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CHANGES IN PHYSICAL EVIDENCE AND THE PERCEPTION OF SERVICE QUALITY OF PATIENTS IN A HOSPITAL FACILITY
... Bukti fisik memainkan peran penting di rumah sakit yang merupakan tempat perawatan pasien yang sebelumnya sudah dalam kondisi depresi atau trauma, suasana yang baik bisa membuat perbedaan (Babu & Rajalakshmi, 2009). Ketika merancang fasilitas rumah sakit harus didesain dengan benar karena bukti fisik merupakan dimensi penting dalam persepsi kualitas layanan untuk pasien di sektor kesehatan (Holder, 2008;Reiling, 2005). ...
Abstrak Pasar pelayanan kesehatan merupakan salah satu sektor jasa terbesar di Indonesia. Dengan meningkatnya keterjangkauan fasilitas kesehatan terus mendorong secara timbal balik pertumbuhan rumah sakit dari segi kuantitas dan kualitas, yang menerapkan konsumen sebagai pusat pelayanan. Studi ini dilakukan dengan mengulas 48 artikel yang terkait bauran jasa pemasaran rumah sakit. Bauran pemasaran jasa sangat penting dalam industri rumah sakit saat ini dan merupakan alat terbaik untuk inovasi. Dalam pelayanan rumah sakit, adanya transparansi harga, penempatan layanan rumah sakit di lokasi yang nyaman bagi pasien, perilaku staf medis, tangibility dan proses melalui teknologi memainkan peran penting yang membedakan dan memberikan corak unik layanan terhadap pesaing. Kata kunci : Bauran pemasaran jasa, Indonesia, pemasaran rumah sakit ABSTRACT The health service market is one of the largest service sectors in Indonesia. With the increase in affordability of health facilities continue to encourage reciprocal growth in hospitals in terms of quantity and quality, which implements consumers as a service center. This study was conducted by reviewing 48 articles related to the mix of hospital marketing services. The marketing mix of services is very important in the hospital industry today and is the best tool for innovation. In hospital services, price transparency, placement of hospital services in locations that are convenient for patients, the behavior of medical staff, tangibility and processes through technology play an important role that differentiates and provides unique features of service to competitors.
... Examples are equipment, buildings, structures and facilities in public hospitals, schools, power authorities, water corporations, ministries, parastatals, government agencies and conditions of access roads. Holder [46] concluded in his study that physical evidence is an important dimension in the perception of service quality. ...
... Physical evidence is considered as an important element in the perception of service quality for patients in healthcare sector (Holder, 2008). It includes the physical and tangible commodities in terms of design, maintenance, ventilation, hygiene and all features that reflect a clean, comfort and good atmosphere for patients (Babu & Rajalakshmi, 2009). ...
Although most of studies have identified different dynamic factors that influence hospitals business development, there is always an increasing interest to find the best practices that ensure effective and sustainable marketing strategies in healthcare. The purpose of this study was to make an approach between patients and hospital managers to develop an effective marketing strategy for hospitals in Lebanon. A quantitative methodology was applied to statistically test both patients and managers’ attitudesthrough conducting two different simple surveys among patients and managers from fourdifferent hospitals in Lebanon. Self-administered questionnaires were designed in terms of marketing mix and hospitalization experience, and distributed randomly among participants to assess the implemented marketing strategies.Majority of patients were satisfied from the healthcare service provided and 93.3% of patients showed high level of loyalty to these hospitals. In terms of experiencing the marketing mix, majorityof patients were able to identify the most significant 7ps in hospitals especially in terms of price and people. Similarly, the results obtained from managers’ surveyshowed consistency of the marketing strategies applied by these hospitals with the patients’ attitudesbut with some conservation regarding the pricing strategies in the Lebanese healthcare system.The importance of healthcare marketing falls mainly in the framework of strengthening public relations with patients and maintaining a proper pricing strategy that is backed by the government and mediated by the guarantors. Future studies can be extended empirically in terms of geographical distribution of hospitals and the methodology applied.
