Brand equity in digital marketing: what does it mean in the health sector and how does it affect consumer decisions?

. Businesses are trying to achieve efficiency in marketing by using digital channels consisting of internet, social media and mobile platforms. The increase to be seen in the annual turnover of an enterprise, as well as the awareness of the brand, the interaction with the customers shows the brand equity. In other words, tangible and intangible assets are also related to brand equity. Here, the power of influence in the market, the customer's perception of value and brand loyalty are seen as factors affecting the situation. As a general concept, the health sector is the formation that deals with individuals and organizations that involve all phases from the production of health-related goods and services to consumption. It is formed by the decision of the consumer in the stages consisting of five steps taken up in the decision-making process of the consumer who needs a service or product. The aim of this study is to try to determine how consumers in the health sector have an effect on the decision-making process in order to understand the value that the consumer shows about a product or service about a business in digital marketing, which is the most important commercial shopping channel of today. In this direction, in order to obtain the necessary information about the field, data were collected from internet users in Istanbul using a Google form. These data were analyzed by applying t test and Anova test in SPSS system. As a result, a positive result has been reached as the effect of brand equity on consumer decision making in the health sector. It has been concluded that consumers give more importance to digital marketing channels and that this area should be more focused on in the health sector.


Digital Marketing
With the widespread use of the Internet and social networking, marketing -one of the most important aspects of business -has evolved into a digital marketing process. They now have the ability to move from a local to a global scale. Businesses can improve and maintain their brand awareness by leveraging the digital environment [2]. It is indispensable to ensure the adaptation to digital transformation, by spreading the digitalization culture throughout the organization and its functions with a holistic vision created within the framework of digitalization [3]. Healthcare organizations use digital marketing channels to promote their brands and inform consumers about the healthcare services they provide. It is evident that digital marketing has process-based relational conditions in brand equity, beneficial effects on the consumer purchasing moods and behavior, and favorable contributions to increasing brand equity [4].
Digital marketing in healthcare is critical for healthcare organizations. Perhaps we need to give examples of how digital marketing has been used in healthcare. The quality, tools and services offered by health-related businesses are posted on their websites, where visitors can schedule appointments and get information. They may use social media platforms like Facebook and Instagram to interact with customers and promote their services [5]. They use search engine optimization (SEO) to improve the visibility of their websites on search engines. They also offer their customers information about their services and promotions through email. Furthermore, they are able to promptly address customer needs and requests by efficiently analyzing data from digital marketing operations using tools such as "Google Analytics" or "Facebook Analytics" [6]. Digital advertising can facilitate the connection with the target audience and potential customers without difficulty. This can be considered as an illustration of the positive impact of digital marketing tools on health since it can also simplify the process for customers to schedule appointments, utilize services, and access information through mobile applications.
Digital marketing has a significant impact on consumer decisions in the healthcare industry. The availability of information through digital marketing tools facilitates the decision-making process for customers, enabling them to attain valuable insights about the healthcare services offered. Healthcare providers utilize their websites to promote their products and services, providing customers with access to information and promotions. Additionally, online scheduling tools and mobile applications expedite the decision-making process while enhancing the level of service provided to customers [7] Healthcare service providers have the potential to offer customers a mobile application that allows them to track and share their health information with their physicians. They may also collect personal information and preferences through personalized digital marketing services. This can help customers make more informed decisions and receive improved service. Additionally, it allows healthcare organizations to better engage with their customers and receive feedback from them. Methods such as website feedback forms or social media platforms can be utilized to reach out to customers [8]. By effectively leveraging digital marketing, businesses can ensure customer satisfaction through the use of various digital marketing channels.

