chapter – 5 an analysis of service quality in...

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CHAPTER – 5

AN ANALYSIS OF

SERVICE QUALITY IN HOSPITALS

Fifth chapter forms the crux of the study. It presents analysis of data and

findings by using SERVQUAL scale, statistical tests and graphs, for the data that

have been collected from the patients of 10 select hospitals through quantitative

survey by conducting in-depth interviews to get a comprehensive idea about every

service quality dimension of SERVQUAL. The collected data is being analyzed

according to the directions mentioned in the SERVQUAL model, frame of

references and literature review. As part of the analysis comparisons were made

between select Government, Private and Missionary owned hospitals based on

their bed strengths i.e. 500 and above bedded hospitals (Medical college

hospitals), 100 and above bedded, 50 to 100 bedded and 30 to 50 bedded hospitals.

Further, analyzed results were tested with formulated hypothesis to draw

conclusions on service quality offered by the select hospitals.

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5.1. INTRODUCTION:

This chapter presents the results of the questionnaire, the patterns of the results and

analyses of their relevance to the research questions and aims in two parts. In the first

part, the results are analysed to identify the demographics to get a broader idea of the

sample. In the second part collected service quality details of select hospitals are

analysed to determine service gaps between patients’ perceptions and expectations by

using SERVQUAL scale proposed by Parasuraman, Berry et al. 19851 and statistical

tools using SPSS 14 Chi-square (X2) and Analysis of Variance (ANOVA).

SERVQUAL: SERVQUAL is a scale for measuring service quality. The model is based

on the premise that the best way to measure service quality is to base it on the patient’s

experience of quality. In SERVQUAL, quality is defined by the gap between what a

customer expects and what the customer perceives. SERVQUAL breaks service quality

down to five basic dimensions - Reliability, Assurance, Tangibles, Empathy and

Responsiveness often referred to as RATER.

According to Parasuraman et al. (1988)2 Service quality = Perception – Expectation. The

higher the positive score, the better the service quality. The main benefit of the

SERVQUAL scale is the capability to identify the service quality shortfalls.

Chi-square: Chi square is a statistical test that examines variation. It compares variation

between two different populations and makes a determination of whether the variation is

1 Parasuraman, A., Zeithaml, V. A., and Berry, L. L (1985), “A Conceptual Model of Service Quality andIts Implications for Future Research”, Journal of Marketing, 49 (Fall) 41–50.

2 Parasuraman, Zeithaml A. Valarja and Berry Leonard (1988). “SERVQUAL. A Multiple – Item Scale forMeasuring Consumer Perceptions of Service Quality”, Journal of Retailing, 64(1), 12-40.

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the same. Chi square helps determine the statistical significance of a relationship between

an Attribute X and an Attribute Y in Y = f(X1, X2... Xn).

The approach used is to assume the variables (X Data and Y Data) independent and set

up the hypotheses as follows:

*Ho: Data are Independent (Not Related)

*Ha: Data are Dependent (Related)

The output of the test is a "p-value", indicates the likelihood of seeing a relationship. A

high p-value means there is no relationship between the X data and Y data. A low p value

(< .10) indicates that there is a relationship. A low p value cannot be purely by random

chance. If the p-value is less than 0.10, then the null hypothesis Ho should be rejected

and Ha should be accepted.

Chi-square X2 is a statistical test commonly used to compare observed data with data we

would expect to obtain according to a specific hypothesis. That is, chi-square is the sum

of the squared difference between observed (O) and the expected (E) data, divided by the

expected data in all possible categories i.e. X2 = (O – E)2 / E.

As with any statistical test, Chi Square comes with its set of "could be" and "might be"

statements.

ANOVA: ANOVA is a statistical method for making simultaneous comparisons between

two or more means, a statistical method that yields values that can be tested to determine

whether a significant relation exists between variables.

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5. 2. DEMOGRAPHIC CHARACTERISTICS – ANALYSIS:

This analysis has been carried-out to have a general idea about the respondents Age

groups, Gender, Income levels and Education levels.

5.2.1 Respondents according to their Age group:

Details relating to age groups of sample respondents are furnished in the following table:

Table 5.1Respondents according to their Age Group

Hospital type<=30YEARS

31 - 40YEARS

41 - 50YEARS

51 - 60YEARS

61 ANDABOVE Total

GovernmentHospitals Count 61 33 21 28 17 160

% 38.125 20.625 13.125 17.5 10.625 100PrivateHospitals Count 29 41 45 44 41 200

% 14.5 20.5 22.5 22 20.5 100MissionaryHospital Count 22 4 5 3 6 40

% 55 10 12.5 7.5 15 100Total Count 112 78 71 75 64 400

% 28 19.5 17.75 18.75 16 100SOURCE: Field data

Table 5.1 indicates respondents according to their rage group. Respondents from

Government hospital are 160 in which maximum respondents 38.125% are from <= 30

years age group followed by 20.625% from 31-40 years, 13.125% from 41-50 years,

17.5% from 51-60 years and 10.625% from more than 61 years age group.

Out of 200 respondents from Private hospitals, maximum respondents are from the age

group 41-50 years with 22.5% followed by 51-60 years with 22%, 31-40 years and 61

and above with 20.5% and age group <=30 years with 14.5%.

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The sample of 40 respondents from Missionary hospital, maximum are from age group

<=30 years with 55%, followed by age groups 61 and above, 41-50, 31-40 and 51-60

with 15%, 12.5%, 10% and 7.5% respectively.

Graph 5.1Respondents according to their Age Group

0

20

40

60

80

100

Government Hospitals Private Hospitals Missionary Hospitals

38.12514.5

55

20.625

20.5

1013.12522.5

12.517.5

227.5

10.625 20.5 15

AGE GROUPS

<=30 YEARS 31 - 40 YEARS 41 - 50 YEARS 51 - 60 YEARS 61 AND ABOVE

Chi-square test is carried out to determine whether there is any significant difference

between the age groups of respondents with respect to Government, Private, and

Missionary hospitals. Calculated Chi-square value 45.844 is greater than Chi-square

critical value 15.507. Thus, there is a significant difference between the age groups of

respondents at 95% confidence level.

Chi-Square TestValue Df Asymp. Sig. (2-sided)

Pearson Chi-Square 45.84473267 8 2.54412E-07

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5.2.2 Respondents according to Gender:

Table 5.2Respondents according to Gender

Hospital type FEMALE MALE TotalGovernment hospitals Count 82 78 160

% 51.25 48.75 100Private hospitals Count 77 123 200

% 38.5 61.5 100Missionary hospital Count 23 17 40

% 57.5 42.5 100Total Count 182 218 400

% 45.5 54.5 100SOURCE: Field data.

Table 5.2 shows that there are 82(51.25%), 77(38.5%) and 23(57.5%) female respondents

representing Government, Private and Missionary Hospitals respectively and the

corresponding male respondents are 78(48.75%), 123(61.5%) and 17(42.5%)

respectively. This shows that female respondents are slightly over-represented in the

Government and Missionary hospitals sample, where as in private hospitals male

respondents are over-represented than female respondents.

Graph 5.2Respondents according to Gender

0

20

40

60

80

100


51.25 38.557.5

48.75 61.542.5

GENDER

Female Male

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Chi-Square TestsValue Df Asymp. Sig. (2-sided)

Pearson Chi-Square 8.408105656 2 0.014934925

To test whether there is any significant difference between respondents’ genders with

respect to Government, Private, and Missionary hospitals, the Chi-square test is

conducted. Calculated Chi-square value 8.408 is greater than Chi-square critical value

5.991. Thus, there is a significant difference between respondents’ gender at 95%

confidence level.

5.2.3 Respondents according to their family Income levels:

The details pertaining to the annual income of the sample respondent families are

furnished in the Table 5.3.

Table 5.3Respondents according to their family Income levels

Hospitaltype

BELOWRS.

60000/-

RS.60000/-

TO120000/-

RS.120000/-TO

180000/-

RS.180000TO

240000/-

RS.240000TO &

ABOVE TotalGovernmenthospitals Count 68 78 12 1 1 160

% 42.5 48.75 7.5 0.625 0.625 100Privatehospitals Count 20 78 55 32 15 200

% 10 39 27.5 16 7.5 100

Missionaryhospital Count 16 17 4 3 0 40

% 40 42.5 10 7.5 0 100Total Count 104 173 71 36 16 400

% 26 43.25 17.75 9 4 100SOURCE: Field data.

Table 5.3 represents according to their family Income levels. It has been observed that

most of the patients who belongs to Income groups Below Rs. 60000/- and Rs. 60000/- to

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120000/- are availing medical facilities of Government and Missionary hospitals i.e.

42.5% and 48.75% respectively. The researcher also observed that few percentage of

people (10%) of below Rs. 60000/- Income level are utilizing Medical facilities of Private

hospitals.