... Physical evidence has a significant role in the hospital where the patients are already depressed or traumatized and a good atmosphere could make all the difference. Reiling (2005) suggested that while designing a hospital facility it should be engineered properly as Holder (2008) concluded that physical evidence is an important dimension in the perception of service quality for patients in health sector. Review has identified following important aspects of physical evidence: Physical design of the hospital (Angood et.al. ...
The current research problem includes in its content various research motivations to serve of the private health sector, which witnesses a great competition from both internal and external environments. In this regard, the researcher has noted through his review of the private medical clinics and his social environment (family, friends and Work colleagues) that there are a great weakness and the lack of educational awareness rather than focusing on the physical evidence for health service. For this reason, the developed countries are far more developed than us in terms of providing the same health services because these countries use advanced methods and tools to enhance the physical Evidence of the quality of health service through providing of marketing awareness among the owners of these clinics about physical evidence and its role in attracting and retaining customers. This research has based on two main hypotheses are the correlation, influence which in turn are divided into sub-hypotheses. As the research investigated in a number of private medical clinics at Maysan, A sample of (379) clients in private medical clinics. The questionnaire was used as a main tool for collecting data and information. A number of statistical methods were used to analyze, interpret and process data (arithmetic mean, standard deviation, coefficient of variation frequency and percentage)) and the adoption of ready statistical programs such as SPSS V.23. The research found a number of conclusions, the most important of which was the interest of the medical clinics, The attention of the medical clinics investigated the dimensions of the physical presentation of the health service at an acceptable level and based on the evaluation of the opinions of the sample investigated as a result of the weakness of its awareness of the importance of this subject in attracting the customer and excellence in the competing clinics of the same jurisdiction to enable them to provide medical service attractive to the customer in the medical field, Marketing mission in its work), and in the light of the conclusions, the set of recommendations were suggested which included (The need for private medical clinics to develop and improve the dimensions of the physical evidence of the health service through the use of modern marketing methods and everything that is new in the field of marketing and keep pace with development because the customer at present is fully aware of the environment in which the provision of health service and the many offers available to him, Inside or outside for clarification and providing the comfort and health service appropriate to the state of illness and its role in attracting and building a positive image toward it).
key words : Physical Evidence Of The Health Service , Attracting The Customer
John Wells-Thorpe, South Downs Health NHS Trust Trust Initiative When self-governing NHS Trusts were set up a decade ago they were given a surprising amount of autonomy. Hitherto, capital projects had been subject to supervision by Regional architects and others further up the line, with local input being confined to detail. All of a sudden the whole process of design procurement became freer and, being one of the first formed, South Downs Health NHS Trust decided to review completely how it handled its ongoing construction programme. Through deft financial stewardship and the sale of surplus property the Trust was able to fund new projects independently with only supplementary help from other quarters. In these circumstances it was relatively easy for its first chairman, John Wells-Thorpe to devise a new design approach that was more responsive to perceived clinical need and patient welfare, not least of all because he was himself an architect. A number of limited competitions were launched with the help of the RIBA Competitions Office covering, in the first instance, a new clinic in Brighton and thereafter a hospital for the elderly physically and mentally frail at Newhaven. In inviting architectural competitors emphasis was placed on at least fifty per cent participation by younger practices who would not have fallen into the category of established hospital architects. The benefit of this approach was immediate. At briefing stage a fully inclusive dialogue engaged local users at each level and their input was maintained throughout each project to ensure a sense of ownership with the finished building, working alongside an enthusiastic design team.
Objective. To evaluate the consumer model in a health care system, by studying the relationship between four variables: expectations, perceived degree of fulfillment, satisfaction and changing of physicians. Design. Cross-sectional study; telephone interview of patients who had visited a primary care physician 1–2 months previously. Setting. The Maccabi health plan, Israel. Study participants. A random sample of 759 patients, aged 18 and over residing in two towns in Israel. Response rate to telephone interview was 50.7% (n=385). Main outcome measures. Expectation, perceived expectations fulfilled by the physician, satisfaction with the visit to the primary care physician and intention to change physician.