Brand Equity
Nowadays, the concept of a brand encompasses much more than just a means of disseminating information about the quality and symbolic value of a given product. The concept of a brand depends on abstract perceptions that go far beyond physical and fictive aspects. It is worth mentioning that the brand on the products and the brand present in the customer's mind are not identical [9]. Strong brands offer businesses the opportunity to maintain their long-term sustainability through enduring competitive advantages. Brand equity is the mix of goodwill and beneficial effects, the value that a brand adds to a product, the manifestation of a brand's competitiveness in the market, and the utilization of an established brand in expanding into new product categories [10]. Depending on the financial standpoint of brand equity, enterprise value may take precedence, but the second definitionfrom a marketing standpoint -gives more weight to consumer-based brand equity [11].
The concept of brand equity comprises various sub-dimensions including brand awareness, association, loyalty, perceived quality, and overall brand equity. Marketing-E3S Web of Conferences 402, 13020 (2023) https://doi.org/10.1051/e3sconf/202340213020 TransSiberia 2023 oriented sponsorship strategies like launching a new product, promoting the use of an existing product, positioning the product, supporting dealers, changing the marketing strategy, and supporting an international marketing strategy can increase brand awareness and connotation among target audiences, boost perceived quality, and foster customer loyalty to the brand [12]. It is obvious that brand perception affects purchasing preferences. Satisfaction is the brand of your closet It is seen that there are correct directional parameters with High-income people have the best It does not appear that they show in choosing the brand. Frequent flyers prefer brand companies states that they are [13]. If consumers respond more (or less) favorably to the marketing mix of a product for which they are familiar with the brand than to the marketing mix of an identical but unbranded product, then the brand has positive (or negative) equity. Brand equity affects the consumer's response to the marketing mix, preference, choice intention and actual choice, and purchase decision [14].
Brand equity is a numerical representation of a brand's financial strength compared to other brands, which is determined by the value customers attach to the brand. Additionally, a brand's overall financial position in the market also affects its brand equity [15]. The price of a brand can impact its overall value, and brand equity plays a crucial role in determining its competitiveness in the market. This situation can be decisive in the strategic management of marketing. Considering the current market conditions, a strong brand equity can give a brand an edge over its competitors. Brand equity is determined by the additions, other variables in the industry and the current market environment [16]. A brand's proficiency in managing the market better than its competitors indicates its excellence in the industry. When a brand is used effectively, it earns admiration from customers and surpasses its competitors [17]. As long as the customer value offers a logical benefit, competitors will find value in it as well. When businesses provide customers with what they desire, their brands become more valuable. The presentation of the brand to the customer, understanding of the customer's requirements, behavior of the brand, and quality of the product all play a role in determining the brand equity [18]. Brand equity provides operational efficiency as a result of its ability to compete with competitors, its ability to contribute to businesses, and the emotional value it provides to consumers [19]. Attracting customers through communication and promotional activities also determines customer orientation. In the strategic management of brand equity, managers can achieve success in this process by seizing opportunities in the current market of the brand equity to customers [20].

Association Equivalence
Association equivalence is a valuable concept for businesses and brands as it enhances their market value. It is developed through customer brand equity and can ultimately generate monetary benefits for the business. Essentially, association equivalence refers to the connections a business has with interest groups beyond itself, like customers, suppliers, lobbyists, and public institutions [21]. In the realm of association equivalence, consumerbased understandings of brand equity draw heavily from cognitive psychology and information economics. This framework identifies several key dimensions of brand equity, including brand awareness, brand associations, perceived quality, brand loyalty, and other proprietary brand assets, such as patents, trademarks, and channel associations [22].

