By definition, marketing is part of a business operation which encompasses planning, promotion, pricing, and delivery of customer-oriented products or services [1] and is considered as a mix of components necessary for planning and implementing all marketing operations as a whole [2]. A marketing mix is a business tool empowering managers to stay in the global competitive environment [3].
In most organizations, the marketing mix is known as 4Ps: namely product, price, place, and promotion. In addition, customer engagement, physical environment, time, and processes are also effective factors in service delivery. Accordingly, “service marketing mixes” or 7Ps include the aforementioned (product, price, place, promotion), in addition to persons, physical environment, and process [4].
Like all organizations, hospitals as the providers of medical and treatment services should employ marketing components in order to achieve a successful performance [5]. Evidence suggests that marketing mix is of essence to optimize service prices, expand surgical operations, increase health awareness, change service providers’ attitudes, increase hospital’s financial resources, and reduce the communication gap between providers and users [6]. On the other hand, enhancing patient satisfaction is the main goal of hospitals and a factor promoting medication adherence and improving patients’ health status; this is the direct output of the marketing mix in hospitals [7]. Other investigations have reported positive outputs for those hospitals which adhere to marketing principles and establish their plans and programs based on marketing mix components [2, 8].
Many studies have been conducted on the relationship of marketing mix and selecting a hospital by patients in Iran. For example, a study in Isfahan, Iran (2001), found the most and the least important factors in selecting a private hospital by patients to be staff members (i.e., physicians and paramedics) and physical environment, respectively [9]. Nasiripour et al. [10] also emphasized on “place” and “price” as the most significant marketing components in public hospital selection in Iran. In Ardabil, Iran (2014), a study detected 13 factors effective in selecting a hospital and classified them into three groups of hospital services, social factors, and hospital facilities, with the hospital services being the major factor affecting such a selection decision [11]. In hospitals affiliated with the Iranian Army (2016), the authors claimed that two factors “physicians and staff,” followed by “clinic facilities,” had the greatest impact on patients’ willingness to choose a clinic [12].
In developed countries, the most important factors according to patients’ perspective differ. For example, a study in London, England (2005), listed factors such as high success rate of surgery, high sanitary standards, effective communication between hospitals and physicians, surgeons’ reputation, post-surgery care at home, hospital reputation, short waiting time, feasible visits for friends and family, ease of access to the hospital, short distance from home, free transfer, free comforts for the patient’s companion, and private and teaching hospitals as the most important factors influencing the patients’ selection in turn [13]. In developing countries, a different ranking of factors was reported by patients. For example, a study in Vietnam (2017) declared that factors such as comfort, specialties, reputation, and word of mouth were the factors effecting hospital choice [14].
In Iran, Abedi and Abedini [2] have identified 7 marketing mix that influence choice. Their results showed that in public hospitals, the price, products, physical assets, place, process, people, and promotion were the determining factors. Meanwhile, in private hospitals, products, physical assets, promotion, place, process, people, and price were a higher priority respectively [2].
Considering the variations of factors among different studies, and given that marketing mix can be an important tool in improving the status of costly hospitals, especially in low- and middle-income countries [15], identification of the main factors affecting the hospital service’s marketing is of essence. Furthermore, as there were no previous studies in this field in Shiraz which is the largest referral metropolitan region in southern Iran, this study aimed to identify the factors in the marketing mix that influence patients’ selection of a hospital in selected hospitals of Shiraz, Iran. The results may provide key information that guide the development of optimal marketing strategies for public corporate and private hospitals and thus enhance patient satisfaction and increase hospitals’ share in the competitive market.