vii

TABLE OF CONTENTS
CHAPTER PAGE
TITLE
NO. NO.
ABSTRACT v
LIST OF TABLES xi
LIST OF FIGURES xv
LIST OF ABBREVIATIONS xvi
1. INTRODUCTION 1
1.1 Service quality 1
1.2 Need for the study 3
1.3 Current scenario of Diabetes in India 3
1.3.1 Type 2 Diabetes mellitus (T2DM) 5
Management in India
1.3.2 Economic Burden of Diabetes in India 8
1.4 Diabetic health care in Chennai 10
1.4.1 Healthcare institutes that provide diabetes 10
treatment in Chennai
1.4.2 Major hospitals treating diabetes in Chennai 11
1.5 Motivation and problem statement 13
1.6 Objectives of the study 14
1.6.1 Elaboration of Objectives 14
1.7 Theoretical Foundation and Hypothesis Framework 15
1.7.1 Service quality dimensions 16
1.8 Research hypotheses 18
1.9 Limitations of the study 22
1.10 Organisation of the Thesis 22
2. REVIEW OF LITERATURE 25
2.1 Conceptualization of service quality 25
2.2 Service quality models 29
2.3 Perceived service quality 35
2.4 Customer satisfaction 49
2.4.1 Patient satisfaction 49
2.4.2 Student satisfaction 66
2.5 Behavioral Intention 73
 viii

CHAPTER PAGE
TITLE
NO. NO.
2.6 Application of Servqual scale in health care 78
2.7 Perceived service quality, Patient satisfaction and 81
Behavioral intention
3. CONCEPTUAL FRAMEWORK OF CONSTRUCTS 85
3.1 Functional quality 85
3.1.1 Tangibles 85
3.1.2 Reliability 86
3.1.3 Responsiveness 86
3.1.4 Assurance 86
3.1.5 Empathy 87
3.2 Technical quality 87
3.3 Image 87
3.4 Perceived Service quality 88
3.5 Customer satisfaction 88
3.6 Behavioral intention 88
4. RESEARCH METHODOLOGY 89
4.1 Research Design 89
4.2 Sampling Method 90
4.2.1 Stage I: Selecting Hospitals 90
4.2.2 Stage II: Selecting respondents for the study 91
4.2.3 Sample characteristics 91
4.3 Constructs/concepts definition 92
4.3.1 Functional (process) quality 92
4.3.2 Technical (outcome) quality 92
4.3.3 Image 93
4.3.4 Customer satisfaction 93
4.3.5 Behavioral intention 93
4.4 Measures 94
4.5 Questionnaire 94
5. DATA ANALYSIS AND INTERPRETATION 96
5.1 Measurement Assessment 96
5.2 Frequency Table of Measures 96
5.3 Hypotheses Testing 151
 ix

CHAPTER PAGE
TITLE
NO. NO.
5.3.1 Chi Square Test 151
5.3.2 Chi Square Test 152
5.4 Descriptive Statistics 153
5.5 Reliability Analysis 155
5.6 Outliers 156
5.7 Correlation 156
5.8 Multivariate normality 157
5.9 Testing for Common method bias 157
5.10 Structural Equation Modelling (SEM) 158
5.11 Model Fit 163
5.12 Predictive Relevance (Q2) 164
6. SUMMARY OF FINDINGS, CONCLUSION, 165
SUGESSTIONS AND RECOMMENDATIONS FOR
FURTHER RESEARCH
6.1 Findings 165
6.1.1 The findings of the frequency distribution 165
analysis
6.1.2 Findings of the Chi-Square test 171
6.1.3 Findings of Descriptive statistics 171
6.2 Conclusion 172
6.3 Theory Testing 174
6.4 Limitations 175
6. 5 Suggestions 175
6.5.1 Suggestions to Hospitals 175
6.5.2 Suggestions to Patients 175
6.5.3 Suggestions to Government organizations 176
6.6 Managerial Implications 176
6.7 Recommendations For Future Research 176
REFERENCES 177
APPENDICES 211
LIST OF PUBLICATIONS 214
VITAE 215