITERATURE   Although it has been studied extensively in other fields, it is the examination of the relationships between the concepts of customer orientation, brand prestige, brand trust and brand advocacy within the scope of healthcare marketing.   DESIGN AND METHOD RESEARCH TYPE   Quantitative Research Method   DATA COLLECTION METHOD Two hundred fifty participants were selected using the convenience sampling method, which is one of the non-probability methods.   QUANTITATIVE / QUALITATIVE ANALYSIS PLS structural equation model was used to test the hypotheses.     RESEARCH HYPOTHESES H1: Customer orientation has a positive effect on brand trust. H2: Customer orientation has a positive effect on brand prestige. H3: Customer orientation has a positive effect on brand advocacy. H4: Brand trust has a positive effect on brand advocacy. H5: Brand trust has a mediating effect between customer orientation and brand advocacy. H6: Brand prestige has a positive effect on brand advocacy. H7: Brand prestige has a mediating effect between customer orientation and brand advocacy.   FINDINGS AND DISCUSSION FINDINGS as a RESULT of ANALYSIS According to the analysis results; it has been determined that the direct impact of customer orientation on prestige is significant; the direct impact of customer orientation on trust is significant; the impact of customer orientation on advocacy is significant; that prestige has a significant direct impact on advocacy; the direct effect of trust on advocacy is significant.   HYPOTHESIS TEST RESULTS According to the analysis results, all hypotheses were accepted.   DISCUSSING the FINDINGS with the LITERATURE The results reached in the study were supported by the studies in the relevant literatüre (Berry, 2000; Swan vd.,1999; Frasquet vd., 2008; Schwepker Jr., 2003; Hanzaee ve Taghipourian, 2012; Baek vd.,2010; Choi vd., 2017;Dean, 2007; Kelley, 1992; Kotler ve Turner, 1993; Peck vd., 1999; Steenkamp vd., 2003; Jin vd., 2016; Turan, 2011; Mahjoub ve Naeij, 2015; Yapraklı ve Keser, 2017; Hwang ve Han, 2016; Hwang ve Hyun, 2012; Gilaninia vd., 2012; Jarvenpaa vd., 2000; Düzgün, 2015; Selvi, 2007; Anderson ve Weitz, 1989; Lee vd., 2016; Elliott ve Yannopoulou, 2007; Hassan vd., 2015).   CONCLUSION, RECOMMENDATION AND LIMITATIONS RESULTS of the ARTICLE   As a result of the analysis, it was determined that the customer-oriented behaviours of the hospitals have a direct and positive effect on brand prestige, brand trust, and brand advocacy. Also, it was found that brand prestige and brand trust play a partial mediating role in the effect of customer orientation on brand advocacy.   SUGGESTIONS BASED on RESULTS   The positive attitudes of employees who strive to meet customer expectations at the highest level, the brand prestige of the organization and the increase of trust in the institution are also crucial for the success of the institutions. The finding that these concepts indirectly contribute to the increase of customers who advocate the institution and its brand, thanks to their mediating role, shows that these two concepts, such as at least customer orientation, are the concepts that should be focused on in the marketing strategies of hospitals.   LIMITATIONS of the ARTICLE   One of the limitations of the study is that it was conducted only in Gaziantep and in two (one state and one private) hospitals. Another limitation is that only the relationships between the selected variables were examined. Conducting future studies in different regions and covering more hospitals will contribute to a more generalizable examination of the subject. Besides, increasing the variables examined by the literature and examining the relations between them in terms of various characteristics of the participants will contribute to the development of the results obtained in this study.

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