Consumer Decisions
One in three hospitals has a website application, according to Google's research on digital marketing efforts in the healthcare industry [23]. Hospitals are able to establish connections with their customers and enhance their marketing strategies with the incorporation of keywords on their websites. Moreover, the availability of English versions on many hospital websites enables them to reach out the customers around the world [24]. Healthcare businesses are able to effectively utilize social media as a means of fulfilling the traditional word-of-mouth communication model [25]. It is possible to access information and gain knowledge from a relative who follows similar healthcare organizations here. Rather than relying on outdated advertising methods that only attract customers to their own areas, some healthcare organizations are now creating innovative profiles to capture even more public interest [26]. Health organizations can greatly benefit their business by establishing an interactive and real-time relationship with consumers through advertising in the digital space round the clock, seven days a week [27]. Gaining insight into the public's current perception during this process can help the organization gain a more favorable position in the marketplace. Additionally, the patient's digital patient experience can be enhanced, thereby strengthening their interaction with the brand providing healthcare services [28]. In our country, private hospitals use the internet at a higher rate than public hospitals do, apparently because of market considerations [29]. Healthcare businesses are increasingly present on social media. Comments posted by patients on sites such as Facebook and YouTube allow other customers and business owners to learn about the business's level of customer service [30].
In today's globalized world, technology plays a crucial role in providing consumers with easy access to information about various goods and services. With the abundance of data available, consumers tend to be more selective in their choices. Marketers often describe the consumer purchase decision process as a five-step process, which includes identifying a need or problem, searching for information, evaluating alternatives, making the purchase decision, and ensuring customer satisfaction. It is, therefore, essential for marketers to have a good understanding of their target audience and consider their characteristics while formulating marketing strategies. Additionally, it is important to accurately identify the sources from which consumers seek information about goods and services and increase their access to data [31].
According to Rust et al. (2010), social media and information technologies will be heavily used in marketing efforts, and the majority of businesses have already begun using various technologies to attract consumers and foster brand awareness and loyalty [32]. Especially in recent years, there has been a significant shift in purchasing decisions of the consumer across all age groups [33], possibly due to the attitudes they have developed through learning [34]. In this context, the efforts of parents to impart consumer skills to their children have an influence on the purchasing attitudes of young consumers [35]. Consumers used to shop mainly in physical stores such as large shopping malls, but now they tend to shop through information and communication technologies and different social media tools or websites. This type of shopping, which involves purchasing items online through the internet or social media platforms, can be described using terms such as online shopping, Internet shopping, or online purchasing. Social media tools provide virtual platforms for users to engage with one another and share diverse content, including photos, videos, and comments. Through the provision of reviews and comments on social media, consumers can impact the purchasing decisions of other consumers. Similarly, corporate promotions and marketing on social media can also sway consumers' choices [36].
It is common for businesses to utilize marketing techniques in order to potentially sway the choices of their customers [37]. When a product is presented to a customer while they are making decision, it is just in time for them to see it in high definition. The goal is to convince a customer who is ready to buy to choose the item that the company is promoting. Businesses continuously seek to influence customers and connect them to their products through marketing. Today, the increasing number of product options and the growing influence of digital channels have created businesses that appeal to well-informed and knowledgeable consumers. In the current digital era, there exists a diverse range of products that cater to the preferences of the consumer. This is indeed heartening as it implies that the consumer is actively engaged in the decision-making process [38]. Consumers tend to evaluate a product briefly before making a decision to repurchase it due to their strong brand loyalty [39]. It is important to understand how the buyer decides and how the seller influences that decision. There is a process from the moment a consumer notices the products to becoming a loyal customer. In the digital marketing process, the consumer makes decisions online after considering the business's website and social media suggestions [40]. Brand values and personal values are taken into account when purchasing a product. "Initiator," "Initial Evaluation," "Re-evaluation," "Purchase," "Continued Exposure," and "Loyalty Cycle" are the steps in the purchase process.

Method and material
Our study aims to comprehend the influence of digital marketing on the healthcare sector, particularly in terms of its impact on customer preferences and brand equity. The Relational Survey Model, a quantitative research technique, was used in the study [41]. The study will determine the impact of surveys created in Google Form over a one-month period in December 2022 on the brand equity of healthcare consumers between the ages of 18 and 65, and how this influences consumer decisions.

Population Sampling
The study was conducted among 398 consumers on the Internet using descriptive content analysis methods. The population of the study consists of Internet users who get health care services. Situations such as the main mass and population in a study project include all the individuals and values that the researcher is considering in great detail [42]. For this reason, the scope of this study was broad and included all of Turkey rather than just one province or region. This population would be challenging to reach, thus the study continued with the sample.
As a sampling volume, it is sufficient to have at least 398 health service consumers from the main masses, which are calculated using the formula for the ratio estimation method in social sciences researches and do not have distinctive features in sampling theory [43]. Convenience sampling was used to select the study respondents and the most accessible individuals were selected. The formula was used to reach the 398 respondents in this study. n = Number of units required for sampling p and q = Homogeneity level of the main mass t = The value obtained from the t table according to the significance level selected in the study a = The margin of error accepted by the researcher before starting the study The frequency analysis and descriptive analysis also revealed the demographic characteristics. The reliability analysis using Cronbach's Alpha indicated that no items needed to be eliminated from the study as a result. In studies conducted in social sciences, the margin of error is generally accepted as 5%. For infinite degrees of freedom, t value is taken as 1.96 for a = 0.05 margin of error [44]. In studies conducted in social sciences, 95% or 99% is mostly used for confidence intervals. The most frequently used confidence interval is 95%. It was determined that the use of a 95% confidence interval in this study was appropriate given the data available.

