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Assessing service quality and customer behavioral responses in hospital outpatient services: A formative measurement approach

Apostolos Giovanis (Department of Business Administration, Faculty of Management and Economics, Technological Educational Institute of Athens , Athens, Greece, and Department of Business Administration, Hellenic Open University , Patra, Greece)
George Pierrakos (Division of Health and Welfare Management, Department of Business Administration, Faculty of Management and Economics, Technological Educational Institute of Athens , Athens, Greece)
Ioannis Rizomyliotis (Brighton Business School, University of Brighton , Brighton, UK)
Spyridon Binioris (Department of Business Administration, Faculty of Management and Economics, Technological Educational Institute of Athens , Athens, Greece)

International Journal of Quality and Service Sciences

ISSN: 1756-669X

Article publication date: 18 June 2018

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Abstract

Purpose

In contrast to the reflective approach of service quality measurement, this paper aims to propose and validate a parsimonious multidimensional second-order formatively measured model of service quality for primary health-care services provided by hospital outpatient departments. The index’s empirical validity is examined by investigating the strength of its relationship with certain behavioral responses such as patient satisfaction and behavioral intentions.

Design/methodology/approach

Data were collected through a stratified random sampling from eight hospital outpatient departments in Greece. Covariance-based structural equation modeling techniques were used to validate the proposed service quality index and further investigate its effect on patient satisfaction and behavioral intention.

Findings

The data analysis indicated that the proposed formative index is fully functional with medical care being the factor and mostly contributes to service quality perception, followed by administrative service and staff performance, and facilities condition and nursing care. It, further, confirmed the partial mediating role of satisfaction, as it enhances the high impact of service quality on behavioral intentions.

Research limitations/implications

The relationships among hospital outpatient departments service quality, patient satisfaction and behavioral intentions were validated with data from one country and a health-care system which is state driven and funded.

Practical implications

An understanding of hospital primary health-care service quality formation is important to health-care decision makers because it offers them the opportunity to consider patients’ needs and wants, and takes the appropriate actions for improving the relevant underling procedures in a more efficient manner to achieve favorable behavioral responses.

Originality/value

The paper manages to propose and empirically evaluate a formatively measured approach of service quality and investigate the effects of the proposed index on patient satisfaction and behavioral intention, especially in the hospital outpatient services context in Greece.

Keywords

Acknowledgements

This study was financially supported by a project conducted by the Department of Business Administration of the Technological Educational Institute of Athens and funded by the European Social Fund (E.S.F.) and Ministry of Education, Lifelong Learning and Religious Affairs of Greece 2012-2015.

Citation

Giovanis, A., Pierrakos, G., Rizomyliotis, I. and Binioris, S. (2018), "Assessing service quality and customer behavioral responses in hospital outpatient services: A formative measurement approach", International Journal of Quality and Service Sciences, Vol. 10 No. 2, pp. 98-116. https://doi.org/10.1108/IJQSS-03-2017-0023

Publisher

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Emerald Publishing Limited

Copyright © 2018, Emerald Publishing Limited