The above table shows that most of the respondents are belong to Rs.60000/- to

Rs.120000/- income group. In Government hospitals 42.5% respondents belong to below

Rs.60000/- income group, 48.75% respondents Rs.60000/- to Rs.120000/- and remaining

8.75% belongs to remaining income groups (i.e. Rs.120000/- to 180000/-, Rs.180000/- to

240000/- and Rs.240000 and above).

In Missionary hospitals 40% respondents are from below Rs.60000/- income group,

remaining 17.5% respondents to income group Rs.120000/- to 180000/- and Rs.180000/-

to 240000/-.

In private hospitals 27.5% are from income group Rs.120000/- to 180000/-, 16% from

Rs.180000/- to Rs.240000/-, 10% from income group below Rs.6000/- and above, and

only 7.5% of respondents belong to income group below Rs.24000/- and above.

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Graph 5.3Respondents according to their family Income levels

0

20

40

60

80

100


42.510

40

48.75

39

42.5

7.5

27.5

100.625

167.50.625 7.5 0

INCOME LEVELS

BELOW RS. 60000/- RS. 60000/- TO 120000/- RS. 120000/- TO 180000/- 180000 TO 240000/- 240000 TO & ABOVE

Chi-Square TestsValue Df Asymp. Sig. (2-sided)


In order to test whether there is any significant difference in the income levels of

respondents with respect to Government, Private and Missionary hospitals, the Chi-

square test is carried-out. Calculated Chi-square value 98.695 is greater than Chi-square

critical value 15.507. Thus, there is a significant difference between the income levels of


5.2.4 Respondents according to their levels of Education:

Table 5.4 shows that nearly 1/3 (33.75%) of the respondents are illiterates and 2/3 are

literates i.e. 23.75% educated up to high school level, 12% graduates and 1.75% post

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graduates. This reveals that total literate percentage of respondents are 66.25% of select

sample Government, Private and Missionary hospitals.

Table 5.4Respondents according to their levels of Education

Hospitaltype ILLITERATE

UPTOSSC GRADUATION

POSTGRADUATION OTHERS Total

Governmenthospitals Count 67 31 4 0 58 160

% 41.875 19.375 2.5 0 36.25 100

Privatehospitals Count 53 60 38 7 42 200

% 26.5 30 19 3.5 21 100

Missionaryhospital Count 15 4 6 0 15 40

% 37.5 10 15 0 37.5 100Total Count 135 95 48 7 115 400

% 33.75 23.75 12 1.75 28.75 100SOURCE: Field data.

Graph 5.4Respondents according to their levels of Education

0

20

40

60

80

100


41.875 26.5 37.5

19.37530 10

2.5 1915

36.25 2137.5

EDUCATION LEVELS

ILLITERATE UPTO SSC GRADUATION POST GRADUATION OTHERS

Chi-Square TestsValue df Asymp. Sig. (2-sided)


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Chi-square test is carried-out to test whether there is any significant difference in the

education levels of respondents with respect to Government, Private and Missionary

hospitals. Calculated Chi-square value 50.0481 is greater than Chi-square critical value

15.507. Thus, there is a significant difference between the education levels of


5.3 COMPARISON BETWEEN SELECT HOSPITALS – ANALYSISPROCESS:

The following process has been followed to analyze patients’ service quality by

SERVQUAL scale and statistical tools between Government, Private and Missionary

hospitals.

Comparison between Hospitals having bed strength 500 and above:

Comparison between Government and Private owned hospitals having bed strength 500

and above i.e. NTR Health University General Hospital (UGH), Vijayawada and

Pinnemaneni Siddhartha Medical College Hospital (Private Medical College Hospital),

Chinaoutapalli has been made. Missionary Medical College Hospital has not been

considered here due to unavailability hence researcher conducted between Government

and Private Medical College Hospitals as per the sample to know hospitals’ service

quality by SERVQUAL scale and patients’ satisfactory levels.

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Figure 5.1 Comparison between hospitals having bed strength 500 and above

patients’ satisfactory levels.

Comparison between Hospitals having bed strength 100 and above:

Comparison between Government and Private owned hospitals having bed strength 100

and above i.e. Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac

and Multispecialty Hospital, Vijayawada has been carried out. Here only one Missionary

hospital exists i.e., St. Anns’ Hospital, Vijayawada but the hospital authorities refused

permission to conduct the present study. Hence the study is conducted between

government and private hospitals as per the sample to know hospitals’ service quality

using SERVQUAL scale and patients’ satisfactory levels.

NTR Health University Private Medical

General Hospital College Hospital

Comparison between

Comparison between

Comparison between

In-patients In-patients

Out-patients Out-patients

Both O/P & I/P Both O/P & I/P

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Figure 5.2 Comparison between hospitals having bed strength 100 and above

Comparison between hospitals having bed strength 50 to 100:

Comparison between Government, Private and Missionary owned hospitals having bed

strength 50 and above i.e., Government Area Hospital-Nuzvid, Prashanth Hospital-

Vijayawada, Dr. M.J. Naidu Hospital-Vijayawada and Gifford Memorial Hospital,

Nuzvid is made for the present study to know hospitals’ service quality by SERVQUAL

scale and patients’ satisfactory levels.

Figure 5.3 Comparison between hospitals having bed strength 50 to 100

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Comparison between hospitals having bed strength 30 to 50:

Comparison between Government and Private owned hospitals having bed strength 30 to

50 i.e., Government Community Health Centre, Jaggaiahpet and Latha Super Speciality

Hospital, Vijayawada has been carried-out. In this category one Missionary hospital

exists i.e. St. Anns’ Hospital, Avanigadda, but the management of this hospital has not

given permission to carry-out present study and hence excluded and conducted study

between government and private hospitals to know hospitals’ service quality by

emphasizing SERVQUAL scale and patients’ satisfactory levels.

Figure 5.4 Comparison between hospitals having bed strength 30 to 50

Comparison between hospitals irrespective of bed strength (all together):

Over all comparison has been carried-out between Government, Private and Missionary

owned hospitals irrespective of bed strength i.e., all Government hospitals considered as

one, all Private hospitals considered as one and Missionary hospitals considered as one to

know over all hospitals’ service quality by emphasizing SERVQUAL scale and patients’

satisfactory levels.

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Figure 5.5 Comparison between all select Government, Private and Missionary hospitalsirrespective of bed strength

4.4 FINDINGS OF SERVICE QUALITY IN SELECT HOSPITALS:

Below mentioned SERVQUAL scale attributes of service quality are analysed to find out

service quality of selective hospitals of Krishna District of Andhra Pradesh. Comparative

analysis has been carried out between Government, Private and Trust owned

(Missionary) hospitals based on bed strength using SERVQUAL scale and Analysis of

Variance (ANOVA).

Table 5.522 Service quality attributes

AttributeNo.

Attribute

1. The hospital has modern looking equipment.

2. The physical facilities in the hospital are visually appearing.

3. Personnel in the hospital are neat in appearance.

Select Government Select Private Select Missionary

Hospitals Hospitals Hospitals

Comparison

Comparison

Comparison

Out-patients Out-patientsOut-patients

In-patients In-patientsIn-patients

Both O/P & I/P Both O/P & I/PBoth O/P & I/P

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4. Materials associated with the services (such as pamphlets, statements, boards) arevisually appearing.

5. When the hospital promises to do something by a certain time it does so.

6. When you have a problem, the hospital shows a sincere interest in solving it.

7. The hospital gets things right the first time.

8. The hospital provides its services at the time it promises to do so.

9. The hospital insists on error-free records.

10. The personnel in the hospital tell you exactly when services will be performed.

11. Personnel in the hospital give you prompt service.

12. Personnel in the hospital are always willing to help you.

13. Personnel in the hospital are never be too busy to respond to your requests.

14. The behavior of personnel in the hospital instills confidence in you.

15. You feel safe in your dealings with the hospital.

16. Personnel in the hospital are consistently courteous with you.

17. Personnel in the hospital have the knowledge to answer your questions.

18. The hospital gives you individual attention.

19. The hospital operating hours convenient to all its patients.

20. The hospital has employees who give you personal attention.

21. The hospital considers your interests best at heart.

22. The personnel of the hospital understand your specific needs.

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COMPARISON BETWEEN HOSPITALS

HAVING BED STRENGTH 500 AND ABOVE

Government Hospital:

NTR University General Hospital, Vijayawada.

Private Hospital:

Pinnemaneni Siddhartha Medical College Hospital, Chinaoutapalli.

