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Article
Publication date: 1 October 2005

Vasco Eiriz and José António Figueiredo

To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables…

4187

Abstract

Purpose

To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically.

Design/methodology/approach

Systematic review of the literature.

Findings

Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non‐technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence).

Originality/value

This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing‐oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 14 September 2023

Oti Amankwah, Weng Wai Choong, Naana Amakie Boakye-Agyeman and Ebenezer Afrane

Patient-centred strategies should be applied in health-care facilities management (HcFM) to guarantee service quality to meet patients’ needs and ensure quality patient health-care

Abstract

Purpose

Patient-centred strategies should be applied in health-care facilities management (HcFM) to guarantee service quality to meet patients’ needs and ensure quality patient health-care experience. This paper aims to examine the intervening influence of the quality of health-care administrative process (QAP) on the association between health-care facilities service quality and patients’ experiences with medical care.

Design/methodology/approach

A quantitative technique was used for this cross-sectional study in three Ghanaian teaching hospitals. A total of 622 relevant questionnaires were used for the analysis of the study using SEM-PLS.

Findings

The intervening influence of the QAP on the relationship between HcFM service quality (empathy and tangibility) and patients’ health-care experience (PHcE) were reinforced whilst that of reliability, responsiveness and assurance were not reinforced. The association between the QAP and PHcE was also established.

Research limitations/implications

A high-quality health-care workforce (both core and supporting) and quality work environment provided by the FM department and QAP are essential during quality-of-care delivery, to reduce threats to patient safety to achieve exceptional PHcE. The constraint on the study is that information was gathered from only Ghana. Hence, the generalisation of the findings will be a challenge. Thus, in future, it is proposed that a comparative study across a developed country and a developing country can be conducted. Future research can assess the influence of the health-care internal appearance on patients’ satisfaction.

Practical implications

Practically, the administrative system can be improved by reducing patients overall waiting time. Steps must also be taken to reduce the problem of needless administrative tasks and practices to simplify administrative practices and improve patients’ total health-care experience (core health-care delivery and HcFM), as this influence patients’ total health-care experience.

Originality/value

To the best of the authors’ knowledge, this empirical validation is one of the initial studies in service quality and FM to examine how health-care administrative process quality affects the relationship between FM service quality and patients’ experiences with medical care. This framework can be adapted for research in different countries to extend knowledge.

Details

Facilities , vol. 41 no. 13/14
Type: Research Article
ISSN: 0263-2772

Keywords

Article
Publication date: 28 November 2022

Oti Amankwah, Weng Wai Choong and Naana Amakie Boakye-Agyeman

With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care

Abstract

Purpose

With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience has become of strategic importance in public health-care delivery. This paper aims to investigate the mediating effect of adequacy of health-care resources on the relationship between the quality of health-care FM services and patient’s health-care experience.

Design/methodology/approach

This cross-sectional study adopts a quantitative approach based on a questionnaire survey conducted on 660 patients of three teaching hospitals in Ghana. In total, 622 valid questionnaires were used for data analysis using partial least squares structural equation modelling.

Findings

The mediating effect of adequacy of health-care resources on the relationship between responsiveness and tangibility and patients’ health-care experience were supported, while that of empathy, reliability and assurance were not supported. The relationship between and adequacy of health-care resources and patients’ health-care experience was also supported.

Research limitations/implications

The study limitation is that it was only the teaching hospitals that were surveyed. In future studies, a comparative analysis can be conducted between both public and private hospitals. Other constructs and relationships such as the mediating effect of the quality of health-care administrative process on the relationship between FM service quality and patients’ health-care experience as well as the moderation effect of adequacy of health-care resource on the relationship between FM service quality and patients’ health-care experience can also be tested. Future studies on the same subject can use health-care workers as the respondents of the study.

Practical implications

The result should inspire health-care managers to prioritize attention on health-care FM to create and sustain a decent health-care environment. Facilities managers should ensure standards are not compromised by keeping health-care resources in good condition through the organisation and management of resources.

Originality/value

To the best of the authors’ knowledge, this paper is one of the pioneer studies to test the mediating effect of adequacy of health-care resources on the relationship between patient’s health-care experience and health-care FM service quality. The proposed framework can be adapted to various sectors and countries as this empirical validation extends knowledge.

Article
Publication date: 12 November 2020

Firas AlOmari

The purpose of this paper is to gauge the health-care services from a patient’s perspective in five private hospitals in the Syrian capital Damascus.

1817

Abstract

Purpose

The purpose of this paper is to gauge the health-care services from a patient’s perspective in five private hospitals in the Syrian capital Damascus.

Design/methodology/approach

The five dimensions-SERVQUAL model (tangibility, empathy, assurance, reliability and responsiveness) was implemented to measure the gap between patient’s perception and expectation in health-care service quality.

