This study aims to identify the types of value co-destruction (VCD) emerging in healthcare services that cause patients to reduce or extinguish their intentions to continue using the services; it also aims to identify the VCD antecedents. Complaints from 1075 dental clinic patients, which are collected as textual data, are analysed in this study. The authors adopt an exploratory approach comprising a quantitative analysis based mainly on the topic model, a type of machine learning, and a qualitative analysis based on the KJ method. Twelve types of VCD were empirically identified, three of which had a significant negative effect on the intention to continue using the service. Ten antecedents that cause these types of VCD were identified, when examined based on a multi-level perspective, institutional factors and social norms were found to be related to the VCD process. This study contributes to understanding the mechanisms by which failures in healthcare services occur and to developing effective decision making to overcome them.
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