Organizational determinants of service quality in nursing homes

This study analyzed four prominent organizational factors thought to influence service quality in nursing homes. Perceptions of service quality were collected from over 400 family members who regularly visited residents in 41 nursing homes. Service quality was measured along five dimensions identified by marketing research on customers in service industries. These five dimensions were responsiveness, reliability, assurance, empathy, and tangibles. Perceptions of service quality exhibited significant associations with each of the four organizational factors: ownership, funding mix, facility size, and nurse staffing. Implications for health services administration are discussed.     

Traveling Abroad for Medical Care: U.S. Medical Tourists' Expectations and Perceptions of Service Quality

The SERVQUAL scale has been widely used to measure service quality in the health care industry. This research is the first study that used SERVQUAL to assess U.S. medical tourists' expectations and perceptions of the service quality of health care facilities located outside the United States. Based on a sample of U.S. consumers, who had traveled abroad for medical care, the results indicated that there were significant differences between U.S. medical tourists' perceived level of service provided and their expectations of the service that should be provided for four of the five dimensions of service quality. Reliability had the largest service quality gap followed by assurance, tangibles, and empathy. Responsiveness was the only dimension without a significantly different gap score. The study establishes a foundation for future research on service quality in the rapidly growing medical tourism industry.     

Traveling abroad for medical care: U.S. medical tourists' expectations and perceptions of service quality

The SERVQUAL scale has been widely used to measure service quality in the health care industry. This research is the first study that used SERVQUAL to assess U.S. medical tourists' expectations and perceptions of the service quality of health care facilities located outside the United States. Based on a sample of U.S. consumers, who had traveled abroad for medical care, the results indicated that there were significant differences between U.S. medical tourists' perceived level of service provided and their expectations of the service that should be provided for four of the five dimensions of service quality. Reliability had the largest service quality gap followed by assurance, tangibles, and empathy. Responsiveness was the only dimension without a significantly different gap score. The study establishes a foundation for future research on service quality in the rapidly growing medical tourism industry.     

Health care quality in NHS hospitals

Hospitals provide the same type of service, but they do not all provide the same quality of service. No one knows this better than patients. Reports the results of a market research exercise initiated to ascertain the different factors which patients of health care identify as being necessary to provide error-free service quality in the NHS hospitals. To measure patients' satisfaction with NHS hospitals, the internationally-used market research technique called SERVQUAL was used in order to measure patients' expectations before admission, record their perceptions after discharge from the hospital, and then to close the gap between them. This technique compares expectations with perceptions of service received across five broad dimensions of service quality, namely: tangibility; reliability; responsiveness; assurance; and empathy. This analysis covered 174 patients who had completed the SERVQUAL questionnaire, including patients who had had treatment in surgical, orthopaedic, spinal injury, medicinal, dental and other specialties in the West Midlands region. Recorded the average weighted NHS service quality score overall for the five dimensions as significantly negative.     

A study of patients' expectations and satisfaction in Singapore hospitals

In today's highly competitive healthcare environment, hospitals increasingly realise the need to focus on service quality as a means to improve their competitive position. Customer-based determinants and perceptions of service quality therefore play an important role when choosing a hospital. This paper attempts to determine the expectations and perceptions of patients through the use of a generic, internationally used market research technique called SERVQUAL. An analysis covering 252 patients revealed that there was an overall service quality gap between patients' expectations and perceptions. Thus, improvements are required across all the six dimensions, namely, tangibility, reliability, responsiveness, assurance, empathy and accessibility and affordability.     

Bridging the dichotomous gap between expectations and perceptions in quantifying hospice care quality

This study uses a fuzzy logic and neural network to ascertain how service quality dimensions of the SERVQUAL model (reliability, assurance, empathy, responsiveness, and tangibility) affect overall customer satisfaction. Using a threshold logic unit to produce observation outcomes, the algorithm indicated that while reliability was the crux of the service outcome, peripheral variables (e.g., assurance, empathy, responsiveness, and tangibility) integrated emotions and feelings into the hospice service process which equated to an increased quality of life, a positive disconfirmation of expectations (service expectations were met or exceeded) and a good death experience equating to a positive perception of quality.     

Assessing the quality of health care: a consumerist approach

Recent investigations show that nontechnical interventions influence patients' ratings of the quality of health care, and that these aspects of the medical encounter are as important to the patient as the technical aspects; perhaps more important. This paper adopts a consumerist approach and measures patients' perceptions of health care quality using a scale adapted from the consumer behavior literature (SERVQUAL). The study measures health care quality as well as five of its individual dimensions. The findings indicate that, for the whole sample, patients' ratings of overall quality as well as the ratings of four of the five dimensions of care are negative. Further analysis indicates that many individual aspects (scale items) are rated negatively by each of two age groups (25-65 and over 65 years old), but the gap between perceptions of the younger group and their expectations is greater than that of the senior group. The two dimensions of "assurance" and "empathy" are found to be the most discriminating dimensions between the two groups. Other analyses indicate that age, annual household income, and work status significantly relate to overall quality rating. Marketing and strategic planning implications of the results are discussed.     

