ZENITH

International Journal of Multidisciplinary Research

Vol.1 Issue 8, December 2011, ISSN 2231 5780

ADAPTING THE SERVQUAL SCALE TO HOSPITAL SERVICES:

AN EMPIRICAL INVESTIGATION OF PATIENTS PERCEPTIONS OF
SERVICE QUALITY

DR. MAMTA BRAHMBHATT*; DR. NARAYAN BASER**; PROF. NISARG JOSHI***

*Associate Professor, National Institute of Cooperative Management,

Shri Jairambhai Patel Institute of Business Management and Computer Applications (SJPI- NICM)
Gandhinagar, Gujarat.
Post Graduate Center of Gujarat Technological University-MBA,
Nr. Indroda Circle, Gandhinagar-382007. Gujarat, India.
**Associate Professor, National Institute of Cooperative Management,
Shri Jairambhai Patel Institute of Business Management and Computer Applications (SJPI- NICM)
Gandhinagar, Gujarat.
Post Graduate Center of Gujarat Technological University-MBA,
Nr. Indroda Circle, Gandhinagar-382007. Gujarat, India.
***Assistant Professor, National Institute of Cooperative Management,
Shri Jairambhai Patel Institute of Business Management and Computer Applications (SJPI- NICM)
Gandhinagar, Gujarat.
Post Graduate Center of Gujarat Technological University-MBA,
Nr. Indroda Circle, Gandhinagar-382007. Gujarat, India.

ABSTRACT

The customers perception is your reality. - Kate Zabriskie

This paper attempts to explore the concept of service quality in a health care setting. Based on
Parasuraman et al.s Modified SERVQUAL variables, the authors tried to identify the effects of
each variable to satisfaction. Data were collected through field research among 246 patients and
the data were analyzed using SPSS and Excel. The paper finds that service quality in health care
is very complex as compared to other services. The results revealed that the customers'
perceptions did not exceed their expectations, as they were dissatisfied with the level of
healthcare services rendered by both public and private sector hospitals. The paper adds a new
perspective towards understanding how the concept of service quality is adopted in a hospital
sector. The authors wish that this study identifies areas of dissatisfaction that can be quickly
remedied and ensures improvement in the areas of satisfaction with ongoing notice and
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importance.

KEYWORDS: Customer expectation, Customer perception, Hospital, Service Quality.

______________________________________________________________________________

1. INTRODUCTION

There is a growing consensus within the NHS of the significance of obtaining feedback from
patients in order to improve the quality of health care; consequently, many patient satisfaction
surveys are now undertaken by health care sector. Knowledge about the patients' perception
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towards health care quality is one of the most important steps towards introducing reforms in the
health care sector. Against a background of growing consumerism, satisfying patients has
become a key task for all healthcare activities. Satisfaction in service provision is increasingly
being used as a measure of health system performance. Customer satisfaction's importance is
well-documented in the marketing literature and is speedily gaining extensive recognition in the
healthcare industry. Many hospitals apply modern marketing ideas to serve customer markets in
a more efficient and effective way. An important strategic variable in this respect is service
quality. This paper attempts to explore the concept of service quality in a health care setting.

2. LITERATURE REVIEW

Service quality has become an important research topic in view of its significant relationship to
costs (Crosby, 1979), profitability (Rust and Zahorik, 1993), customer satisfaction (Boulding et
al., 1993), customer retention (Reichheld and Sasser, 1990), service guarantees (Kandampuly
and Butler, 2001), and financial performance (Buttle, 1996). Curry and Stark (2000) studied the
use of SERVQUAL across nursing homes in the UK, which provided a useful benchmarking
tool. Wan Edura Wan Rashid, Hj. Kamaruzaman Jusoff,1 (2009) attempted to explore the
concept of service quality in a health care setting. This paper probes the definition of service
quality from technical and functional aspects for a better understanding on how consumers
evaluate the quality of health care. It adopts the conceptual model of service quality frequently
used by the most researchers in the health care sector. At the end the researcher concluded that
service quality in health care is very complex as compared to other services because this sector
highly involves risk. Daniel Butler, Sharon L. Oswald, Douglas E. Turner2 (1996) investigated
the effects of demographic factors on users and observers of perceived hospital quality and noted
that previous research suggests the components of perceived service quality are industry
specific, and that calls have been made for academics to integrate their theory into practice. At
the end the researcher found that perceived quality is industry specific, users and observers differ
in their perceptions of hospital quality and demographic factors do make a difference in
perceived hospital quality. Ioannis E. Chaniotakis, Constantine Lymperopoulos 3(2009) aimed to
study the effect of service quality (SQ) dimensions on satisfaction and word of mouth (WOM)
for maternities in Greece. Based on Parasuraman et al.'s SERVQUAL variables, the authors tried
to identify the effects of each variable to satisfaction and WOM. From survey result the author
found that in addition to satisfaction, the only service quality dimension that directly affects
WOM, is empathy. In addition, empathy affects responsiveness, assurance and
tangibles which in turn have only an indirect effect to WOM through satisfaction. Ritu www.zenithresearch.org.in

