A Refereed Monthly International Journal of Management
Patient Satisfaction through modified SERVQUAL Model
Author
|
Dr. Rana Tahir Naveed
Assistant Professor
University of Education
E-mail:- ranatahir28@hotmail.com
|
Ahmad Mohmad Albassami
University Putra Malaysia (UPM)
E-mail:- albassami9500@gmail.com
|
Naveed Ahmad
Faculty of Management Sciences
Lahore Leads University, Pakistan
E-mail:- naveeddgk2010@gmail.com
|
Mahsa Moshfegyan
Lecturer
Salahadin University-Erbil
E-mail:- m.mahsa@live.com
|
Abstract
This study aims at investigating the modified SERVQUAL Model with sixth dimension
of usability and its relation with patient satisfaction in private healthcare sector
of Pakistan. To represent Private Healthcare sector, three large hospitals Iqra
Hospital, Arif Memorial hospital and Hameed Latif were chosen. A total of 348 questionnaires
were distributed among in-patients of these hospitals randomly and 261 fully filled
questionnaires were received. Different statistical tools like descriptive statistics,
Factor analysis, Correlation analysis and regression analysis were performed on
SPSS software. The results of study showed that all six dimensions of SERVQUAL model
like, Responsiveness, reliability, Empathy, Assurance, Tangibility and usability
were significant predictors of Patient satisfaction in private healthcare sector
of Pakistan but Responsiveness factor was the most dominant in this regard. The
present study will help top management and policy makers of healthcare sector to
craft better strategies for patient satisfaction through modified SERVQUAL model.
Keywords: Responsiveness, Reliability, Empathy, Assurance, Tangibility,
Usability, Patient satisfaction
Introduction
Presently every business sector is facing different challenges including survival
and success issues and ever increasing competition further adds to these difficulties
for business organizations. Service sector is also growing with a fast pace during
recent decades and concern for quality in service is an important issue in present
business scenario ( Ahmady et al., 2015 ). Quality is something that is really hard
to imitate and for this reason quality is a crucial factor to earn favorable positioning
(Ameryoun et al., 2017). Similarly in a research, Al-Borie & Sheikh Damanhouri
(2013 ) highlighted the importance of service quality as they acknowledged it a
key factor for successful business strategy especially those businesses that involve
high client involvement like medical or financial services. ( Ali, Hussain, &
Omar, 2016 )
Healthcare industry is one of the most rapidly growing industry and there are different
factors responsible for this rapid growth in health care sector for example environmental
changes, competitive pressures, alternate healthcare mechanism, new roles and regulations
imposed by governments to improve healthcare facilities, access of patients to information,
cost structures and many others contributed in this regard. So, many healthcare
service providers realized that patient satisfaction is a key factor for long run
success of a hospital. Hence patient satisfaction is considered to be a desired
outcome for any hospital or healthcare service provider ( Madan & Goel, 2015
). Patient satisfaction is an important profitable competitive strategy and different
studies (for example, Yesilada & Direktör, 2010 ) have shown people are more
concerned about those organizations which provide high standards of care and attempt
to satisfy their customer in a better way. Mthethwa & Chabikuli ( 2016 ) argued
in their research study that hospitals with better image of patient satisfaction
grab better market share and survive in competition.
Similarly, patients of today are more informative and educated about healthcare
service as compared to past. Due to their information and knowledge they carefully
chose a hospital after observing different standards of healthcare according to
their needs. So availability of information is a crucial factor due to which patients
are much sensitive about delivery of healthcare services and facilities. Buyers
of healthcare services are not trusting on doctors as heavily as was the case in
past, rather they give weight to the opinion of previous patient’s experience at
a certain hospital ( Dagger, Sweeney, & Johnson, 2007 ; Lee, & Kang, 2012
). According to Panchapakesan, Sai, & Rajendran, (2015 ) it is not the issue
whether patient is right or wrong, the issue is how a patient felt during his or
her stay at a particular hospital. Healthcare service providers failing this understanding
may invite trouble for their hospitals.
It goes without saying that patients’ satisfaction is a key factor in patients’
decision making while choosing a specific hospital. There are several general characteristics
for patient satisfaction such as demographic, socioeconomic and general health status.
