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Article
Publication date: 7 November 2016

The influence patient’s characteristics “requests and expectations” on physician prescribing behavior: A review

Mohsen Ali Murshid, Zurina Mohaidin and Goh Yen Nee

The role of patient’s characteristics in the prescribing decision of physicians comprises two major constructs: drug request and expectations. The purpose of this paper…

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Abstract

Purpose

The role of patient’s characteristics in the prescribing decision of physicians comprises two major constructs: drug request and expectations. The purpose of this paper was to examine the existing literature on patient characteristics and then explore the circumstances that reinforce the connection between patient characteristics (drug requests and expectations) and physician prescribing decision.

Design/methodology/approach

A survey of the literature was carried out across online databases from 1994 to 2015, and 25 reviewed articles were identified. The influence of patient factors on physician prescribing decisions was identified in the articles. A conceptual model to investigate the patient characteristics that influence physicians’ prescribing decision was the developed.

Findings

There have been numerous studies on the effect of patient characteristics on physician prescription decision. Some studies discovered patient’s request for drug and expectations strongly influence physicians’ prescribing decision, whereas others found only minor or no relation. To resolve this ambiguity, there is a need to precisely understand how patient factors affect prescribing decisions of physicians, under different contexts and conditions. This review contends that contextual variables – drug characteristics, drug cost/benefits ratio and physician habit persistence – are determining factors in this debate.

Research limitations/implications

The study recommends further studies on the influence of each factor on physician prescribing behaviour and an evaluation of the proposed model and moderating variables.

Originality/value

This paper is the first significant step towards recognizing contextual variables that may moderate the relationship between a patient’s drug request and expectations and prescribing behaviour. This research contributes to resolving the debate on the ways patient factors affect prescribing behaviour.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 10 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/IJPHM-01-2016-0010
ISSN: 1750-6123

Keywords

  • Expectations
  • Prescribing
  • Physician
  • Patient
  • Requests

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Article
Publication date: 9 December 2019

Gender in service quality expectations in hospitals: The role of cognitive and affective components

Taghreed Abu-Salim, Nermeen Mustafa, Okey Peter Onyia and Alastair William Watson

Despite evidence largely confirming gender-based differences in service quality perceptions in healthcare, little research has considered patients’ expectations. This…

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Abstract

Purpose

Despite evidence largely confirming gender-based differences in service quality perceptions in healthcare, little research has considered patients’ expectations. This study aims to examine the gender-based differences in both the affective and cognitive components of customers’ service quality expectations.

Design/methodology/approach

Data were collected through random sampling from three outpatient hospitals in the UAE. Hypothesized relationships between the cognitive and affective components (moderated by gender) were tested by means of CFA and ANOVA.

Findings

The results indicate that the differences between male and female expectations of overall service quality as a singular construct were not statistically significant, except for the empathy dimension. However, when measured as affective and cognitive, the results confirm that significant differences do exist between male and female patients.

Research limitations/implications

The research was limited to the UAE. However, identifying gender differences in patients’ expectations would enable healthcare providers to engage and manage patients’ expectations.

Originality/value

This paper provides theoretical and practical implications on how the male and female are different in the cognitive and affective components of service quality expectations.

Details

International Journal of Quality and Service Sciences, vol. 11 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/IJQSS-08-2018-0074
ISSN: 1756-669X

Keywords

  • Gender
  • Healthcare quality
  • Service quality
  • Expectations
  • Cognitive
  • Affective
  • Healthcare
  • Hospitals

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Article
Publication date: 23 August 2013

Assessing obstetric patient experience: a SERVQUAL questionnaire

Francesca Garrard and Harini Narayan

Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in…

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Abstract

Purpose

Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues.

Design/methodology/approach

This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed.

Findings

Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services.

Practical implications

The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures - between locally responsive and externally comparable.

Originality/value

The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are important to obstetric patients, where expectation scores are high. However, the similar means and small samples left little difference between excellence and room for improvement.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 7
Type: Research Article
DOI: https://doi.org/10.1108/IJHCQA-08-2011-0049
ISSN: 0952-6862

Keywords

  • SERVQUAL
  • Obstetrics
  • Maternity
  • Service change
  • UK

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Article
Publication date: 1 December 1996

Measuring service quality at the University of Texas M.D. Anderson Cancer Center

Elizabeth A. Anderson

Evaluates the service quality of four clinics at the University of Texas M.D. Anderson Cancer Center using a questionnaire methodology. The SERVQUAL instrument was…

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Abstract

Evaluates the service quality of four clinics at the University of Texas M.D. Anderson Cancer Center using a questionnaire methodology. The SERVQUAL instrument was administered to patients of the Medical Breast, Leukemia, Medical Gastroenterology and Bone Marrow Aspiration clinics. Results show that, according to the service gap methodology of comparing expectations and perceptions across all four clinics, the issues of billing accuracy and waiting times are deemed by patients as significant problems. In comparing the individual clinics, the Medical Gastroenterology and Leukemia clinics are best performers and the Medical Breast clinic is the worst. However, these differences in performance are due to differences in patients’ expectations of service quality, rather than differences in perceptions. Concludes that customer expectations can have a strong impact on a firm’s evaluation of its service quality.