1
Wan Edura Wan Rashid, Hj. Kamaruzaman Jusoff, (2009) "Service quality in health care
setting", International Journal of Health Care Quality Assurance, Vol. 22 Iss: 5, pp.471 482
2
Daniel Butler, Sharon L. Oswald, Douglas E. Turner, (1996) "The effects of demographics on
determinants of perceived health-care service quality: The case of users and observers", Journal
of Management in Medicine, Vol. 10 Iss: 5, pp.8 20
3
Ioannis E. Chaniotakis, Constantine Lymperopoulos, (2009) "Service quality effect on
satisfaction and word of mouth in the health care industry", Managing Service Quality, Vol. 19
Iss: 2, pp.229 242
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International Journal of Multidisciplinary Research
Vol.1 Issue 8, December 2011, ISSN 2231 5780

Narang 4(2011) intended to measure the perception of patients towards quality of services in
public health care centres in rural India. A 23-item scale that tested well for reliability and
construct validity was employed for the study. Mixed sampling technique was employed to
select the sample. The researchers found from the survey result that items, availability of
adequate medical equipments and availability of doctors for women are negatively rated.
Education, gender and income were found to be significantly associated with user perception.
Abdul Majeed Alhashem, Habib Alquraini, Rafiqul I. Chowdhury 5 (2011) aimed to identify
factors affecting patient's satisfaction at primary health care clinics. The questionnaires were
distributed in primary healthcare clinics that represent all heath care regions in Kuwait. From the
survey result researchers found that the majority (87 percent) of the patients responded that the
time for communication between physician and patient was not enough. Seventy-nine-percent of
the surveyed patients said they would go to the emergency room of the hospital in future if
needed instead of going to the primary care clinic. Regarding the quality of the communication
relationship between physician and patients most of the patients responded negatively. Norazah
Mohd Suki, Jennifer Chiam Chwee Lian, Norbayah Mohd Suki 6(2011) aimed to investigate
whether patients' perceptions exceed expectations when seeking treatment in private healthcare
settings in the Klang Valley Region of Malaysia. A survey was conducted among 191 patients in
the Klang Valley Region of Malaysia to measure service quality of the private healthcare setting
in Malaysia using SERVQUAL 5 dimensions model. The results revealed that the customers'
perceptions did not exceed their expectations, as they were dissatisfied with the level of
healthcare services rendered by private healthcare settings in that they felt that the waiting time
of more than an hour to receive the service was excessive and, when there was a problem, the
healthcare provider did not provide a response fast enough. Raman Sharma, Meenakshi Sharma,
R.K. Sharma7 (2011) aimed to address the issues of patients satisfaction in health care sector. A
cross sectional study was conducted to assess the patient satisfaction level visiting the hospital
with the objectives to know the behavior and clinical care by the clinicians and para-medical
staff and in terms of amenities available. A pre-designed and pre-tested structured questionnaire
was given to the respondents after the patients had undergone consultation with the doctor. From
the survey result, researchers found that 40.0 per cent were of the view that services were
costlier than their affordability.