You’ll find that this text takes a strongly managerial perspective, yet is rooted in solid academic research, complemented by memorable frameworks. Our goal is to bridge the all-too-frequent gap between theory and the real world. Practical management applications are reinforced by numerous examples within the 15 chapters. Complementing the text are 18 outstanding classroom-tested cases.
We’ve designed Services Marketing, Seventh Edition to complement the materials found in traditional marketing management and principles texts. Recognizing that the service sector of the economy can best be characterized by its diversity, we believe that no single conceptual model suffices to cover marketing-relevant issues among organizations ranging from huge international corporations (in fields such as airlines, banking, insurance, telecommunications, freight transportation and professional services) to locally owned and operated small businesses, such as restaurants, laundries, taxis, optometrists, and many business-to-business services. In response, the book offers a carefully-designed “toolbox” for service managers, teaching students how different concepts, frameworks and analytical procedures can best be used to examine and resolve the varied challenges faced by managers in different situations.
The SERVQUAL instrument has been proposed as an instrument for the measurement of perceived service quality within a wide range of service categories. The current research examines both the operation of the scale and its management implications in four major sectors of the travel and tourism industry. Concerns regarding the SERVQUAL scale and its limitations and problems are discussed; within and across service category comparisons are also considered. Finally, other areas requiring attention in the area of quality of service are suggested.
Purpose
The purpose of this paper is to propose and empirically assess three comparative approaches to measuring service quality: modified gap model, TOPSIS and loss function. Aims to argue for the use of TOPSIS from decision sciences, and Loss function from operations research and engineering, as alternative approaches to the gap model.
Design/methodology/approach
The empirical evidence is provided by large sample consumer data on the service quality for leading Indian commercial banks. The service quality evaluations obtained from these three distinct methods are compared and tested for their mutual agreement.
Findings
Fndings show that the rankings obtained from different methods are statistically in agreement, suggesting that the alternative approaches can provide equally good measurement of service quality. But they should not be used in an interchangeable manner.
Research/limitations/implications
Research shows that a single measure of overall service quality based on gap model is over‐simplistic. It would be more useful to explore a richer profile of customer service quality provided by different measurement approaches. Each methodology has its own advantages and disadvantages, and should be used based on its suitability for a particular application.
Practical implications
This research offers profound practical implications. It offers managers with a framework of service quality improvement that measures service quality gaps, selects an optimal combination of attribute levels to deliver customer satisfaction, and focuses on reducing the future loss caused by poor quality.
Originality/value
Extant marketing literature is replete with gap model applications for measuring service quality. Drawing from interdisciplinary literature, alternatives are provided to the traditional gap model, which show equally good measurement with greater suitability of application under certain conditions.
Purpose
The purpose is to investigate, the difference between SERVQUAL and SERVPERF's predictive validity of service quality.
Design/methodology/approach
Data from 17 studies containing 42 effect sizes of the relationships between SERVQUAL or SERVPERF with overall service quality (OSQ) are meta‐analyzed.
Findings
Overall, SERVQUAL and SERVPERF are equally valid predictors of OSQ. Adapting the SERVQUAL scale to the measurement context improves its predictive validity; conversely, the predictive validity of SERVPERF is not improved by context adjustments. In addition, measures of services quality gain predictive validity when used in: less individualistic cultures, non‐English speaking countries, and industries with an intermediate level of customization (hotels, rental cars, or banks).
Research limitations/implications
No study, that were using non‐adapted scales were conducted outside of the USA making it impossible to disentangle the impact of scale adaptation vs contextual differences on the moderating effect of language and culture. More comparative studies on the usage of adapted vs non‐adapted scales outside the USA are needed before settling this issue meta‐analytically.
