Service Quality and Performance in the Public Health-Care Sector

The purpose of this article is to evaluate service quality and service performance relationship in the health-care sector using respective developed multidimensional scales. Data were collected from 400 inpatient respondents, using stratified sampling method from five departments, namely general medicine, surgery, pediatrics, orthopedics, gynecology, and ENT of a tertiary hospital (North India). The results confirm significant relationship among subdimensions of physical environment quality and interaction quality (service quality) and four service performance measures, namely waiting time, patient satisfaction, patient loyalty, and image in public hospitals.     

顾客满意度和顾客忠诚度在医院管理中的应用

深入开展顾客满意度和忠诚度研究,关注患者满意,培养患者忠诚已经成为学术界和医院经营管理者共同关注的焦点。充分认识满意度与忠诚度的关系,研究顾客满意、服务质量、顾客信任和转换成本对忠诚度的决定影响,对医院经营管理将起到积极的促进作用。它将有助于构建和谐互信的新形医患关系、以顾客为导向的服务质量改进和提升医院经营绩效。     

基于社区卫生服务中心绩效管理及其考核有关思考

目的探究社区卫生服务中心绩效管理与考核机制。方法选取2017年1月-2019年1月在该中心门诊治疗的患者260例回顾分析该中心建立绩效管理及考核机制后对对医疗服务质量控制、预防保健服务质量、患者满意度等相关指标的比较分析。结果观察组在医疗质量控制、预防保健服务质量、患者满意度等方面均好于对照组,差异有统计学意义(P<0.05)。结论社区卫生服务中心作为基层医疗的重要保障,绩效考核管理的水平直接影响着基层医疗的服务质量。为此必须要建立一套适用于社区卫生服务中心规范化、标准化、系统化的绩效管理考核评估机制,全面提高医疗管理质量,保障社区服务水平。     

A sociocognitive approach to service quality and adherence amongst elderly patients: a pilot study

This article examines the relationship between patients' perceptions of emotional intelligence (EI), health competence, service quality, and adherence behavior in the Home Medicines Review (HMR) setting. Participants were purposively recruited from different urban and regional areas in Australia and qualitative data were obtained from in-depth interviews with 20 HMR patients. Service quality is conceptualized from a sociocognitive perspective by incorporating psycho-socio factors such as EI and health competence as moderators to overall service quality and adherence. The findings suggest that EI and health competence influence patient perceptions of service quality and nonadherence at multiple levels of abstraction. Implications are that staff training and development programs that incorporate EI could improve service delivery which could increase patient perceptions of service quality and adherence. Designing intervention initiatives aimed at increasing patient awareness and education of their health conditions could also improve service quality perceptions and adherence behavior.     

A Sociocognitive Approach to Service Quality and Adherence Amongst Elderly Patients: A Pilot Study

This article examines the relationship between patients' perceptions of emotional intelligence (EI), health competence, service quality, and adherence behavior in the Home Medicines Review (HMR) setting. Participants were purposively recruited from different urban and regional areas in Australia and qualitative data were obtained from in-depth interviews with 20 HMR patients.

Service quality is conceptualized from a sociocognitive perspective by incorporating psycho-socio factors such as EI and health competence as moderators to overall service quality and adherence. The findings suggest that EI and health competence influence patient perceptions of service quality and nonadherence at multiple levels of abstraction. Implications are that staff training and development programs that incorporate EI could improve service delivery which could increase patient perceptions of service quality and adherence. Designing intervention initiatives aimed at increasing patient awareness and education of their health conditions could also improve service quality perceptions and adherence behavior.     

Service quality: A subliminal pathway to service differentiation and competitive advantage in private healthcare marketing in Ghana

The study investigates the role of service quality in Ghana’s private hospitals and its effect on patients’ satisfaction and loyalty. A sample of 622 respondents was drawn using convenience sampling. Structural equation modeling using smart PLS was used to test the measures. The study found a significant positive relationship between service quality and patient satisfaction and also a significant positive relationship between patients’ satisfaction and loyalty and that patients’ satisfaction mediates the relationship between service quality and patients’ loyalty. The study provides a useful guide to policy formulation for private healthcare practitioners.     