Findings

The SERVQUAL tool proved to be reliable and valid in assessing service quality in Syrian health-care setting. The assessment of the service quality from a patient’s perspective shows that all SERVQUAL dimensions were negative except for tangible element that scored (+0.57) gap. Based on patient’s expectation, empathy scored the highest score with (4.37), followed by responsiveness (4.17), reliability (3.90), tangibility (3.82) and assurance (3.45). The widest negative gaps among the 22 SERVQUAL items were related to listening skills of hospital staffs (−1.52) and for spending enough time with patient (−1.81). This study indicated that tangible dimension plays a significant role in balancing the deficiency in other service quality dimensions. In addition, communication skills of medical and paramedical staff should be improved to ameliorate patient’s perception about health-care services.

Research limitations/implications

This study provides valuable insights into the patient’s perception, but the feedback from hospital staffs (doctor, nurses) and hospital’s senior managers also considered potential rich information sources. This survey is conducted in the capital, and future research should include replication of this study in the other 13 Syrian governorates before generalizing the findings of this research.

Practical implications

Hospital administrator could use SERVQUAL model to improve their operational performance as well as to benchmark their behavior against other competitors in the health-care market in Damascus. This paper provides valuable information to policymakers and top hospital management to understand patient-centered care and to improve health-care system in Syria. Besides, this research provides a marketing insight to realize what patient expects and how she/he assesses the care service.

Originality/value

To the author’s knowledge, this is one of very few studies conducted to assess service quality in private health-care sector in Damascus. The main contribution of this study is providing the empirical evidence that the five dimensions-SERVQUAL scale proved to be reliable and valid instrument for measuring and analyzing health-care service quality in Syria.

Details

Measuring Business Excellence, vol. 25 no. 4
Type: Research Article
ISSN: 1368-3047

Keywords

Article
Publication date: 31 December 2021

Myesere Avdyl Hoxha

The purpose of this paper is to develop and test a modified service quality (SERVQUAL) model scale for measuring healthcare service quality in Kosovo.

Abstract

Purpose

The purpose of this paper is to develop and test a modified service quality (SERVQUAL) model scale for measuring healthcare service quality in Kosovo.

Design/methodology/approach

An initial dimensions area methodology in construct development, followed by combined exploratory-analytical deductive research with the goal to test theory concepts and validate the measurement tool known from the theory of service quality using new empirical data in a specific context. A cross-sectional survey on a sample of 200 post-encountered patients and using structural equation modelling (SEM) and SEM path analysis to determine satisfaction.

Findings

The findings confirmed that a six-dimensional scale of SERVQUAL is not appropriate for the Kosovo health-care context. The scale development analysis with a new reduced four-dimensional model can be used to measure health service quality in the Kosovan context.

Research limitations/implications

The initial study concept was not piloted. It was developed by the researcher based on secondary data. Systematic random sampling was used, which may have resulted in conclusions that are not applicable to the general population. Finally, this study is applicable to the Kosovo context and cannot be generalized nor represent all patients treated in Kosovo hospitals and clinics. However, the above limitations are less significant compared to the importance of carrying out this type of study for the first time in Kosovo.

Practical implications

This study can help Kosovo health authorities to guide health system-wide improvements and health-care providers to remove quality shortfalls based on a culturally sensitive and validated multiple-item scale for the quality of their service.

Originality/value

This is the first research conducted to identify which of the service quality dimensions require attention by the health-care service providers in Kosovo and develop a validated tool for patient satisfaction measurement that can be used for commercial application.

Details

Journal of Enterprising Communities: People and Places in the Global Economy, vol. 17 no. 2
Type: Research Article
ISSN: 1750-6204

Keywords

Article
Publication date: 3 May 2022

Jitesh J. Thakkar, Shashank Thanki and Sunita Guru

The present situation of COVID-19 pandemic has put the health-care systems under tremendous stress and stringent tests for their ability to offer expected quality of health-care

Abstract

Purpose

The present situation of COVID-19 pandemic has put the health-care systems under tremendous stress and stringent tests for their ability to offer expected quality of health-care services, as it decides the sustainability and growth of health-care service providers. This study aims to deliver a quantitative framework for service quality assessment in the health-care industry by classifying the health-care service quality parameters into four balanced scorecard (BSC) perspectives.

Design/methodology/approach

To determine the service quality for the Indian health-care system, decision-making trial and evaluation laboratory and analytical network process are integrated in a fuzzy environment to contemplate the interaction among BSC perspectives and respective performance measures.

