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Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients’ perspective.

This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications.

Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients’ perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor.

The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction.

According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

Governments all over the world are getting increasingly concerned about their ability to meet their social obligations in the health sector. In this paper, we discuss the design and development of a management information system (MIS) to plan and monitor the delivery of healthcare services in government hospitals in India. Our MIS design is based on an understanding of the working of several municipal, district, and state government hospitals. In order to understand the magnitude and complexity of various issues faced by the government hospitals, we analyze the working of three large tertiary care hospitals administered by the Ahmedabad Municipal Corporation. The hospital managers are very concerned about the lack of hospital infrastructure and resources to provide a satisfactory level of service. Equally concerned are the government administrators who have limited financial resources to offer healthcare services at subsidized rates. A comprehensive hospital MIS is thus necessary to plan and monitor the delivery of hospital services efficiently and effectively.

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.

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.

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.

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.

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.

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.

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

Research on hospital productivity has progressed over the last few decades considerably from early models where measurements of hospital services simply counted inpatient days, and perhaps outpatient visits or numbers of surgeries performed. This simplicity represents an extreme of aggregation, focuses the attention of the analysis entirely on the structure of the organization at the highest levels, and provides no insight into the specific services that might be provided to each patient as well as the characteristics of those patients, which might lead to specialization of their care. This process is fundamentally complex, which makes it especially difficult to model. This table-setting chapter will characterize some of the key contextual choices that must be made by researchers in this field which are then applied in subsequent chapters. The key point of this chapter will be to argue that there are very few “one size fits all” decisions in this process and thus the context of particular research objectives and questions will determine how modeling choices are made in practice. Some intuition about how these decisions have substantial implications for outcomes of measurement for hospital productivity will be provided; however, no attempt will be made to conduct a literature review of all the choices that have been made. Instead, we will suggest that new careful attention to the choices made can make future studies more effective in communicating to the communities implementing the research.

The purpose of this paper is to integrate the ISO 9001:2008 and blueprints by using a process approach, to have systematic regulation in hospital quality management.

This study promotes a process approach when developing, implementing, and improving the effectiveness of hospital service quality to enhance patients’ satisfaction by meeting their requirements. This study completes the hospital’s blueprints with the process approach by using case study research methods such as in‐depth interviews with relevant personnel, on‐site observations, and experts’ advice.

The results of hospital blueprints described in this study comprise five‐plane lines to have systematic regulations. The ISO 9001:2008 process approach and service blueprint are not merely a technological application for medical healthcare services, but rather a fully patient‐driven, technologically integrated, and diligently implemented programme.

Because of organisational financial confidentiality, this study does not consider the financial performance of the case hospital, and the results of blueprints may be revised afterward.

This paper promotes the adoption of a process approach when developing, implementing, and improving the effectiveness of a hospital outpatient service management system, to enhance outpatients’ satisfaction by meeting their requirements.

Until recently Italian hospitals had no cost accounting or activity data collection systems, being formally required only to do financial book‐keeping. The cost analysis method presented here might be used to set up detailed and complete hospital cost accounting, which would permit a better understanding of patterns of resource distribution among departments, better opportunities for cost saving and cost control for hospital managers and health authorities. The study first identified a framework within which to assess the annual cost related to a hospital ward, then calculated the mean bed day cost for each speciality. Cost data were collected over one year in 1996 from manually compiled records, at one local hospital in Northern Italy. Costs were estimated following a step‐down allocation method. Wards requiring a major amount of resources per day of stay are intensive cardio‐coronary unit (US$650.689), and ophthalmology (US$483.322). The less expensive ward is general medicine (US$148.645). The cost analysis method presented in this study might be used to set a detailed and complete hospital cost database, which is a necessary tool for hospital managers to realise cost control and cost recovery.

The purpose of this research is to show that referring physicians play a strategic role in health care management. This study aims to evaluate the perception of hospital services by referring physicians and clinicians for quality improvement.

Referring physicians in private practice and hospital clinicians at a large dermatology academic department providing inpatient and outpatient services at secondary and tertiary care levels were surveyed to determine their perceptions of service quality. A comparative questionnaire survey was established to identify improvement areas and factors that drive referral rates using descriptive and inferential statistics.

Referring physicians' (n=53) and clinicians' (n=22) survey results concordantly revealed that timely and significant information about hospital stay as well as accessibility to hospital staff are major points for improvement. Significant differences between both samples were found with respect to inpatient services and patient commendation. Clinicians tended to rate their services and offerings higher than referring physicians (p=0.019). Geographic range was correlated with the frequency of patient commendation (p=0.005) and the perception of friendliness (p=0.039). The number of referred patients was correlated with medical reports' informational value (p=0.042).

Although the study has a limited sample size it appears that surveying physicians' perspectives is an essential tool for gathering information about how provided health care services are perceived.

Survey results should be useful for continuous quality improvement by regular measuring and reporting to executive boards. Hospitals should pay careful attention to their communication tools, particularly medical reports.

Bundled payments for care are an efficient mechanism to align payer, provider, and patient incentives in the provision of health care services for an episode of care. In this chapter, we use agency theory to examine the evolution of bundled payment programs in private and public payer arrangements, and postulate future directions for bundled payment development as a key component in the provision and payment of health care services.

The objectives of this research are to investigate service quality expectation, perception and satisfaction in outpatient departments and to propose the priority nonconformity index (PNCI) to assess overall prioritization of efforts in relation to expectations.

SERVQUAL has five dimensions: tangibility, reliability, responsiveness, assurance and empathy. It was used to gather data from multiple-responding care providers in 220 Thai hospitals nationwide. Paired-samples t-test and importance-performance analysis (IPA) were used for analysis. The PNCI was initiated to evaluate the overall conformity between expectation and perception and to suggest strategies for improvement.

It was found that assurance is the most important and the best performed dimension with the least dissatisfaction. Tangibility is the least important and the least performed dimension with the most dissatisfaction. From gap analysis, there are significant negative gaps in overall service quality, all dimensions and all indicators. IPA found assurance and responsiveness as strengths, and this suggests transfer of excessive resources from empathy to enhance reliability. PNCI of Thai hospitals is 0.8 and this has suggested similar strategies to IPA.

Findings from this study can be employed to develop strategic policy to improve Thai hospitals as a whole. The newly developed PNCI can be used as an indicator to assess efficiency of resource allocation to fit better with customer requirements.