Research Model and Hypotheses
The conceptual model of the research is based on the effect of brand equity in digital marketing and the association between demographic variables.

Hypotheses:
H1: There is a difference between the gender of the respondents and their digital marketing levels.
H2: There is a difference between the gender of the respondents and their brand equity levels.
H3: There is a difference between the gender of the respondents and their level of consumer decisions.
H4: There is a difference between the age ratios of the respondents and their digital marketing levels.
H5: There is a difference between the age ratios of the respondents and their brand equity levels.
H6: There is a difference between the age ratios of the respondents and their levels of consumer decisions.
H7: There is a difference between the education of the respondents and their level of digital marketing.
H8: There is a difference between the education and brand equity levels of the respondents.
H9: There is a difference between the education of the respondents and their level of consumer decisions.
H10: There is a difference between the income of the respondents and their level of digital marketing.
H11: There is a difference between the income of respondents and the level of brand equity.
H12: There is a difference between the income of the respondents and their level of consumer decisions.
H13: Digital Marketing has a positive impact on Brand equity.

Data Collection Tool
The necessary data were collected with a questionnaire form. Since the main masses of the study consisted of internet users and online shoppers, the data collection method was provided by the application of the questionnaire prepared from the electronic Google form. Time and cost are the most important factors in conducting surveys after obtaining the necessary permits. The questionnaire consists of two sections. The first section includes questions on age, gender, marital status, income and education. A section of questions based on the scales used to assess brand equity and digital marketing is included in the second n = t2 pq / a2 section. Due to inconsistent data from 5 incomplete or insufficiently completed fields and 21 respondents who gave the same answer to each question, a total of 26 respondents were excluded from the analysis. In order to measure the purchase decision process in online shopping, the questionnaire was created using questions from studies conducted by Cengiz and Şekerkaya and Omarlı and Parıltı. 12 Likert-type questions, rated from 1 (strongly disagree) to 5 (strongly agree), were asked to the respondents.

Method
The analysis of the survey data collected from the respondents to determine the results of the application is reported in this section of the study. The research was conducted with 398 respondents between January and December 2023. Analyses were performed by transfer to SPSS 25.0 program through Microsoft Excel 2010. Prior to testing, a missing value analysis and normality test were performed on the collected data. Tests such as kurtosis, skewness coefficients, histograms, and Kolmogorov-Smirnov can be used to determine whether the data have a normal distribution [45]. The results of the data analysis and comments on these results are presented in the findings section.

