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Customer value represents the difference between the benefits the customer (whether an intermediary or an end user) realizes from the use of a product or service and the costs (monetary, psychological, or other) that the customer incurs through that use. A patient, for example, could receive positive customer value through the benefit of having a bacterial infection controlled by an antibiotic with a high level of efficacy. The price paid for the drug is one potential cost; convenient availability of the drug in terms of where it can be purchased, another. The net customer value to that patient/customer would likely be positive if the bacterial infection were controlled promptly, unless the cost was exorbitant. Negative customer value could accrue if the side effects of such a drug were so severe that they produced a condition more medically threatening than the original infection. Similarly, a referring physician likely would be perceived as deriving positive customer value if the specialist to whom the patient was referred saw the patient promptly and diagnosed and treated the patient's condition effectively. Negative customer value might well be the result if the referral specialist saw the patient after so long a delay that the patient's condition had deteriorated significantly.

Customer value must be determined by finding out what the customer of a firm, a hospital, an individual, an intermediary, or another entity wants. Those “wants” are referred to as value dimensions. Costs to obtain those value dimensions must also be understood, to be able to assess what customer value represents in a particular situation, and whether it is positive or negative.

Customer Value and the Value Hierarchy

The value hierarchy is a multilevel representation of how customers deal with products and services in more depth and at greater levels of abstraction. Three levels of the hierarchy exist: attributes, consequences, and values or desired end states. These are interconnected such that the lower levels are the means by which the ends or the higher levels are achieved. At the base of the hierarchy are those attributes or features that the customer immediately perceives on thinking of a product or service. These are the elements that are most objectively defined, what is at the “top of the mind.” In an outpatient clinic, for example, patients who are customers of the clinic might indicate that they are seeking friendly staff, short waiting room time, efficient appointment scheduling, and knowledgeable physicians and support personnel—all concrete features, components, or characteristics that are being sought. No matter what the customer constituency, the first value dimension that occurs to a customer is usually at the attribute level.

Beyond attributes, however, are higher levels of value dimension, which give a more in-depth perspective on how products or services relate to customers but which also tend to be more abstract in nature. Above the basic attributes in the value hierarchy is the consequence level, which characterizes the product or service interaction with the customer. Consequences are, in fact, logical extensions of attributes and are thus higher-order value dimensions. They represent the customer's subjective opinion of what the product or service does for them in terms of both benefits and costs. Patients who indicate that a knowledgeable physician is an attribute/feature that they want in an outpatient clinic might have as higher-level value dimensions the consequences that they want to have confidence that the treatment recommended will be beneficial, that it will ameliorate their medical conditions, and that it will be covered by their medical insurance.

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