analysis of pregnant woman satisfaction to hospital service by servqual method: a case study of...

7/26/2019 Analysis of Pregnant Woman Satisfaction to Hospital Service by SERVQUAL Method: A Case Study of Mahosot Ref

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National and International Conference on Administration and Management

January 30, 2015, KU Home, Bangkok, THAILAND

Analysis of Pregnant Woman Satisfaction to Hospital Service

by SERVQUAL Method: A Case Study of Mahosot Referral Hospital

Bounsathien Phimmasenh*and Dr.Khamlusa Nouansavanh

**

Abstract

The purpose of this research is to investigate the pregnant woman satisfaction to Health care

service in the Department of Mother and Child, Mahosot Referral Hospital by servqual five dimensions.

This survey can give information and evaluation materials to be basis management for improve the

hospital. There are five dimensions SERVQUAL comprising Tangibles, Responsiveness, Reliability, Empathy

and Assurance with theirs 20 attributes which is the evaluation target from service quality factor. The

result of study show that some service quality dimensions need to improve such as regarding tangible

hospital should improve the visual appealing environment and physical facilities, concerning to empathy

dimension hospital should be improved by offering personalized attention to pregnant woman and the

assurance dimension is still need to build up the human source of hospital.

Keywords:Pregnant woman, Health Care, Service Quality, SERVQUAL

Introduction

Referral Hospital Services in Lao People Democrati c Republic are as main implementing facility of

Health sector which involving not only for treatment and curative the patients but also for the promotion,

capacity building to the rural hospital and Health centers and in order to prepare for Asian Economic

Community (AEC) membership in the year 2015and supporting the Governments commitment to

achieving the Millennium Development Goals (MDGs)and identifies improved access, equity, quality and

strengthening the health workforce as key goalsespecially the health status of mother and child.

Mahosot Referral Hospital is one of five central hospitals, which established as the first hospital

of Laos since 1930 and located in the Vientiane Capital. This hospital provides the medical serve general

societies as well.The growth of health service awareness in the society is followed by the social economic

* Ph.D. Student, Faculty of Economics and Business Management, National University of Laos; Email:

[email protected]**Professor, Faculty of Economics and Business Management, National University of Laos


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development, education level, knowledge and Medical technology. Hospitaltherefore should not only

provide a medical aspect, but also the process business to customers, in the hospital should be served

professionally such as registration, administration process, quick responds and warm welcome from the

health providers.

The aim of this research is to investigate the pregnant woman satisfaction as from feminist

perspectives to Health care service in the Department of Mother and Child, Mahosot Referral Hospital by

servqual five dimensions. This survey can give information and evaluation materials to be basis

management for improve the hospital. There are five dimensions SERVQUAL comprising Tangibles,

Responsiveness, Reliability, Empathy and Assurance with theirs 20 attributes which is the evaluation target

from service quality factor. The result of study show that some service quality dimensions need to

improve. The paper proceeds by reviewing the literatures related, methodology used, findings and

discussion and finally conclusions.

Literature Review

Service quality is defined as the discrepancy between customers perceptions of services offered

by the company and their expectations about offering services of the company. The customers

expectations are derived from their perception of the ideal care standards of their previous experiences in

the use of services. According to Grnroos (2001), Service quality is the difference between customer

expectations and perceptions as it is being received by the customer (Parasuraman et al., 1988 &

Ijaz,2011).Thus it is necessary for health care providers to monitor how well the customers expectations

have been met after delivering the services (Zarei, Arab, Froushani, Rashidian, & Tabatabaei, 2012).

Measurement of service quality has been conducted in various service organizations and in

difference service sectors, the SERVQUAL model proposed by Parasuraman et al.(1985,1988) has been

used in awide variety of studies to assesses both the customers service expectat ions and perceptions of

the providers performance (Zarei et al., 2012; Ladhari, 2009; Pakdil & Aydin, 2007). According to

Parasuraman et al. (1985), the SERVQUAL scale was based on the fifth gap and the original ten dimensions

were further consolidate into five dimensions of service quality namely Tangibles, Reliability,

responsiveness, Assurance and Empathy. These dimensions are described as follows:

1) Tangibles-physical facilities, equipment, appearance of personnel and communication

materials.

2) Reliability-the ability of the service provider to perform the promised service responsibly and

accurately.