Results
The association of the scales to each other and to themselves was determined by comparing the originality of the research to related studies in the field. Table 1 below shows the frequency values and reliability analyses of 398 questionnaires. The confidence coefficient was found to range from a minimum of 0.710 to a maximum of 0.887 within the parameters of the study, indicating a high level of reliability. The ratio of male respondents was 225 and the ratio of female respondents was 295. These demographic characteristics of the respondents were examined in accordance with the scope of the research conducted. After analyzing the age of the respondents, 142 are between 20 and 30 years old, 242 are between 31 and 40 years old, 119 are between 41 and 50 years old, and 17 are over 50 years old. Regarding the educational level of the respondents, 170 completed an elementary education, 200 completed a high school or equivalent, 68 have an associate's degree, 58 have a bachelor's degree, and 24 have a master's or doctoral degree. After analysis of the income levels of the respondents, 332 respondents had an income between 1000 and 6000 TL, 156 had an income between 6001 and 10,000 TL, and 32 had an income of 10,000 TL or more. H1: There is a difference between the gender of the respondents and their level of digital marketing.
H2: There is a difference between the gender of the respondents and their brand equity levels.
H3: There is a difference between the gender of the respondents and their level of consumer decisions.
Digital marketing did not differ based on gender status, as determined by an analysis of the values created according to the independent t-test result ratios conducted as part of the research. (p=0.113>0.05).
Brand Equity (p=0.006<0.05) and Consumer Decisions (p=0.008<0.05) were found to differ statistically according to gender. Analysis of the averages shows that men score lower on Brand Equity and Consumer Decisions. H4: There is a difference between the age ratios of the respondents and their digital marketing levels.
H5: There is a difference between the age ratios of the respondents and their brand equity levels.
H6: There is a difference between the age ratios of the respondents and their levels of consumer decisions.
The values obtained as a result of the analysis of variance are as in the table above. Digital Marketing (p=0.756>0.05), Brand Equity (p=0.489>0.05), and Consumer Decisions (p=0.976>0.05) did not differ by age variable when evaluating the data in the table. H7: There is a difference between the education of the respondents and their level of digital marketing.
H8: There is a difference between the education of the respondents and their level of brand equity.
H9: There is a difference between the education of the respondents and their level of consumer decisions.
It was determined that Digital Marketing scores showed a statistically significant difference according to educational status (p=0.014<0.05). Individuals with associate degree education scored higher on the Digital Marketing section than those with elementary education, according to the analysis of the post hoc test to identify the groups from which the differences originated.
It was determined that the Brand Equity scores showed a statistically significant difference according to educational status (p=0.039<0.05). It was found that those with a bachelor's degree scored higher on brand equity than those with a Ph.D. according to the analysis of the post hoc test to identify the groups from which the differences originated.
It was determined that Consumer Decisions scores showed a statistically significant difference according to educational status (p=0.009<0.05). It was found that the Consumer Decisions scores of individuals with an associate degree level of education were higher than those of individuals with a Ph.D. according to the analysis of the post hoc test to identify the groups from which the differences originated. H10: There is a difference between the income of the respondents and their level of digital marketing.
H11: There is a difference between the income of the respondents and the level of brand equity.
H12: There is a difference between the income of the respondents and their level of consumer decisions.
The information about the values obtained as a result of the analysis of variance is as in the The correlation coefficients between the brand equity scale, consumer decisions and digital marketing have values between 0.3 and 0.4 when they are examined. Based on these values, it can be concluded that there is a close to medium positive association between the brand equity scale and consumer decisions.
The data from the correlation study shows that digital marketing does not affect brand equity and consumer decisions in general. Regression analysis should also be used to analyze the data in order to fully explore and quantify the associations. H13: Digital Marketing has a positive impact on Brand equity. The p-value calculated for model significance is 0.000. Regression analysis was used to examine the association between brand equity scale, consumer decision levels and digital marketing, and it was found that the regression model was significant (p=0.00<0.05). The calculations showed that there was no correlation between brand equity and consumer decisions (p=0.000 and p=0.340, respectively). (p>0.05). Digital Marketing (p=0.013<0.05) and brand equity (p=0.018<0.05) are statistically related to consumer decisions.