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5.4.1. Analysis of Service Quality in hospitals having bed strength 500 and above –Out-patients’ perception towards Service Quality:

Table 5.6Gaps between perceptions and expectations towards Service Quality opined by

Out-patients of Government and Private hospitals having bed strength 500 and aboveGOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.3 4 0.3 4.35 4 0.35

2 4.55 4 0.55 4.65 4 0.65

3 4.7 4 0.7 4.95 4 0.95

4 5.4 4 1.4 3.25 4 -0.75

5 4.2 4 0.2 3.45 4 -0.55

6 4.25 4 0.25 4.15 4 0.15

7 4.6 4 0.6 4.1 4 0.1

8 4.1 4 0.1 3.65 4 -0.35

9 4.6 4 0.6 5.3 4 1.3

10 4.75 4 0.75 4.8 4 0.8

11 4.45 4 0.45 4.1 4 0.1

12 4.7 4 0.7 3.95 4 -0.05

13 4.1 4 0.1 3.75 4 -0.25

14 4.2 4 0.2 4.2 4 0.2

15 4.45 4 0.45 4.4 4 0.4

16 4 4 0 4.15 4 0.15

17 4.75 4 0.75 4.85 4 0.85

18 4.25 4 0.25 4.05 4 0.05

19 4.8 4 0.8 4.6 4 0.6

20 4.1 4 0.1 4.2 4 0.2

21 4.2 4 0.2 4.35 4 0.35

22 4.4 4 0.4 4.35 4 0.35

TABLE 1 TABLE 1

Avg Tangable SVQ 0.7375 Avg Tangable SVQ 0.3

Avg Reliability SVQ 0.35 Avg Reliability SVQ 0.13

Avg Responsiveness SVQ 0.5 Avg Responsiveness SVQ 0.15

Avg Assurance SVQ 0.35 Avg Assurance SVQ 0.4

Avg Empathy SVQ 0.35 Avg Empathy SVQ 0.31AVERAGE UNWEIGHTEDSERVQUAL SCORE 0.4575

AVERAGE UNWEIGHTEDSERVQUAL SCORE 0.258

Score fromTable 1

Avg weightfrom Table 2

WeightedScore

Score fromTable 1


WeightedScore

0.7375 29.5 21.75625 0.3 34.5 10.35

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0.35 28.5 9.975 0.13 30.5 3.965

0.5 15 7.5 0.15 21 3.15

0.35 18 6.3 0.4 6 2.4

0.35 9 3.15 0.31 8 2.48AVERAGE WEIGHTEDSERVQUAL SCRORE 9.73625

AVERAGE WEIGHTEDSERVQUAL SCRORE 4.469

Table 5.6 summarizes the gaps between the ‘Perceptions’ and ‘Expectations’ of 22

service quality attributes in case of Government and Private Medical College hospitals

out-patients. The table indicates that all 22 service quality attributes of NTR Health

University General Hospital are positive which shows that all 22 service attributes met

and exceeded out-patients’ expectation levels. 5 service attributes (i.e. attribute no. 4, 5,

8, 12 and 13) out of 22 attributes of Private Medical College hospital are negative. In

other words, out-patients’ expectations levels are higher than perceptions levels in case of

these 5 attributes.

The above table reveals the Average Unweighted and Weighted SERVQUAL scores of

22 attributes opined by sample respondents. The Average Unweighted and Weighted

SERVQUAL scores of NTR Health University General hospital are more than those of

Private Medical College hospital. This shows that out-patients’ service quality of NTR

Health University General Hospital are good enough when compared to those of Private

Medical College Hospital.

Analysis of Variance (ANOVA) is employed to understand whether the differences are

significant or not with respect to the service quality in the mean variance among the

responses given by out-patients of NTR Health University General Hospital and Private

Medical College Hospital and the results are set below.

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Table 5.7ANOVA between Out-patients’ perception towards Service Quality –

Hospitals having bed strength 500 and aboveANOVA TEST

N Mean Std.Deviation F Sig.

TANGIBLES Government Hospital 20 13.8000 4.4909 0.514 0.478Private Hospital 20 12.7000 5.1921Total 40 13.2500 4.8238

RELIABILITY Government Hospital 20 15.9000 5.4086 0.087 0.769Private Hospital 20 15.3500 6.3185Total 40 15.6250 5.8120

RESPONSIVENESS Government Hospital 20 13.2500 4.7114 0.278 0.601Private Hospital 20 12.4500 4.8826Total 40 12.8500 4.7531

ASSURANCE Government Hospital 20 12.8500 4.5338 0.000 1.000Private Hospital 20 12.8500 4.8043Total 40 12.8500 4.6107

EMPATHY Government Hospital 20 16.0000 5.5630 0.004 0.952Private Hospital 20 15.9000 4.8330Total 40 15.9500 5.1438

OVERALL Government Hospital 20 71.8000 23.5810 0.107 0.745Private Hospital 20 69.2500 25.6163Total 40 70.5250 24.3363

The above ANOVA details are also shown in the following graph.

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Graph 5.5Out-patients’ perception towards Service Quality –

Hospital having bed strength 500 and above

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL

13.80 12.70 15.90 15.35 13.25 12.45 12.85 12.85 16.00 15.90

71.80 69.25

4.49 5.195.41 6.32

4.71 4.88 4.53 4.805.56 4.83

23.58 25.62

Std. Deviation Mean

F Table value (1, 38, 0.05) = 4.08. The above ANOVA Table discloses P value is >0.05

i.e. level of significance is found to be not significant at 95 percent confidence level.

This shows that there is no significant difference in service quality in the mean variance

among the responses given by out-patients of NTR Health University General Hospital &

Private Medical College Hospital, because the overall ANOVA value of out-patients is

0.745.

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Table 5.8Out-patients’ satisfactory levels towards Service Quality –

Hospitals having bed strength 500 and aboveSATISFACTORYLEVELS Tangibles Reliability Responsiveness Assurance Empathy OverallGovernmentHospital 69.00 63.60 66.25 64.25 64.00 65.27

Private Hospital 63.50 61.40 62.25 64.25 63.60 62.95The above details are also shown in the following graph.

Graph 5.6Out-patients’ satisfactory levels towards Service Quality –

Hospitals having bed strength 500 and above

56.00

58.00

60.00

62.00

64.00

66.00

68.00

70.00

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI

O/P GOVTMED

COL, VJA

O/P PVTMED

COL, CPAALI


69.00

63.50 63.60

61.40

66.25

62.25

64.25 64.2564.00

63.60

65.27

62.95

% Of Patient Satisfaction

The above table and graph represent satisfactory levels of service quality of out-patients’

services of NTR Health University General Hospital, Vijayawada and Private Medical

College Hospital, Chinaoutapalli. Patients of NTR Health University General Hospital

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are more satisfied with 65.27% to 22 attributes of service quality against 62.95% in case

of Private Medical College Hospital.

On observation the researcher found that NTR Health University General Hospital is

creating more awareness among public by displaying placards and conducting specialized

medical camps with the help of private hospitals being suggested by Government. It is

also found that the NTR Health University General Hospital is offering all specialized

medical services including cardiology, neurology, urology, nephrology, pulmonology,

gastroenterology in OPD services supported by all diagnostic services having skilled and

experienced medical and paramedical staff. On the other side, Private Medical College

hospital management is not showing much interest on public awareness towards health

and diseases at least by displaying statements, boards, disturbing pamphlets as it wants

their premises neat, clean and good looking. OPD services are offered only in mornings

and evenings, as all the time specialized doctors are not available except OPD timings,

due to the reason hospital does not stand on promises to do something by certain time and

in the absence of doctors concerned staff feel free and show full of activity to patients.

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5.4.2. Analysis of Service Quality in hospitals having bed strength 500 and above –In-patients’ perception towards Service Quality:


In-patients of Government and Private hospitals having bed strength 500 and aboveGOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 3.9 4 -0.1 4.3 4 0.32 4.9 4 0.9 4.75 4 0.753 4.9 4 0.9 4.8 4 0.8

4 5.2 4 1.2 3.4 4 -0.65 4.05 4 0.05 3.5 4 -0.56 4.45 4 0.45 4.1 4 0.17 4.65 4 0.65 3.95 4 -0.058 3.95 4 -0.05 3.85 4 -0.15

9 4.5 4 0.5 4.9 4 0.910 4.9 4 0.9 4.6 4 0.611 4.25 4 0.25 3.9 4 -0.112 3.8 4 -0.2 3.95 4 -0.05

13 3.7 4 -0.3 3.7 4 -0.314 4.45 4 0.45 4.1 4 0.115 4.6 4 0.6 4.2 4 0.216 4.75 4 0.75 4.05 4 0.05

17 4.8 4 0.8 4.9 4 0.918 4.4 4 0.4 3.8 4 -0.219 5.05 4 1.05 4.65 4 0.6520 4.35 4 0.35 4 4 021 4.05 4 0.05 3.9 4 -0.1

22 4.05 4 0.05 3.9 4 -0.1

TABLE 1 TABLE 1Avg Tangable SVQ 0.725 Avg Tangable SVQ 0.3125Avg Reliability SVQ 0.32 Avg Reliability SVQ 0.06Avg Responsiveness SVQ 0.1625 Avg Responsiveness SVQ 0.0375Avg Assurance SVQ 0.65 Avg Assurance SVQ 0.3125Avg Empathy SVQ 0.38 Avg Empathy SVQ 0.05AVG UNWEIGHTED SVQSCORE 0.4475

AVG UNWEIGHTED SVQSCORE 0.1545

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Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

0.725 36 26.1 0.3125 33.5 10.93750.32 27 8.64 0.06 26.5 1.71

0.1625 21.5 3.49375 0.0375 18.5 0.71250.65 12 7.8 0.3125 10.5 3.593750.38 3.5 1.33 0.05 6 0.3

AVG WEIGHTED SERSCRORE 9.47275


According to SERVQUAL, the higher the positive score, the better is the service quality.