Besides these general characteristics, patient satisfaction is also decided by the
delivery of healthcare services from a hospital for example experience of doctor
and healthcare delivery environment ( Madan & Goel, 2015 ). According to Ojha
& Sinha (2017 ), Continuity of care is also a crucial factor for patient satisfaction
and it requires partner like relationship between healthcare service provider and
patient. However as the changes emerged in healthcare sector for example changes
in coverage of health insurance etc may cause a forced discontinuity in patients’
satisfaction. Similarly, the extent to which patients’ are satisfied from a healthcare
provider also depends on characteristics of patient and why they are visiting certain
hospital for example in serious cases patients may not wait even for one day to
see their concerned doctor ( Pakdil & Harwood, 2005 ). Previous researches (
Johansson, Oleni, & Fridlund, 2002 ; Chilgren, 2008 ) also indicated continuity
is important in building the trust of patient on some particular hospital. According
to Kansra & Jha, (2016 ) there is a strong interaction between continuity and
satisfaction and this interaction is complex in nature that involves patients’ characteristics
and healthcare factors provided by a specific hospital.
Patient satisfaction is associated with many factors. It may include the waiting
time at healthcare center ( Ameryoun et al., 2017 ), physical structure and cleanliness
( Nadiri & Hussain, 2016 ) and responsiveness and assurance ( Khamis & Njau,
2014 ). Furthermore there are many factors that contribute towards patient satisfaction
at healthcare centers. It may include the privacy, tangibility, courtesy of staff,
clinic environment, registration process and consultation time. The outpatient department
(OPD) of any hospital is actually the shop window of any health care centre. Therefore
the reaction of patient at OPD reflects the overall satisfaction level of patient
for that specific health care unit. Existing literature also advocates that drivers
of patient satisfaction vary at public and private health care centers. Even there
may be different factors associated with patient satisfaction at developed, developing
and least developing countries. It is due to the factor of infrastructure provided
by the government to the health care centers. The study is focusing on the factors
contributing towards patient satisfaction in developing country i.e. Pakistan.
1.1. Healthcare sector of Pakistan
Pakistan is the 6th largest state of the world but the budget allocated
to health is 1.5% of entire budget. Health care sector in Pakistan is running under
Ministry of health. There are two sectors public and private. Public sector provides
basic health facilities with very low cost whereas private sector charges heavily
( Nishtar, 2009 ). In Pakistan, the infrastructure of health sector is moderate
which consists of Rural Dispensaries (RD), Basic Health Units (BHU), Rural Health
Centers (RHCs) and the District hospitals. The wide network of health care facilities
consists of 4755 Rural dispensaries (RD), 5349 Basic Health Units (BHUs), 572 Rural
Health Centers (RHCs), 945 Tehsil and District headquarter hospitals (THQ,DHQ),
903 maternal child health centers (MCHs) and 290 TB Centers (Existing Infrastructure
of Health care in Pakistan ( Mushtaq et al., 2011 )
1.2. Problem Statement
Private Healthcare sector is grooming and becoming highly competitive in metropolitan
cities of Pakistan like Lahore and Karachi. Healthcare service providers have begun
to facilitate their patients with five star treatment facilities ( Ojha & Sinha,
2017 ). Patients of today not only expect state of the art treatment facilities
but also other facilities in order to have a pleasant stay at hospital. This adjustment
in disposition has come because of commercialization. Presently, delivery of high
quality healthcare services is increasing from patient’s side and measurement of
satisfaction in patients is very important in this regard ( Al-Borie & Sheikh
Damanhouri, 2013 ). This situation stems from the concept of patient satisfaction
and quality. So above discussion clearly highlights the importance of present topic,
furthermore this study will also investigate the sixth dimension (usability) of
SERVQUAL model that was previously investigated in turkey by Strawderman & Koubek,
(2008 ).