4
Ritu Narang, (2011) "Determining quality of public health care services in rural India", Clinical www.zenithresearch.org.in
Governance: An International Journal, Vol. 16 Iss: 1, pp.35 49
5
Abdul Majeed Alhashem, Habib Alquraini, Rafiqul I. Chowdhury, (2011) "Factors influencing
patient satisfaction in primary healthcare clinics in Kuwait", International Journal of Health Care
Quality Assurance, Vol. 24 Iss: 3, pp.249 262
6
Norazah Mohd Suki, Jennifer Chiam Chwee Lian, Norbayah Mohd Suki, (2011) "Do patients'
perceptions exceed their expectations in private healthcare settings?", International Journal of
Health Care Quality Assurance, Vol. 24 Iss: 1, pp.42 56
7
Raman Sharma, Meenakshi Sharma, R.K. Sharma, (2011) "The patient satisfaction study in a
multispecialty tertiary level hospital, PGIMER, Chandigarh, India", Leadership in Health
Services, Vol. 24 Iss: 1, pp.64 73
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3. RESEARCH OBJECTIVE

The aim of this research is to comparatively examine and measure of service quality of public
and private sector hospitals of Ahmedabad and Gandhinagar region of Gujarat state and to offer
suggestion based on results of the study.

4. RESEARCH HYPOTHESIS

1. Both public and private hospitals do not meet patients' expectations.

2. There is no difference between public and private hospitals concerning their service quality

3. Private hospitals are not more successful than public hospitals in providing health care
services for patients.

5. RESEARCH INSTRUMENT

The five dimensions of SERVQUAL as proposed by Parasuraman et al. (1988), Othman and
Owen (2001, 2002) and Jabnoun and Al-Tamimi (2003) were adapted and modified in this study.
SERVQUAL has emerged as perhaps the most popular standardized questionnaire to measure
service quality. The instrument poses a set of 22 structured and paired questions designed to
assess customers expectations of service provision and the customers perceptions of what was
actually delivered. A five-point Likert-type scale is used in this study, anchored by strongly
disagree to strongly agree. Content validity (wording and meaning) was checked carefully by
experts. A pre-test was then conducted with a group of patients, and minor changes to the scales
were made accordingly to ensure that the questions were not repetitive. The researchers have
used the 41 structured and paired questions to measure E and P for service quality of Hospitals.

PHYSICAL ASPECTS

The first dimension physical aspects encompasses the appearance of the physical facilities
(1-14) and the convenience offered to the customer by the layout of the physical facilities (15-
16). The literature suggests that appearance is important to customers (e.g., Baker, Dhruv and
Parasuraman, 1994). It also suggests that customers value the convenience offered during the
treatment that physical aspects such as layout offer (Gutman and Alden, 1985; Hummel and
Savitt, 1988; Mazursky and Jacoby, 1985; Oliver, 1981). www.zenithresearch.org.in

RELIABILITY

The second proposed dimension is reliability. It has two sub-dimensions and other variations.
Patients view reliability as a combination of doing it right and availability of all the information
regarding treatment. So, the sub-dimensions of reliability are promises (statements 17 to 19 in
the scale) and information availability (statements 20 to 24 in the scale).

ENCOUNTERS

The third proposed dimension is Encounters. It has two sub-dimensions responsiveness

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International Journal of Multidisciplinary Research
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(statements 25 to 26 in the scale) and empathy (statements 27 to 33 in the scale). These sub-
dimensions are very closely related and capture how the customer is treated by the employee.

PROCESS

The fourth proposed dimension is process (statements 34 to 38 in the scale). Process is critical
for the success of any medical service. This dimension does not have any sub-dimension.

POLICY

The fifth proposed dimension policy (statements 39 to 41 in the scale) captures aspects of
service quality that are directly influenced by hospital policy. For example, when customers
evaluate a hospital on the basis of convenient hours, it is viewed as whether the hospitals policy
is responsive to customers needs. This dimension does not have any sub-dimension.

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International Journal of Multidisciplinary Research
Vol.1 Issue 8, December 2011, ISSN 2231 5780
FIGURE 1: HOSPITAL SERVICE QUALITY MEASUREMENT
MODEL
TANGIBLES

(I1-I14) Sub-D1

PHYSICAL ASPECTS

D1
DESIGN (I15-I16)
HOSQUAL
MODEL Sub-D2

RELIABILITY (I17-I24)
Outcome
D2 RESPONSIVENESS (I25-I26)
Sub-D3

ENCOUNTERS

SATISFACTION/
D3 EMPATHY (I27-I33)
DISSATISFACTION

DISSATISFACTION Sub-D4

PROCESS (I34-I38)

D4

POLICY (I39-I41)

D5
Based on the above dimensions, the proposed measurement tool may be suitable for
measuring the service quality of hospitals, gathering benchmark data regarding current levels of
service quality, and conducting periodic checks to measure service improvement. The
instrument could also serve as a diagnostic tool to determine service areas that are weak and that
need attention. However, in spite of its wide applicability and rigorous development, the use of
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the instrument should be properly tested under different contexts in order to determine its
validity and reliability.