Findings

The results indicate “internal processes” perspective assumes the key role within BSC perspectives, while performance measures “nursing staff turnover” and “staff training” play the key roles. The results also signify that “patient satisfaction” is the most vital issue and can be strongly influenced by measures belonging to the “learning and growth” perspective. In “learning and growth” perspective, “staff training” is the most decisive criteria, very highly influencing “patient satisfaction”, highly influencing “profitability,” “change of cost per patient (both in and out patients)” and “outpatient waiting time” while moderately influencing “staff satisfaction,” “bed occupancy” and “nursing staff turnover”. Moreover, “staff training” criteria have a positive influence on “nursing staff turnover.”

Originality/value

The contributions of this study are in two folds in the domain of quantification of service quality for the health-care system. First, it delivers an assessment framework for Indian health-care service quality. Second, it demonstrates an application of the framework for a case situation and validates the proposed framework.

Details

Journal of Modelling in Management, vol. 18 no. 4
Type: Research Article
ISSN: 1746-5664

Keywords

Article
Publication date: 1 January 2006

Mosad Zineldin

To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health

8709

Abstract

Purpose

To examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Egypt and Jordan evaluate quality of health care similarly or differently.

Design/methodology/approach

A conceptual model including behavioural dimensions of patient‐physician relationships and patient satisfaction has been developed. As the empirical research setting, this study concerns three hospitals in Egypt and Jordan. The survey instrument in a questionnaire form was designed to achieve the research objectives. A total of 48 items (attributes) of the newly developed five quality dimensions were identified to be the most relevant. A total of 224 complete and usable questionnaires were received from the in‐patients.

Findings

Hospital C has above‐average total and dimensional qualities and patients are the most satisfied in accordance with all dimensions of services. Hospitals A and B have under‐average total qualities as the majority of patients are not satisfied with services. Comparing hospitals A and B, in the majority of dimensions (with the exception of Q5), the quality in hospital B is higher than in hospital A. Patients' satisfaction with different service quality dimensions is correlated with their willingness to recommend the hospital to others. A cure to improve the quality for health‐care services can be an application of total relationship management and the 5Qs model together with customer orientation strategy.

Practical implications

The result can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health‐care quality strategies.

Originality/value

In this research a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change‐oriented. This study argues that a patient's satisfaction is a cumulative construct, summing satisfaction with five different qualities (5Qs) of the hospital: quality of object, processes, infrastructure, interaction, and atmosphere.

Details

International Journal of Health Care Quality Assurance, vol. 19 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 8 July 2020

Raghav Upadhyai, Neha Upadhyai, Arvind Kumar Jain, Hiranmoy Roy and Vimal Pant

Health care service is a widely researched area. Several established models and instruments measuring health care service quality (HCSQ) are available in the published academic…

Abstract

Purpose

Health care service is a widely researched area. Several established models and instruments measuring health care service quality (HCSQ) are available in the published academic literature. The objective of this article is to summarize this vast pool of available knowledge under the themes of HCSQ, its determinants and measurement strategies.

Design/methodology/approach

Sixty-three available published studies in peer reviewed journal combed in EBSCO and Google Scholar database have been examined and presented in exemplary literature review.

Findings

The findings have been segregated under the themes of HCSQ, its dimensions and determinants. It can be deduced from the findings that in spite of health care being a professional service, the user defined service quality takes center stage.

Originality/value

Rather than the seeker of care, the authors call for further research by taking a dyadic view of professional exchanges and including providers' perspectives of care in service quality evaluations as well.

Details

Benchmarking: An International Journal, vol. 27 no. 6
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 11 July 2018

Rohit Trivedi and Khyati Jagani

The purpose of this study is to understand that how different demographic variables and repeated availing of service from the same doctor or same hospital shape the overall…

Abstract

Purpose

The purpose of this study is to understand that how different demographic variables and repeated availing of service from the same doctor or same hospital shape the overall perception of health-care service quality and satisfaction among inpatients admitted in private hospitals in an emerging economy.

Design/methodology/approach

A self-administered, cross-sectional survey of inpatients using a questionnaire was translated into Hindi and Gujarati. The data were collected from 702 inpatients from 18 private clinics located in three selected cities from Western India.

Findings

The results indicate that experience with hospital administration, doctors, nursing staff, physical environment, hospital pharmacy and physical environment is significant predictor of inpatient satisfaction. Physical environment was found to be significantly associated with satisfaction only among female inpatient. It was also found that repeat availing of services either from the same hospital or doctor does not increase patient satisfaction. The feasibility, reliability and validity of the instrument that measures major technical and nontechnical dimensions of quality of health-care services were established in the context of a developing country.

Originality/value

The study makes important contribution by empirically investigating the inpatient assessment of health-care service quality based upon their demographic information and repeated availing of services to understand how repeat visit shapes the service quality perception.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 12 no. 3
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 18 June 2018

Apostolos Giovanis, George Pierrakos, Ioannis Rizomyliotis and Spyridon Binioris

In contrast to the reflective approach of service quality measurement, this paper aims to propose and validate a parsimonious multidimensional second-order formatively measured…

1061

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.

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