Discussion and conclusion
The results of the data analysis from this study and the discussions related to other studies can be listed as follows; Depending on how quickly technology evolves, the widespread use of computers and the Internet may allow consumers to conduct all transactions digitally. Social media platforms are where the majority of marketing efforts in the digital world take place. These are important aspects of online consumer interaction.
The knowledge gained from communicating in these areas is reflected in everyday customer behavior. Digital marketing communication is different from traditional marketing communication. Unlike the one-way communication of everyday life, digital marketing is reciprocal. In digital marketing, consumers, or users, produce the content. As a result, digital consumers have become capable of influencing large masses. We can see that the marketing strategy has caught up with the healthcare sector's service delivery in the digital sphere to a considerable extent. It requires greater sensitivity when dealing with marketing and branding because it touches on a sector that involves human lives. This is why it also regulates how digitization affects health and marketing.
As a result of the t-test conducted for "digital marketing", "brand equity" and "consumer decisions" with "gender" variable, it was concluded that there was no difference between the respondents. According to the study by Zhang et al., the effect of "subjective norms" on online shopping behaviors emerged from the observation that it did not significantly differentiate male customers from female customers. Even if this subjective exposure occurs within the confines of an Internet-based marketing activity, male and female consumers are equally influenced by the opinions of others they perceive as important. According to Lieven et al. (2014: 378), brand gender is important to consider because it contributes significantly to the prediction of brand equity even when brand personality dimensions are taken into account. Studies support the idea that brand gender is salient to consumers and significantly influences consumer brand equity ratings. According to the Ioanas study, the data analysis showed that as customers' income increases, their interest in getting confirmation about a product they want to buy decreases. From the gender perspective, women lead the way when it comes to checking product information before making a purchase, doing so 80% of the time, while men are significantly less receptive or disinterested in doing so. There is a significant difference in the proportion of men and women who find reliable information from the many and varied online sources, with women about three times more likely than men to do so.
As a result of the t-test conducted for "digital marketing", "brand equity" and "consumer decisions" with "age" variable, it was concluded that there was no difference between the respondents. Consumers are increasingly using digital technology in their decision-making and purchasing processes, according to a study by Cao et al. These consumers include a new group of consumers who grew up with digital devices, and consumers who did not use digital media in the past but now do. A growing number of consumers have found a "sweet spot" in the waves of emerging technologies and have started to change the traditional chain of consumption behavior: 90% of people shop online. In the study by Lambert-Pandraud et al. regarding public policy implications, our results show that elderly consumers have less understanding about recently emerging options (e.g. new brands). This may lead them to ignore new options that would better suit their needs and thus make sub-optimal decisions. Therefore, elderly consumers should be shielded from this limited and biased perspective. This can be done by giving older people access to more comprehensive or accessible information. According to the study by Wu et al., the results of the analysis showed that sustainable consumer behavior is influenced by two types of attitudes (resource efficient and environmentally friendly), two types of knowledge and skills, life values, age, gender and similar variables. Due to diverse demographic factors including age and gender, people's choices for sustainable consumption have drastically varied.
As a result of the t-test conducted for "digital marketing", "brand equity" and "consumer decisions" with the variable "education level", it was concluded that there was no difference between the respondents. According to the study by Fierro et al., the consumer's perception and adaptation to their own culture has a direct impact on brand loyalty. Businesses have interacted with contextual elements such as geography and location through digital technology. It is acknowledged that the various areas where they strive to build a simpler platform for the customer to communicate with each other has become easier with "Customer Relationship Management" (CRM). It is concluded that diversifying the product portfolio of the enterprises and increasing the options offered, and getting educational support from universities around the world will increase customer satisfaction. According to the study conducted by Beneke, it was stated that managing the brand value of businesses and ensuring competitive success become more effective with continuous education. The corporate brand is similar to all other brands -it has been effective in reducing customers' perceived utility and providing stability and financial benefits to the brand owner. However, it was noted that any brand is much more difficult to manage than it appears. In this context, it was pointed out that there are many factors that make up a brand (e.g. the image of the business, consumer preference for the work done, product diversity, etc.) and all of these need to be adequately controlled. According to the study by Fierro and Rowlingson, for the economic model of financial education as consumer empowerment, increasing the supply of financial products has the potential to broaden and deepen consumer markets. At the same time, the significant increase in the number and variety of financial products on offer poses problems for consumers, as it increases complexity and the risk of poor quality or useless information circulating in the market. Reliance on inadequate information threatens consumers' interests, particularly in the case of financial products that are provided through long-term contracts or require individuals to delegate the management of their assets to decision-makers over whom they have no direct control.