The researchers have used following mentioned 41 structured and paired questions to measure E
and P for service quality of Hospitals

PHYSICAL ASPECTS

1. It is convenient to reach to this Hospital.

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2. The waiting rooms, clinical and diagnostic test rooms, pre-operative and post-operative
(or patient/resident ward) rooms, intensive care units, wards, bathrooms and toilets were
adequate, comfortable and clean.

3. The beds, pillows and mattresses were comfortable and clean.

4. The wards are well furnished, decorated, well ventilated and clean all the time.

5. Employees of excellent hospitals will have neat appearing.

6. This hospital has visually appealing Materials associated with the service (promotional
brochures, service tracking documents, invoices etc).

7. Wards, beds, operation theatres, intensive/post-operative care units and resident rooms
are adequately available for patients in this hospital.

8. Ambulance services are made available to patients with minimal costs in this `hospital.

9. Diagnostic facilities like CT scans, MRI scans, X-rays and ultrasound; telemedicine,
patient information and billing, operation theatres, labs, etc. are adequately and
effectively available.

10. The waiting rooms, clinical and diagnostic test rooms, pre-operative and post-operative
(or patient/resident ward) rooms, intensive care units, wards, bathrooms and toilets were
adequate, comfortable and clean.

11. Amenities such as continuous electricity and water supply, housekeeping and sanitation
facilities, comfortable conditions such as temperature, ventilation, noise and odour are
available.

12. Availability of required drugs in the pharmacy

13. Availability of the desired blood group in the blood bank in the hospital.

14. The meals are offers food which is suitable to the patients

15. The ergonomics (layout) of this hospital is conducive for physically challenged, elderly
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& emergency patients.

16. This hospital provides for proper safety and comfort measures (e.g: handrails in aisles,
rooms and bathrooms, ramps suitably designed for wheelchairs and stretchers, elevators
and spacious corridors).

RELIABILITY

17. This hospital will insist on error free records.

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18. This hospital performs the service right the first time.

19. Patients feel safe in getting treated by the doctors of this hospital.

20. This hospital provides all the required information and instructions regarding admission,
treatment, and discharge clearly to patients and attendants.

21. The patient's attendants are kept informed about the patient's condition.

22. The allergy or reaction to drugs is taken care of in this hospital.

23. Employees of this hospital tell patients exactly when services will be performed.

24. Patients feel safe in getting treated by the doctors of this hospital.

ENCOUNTER: RESPONSIVENESS

25. Employees in this hospital are never too busy to respond to customers requests.

26. When patient has a problem, this hospital will show a sincere interest in solving them.

ENCOUNTER: EMPATHY

27. Employees in this hospital are curious to know & solve my problems.

28. Employees in this hospital are not rude in conveying the rules of the hospital (i.e. asking
attendants of patients to maintain peace).

29. Employees in this hospital understand my requirement and gives individualised attention.

30. This hospital has their patient's best interests at heart.

31. This hospital gives patients individual attention.

32. Employees of this hospital have knowledge to answer patients' questions.

33. Medical staff of this hospital is consistently courteous with people. www.zenithresearch.org.in

PROCESS

34. The hospital provides for an inquiry-cum- complaint counter at a prominent place.

35. Extent to which the time spent waiting for diagnostic tests and treatment, at the
pharmacy, scan centers, blood banks and laboratories was reasonable.

36. Frequency in delays or cancellation of scheduled surgeries due to reasons such as non-
availability of operation theatres or surgeons, or lack of preparation of patients for
surgery.
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37. A proper system of appointment is well-established.

38. Overall process (e.g. Admission, stay and discharge; procurement of drugs and hospital
equipments; allocation of operation theatres and beds) are kept short and simple in this
hospital.