1.3. Significance and Rationale of the study
Existing literature demonstrates that little work has been done in healthcare sector
of Pakistan regarding SERVQUAL model. So this gap provides a good rationale for
present study in private healthcare sector of Pakistan. Furthermore it is also evident
from existing literature that in developing countries including Pakistan the factor
of patient satisfaction is ignored area so it is quite clear that patient satisfaction
in developing nations is not given due importance and this is visible in many developing
nations. Finally the study will incorporate the sixth dimension usability in SERVQUAL
model. The results of present study will help policy makers in framing polices that
can improve the standards of healthcare delivery in order to enhance patient satisfaction
in private healthcare sector of Pakistan.
2 Literature Review
2.1. Service quality
“ Peer & Mpinganjira (2012 ) observed that one of the most vibrant factors having
an effect on satisfaction is service quality. Considering customer hopes is possibly
the most decisive, step in execution of a tremendous service. As detected by “ Slack,
Chambers, & Johnston (2010 )”a favorable link exists between service quality
and client contentment. Gray (2008 ),” reported as throughout previous twenty years,
service quality has turned into a crucial range of consideration towards, directors,
executives and intellectuals as of the aforementioned resilient influence upon corporate
presentation, profit on investment, customer satisfaction, customer loyalty and
achievement of enlarged income. The rapid extension and rivalry of service quality,
in both advanced and emerging nations have made it convincing for organizations
to judge and calculate the value of service quality“( Brown & Bitner, 2006 )”.
2.2. Healthcare service quality
Gray (2008 ),” described that, with customers of current scenario having a lot of
information and experience of the world around them the way to attain advantage
in today’s service sector, without negotiation, is through the superiority of service
delivered to customers. The health department is not omitted from this perception
as there is a growing collection of studies from USA to determine that service quality
and patient satisfaction and its direct association to patients’ communicative objectives
to re-visit the hospital or applaud it to others.
Patients usually concerned to the service by concentrating on quality “( Solomon,
2014 )”. One more clarification of quality is entire characteristics plus traits
of the product or services which depends on capability for contenting specified
or concealed desires “( Kotler & Armstrong, 2010 ). This is vibrant as quality
is something that may provoke contentment or discontentment of patients. “A diffident
definition of quality in health sector is the ability of doing the right thing,
at the right time, in the right way, for the right person – and captivating the
best feasible outcomes” (Zineldin, 2006 ). Service atmosphere in health sector is
decided through not only equipment and innovative facility care, but also work of
labor in a hospital. “Abundant methods and tools are applied by health executives,
researchers, and healthcare strategy originators in an effort to find a better way
to offer great quality of the service” “( Lee, & Kang, 2012 )”.
2.3. Patients vs. Health service providers:
patients’ view of healthcare delivery facility quality might be liable on several
features for instance prior knowledge, communal and outmoded duties, health terms,
patient demographics (e.g., age, gender), patients’ data for methods and treatment
etc “( Sofaer & Firminger, 2005 ). Patients might be embellished by word-of-mouth
which involves in erection standing of a healthcare institute ( Chilgren, 2008 ).
Recurring to the debate that staff of a hospital plays a key part in achieving high
class of health provision. Doctors offer right remedial cure, healthcare directors
remain accountable for assuring that deceased persons get proper facilities during
treatment at their hospital ( Chilgren, 2008 )”.
Andaleeb, Siddiqui, & Khandakar, (2007 ) determined the factors affecting the
patient satisfaction in Bangladesh. They made a comparison of determinants of patient
satisfaction on a sample of patients treated at public, private and foreign hospitals.
Karekar, Tiwari, & Agrawal, (2015 ) investigated the service quality of hospitals
for patient satisfaction by using determinants such as: empathy, tangibles, assurance,
timeliness and assurance. They found that service quality at private hospitals was
much better as compared to Govt. hospitals. High level of quality of service means
more satisfaction. According to the study work of “ Fröjd et al., (2011 )” patients
desired to be given extra info and to have capability to contribute in a cure procedure.
Thus, this is vital to careful efficient class of service excellence, definitely
client-oriented and info measurements.