As a result of the t-test conducted for "digital marketing", "brand equity" and "consumer decisions" with the "income" variable, it was concluded that there was no difference between the respondents. The study by Krajnović et al emphasized that the use of modern technology in the field of digital marketing in general is related to the income of consumers. It has been shown that as individual income levels rise, so does the consumption of digital marketing. According to Brexendorf et al., there is an additional interaction between individuals' income and brand equity. The level of competition in emerging markets has increased significantly over the last few years and the growth in disposable income can lead to ever-evolving purchasing habits for consumers. According to a study by Ramya et al, income expectations are one of the important determinants of an individual's purchase decision. If individuals expect any increase in their income, they tend to spend more on shopping goods, durable goods and luxuries. On the other hand, if they expect any decrease in their future income, they will cut back on comfort and luxury spending and limit their spending to basic needs.
As a result of the analysis for "digital marketing", "brand equity" and "consumer decisions"; it has been determined that there is no association between "Brand Equity" and "Consumer Decisions"; "Digital Marketing" and "brand equity" are statistically related to "consumer decisions". According to the study by Khan et al. brand equity does not strengthen the association between digital marketing and online purchasing. The digital marketing has a positive impact on purchase intention and these two factors are directly related to each other. Overall, the study showed that brand equity in digital marketing has a positive impact on online purchase intention. According to Smith's study, the use of digital marketing to increase the competitive advantage of marketers, to reach target markets faster, to be in constant and live communication with existing customers and to perform all other marketing activities in the digital environment with the lowest costs has become a means of gaining competitive advantage.
According to the study by Al Fayad, multi-channel marketing strategy has gained importance thanks to the development of digital marketing. Thus, e-mail marketing has become an important component of the multichannel marketing strategy. Personal information received from the customer at the customer contact point has led to the development and spread of multi-channel marketing strategy by matching data such as purchasing behavior with the e-mail address. According to a study by Khan et al. digital channels have improved customer diversity and purchasing attitudes while enabling advertisers to deliver advertising messages at extremely low prices and even without having to move. According to the study by Clarke, e-mail marketing is one of the important tools of digital marketing. It can generally be considered as a complement to campaigns. Since it can be more tailored through content, better responses can be given in terms of engagement rate for interaction. For this reason, email marketing has found its place in most digital marketing strategies.
According to the study conducted by Trusov, Bucklin and Pauwels and Bhagwat and Sharma, the increase in the use of mobile devices with the developing technology and the change in people's lifestyles accordingly have changed the usage habits of the product or service. According to the study by Bhagwat and Sharma (2007), Digital marketing has provided many platforms for businesses to create awareness about the product they offer to consumers. Thus, digital marketing tools such as e-mail, mobile marketing, social media marketing, search engine optimization, pay-per-click and online advertising activities have been used in many sectors.
According to the study conducted by Gedik, "digital marketing" has a positive effect on "brand equity". The rapid development of social networks and technology has led to major changes in the way businesses communicate with consumers. Internet and digital marketing have become important factors in campaigns to attract and retain customers. Adoption of digital marketing is critical, especially for small businesses to reach customers more costeffectively and compete with competitors and larger businesses in the fiercely competitive marketplace. The brand, which is developed through the combination of different scenarios in order to create awareness for goods or services that are known between the producer and the consumer, but not shaped, is also essential in the health sector. Creating a strong brand in the digital world will be possible by offering different products from competitors. If the brand is managed correctly, it is possible to have brands with sustainable products. Consumer perceived quality increases brand awareness and supports brand loyalty. A brand with a high value can also demand a higher price from the consumer. The use of all channels to increase brand equity is increasing in the digital world. The use of applications in the digital marketing sector has recently become widespread in health service delivery. The use of digital marketing applications in our country's hospitals and pharmaceutical industry has been increasing, especially in recent years. It details the expected and intended uses of digital marketing in the healthcare industry and how these applications support marketing strategies .
Because of the urge to communicate swiftly with their target customers, every business is at a competitive disadvantage if they lack digital marketing skills. It is likely that the delivery of healthcare services in our country nowadays offers unique scenarios for evaluating digital marketing skills. The analysis showed that the demographic characteristics of gender, age, education and income variables have an impact on the consumer decisions of brand value in digital marketing. Therefore, in today's rapidly evolving digital world, healthcare companies should set new goals with strategic marketing plans to influence consumer decisions in the digital sphere. It is recommended that the study be conducted over a longer period of time with a larger sampling size, as it is not entirely appropriate given the time and financial constraints.