Table 5.9 sums-up the main points, that the gaps found between the ‘Perceptions’ and

‘Expectations’ of the 22 service quality attributes of SERVQUAL of in-patients of

Government and Private Medical College Hospitals. Table 5.9 indicates that 4 service

quality attributes (i.e. 1, 8, 12 and 13) out of 22 service quality attributes are under

expectation and remaining 18 service quality attributes met and exceeded in-patients’

expectation levels of NTR Health University General Hospital. 10 out of 22 service

quality attributes (i.e. attribute no. 4, 5, 7, 8, 11, 12, 13, 18, 21 and 22) of Private medical

college hospital are negative. This shows patients’ perception levels are more than

expectation levels in these service quality attributes and remaining attributes met and

exceeded expectation levels.

Table reveals the Average Unweighted and Weighted SERVQUAL scores of 22

attributes opined by sample respondents. The Average Unweighted and Weighted

SERVQUAL scores of NTR Health University General Hospital are more than those of

Private Medical College hospital. This makes known that in-patients’ service quality of

NTR Health University General Hospital are good enough than Private Medical College

Hospital.

174

Analysis of Variance (ANOVA) is applied to understand whether the differences are


responses given by in-patients of NTR Health University General Hospital and Private

Medical College Hospital and the results are set below.

Table 5.10ANOVA between In-patients’ perception towards Service Quality –









The above ANOVA results are also shown in the following graph.

175

Graph 5.7In- patients’ perception towards Service Quality –


0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

I/P GOVTMED

COL, VJA

I/P PVT MEDCOL, CPAALI

I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA



13.75 12.60 15.80 15.10 12.40 12.10 13.60 12.80 16.25 15.50

71.80 68.10

4.60 5.165.03 6.50

4.27 4.88 4.16 5.084.15 5.48

21.47 26.81

Std. Deviation Mean

F Table value (1, 38, 0.05) = 4.08. The above ANOVA Table discloses P value is >0.05



among the responses given by in-patients of NTR Health University General Hospital &

Private Medical College Hospital because the overall ANOVA value of in-patients is

0.633.

176

Table 5.11In-patients’ satisfactory levels towards Service Quality –

Hospitals having bed strength 500 and aboveSATISFACTORYLEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall

Government Hospital 68.75 63.20 62.00 68.00 65.00 65.27


Graph 5.8In-patients’ satisfactory levels towards Service Quality –


56.00

58.00

60.00

62.00

64.00

66.00

68.00

70.00

I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA


I/P GOVTMED

COL, VJA



68.75

63.00 63.20

60.40

62.00

60.50

68.00

64.00

65.00

62.00

65.27

61.91


The above table and graph represent satisfactory levels of service quality of in-patients’

services of NTR Health University General Hospital, Vijayawada and Private Medical

College Hospital, Chinaoutapalli. Patients of NTR Health University General Hospital

177

are more satisfied with 65.27% to 22 attributes of service quality than those of Private

Medical College Hospital with 61.97%.

The researcher observed that NTR Health University General Hospital lacks of

specialized equipments, instruments and specialized operation theaters to perform

specialized medical & surgical procedures for in-patients suffering from super speciality

syndromes. Most of the consultants are available in the day time due to which the

hospital does not stand on its promises to do something by a certain time and in such a

case the concerned paramedical staff pretends as full of activity to patients. Even this

almost holds good in case of the Private Medical College hospital under study. Also the

Private Medical College hospital management is not showing much interest on public

awareness towards health and diseases. Further, in the case of Private Medical College

hospital Individual attention limited to nursing staff only not by the doctors because more

number of patients are coming for treatment and every patient has to be seen by available

few doctors. Because of the above all service quality attributes are not possible to be

maintained by the Private Medical College hospital.

5.4.3. Analysis of Service Quality in hospitals having bed strength 500 and above –Out & In-patients’ (all together) perception towards Service Quality:

Table 5.12Gaps between perceptions and expectations towards Service Quality opined by Out & In-

patients of Government and Private hospitals having bed strength 500 and aboveGOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.1 4 0.1 4.325 4 0.3252 4.725 4 0.725 4.7 4 0.73 4.8 4 0.8 4.875 4 0.8754 5.3 4 1.3 3.325 4 -0.6755 4.125 4 0.125 3.475 4 -0.525

178

6 4.35 4 0.35 4.125 4 0.1257 4.625 4 0.625 4.025 4 0.0258 4.025 4 0.025 3.75 4 -0.259 4.55 4 0.55 5.1 4 1.1

10 4.825 4 0.825 4.7 4 0.711 4.35 4 0.35 4 4 012 4.25 4 0.25 3.95 4 -0.0513 3.9 4 -0.1 3.725 4 -0.27514 4.325 4 0.325 4.15 4 0.1515 4.525 4 0.525 4.3 4 0.316 4.375 4 0.375 4.1 4 0.117 4.775 4 0.775 4.875 4 0.87518 4.325 4 0.325 3.925 4 -0.07519 4.925 4 0.925 4.625 4 0.62520 4.225 4 0.225 4.1 4 0.121 4.125 4 0.125 4.125 4 0.12522 4.225 4 0.225 4.125 4 0.125

TABLE 1 TABLE 1Avg Tangable SVQ 0.73125 Avg Tangable SVQ 0.30625Avg Reliability SVQ 0.335 Avg Reliability SVQ 0.095Avg Responsiveness SVQ 0.33125 Avg Responsiveness SVQ 0.09375Avg Assurance SVQ 0.5 Avg Assurance SVQ 0.35625Avg Empathy SVQ 0.365 Avg Empathy SVQ 0.18AVG UNWEIGHTED SVQSCORE 0.4525


Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

0.73125 32.75 23.9484375 0.30625 34.75 10.64218750.335 27.75 9.29625 0.095 29.5 2.8025

0.33125 18.25 6.0453125 0.09375 20 1.8750.5 15 7.5 0.35625 8.75 3.1171875

0.365 6.25 2.28125 0.18 7 1.26AVG WEIGHTED SERSCRORE 9.81425


Table 5.12 provides information about the gaps found between ‘Perceptions’ and

‘Expectations’ of 22 service quality attributes of SERVQUAL of both In & Out-patients

179

of Government and Private Medical College Hospitals. It indicates that 1 service quality

attribute i.e. 13 out of 22 service quality attributes is under expectation and remaining 21

service quality attributes met and exceeded both In & Out-patients’ expectation levels of

NTR Health University General Hospital, Vijayawada. 6 out of 22 service quality

attributes (i.e. attribute no. 4, 5, 8, 12, 13 and 18) are negative in case of Private medical

college hospital. This shows expectation levels of patients of Private Medical College

hospital are more than perception levels in these attributes.

The above table reveals Average Unweighted and Weighted SERVQUAL scores.

Average Unweighted and Weighted SERVQUAL scores of NTR Health University

General Hospital are more than Average Unweighted and Weighted SERVQUAL scores

of Private Medical College hospital. This shows medical services quality towards

patients of NTR Health University General Hospital are good enough than those Private

Medical College Hospital.

Hypothesis testing:

1. H0. Overall mean perception score is lower than overall mean expectation score of

Government Hospitals.

From the above results and discussion it is evident that overall mean perception score

(4.443) is higher than overall mean expectation score (4) of NTR Health University

General Hospital, Vijayawada. Hence formulated Hypothesis – 1 viz., “Overall mean

perception score is lower than overall mean expectation score of Government Hospitals”

is rejected.

180

2. H0. Overall mean perception score is higher than overall mean expectation score of

Private Hospitals.

Further overall mean perception score (4.2) is higher than overall mean expectation score

(4) of Private Medical College Hospital i.e. Pinnemaneni Siddhartha Medical College

Hospital, Chinaoutapalli. Hence formulated Hypothesis – 2 viz., “Overall mean

perception score is higher than overall mean expectation score of Private Hospitals” is

significant.


significant or not with respect to the service quality in the variance among the responses

given by overall patients (both I/P & O/P) of NTR Health University General Hospital

and Private Medical College Hospital and the results are set below.

