Adding a competitive dimension to importance-performance analysis: an application to traditional health care systems.

This study introduced an extension of importance-performance analysis by further including the performance of competitors. It demonstrated its value by applying it to a national sample of fee-for-service health care users. This study found that inappropriate strategies may result from importance-performance analysis that excludes a dimension of competition. In particular, the two attributes, availability of both physicians and emergency services, were found to be "high" on importance and "good" on fee-for-service performance. From the basic classic importance-performance approach, a relatively passive strategy would be recommended for each of these attributes. When also considering competition, however, a more appropriate, vigorous strategy of head-to-head competition clearly emerges.