Education and Counseling Pathways to Hospital Pharmacy Membership Adoption: A PLS-SEM and NCA Approach
DOI:
https://doi.org/10.69569/jip.2026.305Keywords:
Medication adherence, Necessary Condition Analysis, Hospital pharmacy membership model, Partial Least Squares-Structural Equation Modeling, Subscription intentionAbstract
Hospital outpatient pharmacies face intensifying competition from community drug outlets, yet evidence on scalable membership models that improve adherence and retention remains limited. This study evaluates a Pharmacy Services Membership Business Model (PSMBM) at The Medical City Iloilo Hospital Inc. (TMCIHI), quantifying how service attributes drive subscription intention and behavior. Using a cross-sectional survey (n = 220), Partial Least Squares Structural Equation Modeling (PLS-SEM) and Necessary Condition Analysis (NCA) were applied to four service domains: Medication Adherence Education (MAE), Medication Counseling (MC), Order & Delivery Services (OPD), and Pricing. The structural model explained 58% of the variance in Intention to Subscribe (R² = 0.58) and 41% in Actual Subscription (R² = 0.41). Pricing (β = 0.801, p < 0.001) and OPD (β = 0.206, p = 0.020) were significant sufficient predictors. NCA identified Pricing (d = 0.444, p < 0.001) and MAE (d = 0.207, p = 0.021) as necessary conditions. Non-parametric tests revealed significant demographic differences across sex, income, education, and payment mode. Findings support PSMBM viability and offer actionable guidance for tiered pricing, logistics enhancement, and educational content design. The model contributes to SDG 3 (Good Health and Well-Being) and SDG 10 (Reduced Inequalities).
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