the development of a qualitative dynamic attribute value model for healthcare institutes

background: understanding customers has become an urgent topic for increasing competitiveness. the purpopse of  the study was to develop a qualitative dynamic attribute value model which provides insight into the customers' value for healthcare institute managers by conducting the initial open-ended questionnaire survey to select participants purposefully. methods: a total number of 427 questionnaires was conducted in two hospitals in taiwan (one district hospital with 635 beds and one academic hospital with 2495 beds) and 419 questionnaires were received in nine weeks. then, apply qualitative in-depth interviews to explore customers' perspective of values for building a model of partial differential equations. results: this study concludes nine categories of value, including cost, equipment, physician background, physicain care, environment, timing arrangement, relationship, brand image and additional value, to construct objective network for customer value and qualitative dynamic attribute value model where the network shows the value process of loyalty development via its effect on customer satisfaction, customer relationship, customer loyalty and healthcare service. conclusion: one set predicts the customer relationship based on comminent, including service quality, communication and em­pahty. as the same time, customer loyalty based on trust, involves buzz marketing, brand and image.  customer value of the current instance is useful for traversing original customer attributes and identifing customers on different service share.