Relationships building. Measure service quality across health care encounters

The relationships between service quality and satisfaction is a function of multiple service encounters across a wide variety of exchange partners within a health care organization. Studying the patient provider relationship leads to improved service quality. The authors report their findings from a study that tests a relationship-building framework that integrates service quality issues across multiple internal health care publics. Strategies for developing a strong patient-provider relationship bond are also discussed.     

The impact of visit frequency on the relationship between service quality and outpatient satisfaction: a South Korean study

OBJECTIVE: To examine the relative impact of four service quality dimensions on outpatient satisfaction and to test the invariance of the structural relationships between the service quality dimensions and satisfaction across three patient groups of varying numbers of prior visits to the same hospital as outpatients. DATA SOURCES/STUDY SETTING: Survey of 557 outpatients using a self-administered questionnaire over a 10-day period at a general hospital in Sungnam, South Korea. DATA COLLECTION: Patients answered questions related to two main constructs, patient satisfaction and health care service quality. The health care service quality measures (30 items) were developed based on the results of three focus group interviews and the SERVQUAL scale, while satisfaction (3 items) was measured using a previously validated scale. STUDY DESIGN: Confirmatory factor analysis was used to assess the construct validity of the service quality scale by testing convergent and divergent validity. A structural equation model specifying the four service quality dimensions as exogenous variables and patient satisfaction as an endogenous variable was estimated to assess the relative impact of each of the service quality dimensions on satisfaction. This was followed by a multigroup LISREL analysis that tested the invariance of structural coefficients across three groups with different frequencies of outpatient visits to the hospital. PRINCIPAL FINDINGS: Findings support the causal relationship between service quality and satisfaction in the context of the South Korean health care environment. The four service quality dimensions showed varying patterns of impact on patient satisfaction across the three different outpatient groups. CONCLUSION: The hospital management needs to be aware of the relative importance of each of the service quality dimensions in satisfaction formation of outpatients, which varies across different hospital utilization groups, and use this in strategic considerations.     

门急诊退号原因分析与改进

分析门急诊退号现状及原因,从构成患者忠诚度的服务质量、服务效果、客户关系维护、品牌战略、持续地良性主观体验和增值感受等5个方面,制定门急诊退号相应控制措施。实施后,退号占比由实施前的8.3%下降至5.9%（P＜0.05）。提高门急诊服务质量,形成患者忠诚,能够显著降低退号量。     

A roadmap for improving healthcare service quality

A data-driven, comprehensive model for improving service and creating long-term value was developed and implemented at Mayo Clinic Arizona (MCA). Healthcare organizations can use this model to prepare for value-based purchasing, a payment system in which quality and patient experience measures will influence reimbursement. Surviving and thriving in such a system will require a comprehensive approach to sustaining excellent service performance from physicians and allied health staff (e.g., nurses, technicians, nonclinical staff). The seven prongs in MCA's service quality improvement model are (1) multiple data sources to drive improvement, (2) accountability for service quality, (3) service consultation and improvement tools, (4) service values and behaviors, (5) education and training, (6) ongoing monitoring and control, and (7) recognition and reward. The model was fully implemented and tested in five departments in which patient perception of provider-specific service attributes and/or overall quality of care were below the 90th percentile for patient satisfaction in the vendor's database. Extent of the implementation was at the discretion of department leadership. Perception data rating various service attributes were collected from randomly selected patients and monitored over a 24-month period. The largest increases in patient perception of excellence over the pilot period were realized when all seven prongs of the model were implemented as a comprehensive improvement approach. The results of this pilot may help other healthcare organizations prepare for value-based purchasing.     

新形势下医患关系和医疗服务的伦理学思考

本文对新形势下医患关系和医疗服务进行伦理学思考。介绍医学伦理学慨念和医患关系的发展趋势,提出构建和谐医患关系的办法策略,以及加强医疗服务工作的具体措施。     

Service quality measurement

Extending the research on service quality in health care, the authors examine the efficacy of four models for measuring service quality and conclude that SERVPERF methods are superior to SERVQUAL methods. Their study found that dental patients' assessments of overall service quality were strongly influenced by assessments of provider performance. Furthermore, an examination into the causal order between perceptions of overall service quality and patient satisfaction reveals such strong reciprocal influences that it's impossible to conclude that one empirically precedes the other. Finally, the authors found that purchase intentions are influenced by both patient satisfaction and patient assessments of overall service quality.     

