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During the last 20 years, companies started paying more attention to customer loyalty to retain existing customers due to increased competition globally. Existing studies showed that customer satisfaction is one of the most important factors in achieving customer loyalty (Palmer, 1998; Jones and Sasser, 1995; Oliver, 1999). However, although customer satisfaction influence purchase behavior (Kotler, 1998), it may not be sufficient for customer loyalty (Fornell, 1992). Because of that, companies may try to create structural barriers so that it may be more difficult for customers to prefer another brand or product. These barriers increase the cost of changing brand or product for the customer and one of the most important structural barriers is accepted as the switching costs (Klemperer, 1987a; Farrel ve Shapiro, 1988; Klemperer, 1995). Switching costs are the economic, physical and psychological costs that customer face when he/she switch from one brand/product to another (Jackson, 1985). These costs lowers customer loss due to slight fluctuations in product quality in the short-run (Fornell, 1992) and also, by having a monopoly power on existing customers, current market share becomes an important determinant for future income flow (Klemperer, 1987b; Klemperer, 1987c; SchIesinger and Schulenburg, 1991; Beggs and Klemperer, 1992).

The Effects Of Customer Satisfaction and Switching Costs On Customer Loyalty In Health Care