2.4. Dimensions of Service Quality and Patient Satisfaction
2.4.1. Tangibility and Patient Satisfaction
Tangibility narrates the result of physical facility, apparatus, employees and communication
resources for patient. The outcome of these interferences, commonly identified as
"services capes" impact patients level of satisfaction in many ways ( Materla, Cudney,
& Antony, 2017 ). Brown & Bitner, (2006 ) illuminated how the workers and
clients are affected by these tangibles aspects of services in physical, psychosomatic,
sociological, intellectual, and passionate ways. According to Kotler & Armstrong,
(2010 ) a product goes beyond the tangible features generally connected with it,
adding numerous other features, comprising of a scheduled atmosphere, a bundle that
establishes the “true product” professed by clients”. The above literature paves
the way to state the following hypothesis
H1: tangibility has a positive and significant impact on patient
satisfaction in private hospitals of Pakistan.
2.4.2. Reliability and Patient Satisfaction
“Reliability is the ability to produce reliable outcomes ( Kotler & Armstrong,
2010 ). For the client’s overall valuation of service quality, this dimension is
very imperative. Hence, organizations should recognize the fundamental prospect
of their clients and make accessible the major services in the straightest method
( Goel, 2016 ). Reliability is demarcated as the capability to execute the guaranteed
service devotedly and flawlessly ( Cheng Lim & Tang, 2000 ). “ Peer & Mpinganjira
(2012 ) observed that among all other service quality components, reliability has
repeatedly been shown to be the most important for client satisfaction. On the basis
of above discussion, the following hypothesis is developed;
H2: There is positive and significant relationship between reliability
and patient satisfaction in private hospitals of Pakistan
2.4.3. Responsiveness and Patient Satisfaction
Societal responsibility is a vital perception, which is possibly neglected absolutely
in the quality management writings, however it has repetitively got due respect
and demonstration in existing literature ( Goel, 2016 ; Al-Borie & Sheikh Damanhouri,
2013 ). Responsiveness is willingness to offer help and quick services to consumers.
This consists of attentiveness and swiftness in dealing with patients wants, complaints
and worries. In the hospitals, patients don’t have time to wait for their turn to
be entertained. This is the reason that why the waiting time in most hospitals is
crucial. The services rendered by the hospitals must be customized to satisfy the
single customer’s desire. Every patient in the hospital attains a specific plan
of cure because they are suffering from different ailments. Responsiveness means
that patients obtain rapid and justifiable care from the hospital workforce as well
as being indulged in decisions about their care ( de Jager & du Plooy, 2011
). According to Peer & Mpinganjira, (2012 ) and Ojha & Sinha, (2017 )” this
element stresses thought as well as speed in handling customer queries, objections,
requests and troublesomeness. So the following proposition is developed
H3: There is positive relationship between the responsiveness and
patient satisfaction in private hospitals of Pakistan.
2.4.4. Assurance and Patient Satisfaction
“Assurance means constantly looking to deliver improved products to clients based
on the thought that the uppermost importance is given to quality. A quality assurance
structure is supposed to raise customer sureness and an organization's believability,
to enhance work processes and proficiency, and to empower an organization to enhanced
contest with others. Quality assurance “refers to the procedures, attitudes, activities
and processes essential to confirm that quality is being sustained and enriched”
( Kitapci et al., 2014 ; Moore et al., 2016 ). Quality assurance is projected to
confirm answerability and/or to bring about enhancement. “Quality occupies the medium
ground between the exterior and the interior; a philosophy or structure that emphases
and helps the collaboration between the external calls for enlarged answerability
and the internal efforts of an institution that is showing it ( Brown & Bitner,
2006 ). Hence it is proposed
H4: There is positive and significant relationship between the
assurance and patient satisfaction in private hospitals of Pakistan.
2.4.5. Empathy and Patient Satisfaction
Empathy refers to the visionary forecast into another's emotional state, a state
of total identification with another's condition, situation, and opinions. Empathy
is the partaking of sensitivity and perspective-taking persuaded by reading, inspecting,
hearing, or envisioning descriptions of another’s state and circumstance. Empathy
shows a role in the aesthetics of construction when writers experience it ( Peprah
& Atarah, 2014 ; Pitt et al., 2016 ). For having a good client relationship,
the information of the patients by name is even very significant. In the health
department, patients need care. The implication of empathy before and after a treatment
builds sureness and trust in the mind of patient. The families of patients stand
constantly maddened whereas waiting for the consequence of methods. The family members
want gentleness and demand carefulness to decrease the degree of pressure and uneasiness
they are going through. Empathy confirms the handling customers as distinctive persons
( Raju & Lonial, 2001 ). So in line with the above discussion the following
hypothesis is proposed.