Practical implications
SERVQUAL scales require to be adapted to the study context more so than SERVPERF. Owing to their equivalent predictive validity the choice between SERVQUAL or SERVPERF should be dictated by diagnostic purpose (SERVQUAL) vs a shorter instrument (SERVPERF).
Originality/value
Because of the high statistical power of meta‐analysis, these findings could be considered as a major step toward ending the debate whether SERVPERF is superior to SERVQUAL as an indicator of OSQ.
This exploratory study investigated patients’ satisfaction with nursing care at a major teaching hospital in Jordan. A total of 266 in-patients participated in the study. Patients were recruited from the medical, surgical, and gynecological wards. Pearson correlation, one-way analysis of variance, and logistic regression analyses were used. The findings showed that patients in surgical wards had lower levels of satisfaction than patients in medical or gynecological wards. Gender, educational level, and having other diseases were significant predictors for patients’ satisfaction with nursing care. Methodological challenges, implications to nursing practice, and recommendations to nursing research are discussed.
Since its launch in 1985, SERVQUAL has become a widely adopted technology for measuring and managing service quality. Recently, a number of theoretical and operational concerns have been raised concerning SERVQUAL. Reviews these concerns and proposes a research agenda.
SERVQUAL:
A Multiple-Item Scale for Measuring Consumer Perceptions of
Service Quality
A. PARASURAMAN
Foley's/Federated Professor of Retailing and Marketing Studies
Texas A & M University College Station, Texas
VALARIE A. ZEITHAML
Associate Professor
of Marketing Duke University
Raleigh-Durham, N. Carolina
LEONARD L. BERRY
Foley's/Federated Professor of Retailing and Marketing Studies
Texas A & M University College Station, Texas
This paper describes the development of a 22-item instrument (called SERVQUAL) for assessing customer perceptions of service quality in service and retailing organizations. After a discussion of the conceptu alization and operationalization of the service quality construct, the procedures used in constructing and refining a multiple-item scale to measure the construct are described. Evidence of the scale's reliability, factor structure, and validity on the basis of analyzing data from four independent samples is presented next. The paper concludes with a discussion of potential applications ef the scale.
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Patients' views are being given more and more importance in policy-making. Understanding populations' perceptions of quality of care is critical to developing measures to increase the utilization of primary health care services.
Documentation of user's opinion on the quality of care of primary health care services.
A 20-item scale, including four sub-scales related to health personnel practices and conduct, adequacy of resources and services, health care delivery, and financial and physical accessibility, was administered to 1081 users of 11 health care centres in the health district of Nouna, in rural Burkina Faso.
The respondents were relatively positive on items related to health personnel practices and conduct and to health care delivery, but less so on items related to adequacy of resources and services and to financial and physical accessibility. In particular, the availability of drugs for all diseases on the spot, the adequacy of rooms and equipment in the facilities, the costs of care and the access to credit were valued poorly. Overall, the urban hospital was rated poorer than the average rural health care centre. Analysis of variance showed that, overall, health system characteristics explain 29% of all variation of the responses.
Improving drug availability and financial accessibility to health services have been identified as the two main priorities for health policy action. Policy-makers should respect these patient preferences to deliver effective improvement of the quality of care as a potential means to increase utilization of health care.
Patients' feedback is of great importance in health care policy decisions. The Consumer Quality Index Cataract Questionnaire (CQI Cataract) was used to measure patients' experiences with quality of care after a cataract operation. This study aims to evaluate the reliability and the dimensional structure of this questionnaire and assesses its ability to measure differences between hospitals in patients' experiences with quality of care.
Survey data of 4,635 respondents were available. An exploratory factor analysis was performed to evaluate the construct validity of the questionnaire and item-correlations and inter-factor correlations were calculated. Secondly, Cronbach's alpha coefficients were calculated to assess the internal consistency of the scales. Thirdly, to evaluate the ability of the questionnaire to discriminate between hospitals, multilevel analyses were performed with patients hierarchically nested within hospitals.