3) Responsiveness-the willingness of employees to help and provide prompt service to

customers.

4) Assurance-the knowledge, courtesy and competence of employees and their ability to inspire

trust and confidence in the customer towards the service provider.


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5) Empathy-the caring, individualized and personalized attention provided to customers.

The SERVQUAL scale contained 22 pairs of items spanning across five dimensions covering key

issues of service quality. It comprises two sets of similar statements; the first is a customer expectations

measure (E) and the second is a measure of customers perceptions as to the actual service delivered by

the provider (P). The instrument measures the quality as the difference between expectations and

perceptions (E-P). This tool has been widely applied by researchers in diversity of service settings,

including hospital to assess the difference in service quality between the public and private hospital

(Andaleeb, 2000; Arasli, Ekiz & Katircioglu, 2008; Irfan & Ijaz, 2011; Polsa et al., 2011; Taner & Antony,

2006).

Application of SERQUAL Model

Anderson (1995) applied the SERVQUAL model to measure the quality of Health Care Service

offered by a public university of health clinic. The findings of the research pointed out that the clinic was

poor on the assurance dimension.

Lam (1997) examined the validity, reliabil ity and predictive validity of SERVQUAL and analyzed its

applicability to the health sector in Hong Kong. The study result proved that SERVQUAL is a reliable

model to measure health care service quality. However, factor analysis on five dimensions indicated that

the scale could b treated as one-dimensional for the results identified one dominating factor representing

expectations and perceptions.

Karassavidou et.al. (2007) applied SERVQUAL model to measure a services quality on three

dimensions viz. a) human aspects, b) physical environment and infrastructure of the care unit and c)

access.

Mangkolrat (2008), in her recent work on patient satisfaction measurement, suggested a

conceptual framework where she measured the gap between patients expectation and their perception

in the light of service quality.

Akter et.al. (2008), in their research on service quality perception and satisfaction, applied

SERVQUAL model considering three new dimensions viz. communication (a system to convey message to

patients and patient parties), discipline (control of non-performance of prescribed duties and non-

adherence to written rules), tips or Baksis(extra compensation in order to receive satisfactory service)

replacing other three dimensions viz reliability, tangibles and empathy suggested by Parasuraman et.al. to

determine the gap between patient expectation and perception of service quality.

Qin et.al. (2009) considered the perceived quality as one of the antecedents of patient

satisfaction and compared perceived quality with the expected service quality on the basis of SERVQUAL

model to measure the satisfaction level of a patient regarding waiting time in a hospital.


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Research Methodology

Method

The study was conducted between March to June 2014 in the Department of Mother and child,

Mahosot Referral Hospital in Vientiane Capital, Lao PDR.

Survey instrument

The study questionnaire was composed of 2 parts; the first part assessed demographic

characteristics of the hospital patient, such as age, education and occupation. In the second part, The

SERVQUAL questionnaire was used to assess the pregnant womans expectation and perceptions of

service quality that included 20 items across 5 dimension: Tangibles (4 items), reliability (4 items),

responsiveness(4 items), assurance(4 items) and empathy(4 items). The SERQUAL scale was translated into

the lao and back-translated into English from Parasuraman et al. (1991).

A 5-point likert-type scale was used, ranging from strongly disagree (1) to strongly agree (5) to

access the level of expectations and perceptions of pat ient service quality.

The survey questionnaires were collected 242 sets whichtotally distributed 250 sets, 3 sets were

not returned and 5 sets were not completely responses.

The demographic distribution of the pregnant woman indicated as following:

Five Dimensions SERVQUAL Method

SERVQUAL Method divide service quality into 5 dimensions with 20 attributes, they are:

Age Education Occupation

F % F % F %

35 20 8.3 Higher than

Diploma

60 24.8 Civil Servant 100 41.3

Total 242 100.0 Total 242 100.0 Total 242 100.0


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No SERVQUAL Attribute 1 2 3 4 5