Quality Assessment of Services in Primary Healthcare in Iran: A Systematic Review and Meta-analysis

BackgroundPrimary healthcare (PHC) plays an important role in achieving universal health coverage (UHC). The SERVQUAL instrument is the tool for evaluating the quality of services in the health sector. The main purpose of this study is to evaluate the quality of services provided in PHC in Iran using the SERVQUAL instrument.Materials and MethodWe searched eight databases from January 2000 to September 2021. We analyzed the mean of various SERVQUAL instrument items using the DerSimonian-Laird approach via a random model with 95% confidence interval. Also, we used I2 to evaluate the heterogeneity of the studies.ResultsFinally, 17 studies were chosen for analysis in the present study. There were 8,767 study participants, out of which 8,237 were female and 530 were male. The mean dimensions of perception were as follows: Tangibles = 3.71, reliability = 4, responsiveness = 3.79, assurance = 3.83, and empathy = 3.86. For the expectation, the mean dimension were: Tangibles = 4.46, reliability = 4.46, responsiveness = 4.36, assurance = 4.36, and empathy = 4.36 respectively. The total gap quality between perception and expectation was -0.53.ConclusionAll dimensions of quality based on SERVQUAL were negative, and the quality of service in PHC is not satisfactory. Therefore, policymakers must adopt serious and effective programs to improve services in this area. We also recommend that quality management of services in PHC in Iran should move toward comprehensive optimization in all areas, and quality in this area should be a priority.     

Service quality perceptions and patient satisfaction: a study of hospitals in a developing country

Patients'perceptions about health services seem to have been largely ignored by health care providers in developing countries. That such perceptions, especially about service quality, might shape confidence and subsequent behaviors with regard to choice and usage of the available health care facilities is reflected in the fact that many patients avoid the system or avail it only as a measure of last resort. Those who can afford it seek help in other countries, while preventive care or early detection simply falls by the wayside. Patients'voice must begin to play a greater role in the design of health care service delivery processes in the developing countries. This study is, therefore, patient-centered and identifies the service quality factors that are important to patients; it also examines their links to patient satisfaction in the context of Bangladesh. A field survey was conducted. Evaluations were obtained from patients on several dimensions of perceived service quality including responsiveness, assurance, communication, discipline, and baksheesh. Using factor analysis and multiple regression, significant associations were found between the five dimensions and patient satisfaction. Implications and future research issues are discussed.     

The great gap. Physicians' perceptions of patient service quality expectations fall short of reality

The various players in a health care encounter all hold different perspectives on what constitutes service quality. Findings from this preliminary investigation show that doctors in a multispecialty clinic rated patient expectations of reliability, responsiveness, assurance, and empathy lower than did administrators, patient-contact personnel, and, most significantly, the patients themselves. Health care marketers need to educate doctors on the importance patients place on certain issues and how to address them.     

Evaluation of products and services of a nursing library: user satisfaction

The goal of the study was to evaluate the quality of the services provided by the library at the Nursing School of the University of S?o Paulo. A questionnaire evaluating users' satisfaction with the service was employed, covering five quality components: tangibles, reliability, responsiveness, assurance and empathy. The Satisfaction Rate was calculated through the degree of importance in relation to satisfaction. The analysis of the open-ended answers was quanti-qualitative. For Reliability and Empathy, the users showed dissatisfaction with the training for bibliographic research and the librarian's willingness to meet the clients' information needs, respectively. Responsiveness did not fully satisfy the users, disagreeing with the providers. However, both agreed that the archives are outdated. Among the tangible aspects, equipment and noise were criticized most often. The results show that the library offers good service quality to its users.     

Patient perceptions of service quality in group versus solo practice clinics.

OBJECTIVE: To compare patient perceptions of service quality at solo and group practices, and to examine the association of perceptions with 'potential patient loyalty' (PPL), the potential for seeking future service from the same clinic. DESIGN: A self-administered, cross-sectional survey of clinic outpatients, using an adapted SERVQUAL questionnaire translated into Chinese, with additional items on overall satisfaction and intent to return/recommend the clinic to others. Sampling and study subjects. Every third outpatient at all newly started group practices (four) and solo clinics (thirteen) in Taiwan in the preceding 4-7 months, including 150 and 50 patients from each group and solo practice, respectively, for a total of 1250 patients. MAIN OUTCOME MEASURES: Perceived service quality on five dimensions-tangibles, reliability, responsiveness, assurance, and empathy-and PPL. All constructs were measured on a five-point scale. RESULTS: After accounting for random effects of clinical and geographical location, group practice patients perceived significantly higher service quality on all dimensions relative to solo practice patients, after adjusting for age, gender, education, and illness type. All service quality dimensions except assurance were significantly positively associated with PPL after adjusting for age, gender, education, and illness type, and random effects at the clinical and geographical location levels. CONCLUSIONS: Patients perceive better service quality at group practices compared with solo practices on all dimensions. Patients' quality perceptions are significant predictors of PPL. The implications for physician practices both internationally and in Taiwan are discussed, as well as policy implications for the Taiwan government.     