Exploratory factor analysis resulted in 14 quality of care items subdivided over three factors (i.e. communication with ophthalmologist, communication with nurses, and communication about medication). Cronbach's alpha coefficients of 0.89, 0.76 and 0.79 indicated good internal consistency. Multilevel analyses showed that the questionnaire was able to measure differences in patients' experiences with hospital care regarding communication with ophthalmologist and communication about medication. In addition, there was variation between hospitals regarding ophthalmologist ratings, hospital ratings and one dichotomous information item.
These findings suggest that the CQI Cataract is a reliable and valid instrument. This instrument can be used to measure patients' experiences with three domains of hospital care after a cataract operation and is able to assess differences in evaluated care between hospitals.
The 6th Edition of this successful textbook. Completely revised with every chapter updated in a new 15 chapter version. Additional emphasis on "Services for a Better World" and the aging consumer. Global perspective with featured vignettes on e-services.
Purpose: The purpose of this research is to measure service quality offered to patients treated in a government controlled hospital in South Africa. Desig/Methodology/Approach: A service satisfaction survey was conducted amongst patients treated at a provincial hospital in Gauteng. The attitudes of the patients were tested regarding pre-identified service quality aspects related to health care. Tangibility and assurance categories are analysed for the purposes of this paper. A total of 583 in- and out-patients were selected at random and were personally interviewed. A five point Likert type scale was used to measure their expectations and perceived performance. Findings: These indicated patient dissatisfaction with both service quality dimensions measured, although significant differences exist between in- and out-patients. Personal safety and cleanliness of facilities were regarded as the most important variables in the assurance and tangibility dimensions. The level of satisfaction was the highest for clear information signage and communication at an understandable level in the tangibility-and assurance categories, respectively. Implications: This paper presents a comprehensive framework for prioritising important issues by provincial hospital management policy makers to satisfy patients' expectations and, because they have more authority over expenditure, the findings are important in the interest of supplying acceptable health care. Originality/Value: This study challenges existing work on health care services. Its significance lies in investigating the diversified health care needs and wants of various cultural groups in South Africa, because it focuses on service quality as experienced by in- and out-patients. It offers a new framework from an original South African perspective, focusing on differences and similarities between in- and outpatients of a Gauteng public hospital.
In exemplary service organizations, executives understand that they need to put customers and frontline workers at the center of their focus. Those managers heed the factors that drive profitability in this service paradigm: investment in people, technology that supports frontline workers, revamped recruiting and training practices, and compensation linked to performance. They also express a vision of leadership in somewhat unconventional terms, referring to an organization's "patina of spirituality" and the "importance of the mundane." In this article, Heskett, Jones, Loveman, Sasser, and Schtesinger take a close look at the links in the service-profit chain, which puts hard values on soft measures so that managers can calibrate the impact of employee satisfaction, loyalty, and productivity on the value of products and services delivered. Managers can then use this information to build customer satisfaction and loyalty and assess the corresponding impact on profitability and growth. Describing the links in the service-profit chain, the authors explain that profit and growth are stimulated by customer loyalty; loyalty is a direct result of customer satisfaction; satisfaction is largely influenced by the value of services provided to customers; value is created by satisfied, loyal, and productive employees; and employee satisfaction, in turn, results from high-quality support services and policies that enable employees to deliver results to customers. By completing the authors' service-profit chain audit, companies can determine not only what drives their profit but how they can sustain it in the long term.
An intentional meander around the central issue of servicescapes design. Proposes that there are worthwhile lessons to be learned from the way in which users divert and subvert the planned design of physical support. Advocates that servicescape is not only acting on users in order to achieve marketing goals, but also it is acted on by users in order to frame existential goals. In this constructivist approach, the consumer is considered as a co-builder of the servicescape. While experiencing service, the consumer can create new meanings and unusual functions which could raise opportunities to improve service management.