Strongly

disagree

Disagree Uncertain Agree Strongly

agree

Tangibles

1 Physical building are visually appealing2 Up to date equipment and in good working condition

3 Hospital Employee are appeal neat

4 Availability of Medical devices

Assurance

5 Hospital employee attitude to pregnant woman

6 Having great confidence and safe in their interaction

with Doctors

7 Attention and patience of the nurses

8 Experience and knowledge of doctorsEmpathy

9 Politeness of the staff to pregnant woman

10 Ease of communication

11 Doctor know what type of problem arises to pregnant

woman

12 Doctor know what type of pregnant woman suffering

Responsiveness

13 Speed of service

14 Speed of registration15 Telling pregnant woman exactly when services will be

performed

16 Desire for helping

Reliability

17 Handling and comprehensive action

18 Reputation of doctors

19 Qualification of sta ff

20 Accuracy of treatment

Research Framework

Research framework had shown in this following figure. This research used primary data collected

directly through questionnaire given to pregnant woman from three group demography from age,

education and occupation. Indicators in the questionnaire were taken from the five dimensions of

servqual tangible, assurance, empathy, responsiveness and reliability, each of which contai ns four

statements


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The Study Findings and Discussion

The SPSS for Windows was used to analyze data. The mean expectation and perception scoresfor all 5 dimensions and 20 attributes are presented in the table for the service of Department of Mother

and child, Mahosot referral Hospital to the pregnant woman satisfaction with the mean service quality

gap score calculated using Service Quality (SQ).The result are shown in the following table:

Service Quality (SQ) =Perception (P)-Expectation (E)

Tangibles

This table shows the mean service quality for four att ributes in the tangible dimension for

Department of mother and child, Mahosot referral Hospital. The first and second highest of gap score of

20 attributes occurring in this dimensions such as SQ1 =3, 47 and SQ2 =3.03. The result for items

measuring that the pregnant woman need the hospital urgent improve for physical facility and medical

equipments supporting visual appealing and good working condition. In addition the remain two items,

i.e.,SQ3 and SQ4 representative to the appeal neat of staff and medical devices are request to looking

after by the Director and Manager of Hospital. The tangible dimension is the priority to making better of

the service in the feminist views.


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Assurance

There are two mean significant gap score in the Assurance Dimension, SQ5=1.27 and SQ7=1.35

which representat ive to hospital staff attitude, attention and patience to pregnant woman. One gap score,SQ8=0 which indicate that the experience and knowledge of Doctor are accepted. This assurance

dimension is still need to build up the human source of hospital.

Empathy

Measuring the empathy dimension show that the gap score SQ10= 1.01 as representative of

attribute on easy of communication and SQ9=0.77 as representative of the attribute of politeness of staff

to customers are suggested for adjustment the service mechanism and concerning to be more pay

attention and polite to patients.

Responsiveness


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In the dimension of responsiveness, the measuring of gap score of quality service indicate that

three attributes are essential improvement to meet the first helping of the pregnant woman required

while arriving the hospital such as SQ13=1.56 as speed of service, SQ16=1.27 as desire for helping and

SQ14=0.29 as speed of registration. These attributes are related to routine performance of hospital staff.

Reliability

The result in testing for measuring on reliability was 0.31 in average while the biggest number of

gap score of service quality is 0.84 for the SQ17 which representative of the handling and comprehensive

action of hospital staff to the pregnant woman.

Overall Service Quality

The overall mean values of service quality gap score for the Mahosot Referral Hospital was 0.86

respectively. Among the five dimensions, the highest mean values was tangible (1.94); followed by

assurance (0.82), responsiveness (0.78), empathy (0.53) and the lowest for reliability (0.31).

Concerning to the measuring of the service quality gap score on the 20 attributes, the highest

mean values was physical building to be visually appealing (SQ1 =3, 47) and the lowest was the

qualificat ion of staff (SQ19=0.13). Addit ionally there are four attributes having the testing gap score equal

zero such as SQ8 as experience and knowledge of doctors, SQ11 as in which doctor know what type of

problem arises to pregnant woman, SQ15 as the telling exactly when service will be performed and the

final attribute SQ18 as reputation of doctor. It was note that no positive means values of service quality

gap score in any attributes.


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Conclusion

The findings from this study show that some service quality dimensions and attributes of the

department of mother and child, Mahosot hospital need to improve in order to meet the required of the

customer satisfaction and expectation as well as the pregnant woman. The respond of the performance

in 16 attribute are not strong agree and not agree while service attribute which is the main priority has not

implement yet. Only four performance attribute are acceptable and should be kept to serve the

customer. It is important for service organization to know how well they are serving customer and they

therefore could improve and maintain the quality of hospital services.

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