H5: There is positive and significant relationship between the
empathy and patient satisfaction in private hospitals of Pakistan.
2.4.6. Usability and patient Satisfaction
Strawderman & Koubek, (2008 ) used human factor in service by including usability
factor in SERVQUAL model and the modified model was named as SERVUSE. The frameworks
tended to by human factors include apparatuses tools and machines, tasks and jobs,
and environments. Apparatuses and machines are things that are used in service procedure.
This may incorporate PCs, interfaces, or office accessories. Tasks and jobs are
finished all through the service procedure. These might be finished by the client
or the organization. Environments are the surroundings of both the client and the
organization. They may incorporate an office setting, home, eatery, or even a website
( Sanders & Cormick, 1993 )
Evaluating usability of a system presents many advantages for the client including
expanded efficiency, reduced error and time and cost and expanded precision. An
organization that makes usable items can profit by more prominent benefits, expanded
business and an expansion in client loyalty ( Mayhew, 1999 ). Strawderman &
Koubek, (2008 ) found that including usability dimension in SERVQUAL model, delivers
a more precise indicator of behavioral intentions of clients. Along these lines,
the usability of a framework is an essential player to predict a customer revisit
of a healthcare organization. Therefore, the usability of a system is an important
factor in predicting a customer’s return behavior. If a system is easy to use, the
customer will be more likely to return in the future. If the usability of a system
is poor, the customer is likely to become frustrated and not be willing to use the
same system in the future. The outcomes of their study strongly supported the inclusion
of usability dimension when measuring behavioral intentions. They further recommended
that usability ought to be incorporated as an important factor when measuring service
quality and patient satisfaction. Hence it is proposed.
H6: There is positive and significant relationship between the
usability and patient satisfaction in private hospitals of Pakistan.
3.1. Population and Sample
Simple random sampling approach was adapted as the study focused on a population
of in-patients in private healthcare sector of Lahore. To represent private healthcare
sector of Lahore three major hospitals, Iqra Hospital, Arif Memorial Hospital and
Hameed Lateef Hospital were considered. A self administered questionnaire was distributed
among respondents randomly. A total of 348 questionnaires were distributed and a
total of 261 fully filled questionnaires were received and hence response rate remained
75 percent.
3.2. Questionnaire
“An adapted questionnaire (Parasuraman, & Grewal, 1988 and Strawderman &
Koubek, 2008 ) which featured the 6 dimensions of service quality; tangibility,
responsiveness, reliability, assurance, empathy and usability was used to collect
the data. Each question in the questionnaire was valued on a five-point Likert scale
ranging from 1 for “Strongly Disagree” and 5 for “Strongly Agree”.
4.0 Results and analysis
“ Table 4. 1 : Gender of Respondents
|
|
Categories of gender
|
Frequency
|
Percent
|
|
|
|
|
Male
|
171
|
65.5
|
|
|
|
Female
|
90
|
34.5
|
|
|
Age Limits
|
|
|
|
18-30
|
62
|
23.7
|
|
|
31-50
|
108
|
41.4
|
|
|
Above 50
|
91
|
34.9
|
|
|
|
Marital Status
|
|
|
|
Single
|
62
|
31.8
|
|
|
Married
|
178
|
68.2
|
|
|
Total
|
261
|
100.0
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The above table presents the descriptive of respondents in term of gender, Age and
Marital Status. As it can be seen that majority of respondents were male ( 171)
and married (178), similarly the maximum age bracket was 31-50 years of age (108)
from a total of 261 respondents.
4.1 Reliability and validity
KMO and Bartlett test was incorporated for checking the appropriateness of scale
used in this study and prove about adequacy of sample. Table shows the results for
KMO and Bartlett test. The value of KMO is 0.761 which shows more than the appropriateness
according to the standard criteria of KMO value 0.50 so KMO value is above average.