Table 5.13ANOVA between Out & In-patients perception towards Service Quality –









181

The ANOVA test results are also shown in the following graph.

Graph 5.9Out & In-Patients’ perception towards service quality –


0.00

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30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI


13.78 12.65 15.85 15.23 12.83 12.28 13.23 12.83 16.13 15.70

71.80 68.68

4.49 5.115.16 6.33

4.46 4.82 4.31 4.884.85 5.11

22.26 25.89

Std. Deviation Mean

F Table value (1, 78, 0.05) = 3.96. Table 5.13 discloses P value is >0.05 i.e. level of

significance is found to be not significant at 95 percent confidence level. This shows that

there is no significant difference in service quality in the mean variance among the

responses given by patients (both out & in-patients) of NTR Health University General

Hospital & Private Medical College Hospital, because the overall ANOVA value of both

in & out-patients is 0.564.

182

Table 5.14Out & In-Patients’ satisfactory levels towards Service Quality –


Government Hospital 68.88 63.40 64.13 66.13 64.50 65.27

Private Hospital63.25 60.90 61.38 64.13 62.80 62.43

The above details are also shown in the following graph.

Graph 5.10Out & In-Patients’ satisfactory levels towards Service Quality –


56.00

58.00

60.00

62.00

64.00

66.00

68.00

70.00

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI

GOVT MEDCOL, VJA

PVT MEDCOL, CPAALI


68.88

63.25 63.40

60.90

64.13

61.38

66.13

64.1364.50

62.80

65.27

62.43


The above table and graph represent satisfactory levels of service quality of overall

patients (O/P & I/P) of NTR Health University General Hospital, Vijayawada and Private

Medical College Hospital, Chinaoutapalli. Patients of NTR Health University General

183

Hospital are more satisfied with 65.27% to 22 service quality attributes of SERVQUAL

than Private Medical College Hospital with 62.43%.

On observation researcher found that in NTR Health University General Hospital most of

the consultants are available in the day time only to give treatment to OPD patients due to

the result specialized procedures and diagnostic tests are conducting during day time.

Because of this reason the staff pretends full of activity not even to respond patients’

requests in the day time. In absence of administrative staff and concerned doctors during

night times, nursing and other staff feel free and do not show much interest to perform

regular duties. In Private Medical College hospital, the management is not showing

interest towards health and diseases among public, OPD services are offered in morning

and evening times only and the specialist doctors are not available except OPD timings,

due to which the hospital is failing to fulfill its promises and to do things by time.

Available few consultants have to take care of both out-patients and in-patients due to the

reason individual attention is limited to nursing staff only not by the doctors.

184


HAVING BED STRENGTH 100 AND ABOVE


District Hospital, Machilipatnam.

Private Hospital:

Dr. Ramesh Cardiac and Multispeciality Hospital, Vijayawada.

185

5.4.4. Analysis of Service Quality in hospitals having bed strength 100 and above –Out-patients’ perception towards Service Quality:

Table 5.15Gaps between perceptions and expectations towards Service Quality opined by Out-

patients of Government and Private Hospitals having bed strength 100 and aboveGOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.7 4 0.7 5.1 4 1.12 4.55 4 0.55 4.75 4 0.753 4.4 4 0.4 4.6 4 0.64 4.65 4 0.65 4.1 4 0.15 3.8 4 -0.2 4.4 4 -0.156 4 4 0 4.8 4 0.87 4.15 4 0.15 4.9 4 0.98 4 4 0 4.65 4 0.659 4.25 4 0.25 5.55 4 1.55

10 4.35 4 0.35 4.55 4 -0.1011 4.2 4 0.2 4.45 4 -0.0512 4 4 0 4.5 4 0.513 4.15 4 0.15 4.7 4 0.714 4.3 4 0.3 4.75 4 0.7515 4.55 4 0.55 4.9 4 0.916 4.55 4 0.55 4.6 4 0.617 4.2 4 0.2 4.8 4 0.818 3.6 4 -0.4 4.75 4 0.7519 3.7 4 -0.3 4.6 4 0.620 3.8 4 -0.2 4.8 4 0.821 4.05 4 0.05 4.45 4 0.4522 4.15 4 0.15 4.65 4 0.65

TABLE 1 TABLE 1Avg Tangable SVQ 0.575 Avg Tangable SVQ 0.6375Avg Reliability SVQ 0.04 Avg Reliability SVQ 0.75Avg Responsiveness SVQ 0.175 Avg Responsiveness SVQ 0.2625Avg Assurance SVQ 0.4 Avg Assurance SVQ 0.7625Avg Empathy SVQ -0.14 Avg Empathy SVQ 0.65AVG UNWEIGHTED SVQSCORE 0.21

AVG UNWEIGHTEDSVQ SCORE 0.6125

Score fromTable 1


WeightedScore

Score fromTable 1

Avg weightfrom Table2

WeightedScore

0.575 33.5 19.2625 0.6375 33 21.0375

186

0.04 27.5 1.1 0.75 28 210.175 23 4.025 0.2625 21 5.5125

0.4 8 3.2 0.7625 12.5 9.53125-0.14 8 -1.12 0.65 5.5 3.575



Table 5.15 gives information about the gaps found between the ‘Perceptions’ and

‘Expectations’ of 22 service quality attributes of SERVQUAL of Out-patients of

Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada. Table indicates that 4 attributes (i.e. 5, 18, 19 and

20) out of 22 service quality attributes of Government District Hospital, Machilipatnam

are under expectation and remaining 18 service quality attributes met and exceeded out-

patients’ expectation levels. Other side 3 attributes (i.e. 5, 10 & 11) are negative out of

22 service quality attribute scores of Ramesh Cardiac and Multispecialty Hospital,

Vijayawada i.e. expectation levels are more than perception levels in these attributes.

The above table reveals the Average Unweighted and Weighted SERVQUAL scores of

22 attributes opined by sample respondents. Average Unweighted and Weighted

SERVQUAL scores of Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada are

more than those of Government District Hospital, Machilipatnam. This shows that out-

patients’ service quality of Dr. Ramesh Cardiac & Multispecialty Hospital are good

enough than Government District Hospital.



responses given by out-patients of Government District Hospital, Machilipatnam and Dr.

Ramesh Cardiac and Multispecialty Hospital, Vijayawada and the results are set below.

187



N MeanStd.

Deviation F Sig.TANGIBLES Government Hospital 20 13.3000 4.9958 0.028 0.869

Private Hospital 20 13.5500 4.5012Total 40 13.4250 4.6953







188



0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00O

/P G

OV

T D

IST

HO

SP, M

TM

O/P

RA

MES

H H

OSP

, VJA

O/P

GO

VT

DIS

T H

OSP

, MTM

O/P

RA

MES

H H

OSP

, VJA

O/P

GO

VT

DIS

T H

OSP

, MTM

O/P

RA

MES

H H

OSP

, VJA

O/P

GO

VT

DIS

T H

OSP

, MTM

O/P

RA

MES

H H

OSP

, VJA

O/P

GO

VT

DIS

T H

OSP

, MTM

O/P

RA

MES

H H

OSP

, VJA

O/P

GO

VT

DIS

T H

OSP

, MTM

O/P

RA

MES

H H

OSP

, VJA


13.30 13.55 15.10 17.8012.50 13.45 12.75 14.00 14.35 17.20

68.0076.00

5.00 4.50 5.71 4.584.24 4.49 4.78 4.47 5.04 4.03

24.16

21.27

Std. Deviation Mean

F Table value (1, 38, 0.05) = 4.08. The above ANOVA table discloses P value is >0.05


This shows that there is no significant difference in service quality in the variance among

the responses given by out-patients perception of Government District Hospital,

Machilipatnam & Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada, because

the overall ANOVA value of out-patients is 0.273.

189


Hospitals having bed strength 100 and aboveSATISFACTORYLEVELS Tangibles Reliability Responsiveness Assurance Empathy OverallGovernmentHospital 66.50 60.40 62.50 63.75 57.40 61.82

Private Hospital 67.75 71.20 67.25 70.00 68.80 69.09




0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

O/P GOVTDIST

HOSP, MTM

O/P RAMESHHOSP, VJA

O/P GOVTDIST

HOSP, MTM

O/P RAMESHHOSP, VJA

O/P GOVTDIST

HOSP, MTM

O/P RAMESHHOSP, VJA

O/P GOVTDIST

HOSP, MTM

O/P RAMESHHOSP, VJA

O/P GOVTDIST

HOSP, MTM

O/P RAMESHHOSP, VJA

O/P GOVTDIST

HOSP, MTM

O/P RAMESHHOSP, VJA


66.50 67.75

60.40

71.20

62.50

67.25

63.75

70.00

57.40

68.80

61.82

69.09


The above table and graph represent satisfactory levels of service quality of out-patients’

services of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada. Patients of Dr. Ramesh Cardiac and Multispecialty

190

Hospital are more satisfied with 69.09% to 22 service quality attributes of SERVQUAL

against 61.82% in case of Government District Hospital.