Details

International Journal of Health Care Quality Assurance, vol. 9 no. 7
Type: Research Article
DOI: https://doi.org/10.1108/09526869610150200
ISSN: 0952-6862

Keywords

  • Evaluation
  • Service quality
  • Service systems

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Article
Publication date: 7 June 2013

Service quality in healthcare institutions: establishing the gaps for policy action

Aaron A. Abuosi and Roger A. Atinga

The authors seek to examine two key issues: to assess patients' hospital service quality perceptions and expectation using SERVQUAL; and to outline the distinct concepts…

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Abstract

Purpose

The authors seek to examine two key issues: to assess patients' hospital service quality perceptions and expectation using SERVQUAL; and to outline the distinct concepts used to assess patient perceptions.

Design/methodology/approach

Questionnaires were administered to 250 patients on admission and follow‐up visits. The 22 paired SERVQUAL expectation and perception items were adopted. Repeated t‐measures and factor analysis with Varimax rotation were used to analyse data.

Findings

Results showed that patient expectations were not being met during medical treatment. Perceived service quality was rated lower than expectations for all variables. The mean difference between perceptions and expectations was statistically significant. Contrary to the SERVQUAL five‐factor model, four service‐quality factors were identified in the study.

Practical implications

Findings have practical implications for hospital managers who should consider stepping up staffing levels backed by client‐centred training programmes to help clinicians deliver care to patients' expectations.

Originality/value

Limited studies are tailored towards patients' service‐quality perception and expectation in Ghanaian hospitals. The findings therefore provide valuable information for policy and practice.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 5
Type: Research Article
DOI: https://doi.org/10.1108/IJHCQA-12-2011-0077
ISSN: 0952-6862

Keywords

  • Service quality
  • SERVQUAL
  • Perception
  • Expectation
  • Ghana
  • Health services
  • Medical treatment

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Article
Publication date: 1 December 2000

A study of patients’ expectations and satisfaction in Singapore hospitals

Puay Cheng Lim and Nelson K.H. Tang

In today’s highly competitive healthcare environment, hospitals increasingly realise the need to focus on service quality as a means to improve their competitive position…

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Abstract

In today’s highly competitive healthcare environment, hospitals increasingly realise the need to focus on service quality as a means to improve their competitive position. Customer‐based determinants and perceptions of service quality therefore play an important role when choosing a hospital. This paper attempts to determine the expectations and perceptions of patients through the use of a generic, internationally used market research technique called SERVQUAL. An analysis covering 252 patients revealed that there was an overall service quality gap between patients’ expectations and perceptions. Thus, improvements are required across all the six dimensions, namely, tangibility, reliability, responsiveness, assurance, empathy and accessibility and affordability.

Details

International Journal of Health Care Quality Assurance, vol. 13 no. 7
Type: Research Article
DOI: https://doi.org/10.1108/09526860010378735
ISSN: 0952-6862

Keywords

  • Hospitals
  • Perceptions
  • Service quality
  • Performance measurement
  • Singapore

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Article
Publication date: 8 February 2011

Service quality in alcohol treatment: A research note

Sheilagh M. Resnick and Mark D. Griffiths

The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic.

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Abstract

Purpose

The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic.

Design/methodology/approach

Data were gathered via interviews with two groups of participants using the SERVQUAL questionnaire. The first group comprised 32 patients and the second 15 clinic staff. The SERVQUAL instrument measures service quality expectations and perceptions across five service dimensions and identifies gaps between service expectations and perceptions of what was delivered.

Findings

Patients' service quality expectations were exceeded on four of five dimensions. However, staff members felt services fell below expectations on four of five dimensions with the “reliability” service dimension emerging as the common service element falling below expectations for both participant groups. It was concluded that achieving consistent service delivery and increasing empathy between staff and patients improves overall service quality perceptions.

Research limitations/implications

The paper relies on self‐report methods from a relatively small number of individuals.

Originality/value

There have been limited research studies measuring alcohol treatment service quality in the private sector.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 2
Type: Research Article
DOI: https://doi.org/10.1108/09526861111105103
ISSN: 0952-6862

Keywords

  • Alcoholism
  • Health services
  • Customer services quality
  • SERVQUAL
  • United Kingdom

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Article
Publication date: 13 June 2016

Waiting time at a fast-track diagnostic clinic

Y. L. Basta, K. M.A.J. Tytgat, J. H.G. Klinkenbijl, P. Fockens and E. M.A. Smets

Guidelines stating maximum waiting times fail to take cancer patients’ expectations into account. Therefore, the purpose of this paper is to assess patients’ expectations…

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Abstract

Purpose

Guidelines stating maximum waiting times fail to take cancer patients’ expectations into account. Therefore, the purpose of this paper is to assess patients’ expectations and experiences with their waiting time at a fast-track clinic.

Design/methodology/approach

Patients were selected using a purposeful sampling strategy and were interviewed four times: before the visit; one day after; two weeks after the visit; and one week after starting treatment. Interviews were audiotaped and independently coded by two researchers.