POLICY

39. The hospital provides for significant loyalty rewards through membership cards.

40. This hospital has consulting hours convenient to all their patients.

41. Over all, I am satisfied with the service quality of this hospital.

6. METHODOLOGY

This is an analytical study based on the primary data collected through scientifically developed
questionnaire. The questionnaire has been personally administered on sample size of 246, chosen
on a convenient basis from the two cities of Gujarat state. A literature review was undertaken to
identify what parameters to consider in research. The data was collected through questionnaire
consisting of 3 parts. The first two parts consist of the SERVQUAL items (Parasuraman et al.,
1985), which measure service quality. In Part I, there were 41 statements measuring the expected
service quality from excellent hospitals. In Part II, the same items were measuring the service
quality perceptions of public/private hospitals in Ahmedabad and Gandhinagar region. Here,
respondents were asked to evaluate the statements with regard to the hospital(s). All of the
statements in Part I and Part II were measured on a five point "Agree-Disagree" Likert scale. The
last part of the questionnaire consisted of demographic questions. A questionnaire was
constructed and piloted on 57 patients.Care was taken to minimize the possibility of wrong
interpretation and biased views. For the analysis of data statistical methods are applied with the
aid of SPSS (Statistical Package for Social Science) software, version 16.0 and excel. Sample
size was determined using following formula.

Here Z = 1.96, p = 0.20, q = 0.80, d = 0.05, www.zenithresearch.org.in

n = 245.8624 246

7. SAMPLE

The sample was drawn form the people living in Ahmedabad and Gandhinagar area who were
above the age of eighteen. Family members who had benefited from the services of public and
private hospitals within a two-year period were asked to complete a self-administered
questionnaire. In order to collect quantitative data for the study, a total of 246 questionnaires
were printed and distributed to respondents. There are3 public and 5 private hospitals that
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International Journal of Multidisciplinary Research
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include medium -scale clinics in which surgery is carried out were selected for survey. They are
Ahmedabd Civil Hospital, Gandhinagar Civil Hospital, V.S. Hospital, , Sanjivani Hospital, Shrey
Hospital, Samved Hospital, Nidhi Hospital , Medi Link Hospital.

8. CHARACTERISTICS OF SAMPLE

The following table shows the demographic profile of surveyed respondents.

TABLE: 1 CHARACTERISTICS OF SAMPLE

Variables Category Frequency

18-23 46

24-29 63

30-35 49
Age
35-40 41

40+ 47

Total 246

10,000-20,000 58

20,001-30,000 73
Monthly
30,001-40,000 41
Income
40,000+ 74

Total 246

Student 33
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Professional 109

Businessman 27
Occupation
Housewife 17

Govt. employee 32

Others 28
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International Journal of Multidisciplinary Research
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Total 246

Undergraduate 8

Education Graduate 78

Level Postgraduate 160

Total 246

Male 183

Gender Female 63

Total 246

9. DATA ANALYSIS AND INTERPRETATIONS

Randomly 246 respondents, who have recently benefited from hospital services in Ahmedabad
and Gandhinagar regions, were selected to answer a modified version of the SERVQUAL
instrument. Results of a sample of 246 patients from 8 hospitals were analyzed thru SPSS and
Excel. For all 41 statements of expectation and perception each, weighted arithmetic mean was
calculated, and gap score was determined by deducting perception values from expectation
values. Dimensions wise Mean Score of Perception and Expectation of Public and Private
Hospitals was determined and comparative analysis was prepared keeping in mind the gap score
of each dimensions.

TABLE: 2 STATEMENTS WISE MEAN SCORE OF PERCEPTION AND

EXPECTATION OF PUBLIC AND PRIVATE HOSPITALS

Public Hospitals Private Hospitals

Dimension E P G E P G
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PA1 4.68 2.77 1.91 3.74 4.58 -0.84

PA2 4.75 2.34 2.41 3.37 4.37 -1.00

PA3 4.70 2.63 2.07 3.38 3.97 -0.59

PA4 3.89 2.87 1.02 3.27 3.01 0.26

PA5 3.69 2.53 1.16 3.52 3.29 0.23

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PA6 4.43 2.58 1.85 3.17 2.43 0.74