The purpose of this study is to describe and analyse the quality of a professional surgical service process, and to reveal the main elements that constitute excellence in the experience of the surgical service of a private hospital. First, a theoretical framework for the surgical service process is created. Second, empirical research is conducted through a mail survey of surgical patients in a private hospital. A total of 240 questionnaires were delivered and the response rate was 83 per cent. Third, the underlying quality dimensions in the surgical service process are constructed using factor analysis. Finally, the main elements of excellence in a surgical service experience are revealed by utilising discriminant analysis. Empirical results indicate that, in private surgical services, the surgical procedure itself is the single most important element, but that it must be supplemented by quality dimensions in both output and process throughout the whole surgical service process.
The stimulus for this research is that as US hospitals and health care organizations become more competitive, wise investments in technology and quality improvement are keys to financial success and survival. A structural equation model is hypothesized using the following five constructs: clinical technology; information technology; clinical quality; process quality; and hospital financial performance. No research to date has examined the relationships between the type of technology, the type of quality, and hospital financial performance. The general research hypothesis tested is that hospital technology directly drives (affects) quality and hospital financial performance. The results indicate that the type of hospital technology (clinical or information) drives different types of quality-related performance (clinical or process), and directly and indirectly affects hospital financial performance. The simple recursive model documented here is an important first step to defining more complete models that accurately predict hospital financial performance as a function of technology and quality investments and initiatives. The article concludes by summarizing results, discussing their implications, and proposing future research ideas.
This paper presents a case study of a pioneering nationwide implementation of SERVQUAL by a major UK high street bank between 1993 and 1997 at an annual cost of one million pounds. In addition to highlighting serious weaknesses in the value of SERVQUAL as a measure of service quality and as a diagnostic tool, this study raises some of the practical difficulties entailed in its implementation. Moreover, in this particular instance, it becomes apparent that difficulties are introduced by the separation of service quality management from the management of marketing and human resources. In addition, there was a discernible lack of top management commitment, as well as obstacles in the form of functional and informational silos, which served to constrain an integrated company response to SERVQUAL criteria.
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. Gives a theoretical
conceptualization of the service-quality construct and discusses its
major underlying assumptions and concepts. Also describes some specific
characteristics of the quality construct in the health-care sector.
Explores the dimensionality of the service-quality construct using the
SERVQUAL instrument. Also describes the Access concept, which is widely
used in the health-care literature. On the basis of these theoretical
considerations, reports an empirical study in a Belgian hospital to
develop an appropriate multiple-item scale to measure hospital service
quality. Discusses discrepancies between SERVQUAL and the dimensions
obtained from this study in some detail along with the reliability and
validity properties of our scale and makes some critical comments on the
SERVQUAL approach with recommendations for future research.
Intangibility is one of the distinctive characteristics of service. However, the literature also highlights “tangibles” as one of the basic service quality dimensions. Investigates the importance of tangibles and intangibles in perceptions of service quality as assessed by both customers and service providers. Selects four service industries to reflect a range from high to low levels of tangible components and degree of intangibility in both service process and output. Based on 400 telephone interviews with consumers, shows that the level of tangible components has a positive impact on the perceived importance of the tangible dimension in service quality. However, the second phase of this research, involving a qualitative study with managers in the studied industries, shows that the tangibles dimension is relatively neglected in service industries with high tangible involvement. Presents a model of tangibility and intangibility to aid managers in understanding customers’ perceptions, and to stimulate further research.
This study investigates the applicability of a modified SERVQUAL instrument as a means of measuring residents' perceptions of long-term health-care service quality in the USA and UK. The results confirm a stable, four-factor structure that is similar to previously defined service quality dimensions and is invariant across the countries studied.
Using two complementary ideographic approaches, investigates theimpact of the servicescape on women's experience of the public houseservice encounter. Preliminary findings from both the focus group andthe in-depth interviews conducted indicate that women perceive theirdesired pub experience as diametrically opposite to that provided by thetraditional male-dominated pub. In the latter, barriers to enjoymentarise from the dynamic interplay between the physical environment andthe behaviour of staff. The latter, unless carefully managed, can act asreinforcement of the behaviour of other established male customers,whose actions have the effect of signalling to women that they areunwelcome. These barriers are seen to be particularly strong on entry,when getting served and when being seated. Explores how publicans canmake use of these crucial stages and shape the servicescape tofacilitate a more satisfactory encounter, thus enhancing loyalty amongfemale customers.
