Service Quality and Customer Satisfaction in the Health Care Industry - Towards Health Tourism Market
16 PagesPosted: 16 Dec 2014
Date Written: November 15, 2014
The Purpose – Service quality and customer satisfaction have been extensively researched in the profit sector, but are also important in the non-profit sector. Specialty hospitals and health spas operate in the non-profit sector in Croatia, but some of them try to provide a part of their services to the health tourism market. Hospitals that work in the non-profit sector and especially those that see their future in the health tourism market need to pay attention to service quality and customer satisfaction. Although specialty hospitals are a vital segment of the Croatian health system, there has not been enough research regarding service quality and customer satisfaction measurement in that sector. Therefore, the purpose of this study is to assess the impact of service quality on customer satisfaction in the healthcare sector.
Design/Methodology – Empirical research is used to determine patients’ perceptions and expectations of service quality in one specialty hospital for medical rehabilitation. SERVQUAL instrument was used to measure the service quality. The SERVQUAL questionnaire included an expectations and perceptions section, each consisting of 34 statements. In addition, the questionnaire contained an extra section relating to demographics and an overall question on the impression of quality of the service provided. One hundred and four (104) satisfactorily completed questionnaires were collected.
Findings – The analysis revealed that patients perceived a rather satisfactory level of health care quality across all SERVQUAL dimensions. Patients who perceived a higher level of service quality show greater satisfaction with the services, as well as a higher level of loyalty to the hospital which provides medical services. Research results indicate the multidimensionality of the concept and the existence of a gap between patients' expectations and the perceptions of service quality. Finally, despite the criticism of the SERVQUAL instrument, this study confirms the usefulness of the SERVQUAL model in terms of its reliability and validity for measuring quality in the health care sector.
Originality of the Research – This paper sheds light on a poorly researched field in the Croatian context. The specific environment in which the research was done demanded the implementation of a modified SERVQUAL model which was broadened with the items referring to sports, recreation and amusement activities. Theoretical contribution of this paper is reflected in testing the dimensionality and reliability of the modified SERVQUAL instrument for measuring service quality in a specialty hospital. It was found that the modified model has four dimensions. The ‘Output quality’ dimension, which refers to the services outside the sphere of medical services, has the greatest impact on the patients’ satisfaction. The practical contribution of the paper is manifested as an encouragement for managers in specialty hospitals to devote greater attention to service quality and customer satisfaction measurement, especially when their goal is to enter the health tourism market. It provides directions for hospital managers to develop strategies which will meet patients’ expectations of service quality and increase their competitiveness in the health tourism market.
Keywords: service quality, customer satisfaction, SERVQUAL, health care industry, health tourism
JEL Classification: L83
Suggested Citation:Suggested Citation
Markovic, Suzana and Lončarić, Dina and Lončarić, Damir, Service Quality and Customer Satisfaction in the Health Care Industry - Towards Health Tourism Market (November 15, 2014). Tourism & Hospitality Management, Vol. 20, No. 2, 2014. Available at SSRN: https://ssrn.com/abstract=2538570
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Consumer Satisfaction about Hospital Services: A Study from the Outpatient Department of a Private Medical College Hospital at Mangalore
KS Prasanna,MA Bashith, and S Sucharitha
Department of Community Medicine, Father Muller Medical College, Mangalore, India
Address for correspondence: Dr. Prasanna KS, Department of Community Medicine, Father Muller Medical College, Mangalore, India. E-mail: moc.oohay@rdskannasarp
Author information ►Article notes ►Copyright and License information ►
Received 2008 Apr 18; Accepted 2009 Jan 1.
Copyright © Indian Journal of Community Medicine
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Consumer satisfaction is an important parameter for assessing the quality of patient care services. There is a need to assess the health care systems regarding the consumer satisfaction as often as possible.
To assess the consumer satisfaction regarding the services provided in our outpatient department in terms of clinical care, availability of services, waiting time, and cost.
Materials and Methods:
A 27-item pre-tested questionnaire was given to 100 patients (caretakers in pediatric patients) at the end of their O.P.D visit from 3 to 4 pm for 5 days from November 7, 2005 to November 11, 2005. The items in the questionnaire referred to particulars of the patients such as age, sex, occupation, department requested, lab, and medical stores. While analyzing, they were grouped into categories like availability, clinical care, waiting time, and cost. The responses were expressed in proportions.
The availability of services and clinical care was found to be satisfactory. 81% of the respondents found the communication by the doctor good, 97% of the respondents were satisfied about the explanation of the disease by the doctor The average time required for consulting the doctor was 46.5 ± 20.9 min. But when time spent in pharmacy was considered, it was not significantly satisfactory. The cost of investigation was significantly moderate or high in 97% of the respondents.
Recommendations are required for reduction of time spent in the pharmacy and the cost of investigations to improve consumer satisfaction.
Keywords: Consumer satisfaction, hospital services, clinical care
Health care has two connotations (a) health care programs and (b) medical care organizations. Medical care organizations are mainly providing curative care. They are attractive and high-tech oriented and they should be cost effective.(1) In recent years, quality assurance has emerged as an internationally important aspect in the provision of health care services.(2) The health care system depends on availability, affordability, efficiency, feasibility, and other factors.(3) Consumer satisfaction is recognized as an important parameter for assessing the quality of patient care services. Satisfaction regarding the attitude of providers toward these services is expected to affect treatment outcome and prognosis. There is a need to analyze the health care system as often as possible.(4)
Consumer satisfaction regarding medical care organizations like our tertiary care hospital is important in the provision of services to patients. So, we have designed a study to assess consumer satisfaction with regard to clinical care such as the approach of the doctor, examination, education on taking medication, availability of services, waiting time, and cost provided in the outpatient department of our medical college hospital.