Bartlett Test is also showing the significant value 0.000 which makes this analysis
perfect for performing factor analysis.
Table 2: KMO and Bartlett’s test
KMO measure of sampling adequacy 0.761
Approx. Chi Square 4751.023
Bartlett’s test of sphericity df 426
Sig. 0.000
Gerbing & Anderson, (1988 ) defined various basic guidelines for the reliability
and validity of measurement scale used in the study. A step-by-step approach is
used for analysis. First of all, it’s necessary to perform factor analysis as data
reduction methods in order to lessen the questions in the measurement tool. For
the purpose of examining the common variance, all the items were included in the
analysis. According to the recommendation of Hair, (2007 ), Promax rotation was
used that is an oblique rotation method and set criteria of cut-off value is 0.50
in factor analysis. All the values were above the set criteria of cut-off value.
The reliability of this scale was checked with the help of Cronbach’s alpha and
set criteria of 0.70. All the variables were having a good reliability of the scale
used in this context”.
Table 3: Factor Analysis and Alpha Values
Variables Factors loadings and Cronbach’s
Tangibility 0.799
T1 0.718
T 2 0.808
T3 0.723
T4 0.716
T5 0.854
T6 0.761
T7 0.893
T8 0.726
T9 0.868
Reliability 0.758
R1 0.757 R2 0.894
R3 0.794
R4 0.717
R5 0.734
Responsiveness 0.910
RS1 0.909
RS2 . 0.708
RS3 0.803
RS 4 0.794
RS 5 0.853
RS 6 0.707
RS 7 0.801
RS 8 0.791 Assurance 0.713
AS1 0.725
AS2 . 0.768
AS3 0.861
AS4 0.816
AS5 0.730
Empathy 0.817
E1 0.818
E2 0.791
Usability 0.756
U1 0.763
U2 0.740
U3 0.843
U4 0.772
U5 0.730 Patient Satisfaction 0.950
CS1 0.909
CS2 0.908
CS3 0.803
*Values in bold are Alpha Values
Table 4: Correlation Analysis
|
|
1
|
2
|
3
|
4
|
5
|
6
|
|
Tangibility
|
|
|
|
|
|
|
|
Reliability
|
.353**
|
|
|
|
|
|
|
Responsiveness
|
.257**
|
.284**
|
|
|
|
|
|
Assurance
|
.341**
|
.179**
|
.389**
|
|
|
|
|
Empathy
|
.446**
|
.459**
|
.306**
|
.453**
|
|
|
|
Usability
|
.382**
|
.273*
|
.241**
|
.231**
|
.193**
|
|
This study used the Pearson correlation in order to check the correlation among
different variables. Table 4 shows the confirmation of correlation among different
variables in this study. As it can be seen that all predictors are having positive
and significant correlation with each other. Similarly the value of correlation
among all predictors is modest that is indicative that data is not suffering from
multicollinearity issue.