On observation researcher found that Government District Hospital is a first referral

hospital for all Government Community Health Centres. Because of the reason more

number of patients are coming throughout the district for treatment regularly and every

patient has to be treated by available few doctors and paramedical staff. This is does not

happen in all at a time due to a reason, as hospital does not stand on promises to do

something by a certain time. Individual attention is limited to nursing staff only due to

the same reason. Most of the consultant specialists are available in the day time only and

most of the specialized procedures and diagnostic tests are carried-out in morning times.

In case of emergency consultants and skilled technicians to perform specialized

diagnostic tests and procedures are not available with-in the time. This leads to negative

impression on government hospitals. On the other side private hospital i.e., Dr. Ramesh

Cardiac and Multispecialty Hospital is creating health and disease awareness among

public by conducting specialized camps, offering all specialized medical services

including cardiology, neurology, nephrology and pulmonology, diabetology etc., in OPD

services supporting all diagnostic services having skilled and experienced medical and

paramedical staff round the clock. Out-patients are dissatisfied due to long waiting time

at Out-patient department to meet concerned consultant even after taking prior

appointment. Since hospital is renowned for cardiac ailments and cardiac emergencies,

hospital staff also not sure when a particular consultant is available in OPD. Due to the

reason hospital does not stand on promises to do something by a certain time.

191

4.4.5. Analysis of Service Quality in hospitals having bed strength 100 and above –In-patients’ perception towards Service Quality:

Table 5.18Gaps between perceptions and expectations towards Service Quality opined by In-patients of Government and Private hospitals having bed strength 100 and above

GOVERNMENT HOSPITALS PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.4 4 0.4 5.4 4 1.42 4.3 4 0.3 5.2 4 1.23 4.55 4 0.55 5.15 4 1.154 4.65 4 0.65 3.3 4 -0.75 4.2 4 0.2 4.95 4 0.956 4.1 4 0.1 5.05 4 1.057 4.3 4 0.3 5.35 4 1.358 4 4 0 4.65 4 0.659 4.55 4 0.55 5.65 4 1.65

10 4.7 4 0.7 5.1 4 1.111 4.1 4 0.1 4.7 4 0.712 4.05 4 0.05 5.05 4 1.0513 3.9 4 -0.1 4.7 4 0.714 4.05 4 0.05 4.7 4 0.715 4.25 4 0.25 4.75 4 0.7516 4.5 4 0.5 4.7 4 0.717 4.55 4 0.55 5.05 4 1.0518 4 4 0 5 4 119 4.05 4 0.05 4.65 4 0.6520 4.1 4 0.1 4.85 4 0.8521 4.05 4 0.05 4.8 4 0.822 3.9 4 -0.1 4.65 4 0.65

TABLE 1 TABLE 1Avg Tangible SVQ 0.475 Avg Tangible SVQ 0.7625Avg Reliability SVQ 0.23 Avg Reliability SVQ 1.13Avg Responsiveness SVQ 0.1875 Avg Responsiveness SVQ 0.8875Avg Assurance SVQ 0.3375 Avg Assurance SVQ 0.8Avg Empathy SVQ 0.02 Avg Empathy SVQ 0.79AVG UNWEIGHTEDSVQ SCORE 0.25


Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

192

0.475 36.5 17.3375 0.7625 36 27.450.23 27.5 6.325 1.13 26.5 29.945

0.1875 20.5 3.84375 0.8875 20 17.750.3375 11 3.7125 0.8 9.5 7.6

0.02 4.5 0.09 0.79 8 6.32AVG WEIGHTED SER

SCRORE 6.26175AVG WEIGHTED SER

SCRORE 17.813

Table 5.18 provide information about the gaps found between the ‘Perceptions’ and

‘Expectations’ of the 22 service quality attributes of SERVQUAL of In-patients of

Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada. Table indicates that 2 attributes (i.e. 13 and 22) out

of 22 service quality attributes are under expectation and remaining 20 service quality

attributes met and exceeded In-patients’ expectation levels of Government District

Hospital, Machilipatnam. 1 service quality attribute i.e., attribute no. 4 is negative out of

22 service quality attributes of Dr. Ramesh Cardiac and Multispecialty Hospital,

Vijayawada. This confirms remaining 21 service quality attributes met and exceeded

expectation levels of service quality offered by Dr. Ramesh Cardiac and Multispecialty

hospital.

The above table reveals Average Unweighted and Weighted SERVQUAL scores of 22


SERVQUAL scores of Dr. Ramesh Cardiac & Multispecialty Hospital, Vijayawada are

more than those of Government District Hospital, Machilipatnam. This shows in-patients

service quality of Dr. Ramesh Cardiac and Multispecialty Hospital are good enough than

that of Government District Hospital.

193

ANOVA is applied to understand whether the differences are significant or not with

respect to the service quality in the mean variance among the responses given by in-

patients of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada and the results are set below.


Hospital having bed strength 100 and aboveANOVA TEST

N MeanStd.









194

Graph 5.13In-patients’ perception towards Service Quality –


0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00I/

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SP, M

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I/P

RAM

ESH

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SP, V

JA

I/P

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, MTM

I/P

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GO

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, MTM

I/P

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I/P

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I/P

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I/P

RAM

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SP, V

JA


13.20 14.00 15.85 18.8012.50 14.25 12.80 14.05 15.00 17.65

69.3578.75

5.63 3.155.95 4.06

4.58 2.77 5.22 3.19 6.29 3.25

26.6715.23

Std. Deviation Mean




among the responses given by in-patients’ perception of Government District Hospital,

Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada,

because the overall ANOVA value of in-patients is 0.273.

195


Hospital having bed strength 100 and aboveSATISFACTORYLEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall

GovernmentHospital

66.00 63.40 62.50 64.00 60.00 63.05


The above details are also shown in the following Graph.



0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

I/P GOVTDIST

HOSP, MTM

I/P RAMESHHOSP, VJA

I/P GOVTDIST

HOSP, MTM

I/P RAMESHHOSP, VJA

I/P GOVTDIST

HOSP, MTM

I/P RAMESHHOSP, VJA

I/P GOVTDIST

HOSP, MTM

I/P RAMESHHOSP, VJA

I/P GOVTDIST

HOSP, MTM

I/P RAMESHHOSP, VJA

I/P GOVTDIST

HOSP, MTM

I/P RAMESHHOSP, VJA


66.00

70.00

63.40

75.20

62.50

71.25

64.00

70.25

60.00

70.60

63.05

71.59


The above table and graph represents satisfactory levels of service quality of In-patients’

services of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada. Patients of Dr. Ramesh Cardiac and Multispecialty

196

Hospital are more satisfied with 71.59% to 22 attributes of service quality against 63.05%

in case of Government District Hospital.

The researcher found that in Government District hospital, Machilipatnam all the doctors

are available in OPD timings. Specialist doctors / department heads take daily rounds

(visit in-patients in wards) before or after OPD timings. RMOs/DMOs only are available

after OPD timings and during nights. In the absence of doctors paramedical staff

pretends full of activity to patients. This creates negative impression on Government

hospital In-patient services. All the service quality attributes are not possible in the

government hospital for patients due to lack of medical, paramedical staff and sufficient

resources. On the other side private hospital management wants to keep their hospital

and premises neat and clean and doesn’t show much interest on health and disease

awareness among public by displaying placards. Remaining service quality attributes are

positive meet and exceed patients’ expectation levels of Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada.