PA7 4.42 1.89 2.53 3.29 1.47 1.82

PA8 4.64 2.10 2.54 3.37 1.99 1.38

PA9 3.98 1.91 2.07 3.88 1.62 2.26

PA10 3.77 1.74 2.03 3.62 1.57 2.05

PA11 4.44 2.45 1.99 2.22 2.55 -0.33

PA12 4.54 2.76 1.78 3.32 2.35 0.97

PA13 4.65 2.59 2.06 2.76 2.56 0.20

PA14 4.32 2.22 2.10 3.59 2.33 1.26

PA15 3.32 2.98 0.34 3.58 4.22 -0.64

PA16 3.57 2.64 0.93 3.18 3.89 -0.71

AVG. 4.30 2.44 1.86 3.33 2.89 0.44

R17 3.62 2.98 0.64 4.24 4.01 0.23

R18 3.84 2.63 1.21 4.81 4.53 0.28

R19 4.95 1.98 2.97 4.92 1.12 3.80

R20 4.77 2.03 2.74 4.75 1.34 3.41

R21 4.63 1.32 3.31 4.69 1.63 3.06

R22 4.82 1.48 3.34 4.86 1.39 3.47

R23 4.86 2.42 2.44 4.91 1.37 3.54

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R24 3.82 3.13 0.69 3.95 3.27 0.68

AVG. 4.41 2.25 2.17 4.64 2.33 2.31

Res25 3.91 3.43 0.48 4.87 3.44 1.43

Res26 3.78 3.51 0.27 4.74 3.42 1.32

AVG. 3.85 3.47 0.38 4.81 3.43 1.38

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E27 3.89 3.46 0.43 3.71 3.22 0.49

E28 3.33 3.21 0.12 3.38 3.14 0.24

E29 3.56 3.48 0.08 3.52 3.29 0.23

E30 4.39 1.22 3.17 4.07 4.04 0.03

E31 4.05 2.52 1.53 4.49 2.98 1.51

E32 4.61 1.62 2.99 4.98 4.79 0.19

E33 4.03 2.43 1.60 3.03 2.98 0.05

AVG. 3.98 2.56 1.42 3.88 3.49 0.39

Pro34 4.15 2.98 1.17 3.14 3.01 0.13

Pro35 4.17 2.43 1.74 3.13 2.45 0.68

Pro36 4.43 2.58 1.85 3.67 2.58 1.09

Pro37 4.65 2.01 2.64 3.89 2.65 1.24

Pro38 4.23 2.98 1.25 3.45 2.98 0.47

AVG. 4.33 2.60 1.73 3.46 2.73 0.72

policy39 4.45 4.28 0.17 3.34 4.13 -0.79

policy40 4.98 4.69 0.29 4.65 4.53 0.12

Policy41 4.01 3.90 0.11 4.83 4.71 0.12

AVG. 4.48 4.29 0.19 4.61 4.79 -0.18

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International Journal of Multidisciplinary Research
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TABLE: 3 DIMENSIONS WISE SCORE OF PERCEPTION AND EXPECTATION OF