Table 5: Overall Regression Analysis
|
Hypo-thesis
|
R Square
|
Standard
Error
|
Beta
Value
|
T-Value
|
P-Value
|
Significant/
In-significant
|
Collinearity Statistics
|
|
Tolerance
|
VIF
|
|
H1
|
.473
|
.068
|
0.688
|
16.438
|
.0000**
|
Significant
|
.691
|
2.74
|
|
H2
|
.599
|
.043
|
0.774
|
21.191
|
.0000**
|
Significant
|
1.76
|
2.29
|
|
H3
|
.883
|
.021
|
0.940
|
47.710
|
.0000**
|
Significant
|
1.36
|
1.92
|
|
H4
|
.748
|
.034
|
0.865
|
29.857
|
.0000**
|
Significant
|
.731
|
1.39
|
|
H5
|
.536
|
.039
|
0.732
|
18.634
|
.0000**
|
Significant
|
1.12
|
2.21
|
|
H6
|
.586
|
.042
|
0.766
|
20.662
|
.0000**
|
Significant
|
.935
|
1.39
|
The table represents the results of all the variables which have been observed in
the study. All the dimensions of service quality have positive relationship with
patient’s satisfaction. In the research, it is found that responsiveness (H3) has
the strongest positive relation with patient satisfaction (b=0.883) in private hospitals
of Pakistan that means private sector hospitals are providing prompt services to
their patients as they approach in a specific private hospital.. Assurance (H4)
has the second highest positive relationship with patient satisfaction (b=0.748)
meaning that patients have high level of trust and confidence in healthcare delivery
services of private sector hospitals. Reliability is third significant factor in
present research study (b=0 .599) as mostly patients have shown in present survey
that have confidence in private sector hospitals of present study about accuracy
in delivering healthcare services. Usability was fourth significant factor contributing
towards patient satisfaction of private hospitals (b=0.586) its mean that patients
feel ease of learning and memorizing of where, how and from whom to receive the
offered healthcare delivery services. similarly, empathy was at fifth place in term
of its significant towards patient satisfaction as most of the patients of present
study were of the opinion that they receive personalize attention when they visit
a specific private sector hospital for any treatment. Finally tangibility factor
was at sixth place (b=0.473) but as the beta value is significant so we cannot ignore
this factor too because patient of present survey are also keen to observe Appearance
of hospital’s facilities, staff, equipment, and communication materials.
5.1 Discussion and Conclusion
The results of present study are evident that usability dimension as the sixth dimension
is playing a significant role for enhancing patient satisfaction in private healthcare
sector of Pakistan. These results are in line with the findings of Strawderman &
Koubek, (2008 ) who also reported that usability as sixth dimension of SERVQUAL
model is significant predictor of patient satisfaction in Turkish hospitals.
Similarly all other five dimensions of SERVQUAL model are also predicting patient
satisfaction positively and significantly as evident by the results of present study
but the responsiveness factor is the most strongest predictor of patient satisfaction
in private healthcare sector of Pakistan. This is similar with the findings of Li
et al., (2015 ) and Ojha & Sinha, (2017 ) but inconsistent with the findings
of Peprah & Atarah, (2014 ) who reported responsiveness dimension is insignificant
but his study was in public sector where doctors are not as responsive as it can
be observed in private hospitals. So based on the results of present study all hypotheses
are producing positive and significant results for private healthcare sector of
Pakistan.
Contributions and Implications For Policy Makers
The discoveries of the present investigation are of significance for managers and
policy makers of healthcare sector in Pakistan concerning the inpatient part of
service quality. The policy makers of healthcare sector must put effort to modernize
doctor's facilities and other facilities in order to better satisfy patients satisfaction
and level of service quality
In the globalized period, patients have been given a lot of importance because of
serious rivalry among the different health service providers. On the off chance
that a patient is not happy with the service offered by a specific hospital, he
will instantly switch over others hospitals. In this way, top rated hospitals try
to give every possible careful consideration in offering patient care services.
In this manner, it turns into a critical to keep up the nature of wellbeing of health
services consequently can hold the patients. SERVQUAL strategy for evaluating is
generally used to look at the service quality offered by healthcare providing institutions.
In this regard the present study is evident that patients of today are very keen
in observing how private hospitals are serving them and they think that responsiveness
factor of these hospitals is very important as the statistical results of present
investigation showed.
5.2 Limitations and Future Research Directions
There are some important limitations of present study but the author(s) perceive,
it opportunity for other researchers to investigate the topic in future by keeping
these limitations in mind. The first limitation of study is that it was only focusing
on private healthcare sector of Lahore and in private sector three large hospitals
were considered so it is suggested for future researchers to investigate the model
of present study with a mix of hospital of private and public and similarly hospitals
having average ranking and best ranking so that a proper comparison may be drawn.
Second limitation of present study is that it only focused on in-patients so future
studies can take both in and out patients. Similarly the data was cross- sectional
in nature and generizability may be a question as cross- sectional data just provide
only one time snapshot and we don’t know any background of the story so future studies
need to consider longitudinal data for analysis. Finally the study took into consideration
only the functional aspect of SERVQUAL model as it only considered patients’ point
of view so for future studies it is suggested that both functional and technical
aspects should be considered by taking into consideration the view point of healthcare
service providers.
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