Materials and Methods
The study was carried out in the outpatient department of Father Muller Medical College Hospital, Mangalore. A 27 item pre-tested and pre-structured questionnaire was given to the patients or their attendants at the end of their outpatient visit. A total of 100 patients were selected at random in a time span of 5 days from November 7, 2005 to November 11, 2005 between 3 and 4 p.m. The items in the questionnaire referred to the particulars of the patient such as age, sex, occupation, The concerned department, service particulars in the registration counter, concerned doctor in the respective department, the lab, and the medical stores. The questionnaire included choices like convenient/inconvenient, satisfactory/unsatisfactory, easy/difficult, good/moderate, adequate/inadequate, and 30 minute time slots of actual time spent in each stage of the visit. Informed consent was obtained from the patient. The patients were told that the purpose of the study was to assess the consumer satisfaction of services provided by the hospital so as to bring about further improvement of services. The patients were also told that the investigator was not part of the treatment team. It was also emphasized that they were free to give their honest responses. Anonymity of the examining doctor and the patient was maintained. The responses were expressed in proportions.
The study population consisted of 100 patients (66 males and 34 females). A total of 65% were in the age group between 15-45 years old [Table 1]. Respondents were patients themselves (90%) and accompanying relatives for pediatric patients younger than 15 years old (10%). The opinions of the patients were grouped into the following 4 groups:
Distribution of the respondents according to the age sex, occupation and the concerned departments
Overall availability of services [Table 2] was very good regarding the seating arrangements in the outpatient department (100%) and the cleanliness of the outpatient department (100%). A total of 98% of the respondents were satisfied with the outpatient department timings, 88% of the respondents were satisfied with the services of the outpatient nursing staff, 84% of the respondents found it easy to locate the concerned specialist department in the outpatient department, and 99% of the respondents found the availability of the doctors in the outpatient department to be adequate. Only 14% of the respondents found it difficult to locate the pharmacy.
Distribution of responses from the respondents according to availability of services
Regarding clinical care [Table 3], 97% of the respondents found the approach of the doctors satisfactory, 81% of the respondents found the communication by the doctor good, 97% of the respondents were satisfied about the explanation of the disease by the doctor, 94% of the respondents found clinical care satisfactory, and 97% found the doctor efficient. A total of 99% of the respondents gave an opinion that the investigations were conducted necessarily and 83% of the respondents were satisfied with the number of investigations that are necessary. Interpretation of the investigation report by the doctor to the patient was satisfactory in 96% of the respondents. The nature of prescription was either simple and easy or satisfactory in 83 % of the respondents. Instruction regarding medication usage by dispensing pharmacists was satisfactory in 86% of the respondents.
Distribution of responses from the respondents regarding clinical care
With regard to waiting time [Table 4], 79% of the patients found that the time required for registration was convenient for them (average time = 12.6 ± 6.87 min.). A total of 89% of the patients found the concerned department conveniently (average time = 10.05 ± 3.99 min.). The time required for consulting the doctor was less than 30 minutes in 20% of the cases, 30 to 60 minutes in 57% of the cases, 60 to 90 minutes 21% of the cases, and 90 to 120 minutes in 2% of the cases (average time = 46.5 ± 20.9 min.). Time taken for the investigations was satisfactory in 72% of the patients (average time = 142.75% ± 234.92 min). Time required to locate the pharmacy was satisfactory in 91% of the cases (average time = 9.9% ± 3.01 min) and the time spent in the pharmacy was satisfactory in only 53% of the patients (average time = 26.8 ± 18.36 min.).
Distribution of responses of the respondents regarding waiting time
The cost of registration and consultation [Table 5] was satisfactory for 100% of the respondents. The cost of investigation was low for 3% of the respondents, moderate for 73% of the respondents, and high for 24% of the respondents. The cost of medicines was satisfactory for 80% of the respondents. This may be dependent on the consumer's purchasing power and different costs of medicines.
Distribution of responses from the respondents regarding cost
In this study, each step of the outpatient services assessment was made by the consumer on factors such as availability of services, clinical care, time, and cost of services. It was found to be satisfactory regarding the availability of services and clinical care. But when the time spent in pharmacy was analyzed, it was considered that it was not significantly satisfactory. The costs of investigation were significantly moderate and high in 97% of the cases as assessed by the respondents. In a study by Acharya and Acharya, 82.8% of the respondents showed the approach of the doctor is personal. In their study, 81.6% regarded the explanation of the disease to the patient as satisfactory, 93.2% of the subjects were satisfied with the examination by the doctor, and it was simple and easy to understand in 60% of the cases.(5)
According to the consumer's opinion, the study showed good results with respect to availability and clinical care. Recommendations regarding ways to reduce the time spent in the pharmacy and the cost of investigations are required to improve consumer satisfaction.
We sincerely thank the Indian Council of Medical Research for giving us an opportunity to take up this research studentship. Heartful thanks to Rev. Fr. Patrick Rodrigues, The Director Father Muller Charitable Institutions, Rev. Fr. Denis D'sa, The Administrator, Father Muller Medical College, Dr. B. Sanjeev Rai, The Dean, Father Muller Medical College for giving permission, Dr. Rotti SB, Vice Dean and Head of the department of Community Medicine for suggestions.
Source of Support: Nil
Conflict of Interest: None declared.
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