PUBLIC AND PRIVATE HOSPITALS

Dimen- Public Private

sions Hospitals Hospitals

E P G E P G

Physical

Aspects 4.30 2.44 1.86 3.33 2.89 0.44

Reliability 4.41 2.25 2.17 4.64 2.33 2.31

Responsiveness 3.85 3.47 0.38 4.81 3.43 1.38

Empathy 3.98 2.56 1.42 3.88 3.49 0.39

Encounter 7.83 6.03 1.80 8.69 6.92 1.77

Process 4.33 2.60 1.73 3.46 2.73 0.72

Policy 4.48 4.29 0.19 4.61 4.79 -0.18

TABLE: 4 DIMENSIONS WISE COMPARATIVE ANALYSIS OF PUBLIC AND

PRIVATE HOSPITALS

Public Private
Best
Dimensions Hospital Hospital
Performer
-GAP -Gap

Physical Aspects 1.86 0.44 Private Hospital www.zenithresearch.org.in

Reliability 2.17 2.31 Public Hospital

Encounter 1.80 1.77 Private Hospital

Process 1.73 0.72 Private Hospital

Policy 0.19 -0.18 Private Hospital

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10. MAJOR FINDINGS

The mean expectation scores were high when compared to the perception scores - ranging from
3.34 to 0.08 for the public hospitals and from 3.80 to -1 for the private hospitals. The lowest
public hospital expectation score was obtained from question 15(This hospital provides for proper
safety and comfort measures (e.g: handrails in aisles, rooms and bathrooms, ramps suitably
designed for wheelchairs and stretchers, elevators and spacious corridors). and highest from
question 40.( This hospital has consulting hours convenient to all their patients) The lowest public
hospital Perception score was obtained from question 40(This hospital has consulting hours
convenient to all their patients) and highest from question30 (This hospital has their patient's best
interests at heart). The lowest private hospital expectation score was obtained from question 11
(Amenities such as continuous electricity and water supply, housekeeping and sanitation
facilities, comfortable conditions such as temperature, ventilation, noise and odour are available)
and the highest private hospital expectation score was obtained from question32. (Employees of
this hospital have knowledge to answer patients' questions.) The lowest private hospital
perception score was obtained from question 19(Patients feel safe in getting treated by the doctors
of this hospital) and the highest private hospital perception score was obtained from question32
(Employees of this hospital have knowledge to answer patients' questions.) Out of five
dimensions Private hospitals perform better than public hospital in 4 dimensions namely Physical
Aspects, Encounter, Process and Policy, while public sector hospitals perform better than private
sector only in one dimension namely Reliability. Overall private sector is performing better in
Encounter dimension, but specific Encounter-Responsiveness public sector has lowest score.

11. LIMITATIONS AND FUTURE RESEARCH DIRECTIONS

The findings of this study are limited to the two cities Gujarat State. It should be replicated in
other part of countries especially with all major cities. Second, for the researchers convenience,
the study questionnaire included both expectation and perception questions. In future, the
expectation and perception sections should be separated, although this may create difficulties
contacting respondents just before their service and just after the service encounter. Future
studies should also investigate the effects of service quality dimensions on the overall
satisfaction, recommending behavior and loyalty. Replication studies using large diversified
samples elsewhere would be useful in order to corroborate our study findings.

12. CONCLUSION AND MANAGERIAL IMPLICATIONS www.zenithresearch.org.in

This study set out to expand understanding of how Consumers evaluate service quality in the
context of a developing economy, an environment that differs significantly from the European
and American context. The current research reinforces the fact that service quality is a complex
and multidimensional construct. Our findings have important implications for private hospital
and public hospital owners, managers, government officials, academics and other related parties
in the hospital services. Hospital administrations need to gather systematic feedback from their
patients and to establish visible and transparent complaint procedures so that patients' complaints
can be addressed effectively and efficiently. Most customers are reluctant (Ekiz, 2004) to make
their needs and expectations explicit, including their complaints, although the opportunity to do
so is clearly provided in order to promote healing environment.
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13. REFERNCES

1. Abdul Majeed et.al (2011) "Factors influencing patient satisfaction in primary healthcare
clinics in Kuwait", International Journal of Health Care Quality Assurance, Vol. 24 Iss: 3,
pp.249 262

2. Daniel Butler et.al (1996) "The effects of demographics on determinants of perceived

health-care service quality: The case of users and observers", Journal of Management in
Medicine, Vol. 10 Iss: 5, pp.8 20

3. Ioannis E. et.al (2009) "Service quality effect on satisfaction and word of mouth in the
health care industry", Managing Service Quality, Vol. 19 Iss: 2, pp.229 242

4. Norazah Mohd et.al (2011) "Do patients' perceptions exceed their expectations in private
healthcare settings?", International Journal of Health Care Quality Assurance, Vol. 24
Iss: 1, pp.42 56

5. Raman Sharma, et.al (2011) "The patient satisfaction study in a multispecialty tertiary
level hospital, PGIMER, Chandigarh, India", Leadership in Health Services, Vol. 24 Iss:
1, pp.64 73

6. Ritu Narang (2011) "Determining quality of public health care services in rural India",
Clinical Governance: An International Journal, Vol. 16 Iss: 1, pp.35 49

7. Rust et.al. (1996), "The satisfaction and retention of frontline employees: a customer
satisfaction approach", International Journal of Service Industry Management, Vol. 7 No. 5,
pp. 62-80.

8. Sohail, M.S. (2003), "Service quality in hospitals: more favorable than you might think",
Managing Service Quality, Vol. 13 No. 3, pp. 197-206.

9. Uzun, O. (2001), "Inpatient satisfaction with nursing care at a university hospital in

Turkey", Journal of Nursing Care Quality, Vol. 16 No. 1, pp. 24-33.

10. Valdivia, M.T.R. and Crowe, T.J. (1997), "Achieving hospital operating objectives in the
light of inpatient preferences", International Journal of Health Care Quality Assurance, Vol. www.zenithresearch.org.in
10 No. 5, pp. 208-12.

11. Wan Edura Wan Rashid, Hj. Kamaruzaman Jusoff, (2009) "Service quality in health care
setting", International Journal of Health Care Quality Assurance, Vol. 22 Iss: 5, pp.471
482
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