Technology usage, quality management system, and service quality in Thailand

PURPOSE: This article aims to explore the relationship between technology and quality management for enhancing Thai hospital service quality. DESIGN/METHODOLOGY/APPROACH: The paper presents the findings of an exploratory study that investigates service quality from the customer and service provider perception. In-depth interviews were conducted with respondents in Thai hospitals. The interviews explored service-related factors that patients and service providers perceive to be important for hospital services. The first interview group consisted of professionals as internal customers in direct contact with external customers, while the second group consisted of external customers of the same hospitals. FINDINGS: The study's outcomes clearly suggest factors that make significant contribution to service quality. These factors can be categorized according to five SERVQUAL dimensions (reliability, responsiveness, assurance, empathy, and tangibility), although some factors required slightly different interpretation. ORIGINALITY/VALUE: The findings suggest that hospitals can develop an appropriate approach to their advantage, which can yield sustainable improvement in service quality as perceived by patients and professionals. Hospitals can make better quality decisions based on structured measurement and knowledge. It is recommended that managers apply this knowledge for successful implementation of activities related to service quality in their organizations.     

运用ServQual量表评价医院医疗服务质量

目的 测评医院患者和职工的感知服务质量,了解患者就诊和职工工作满意程度,提升医疗服务质量。方法 根据ServQual量表5个维度定义设计患者组与职工组两套量表,每套量表共设22个问项的问卷调查表,分别对医院门诊、住院患者和职工发放问卷,并让职工填写患者卷自评对患者提供的服务质量,用数据SPSS20.0统计分析。结果 患者卷和职工自评卷5个维度感受满意。职工卷有形性感受满意,移情性和可靠性感受性差,保证性与响应性感受性次之。女职工较男职工感受性好,30～49岁组职工感受性差,临床一线职工感受性差,其中以医技人员和医生为突出。结论 医院应保护职工利益、需求,合理安排工作时间与强度。提升职工感知服务质量更能提升患者感知的医疗服务质量。     

医患双方对优质医疗服务的认知差异分析

目的 医方"以病人为中心"思想的偏差、服务质量的难以改进,在一定程度上可由优质医疗服务的医患双方认知差异引起,因此有必要对其进行研究以提升医疗质量.方法 利用自编的优质医疗服务认知评价量表对医患双方开展调查,并对数据进行描述性统计分析和Mann-Whitney秩和检验分析.结果 患方认知总分和4个维度得分均高于医方;在响应性、保证性、移情性3个非技术性维度,以及具体的10个优质医疗服务指标上,医患间的优质医疗服务认知差异有统计学意义.结论 患方对于优质医疗服务的要求更加全面;医方对非技术性优质服务的重视程度低于患方,并且对于大多数的优质医疗服务指标,医方认知程度也低于患方,故医院应将上述差异维度、指标的良好患者体验作为服务提升工作重点.     

基于SERVQUAL的乡镇卫生院健康服务质量评价模型研究

该研究探索构建适用于乡镇卫生院健康服务质量评价的指标,为研究乡镇卫生院服务质量提供一个最基本的理论方法。研究在SERVQUAL模型的基础上,结合乡镇卫生院健康工作开展的实际情况进行量表设计,最终确立了有形性、可靠性、响应性、移情性4个维度,采用20个指标对乡镇卫生院健康服务质量进行测量。为评价乡镇卫生院服务质量现状,分析其服务质量水平的高低和具体改进措施提供科学、有效依据。     

Service quality perceptions in primary health care centres in Greece

Context The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services.     

基于决策树模型的门诊患者满意度调查

目的找出门诊患者满意度的影响因素并提出对策。方法将满意度影响因子设为意识忠诚、行为忠诚、医院文化、转换成本、社会支持、有形性、可靠性、响应性、保证性和移情性。数据采用SPSS 22.0统计软件做描述性统计分析、因素分析、信度分析,用决策树算法建模预测满意度变量重要性。结果问卷的KMO（Kaiser-Meyer-Olkin,检验统计量）取样适切性量数值为0.913,克隆巴赫系数0.975。医院文化是门诊患者满意度最重要的影响变量,其次是保证性、响应性、可靠性、有形性和意识忠诚,该模型适用。结论医院应积极参与社会医疗救助活动,发挥其公益性,不断提高服务患者的意识与能力,提升医疗服务质量与患者满意度。     

Quality improvement in primary care and the importance of patient perceptions

Increasing consumerism poses many challenges for health care providers, particularly for those in primary care. Quality improvement to meet patients' heightened demand for service excellence will require effective, continuous measurement of patient perceptions. The study described in this article evaluated the psychometric properties of a new instrument designed to survey patients' experiences with the delivery of primary care and assessed the factors that contribute to patient retention and likelihood to return. By systematically measuring patient satisfaction and perceptions of quality, medical practices can increase the effectiveness of primary care, improve patient outcomes, and control costs.