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CIRMQUAL: a conceptual framework of healthcare service quality

Mohit Datt (Department of Industrial and Production Engineering, Dr BR Ambedkar National Institute of Technology, Jalandhar, India)
Ajay Gupta (Department of Industrial and Production Engineering, Dr BR Ambedkar National Institute of Technology, Jalandhar, India)
Sushendra Kumar Misra (Center for Executive Education, I.K. Gujral Punjab Technical University, Kapurthala, India)
Mahesh Gupta (College of Business, University of Louisville, Louisville, Kentucky, USA)

The TQM Journal

ISSN: 1754-2731

Article publication date: 26 February 2024




The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.


This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.


This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.


After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.



Datt, M., Gupta, A., Misra, S.K. and Gupta, M. (2024), "CIRMQUAL: a conceptual framework of healthcare service quality", The TQM Journal, Vol. ahead-of-print No. ahead-of-print.



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