The premise of 'quality of service' as the competitive edge in gaining market leadership has been well recognized both in academic research and by leading service organizations. However, it has become increasingly important for organizations to find ways, not only to reach the top, but to maintain that leadership in an ever increasing competitive market-place. In order to protect their long-term interest, service organizations are seeking ways to forge and to maintain an on-going relationship with their customers. This paper presents the changing focus of service quality from a mere competing instrument to that of the basic core of the service concept in meeting and exceeding customer expectations. It is argued that long-term superiority of a service firm is dictated by the organization's ability to maintain their relationship with the customer by offering 'service loyalty': a demonstration of the organization's commitment to maintain the service promise. The thesis here argues that service loyalty precedes customer loyalty. This paper outlines how a firm's service employees develop the emotional connection with customers which leads to exceptional service and the ability to exceed customer expectations. It is proposed that offering loyal service gives an organization the advantage, not only to be able to fulfil customers' present needs, but also the ability to anticipate their future needs. This ability to anticipate presents the firm with the opportunity to surprise and delight customers on a consistent basis thereby reinforcing to the customer, the firm's service loyalty and subsequently effecting a responsive and sustained patronage.
textlessptextgreaterThe authors investigate the conceptualization and measurement of service quality and the relationships between service quality, consumer satisfaction, and purchase intentions. A literature review suggests that the current operationalization of service quality confounds satisfaction and attitude. Hence, the authors test (1) an alternative method of operationalizing perceived service quality and (2) the significance of the relationships between service quality, consumer satisfaction, and purchase intentions. The results suggest that (1) a performance-based measure of service quality may be an improved means of measuring the service quality construct, (2) service quality is an antecedent of consumer satisfaction, (3) consumer satisfaction has a significant effect on purchase intentions, and (4) service quality has less effect on purchase intentions than does consumer satisfaction. Implications for managers and future research are discussed.
Service quality can often make the difference between a business's success and failure. But what causes problems, and what can a business do to eliminate them? The answers are here.
The role of the health care physical or tangible environment, including the facility, is essentially an unstudied area. This article identifies and defines components of "atmospherics" concerning health care (Healthscapes), to assess their strengths and predictiveness in the relationship between patient and other customer outcomes, satisfaction, quality assessments, intention to return, and willingness to recommend a health care provider to others and to propose much needed research in the area.
To examine the quality of response rate reporting and to identify methodological factors influencing response rates in published patient satisfaction studies.
Examination and analysis of 210 studies from 200 papers published in 1994 in 141 different health journals. Papers were located in the following databases: British Nursing Index, CINAHL, EMBASE, MedLine, Popline, and PsycLIT.
Reported and calculated response rates, collection and recruitment procedures of published studies, and type of instruments used for data collection.
Forty-eight per cent of studies reported a response rate. The mean response rate was 72.1%. There was no association between response rate and the type of instrument used for data collection. Studies which used a face-to-face approach to either subject recruitment (mean response rate, 76.7%) or data collection (mean response rate, 76.9%) were associated with significantly higher response rates than those in which subjects were recruited by mail (mean response rate, 66.5%) or data were collected by mail (mean response rate, 67%). Response rate was not related to questionnaire length.
Patient satisfaction studies generally show poor awareness of the importance of methodological issues relevant to response rate. Far more attention to this aspect is needed if findings in this field are to be accepted as valid and useful.
Notes 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. Investigates the effects of demographic factors on users and observers of perceived hospital quality. Reports results suggesting 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.