Findings

All patients (n=9) preferred a short waiting time before the first visit; they feared that their disease would spread and believed that cancer warrants priority treatment. Six patients experienced the waiting time as short, one had no expectations and two felt they waited longer than expected; three patients changed this evaluation during the study. Six patients received treatment – four preferred to wait before treatment and two wanted to start treatment immediately. Reasons to wait included putting one’s affairs in order, or needing to adjust to the diagnosis.

Practical implications

Cancer patients prefer a short waiting time before the first visit but have different expectations and needs regarding waiting time before treatment. Ideally, their expectations are managed by their treating physician to match waiting time reality.

Originality/value

This is the first study to assess cancer patients’ waiting time experiences and how these experiences change over time. This study paves the way for establishing a framework to better assess patient satisfaction with oncology care waiting time. An important aspect, is managing patients’ expectations.

Details

International Journal of Health Care Quality Assurance, vol. 29 no. 5
Type: Research Article
DOI: https://doi.org/10.1108/IJHCQA-09-2015-0116
ISSN: 0952-6862

Keywords

  • Patient satisfaction
  • Patient preference
  • Patient expectations
  • Appointment and schedules
  • Fast-track clinics

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Article
Publication date: 4 September 2017

Equating the expected and perceived service quality: A comparison between public and private healthcare service providers

Asma Shabbir, Shahab Alam Malik and Saquib Yusaf Janjua

The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of…

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Abstract

Purpose

The purpose of this paper is to investigate patients’ views toward the perceived service quality of public and private healthcare service providers. Determinants of healthcare service quality were compared by carrying out a GAP analysis to equate perceived and expected services and examined differences in the service quality.

Design/methodology/approach

The study sample comprises 310 inpatients of public and private healthcare service providers. Self-administered questionnaires were used along a five-point Likert scale and analyzed through the Statistical Package for Social Sciences. GAP analysis was used to observe the difference between expectations and perceived service quality.

Findings

A cross-sectional study revealed significant quality gaps between the expected and perceived services of public and private healthcare service providers; conversely patients’ expectations are not fully met in both types of hospitals. Private hospitals surpassed in terms of overall perceived service quality from their counterparts. Perceived services were found better in terms of physician medical services in public sector hospitals, while rooms and housekeeping services were found better in terms of private sector hospitals.

Practical implications

The result can be used by both public and private healthcare service providers to restructure their quality management practices which could only be possible through effective management commitment, regular patients’ feedback and translucent complaint procedures.

Originality/value

The study conceptualizes the expected and perceived hospital service quality dimensions as an eight-dimensional framework. A comparison between public and private sector hospitals is made to get a better understanding about the differences in the perceived healthcare services among two sectors. Consequences of the study will aid hospital managers and policy makers to get a fuller picture of healthcare services in order to contrive enhancement practices.

Details

International Journal of Quality & Reliability Management, vol. 34 no. 8
Type: Research Article
DOI: https://doi.org/10.1108/IJQRM-04-2016-0051
ISSN: 0265-671X

Keywords

  • Pakistan
  • Service quality
  • Hospitals
  • Gap analysis
  • Expected services
  • Perceived services

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Article
Publication date: 21 January 2019

Patient satisfaction with pharmaceutical care services provided at primary-level and secondary-level health facilities in Indonesia’s health coverage system

Luh Putu Febryana Larasanty, Maria Fiani Cahyadi, Ni Made Rai Sudarni and I Made Agus Gelgel Wirasuta

The purpose of this paper is to determine patient expectation and perception of pharmaceutical care services in order to measure the level of patient satisfaction provided…

Open Access
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Abstract

Purpose

The purpose of this paper is to determine patient expectation and perception of pharmaceutical care services in order to measure the level of patient satisfaction provided by Indonesia’s health coverage (IHC) system.

Design/methodology/approach

A patient satisfaction survey was conducted at primary-level and secondary-level health facilities operating under IHC system. The assessment was performed using a closed-ended questionnaire that had been tested for validity and reliability. The patients’ point of view was evaluated based on their expectation and perception of six dimensions of the pharmaceutical care services they had received. Patient satisfaction was calculated based on the gap between their expectation and their perception.

Findings

A total of 602 patients participated in this research. The levels of the patients’ expectation of the pharmaceutical care services provided at primary-level health facilities range from high (3.39) to very high (3.54), whereas at secondary-level health facilities, the range was from low (2.04) to very high (3.75). This indicates that patients have a higher expectation of the provided pharmaceutical care services compared to the actual experience of the healthcare services that they received, resulting in a low value in the measurement of patient satisfaction levels.

Originality/value

The high level of patient expectation is an opportunity for pharmacists at both primary-level and secondary-level health facilities to continue developing pharmaceutical care services. Improving drug information service, patient counseling and reducing patient waiting time can be good ways to increase patient satisfaction within pharmaceutical care services.

Details

Journal of Health Research, vol. 33 no. 1
Type: Research Article
DOI: https://doi.org/10.1108/JHR-06-2018-0033
ISSN: 2586-940X

Keywords

  • Health facilities
  • Indonesia’s health coverage
  • Patient satisfaction
  • Pharmaceutical care

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