绩效分配考核体系在消毒供应中心的应用及评价

目的探讨绩效分配考核体系在消毒供应中心的建立和实施效果。方法运用竞聘机制,实行以服务质量及岗位工作量和工作质量为主的绩效考核和岗位绩效工资制度,对提高工作效率和服务质量的情况进行分析。结果绩效考核管理提高了消毒供应中心工作人员的积极性,确保医疗和病人安全,提高了服务满意度,降低了差错发生率,差异均具有统计学意义(P<0.01)。结论有效的激励机制可以提高服务满意度和工作质量,促进了该学科的专业化发展。     

浅谈医患关系"寒冷期"的形成原因与对策

医患关系是一种特殊的社会人际关系，其好坏程度直接影响社会的稳定，由于种种原因，此关系目前进入了一个相对的“寒冷期”，严重影响着医患双方的行为，进而影响卫生事业的发展和人民群众的生命健康。该文初步探讨了其形成原因有：（1）医者的支配地位与患者自我保护意识增强之间的矛盾。（2）医疗的高风险性与患者高期望值之间的矛盾。（3）医疗费用上涨过快与患者经济承受能力低下之间的矛盾。（4）传统价值观与现实之间的矛盾。（5）新闻媒体的炒作起着推波助澜的作用。针对上述原因，应采取的对策有：（1）加强信息交流，提高医患双方的风险意识。（2）服务到位，心理相融，建立新型服务关系。（3）增加收费透明度，切实减轻患者经济负担。（4）加强职业修养。（5）明确卫生政策定位，政府增加投入。     

Determinants of Patient Satisfaction With Public Hospital Services

The aim of this research is to propose and test a model of the causal relationships among the constructs of perceived service quality, consumption emotions, and satisfaction among users of public hospital services. The conceptual model proposed in this study postulates that: (a) perceived service quality is positively related to positive emotions and negatively related to negative emotions; (b) perceived service quality is positively related to patient satisfaction; and (c) positive emotions are positively related to patient satisfaction and negative emotions are negatively related to patient satisfaction. The model was tested with data from an empirical study in the Canadian public hospital setting. Data were collected from 314 respondents. The relationships between the constructs were tested using structural equation modeling by means of the EQS software. All hypothesized relationships were supported. The results confirm that perceived service quality exerts both direct and indirect effects (through positive and negative emotions) on satisfaction. The study demonstrates that emotions play an important role in determining satisfaction with hospital services.     

优质护理的研究进展

随着社会的发展,人们对医疗服务质量的要求越来越高。许多研究表明,开展优质护理服务示范工程活动,为患者提供更为安全、优质、满意的护理服务,有利于构建和谐护患关系和全面提升临床护理服务质量及患者满意度,使医院、护士、患者获得三方受益的效果。当前我国对优质护理服务的研究尚处于起始阶段,各个医院需要根据自身的实际情况和对优质护理内涵的理解,制定适合自己的相关规章制度并实施,以促进护理质量的提高。     

浅谈医患关系紧张的原因及对策

医患关系紧张、医疗纠纷增加，是当前医疗服务中一个十分突出的问题。医患之间缺乏信任和理解，医患关系紧张的现状不容乐观。其产生的原因应该是多方面的：医疗资源配置的不合理和国家与社会医疗投入比重降低、医疗机构自身的原因、患者的因素等。解决这些矛盾应该重视调整医疗资源的合理性配置，更多的体现医疗服务的公平性及可及性。加强对医疗机构的监控力度，提高医务人员的自身素质，普及医疗知识的宣传教育，加强医患双方的沟通和理解。建立医患互信的良好关系，完善现有的法律法规，通过人性化、制度化的有效措施缓解医患关系的紧张。     

Modeling patient satisfaction and service quality

The authors attempt to clarify and extend the conceptualization and measurement of consumer satisfaction and service quality in health services. Although the two constructs serve as cornerstones in the design and implementation of health care marketing strategies, a literature review suggests that satisfaction and service quality are currently difficult to distinguish--both conceptually and operationally--in health care settings. The findings from two studies conducted by the authors to distinguish the nature of these two important constructs within a health care marketing context reveal that a nonrecursive relationship between service quality and patient satisfaction may account for much of the conflicting evidence in the literature.