Long waiting times are a serious problem for patients using urban health centres in developing countries. A block appointment system was introduced and evaluated in a large South African health centre. Waiting times of all patients were measured over a one-week period before and after the implementation of appointments. Focus group and individual interviews were conducted with staff and patients. After introducing appointments, patients with acute and chronic illnesses and having appointments had significantly shorter waits than similar patients without appointments (difference in median waits: 63 and 39 minutes respectively). Appointments had no benefits for patients not seeing doctors or collecting repeat medication. There was, however, an overall increase in patients' waiting times after introducing the system, mainly due to one atypical day in the follow-up study. Focus groups and interviews revealed that staff were sceptical at baseline but at follow-up were positive about the system. Patients were enthusiastic about the appointment system at all stages. The study shows that block appointments can reduce patient waiting times for acute patients, but may not be suitable for all patients. Staff and patients had different views, which converged with experience of the new system.
States that rapid changes in the environment have exerted significant pressures on hospitals to incorporate patient satisfaction in their strategic stance and quest for market share and long-term viability. This study proposes and tests a five-factor model that explains considerable variation in customer satisfaction with hospitals. These factors include communication with patients, competence of the staff, their demeanour, quality of the facilities, and perceived costs; they also represent strategic concepts that managers can address in their bid to remain competitive. A probability sample was selected and a multiple regression model used to test the hypotheses. The results indicate that all five variables were significant in the model and explained 62 per cent of the variation in the dependent variable. Managerial implications of the proposed model are discussed.
The purpose of this study was to develop and test a core set of questions to measure patients' experiences of in-patient care. Questions were selected from the bank of items developed for use in in-patient surveys undertaken by the Picker Institute for the purposes of assessing the quality of care.
The data reported here come from surveys of patients who had attended acute care hospitals in five countries: the United Kingdom, Germany, Sweden, Switzerland, and the USA. Questionnaires were mailed to patients' homes within 1 month of discharge, either to all patients, or to a random sample, discharged during a specified period.
A total of 62 925 questionnaires were returned, with response rates of 65% (UK), 74% (Germany), 63% (Sweden), 52% (Switzerland), and 46% (USA).
Fifteen items were selected from the bank of questions included in the Picker in-patient questionnaires. These items have a high degree of face validity and when summed to an index they show a high degree of construct validity and internal reliability consistency.
Fifteen items derived from the longer form Picker in-patient survey have been found to provide a meaningful picture of patient experiences of health care, and constitute the 15-item Picker Patient Experience Questionnaire. These questions comprise a core set that should be measured in all in-patient facility surveys. The Picker Patient Experience Questionnaire represents a step forward in the measurement of patient experience as it provides a core set of questions around which further optional modules may be added. Scores are easy to interpret and actionable.
This small set of questions could be incorporated into in-patient surveys in different settings, enabling the comparison of hospital performance and the establishment of national or international benchmarks.
To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health care similarly or differently.
A conceptual model including behavioural dimensions of patient-physician relationships and patient satisfaction has been developed. As the empirical research setting, this study concerns three hospitals in Egypt and Jordan. The survey instrument in a questionnaire form was designed to achieve the research objectives. A total of 48 items (attributes) of the newly developed five quality dimensions were identified to be the most relevant. A total of 224 complete and usable questionnaires were received from the in-patients.
Hospital C has above-average total and dimensional qualities and patients are the most satisfied in accordance with all dimensions of services. Hospitals A and B have under-average total qualities as the majority of patients are not satisfied with services. Comparing hospitals A and B, in the majority of dimensions (with the exception of Q5), the quality in hospital B is higher than in hospital A. Patients' satisfaction with different service quality dimensions is correlated with their willingness to recommend the hospital to others. A cure to improve the quality for health-care services can be an application of total relationship management and the 5Qs model together with customer orientation strategy.
The result can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health-care quality strategies.
In this research a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented. This study argues that a patient's satisfaction is a cumulative construct, summing satisfaction with five different qualities (5Qs) of the hospital: quality of object, processes, infrastructure, interaction, and atmosphere.
A comparison of service quality in the banking industry
- H Arsali
- S T Katircioglu
- S Mehtap-Smadi
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