197

4.4.6. Analysis of Service Quality in hospitals having bed strength 100 and above –O/P & I/P patients’ (all together) perception towards Service Quality:

Table 5.21Gaps between perceptions and expectations towards Service Quality opined by Out and

In-patients of Government and Private hospitals having bed strength 100 and aboveGOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.55 4 0.55 5.25 4 1.252 4.425 4 0.425 4.975 4 0.9753 4.475 4 0.475 4.875 4 0.8754 4.65 4 0.65 3.7 4 -0.35 4 4 0 4.4 4 0.46 4.05 4 0.05 4.925 4 0.9257 4.225 4 0.225 5.125 4 1.1258 4 4 0 4.65 4 0.659 4.4 4 0.4 5.6 4 1.6

10 4.525 4 0.525 4.5 4 0.511 4.15 4 0.15 4.325 4 0.32512 4.025 4 0.025 4.775 4 0.77513 4.025 4 0.025 4.7 4 0.714 4.175 4 0.175 4.725 4 0.72515 4.4 4 0.4 4.825 4 0.82516 4.525 4 0.525 4.65 4 0.6517 4.375 4 0.375 4.925 4 0.92518 3.8 4 -0.2 4.875 4 0.87519 3.875 4 -0.125 4.625 4 0.62520 3.95 4 -0.05 4.825 4 0.82521 4.05 4 0.05 4.625 4 0.62522 4.025 4 0.025 4.65 4 0.65

TABLE 1 TABLE 1Avg Tangable SVQ 0.525 Avg Tangable SVQ 0.7Avg Reliability SVQ 0.135 Avg Reliability SVQ 0.94Avg Responsiveness SVQ 0.18125 Avg Responsiveness SVQ 0.575Avg Assurance SVQ 0.36875 Avg Assurance SVQ 0.78125Avg Empathy SVQ -0.06 Avg Empathy SVQ 0.72AVG UNWEIGHTED SVQSCORE 0.23


Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

0.525 35 18.375 0.7 34.5 24.15

198

0.135 27.5 3.7125 0.94 27.25 25.6150.18125 21.75 3.9421875 0.575 20.5 11.78750.36875 9.5 3.503125 0.78125 11 8.59375

-0.06 6.25 -0.375 0.72 6.75 4.86AVG WEIGHTED SERSCRORE 5.831563


Table 5.21 present information that the gaps found between ‘Perceptions’ and


of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada. Table shows that 3 service quality attributes (i.e.

18, 19 and 20) out of 22 service quality attributes are under expectation and remaining 19

service quality attributes met and exceeded both In & Out-patients’ expectation levels of

Government District Hospital, Machilipatnam. 1 service quality attribute i.e. attribute no.

4 is negative out of 22 service quality attributes of Dr. Ramesh Cardiac and

Multispecialty Hospital, Vijayawada.

Above table reveals Average Unweighted and Weighted SERVQUAL scores of 22


SERVQUAL scores of Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada are

more than Average Unweighted and Weighted SERVQUAL scores of Government

District Hospital, Machilipatnam. This shows service quality of patients (both O/P & I/P)

of Dr. Ramesh Cardiac and Multispecialty Hospital are good enough than Government

District Hospital.

199

Hypothesis testing:



From the above results and discussion it is evident that overall mean perception score (4.213) is

higher than overall mean expectation score (4) of Government District Hospital,

Machilipatnam. Hence formulated Hypothesis – 1 viz., “Overall mean perception score is

lower than overall mean expectation score of Government Hospitals” is rejected.


Private Hospitals.

Further overall mean perception score (4.790) is higher than overall mean expectation score

(4) of Private Hospital i.e. Dr. Ramesh Cardiac and Multispeciality, Vijayawada. Hence

formulated Hypothesis – 2 viz., “Overall mean perception score is higher than overall mean

expectation score of Private Hospitals” is significant.

ANOVA is applied to understand whether the differences are significant or not with

respect to the service quality in the mean variance among the responses given by patients

(both I/P & O/P) of Government District Hospital, Machilipatnam and Dr. Ramesh

Cardiac and Multispecialty Hospital, Vijayawada and the results are set below.

200

Table 5.22ANOVA between patients’ perception towards Service Quality –


N MeanStd.









201

Graph 5.15Patients’ perception towards Service Quality –Hospitals having bed strength 100 and above

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00G

OVT

DIS

T H

OSP

, MTM

RAM

ESH

HO

SP, V

JA

GO

VT D

IST

HO

SP, M

TM

RAM

ESH

HO

SP, V

JA

GO

VT D

IST

HO

SP, M

TM

RAM

ESH

HO

SP, V

JA

GO

VT D

IST

HO

SP, M

TM

RAM

ESH

HO

SP, V

JA

GO

VT D

IST

HO

SP, M

TM

RAM

ESH

HO

SP, V

JA

GO

VT D

IST

HO

SP, M

TM

RAM

ESH

HO

SP, V

JA


13.25 13.78 15.48 18.30 12.50 13.85 12.78 14.03 14.68 17.43

68.6877.38

5.26 3.84 5.77 4.304.36 3.70 4.94 3.83 5.64 3.62

25.1318.32

Mean Std. Deviation



This means that there is no significant difference in service quality in the mean variance

among the responses given by in-patients’ perception of Government District Hospital,

Machilipatnam & Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada, because

the overall ANOVA value of both out & in-patients is 0.081.

202

Table 5.23Patients’ satisfactory levels (both O/P & IP) towards Service Quality –


GovernmentHospital

66.25 61.90 62.50 63.88 58.70 62.43



Graph 5.16Patients’ satisfactory levels (both O/P & I/P) towards Service Quality –


0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

GOVT DISTHOSP, MTM

RAMESHHOSP, VJA

GOVT DISTHOSP, MTM

RAMESHHOSP, VJA

GOVT DISTHOSP, MTM

RAMESHHOSP, VJA

GOVT DISTHOSP, MTM

RAMESHHOSP, VJA

GOVT DISTHOSP, MTM

RAMESHHOSP, VJA

GOVT DISTHOSP, MTM

RAMESHHOSP, VJA


66.2568.88

61.90

73.20

62.50

69.25

63.88

70.13

58.70

69.70

62.43

70.34


The above table and graph represent satisfactory levels of patients (both OP & IP) of

Government District Hospital, Machilipatnam & Dr. Ramesh Cardiac and Multispecialty

Hospital, Vijayawada. Patients of Dr. Ramesh Cardiac and Multispecialty Hospital were

203

more satisfied with 70.34% to 22 service quality attributes of SERVQUAL than

Government District Hospital with 62.43%.

On study researcher found that more number of patients is coming for treatment all over

the district regularly to Government District hospital. Available few consultants and

doctors take care of both out-patients and In-patients. Individual attention is not possible

due to limited medical and paramedical staff and this is not happen all at a time. A

trained nurse is available round-the-clock in wards to give medical aid to the in-patients

and at OPDs for out-patients. Hence individual attention limited to nursing staff only.

All specialized procedures and diagnostic tests are carried-out in the day time due to

availability of consultants, specialist doctors and technicians. Consultants, technicians,

specialized diagnostic tests and procedures are not available within the time during nights

this leads negative impression on government hospital services. Where in private

hospital (i.e. Dr. Ramesh Cardiac and Multispecialty Hospital) all service quality

attributes are positive except one. Unlike government hospitals, private hospitals want to

keep their hospitals buildings, premises clean, neat and well furnished not with placards

and statements on walls to bring health and disease awareness among public which

disturbs building elevation, spoils hospital wall paintings some times looks odd. Due to

the reason private hospital management does not show much interest on health and

disease awareness by displaying materials associated with the services and diseases.

204


HAVING BED STRENGTH 50 TO 100


Area Hospital, Nuzvid

Missionary Hospital:

Gifford Memorial Hospital, Nuzvid

Private Hospital:

Prashanth Hospital, Vijayawada

M.J. Naidu Hospital, Vijayawada

205

5.4.7. Analysis of Service Quality in hospitals having bed strength 50 to 100 – Out-patients’ perception towards Service Quality:


patients of Government, Missionary and Private Hospitals having bed strength 50 to 100GOVERNMENT HOSPITAL MISSIONARY HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.65 4 0.65 4.85 4 0.852 4.25 4 0.25 4.85 4 0.853 4.45 4 0.45 5.1 4 1.14 5.2 4 1.2 5.1 4 1.15 4.05 4 0.05 4.95 4 0.956 4.35 4 0.35 4.9 4 0.97 4.35 4 0.35 4.7 4 0.78 3.95 4 -0.05 4.9 4 0.99 4.95 4 0.95 5.3 4 1.3

10 4.35 4 0.35 5.35 4 1.3511 4.05 4 0.05 4.85 4 0.8512 3.95 4 -0.05 4.65 4 0.6513 3.9 4 -0.1 5 4 114 4.25 4 0.25 4.7 4 0.715 4.6 4 0.6 4.8 4 0.816 4.25 4 0.25 5 4 117 4.25 4 0.25 5.5 4 1.518 4.45 4 0.45 4.6 4 0.619 4.05 4 0.05 5.15 4 1.1520 4.2 4 0.2 4.8 4 0.821 4.1 4 0.1 4.8 4 0.822 4.15 4 0.15 4.7 4 0.7

TABLE 1 TABLE 1Avg Tangible SVQ 0.6375 Avg Tangible SVQ 0.975Avg Reliability SVQ 0.33 Avg Reliability SVQ 0.95Avg Responsiveness SVQ 0.0625 Avg Responsiveness SVQ 0.9625Avg Assurance SVQ 0.3375 Avg Assurance SVQ 1Avg Empathy SVQ 0.19 Avg Empathy SVQ 0.81AVG UNWEIGHTEDSVQ SCORE 0.3115


Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

0.6375 34.5 21.99375 0.975 37.5 36.56250.33 30.5 10.065 0.95 29.5 28.025

206

0.0625 21 1.3125 0.9625 17 16.36250.3375 11 3.7125 1 8 8

0.19 3 0.57 0.81 8 6.48AVG WEIGHTED SER


SCRORE 19.086

PRIVATE (PRASHANTH)HOSPITAL

PRIVATE (M.J. NAIDU)HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 5 4 1 5.5 4 1.52 4.7 4 0.7 4.9 4 0.93 7.75 4 3.75 5.4 4 1.44 4 4 0 3.9 4 -0.15 4.8 4 0.8 5 4 16 4.5 4 0.5 5.1 4 1.17 4.8 4 0.8 4.8 4 0.88 4.85 4 0.85 4.75 4 0.759 5.35 4 1.35 5.6 4 1.6

10 5.15 4 1.15 5 4 111 5 4 1 4.95 4 0.9512 4.4 4 0.4 4.95 4 0.9513 4.25 4 0.25 5.05 4 1.0514 4.65 4 0.65 5.3 4 1.315 4.8 4 0.8 5.05 4 1.0516 4.5 4 0.5 5.05 4 1.0517 5.2 4 1.2 5.05 4 1.0518 4 4 0 4.55 4 0.5519 4.4 4 0.4 4.55 4 0.5520 5 4 1 4.95 4 0.9521 4.8 4 0.8 5.05 4 1.0522 5.15 4 1.15 4.9 4 0.9



207

Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

1.3625 35 47.6875 0.925 37 34.2250.86 30 25.8 1.05 29 30.45

0.7 15.5 10.85 0.9875 17.5 17.281250.7875 7 5.5125 1.1125 8 8.9

0.67 12.5 8.375 0.8 8.5 6.8AVG WEIGHTED SER


SCRORE 19.53125

Table 5.24 shows that the gaps found between ‘Perceptions’ and ‘Expectations’ of 22

service quality attributes of SERVQUAL of out-patients of Government Area Hospital-

Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.

Naidu Hospital-Vijayawada. Table indicates that 3 service quality attributes (i.e. 8, 12

and 13) out of 22 service quality attributes are under expectation and remaining 19

service quality attributes met and exceeded out-patients’ expectation levels of

Government Area Hospital-Nuzvid. In Missionary hospital i.e., Gifford Memorial

Hospital, Nuzvid and Prashanth Hospital, Vijayawada all 22 service quality attribute

scores are positive which confirm patients’ perceptions levels are met or exceeded in

service quality provided by these hospitals. 1 service quality attribute i.e. attribute no. 4

is negative out of 22 service quality attributes of M.J. Naidu Hospital, Vijayawada. This

means patients’ perception levels are equal or more than expectation levels in remaining

21 service qualities attributes.


Average Unweighted and Weighted SERVQUAL scores of Gifford Memorial Hospital-

Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada are nearly

same and more than the scores of Government Area Hospital, Nuzvid. This make known

208

that out-patients’ service quality of Gifford Memorial Hospital-Nuzvid, Prashanth

Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada are good enough than that of

Government Area Hospital, Nuzvid.

A detailed analysis with the help of Analysis of Variance (ANOVA) is applied to

understand whether the differences are significant or not with respect to the service

quality in the variance among the responses given by out-patients of Government Area

Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada

and M.J.Naidu Hospital, Vijayawada and the results are set below.

Table 5.25ANOVA between Out-patients’ perception towards Service Quality – Hospitals having

bed strength 50 to 100ANOVA TEST

N MeanStd.

Deviation F Sig.TANGIBLES Government Hospital 20 13.5500 3.9533

0.352 0.788Missionary Hospital 20 14.5500 3.7201Private (Prashanth) Hospital, 20 13.7000 3.6864Private (M.J. Naidu) Hospital 20 14.4000 3.6620Total 80 14.0500 3.7107

RELIABILITY Government Hospital 20 15.9500 5.7809


RESPONSIVENESS Government Hospital 20 12.0000 3.4793


ASSURANCE Government Hospital 20 12.9500 4.2855


EMPATHY Government Hospital 20 15.5500 4.2112 0.917 0.437

209

Missionary Hospital 20 17.6000 4.1600Private (Prashanth) Hospital, 20 17.1000 4.1536Private (M.J. Naidu) Hospital 20 17.4000 4.8384Total 80 16.9125 4.3435

OVERALL Government Hospital 20 70.0000 21.2727



Graph 5.17Out-patients’ towards Service Quality –Hospital having bed strength 50 to 100

0.00

20.00

40.00

60.00

80.00

100.00

120.00

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J

.NA

IDU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J

.NA

IDU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J

.NA

IDU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J

.NA

IDU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J

.NA

IDU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J

.NA

IDU

, VJA


13.5514.5513.7014.4015.9518.1517.9018.5012.0014.5513.8514.6012.9514.6514.1014.9015.5517.6017.1017.40

70.0079.5076.6579.80

3.95 3.72 3.69 3.66 5.78 4.49 4.49 5.49

3.483.80 3.15 4.32 4.29 3.69 3.68 3.77 4.21 4.16 4.15 4.84

21.27

19.4118.59

21.04

Std. Deviation Mean




among the responses given by out-patients’ perception of Government Area Hospital-

210

Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and

M.J.Naidu Hospital-Vijayawada, because the overall ANOVA value of out-patients is

0.387.


Hospitals having bed strength 50 to 100SATISFACTORYLEVELS Tangibles Reliability Responsiveness Assurance Empathy OverallGovernmentHospital 67.75 63.80 60.00 64.75 62.20 63.64MissionaryHospital 72.75 72.60 72.75 73.25 70.40 72.27Private Hospital(Prashanth) 68.50 71.60 69.25 70.50 68.40 69.68Private Hospital(M.J. Naidu) 72.00 74.00 73.00 74.50 69.60 72.55



Hospitals having bed strength 50 to 100

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J.

NAI

DU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J.

NAI

DU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J.

NAI

DU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J.

NAI

DU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J.

NAI

DU

, VJA

O/P

ARE

A H

OSP

, NU

Z

O/P

GIF

F M

ISS,

NU

Z

O/P

PRA

SAN

TH, V

JA

O/P

M.J.

NAI

DU

, VJA


67.75

72.75

68.5072.00

63.80

72.60 71.6074.00

60.00

72.7569.25

73.00

64.75

73.2570.50

74.50

62.20

70.4068.40 69.60

63.64

72.2769.68

72.55


211

The above table and graph represents satisfactory levels of out-patients of Government

Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-

Vijayawada and M.J.Naidu Hospital, Vijayawada. Patients of private hospitals

(Prashanth Hospital-Vijayawada with 69.68% and M.J.Naidu Hospital, Vijayawada with

72.55%) and missionary hospital (Gifford Memorial Hospital-Nuzvid with 72.27%) are

more satisfied than patients of Government area hospital, Nuzvid with 63.64%.

On study the researcher found that in Government Area Hospital-Nuzvid all the day time

OPD services are not available except in morning and evenings. Most of the doctors are

available in OPD timings to treat out-patients. All the out-patients have to be treated by

available few medical and paramedical staff this is does not happen all at a time i.e., OPD

waiting time, waiting time for diagnostic reports. Due to the reason hospital does not

stand on promises to do something by a certain time. Secure minds feels free,

government employees have job security due to the reason few hospital staff pretends as

busy to respond patient’s requests. In missionary hospital i.e. Gifford Memorial Hospital,

Nuzvid and Prashanth Hospital, Vijayawada all 22 service quality attribute scores are

positive which confirm these hospital is creating more awareness among public by

displaying placards, conducting specialized health camps, offering medical services as

they have specified including necessary diagnostic services and have skilled, experienced

medical and paramedical staff. In another private hospital named M.J. Naidu Hospital,

Vijayawada management does not show much interest on displaying placards to bring

awareness among public to keep their hospital clean and neat except this management has

been taking steps to fulfill patients’ desires more than what they expected.

212

4.4.8. Analysis of Service Quality in hospitals having bed strength 50 to 100 – In-patients’ perception towards Service Quality:

Table 5.27Gaps between perceptions and expectations towards Service Quality opined by In-

patients of Government, Missionary and Private hospitals having bed strength 50 to 100GOVERNMENT HOSPITAL MISSIONARY HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.25 4 0.25 4.75 4 0.752 4.3 4 0.3 4.5 4 0.53 4.65 4 0.65 4.85 4 0.854 5.3 4 1.3 4.65 4 0.655 4.2 4 0.2 4.5 4 0.56 4.4 4 0.4 4.3 4 0.37 4.75 4 0.75 4.75 4 0.758 4.3 4 0.3 4.55 4 0.559 4.7 4 0.7 5.35 4 1.35

10 4.4 4 0.4 4.3 4 0.311 4.3 4 0.3 4.35 4 0.3512 4.25 4 0.25 4.65 4 0.6513 4.35 4 0.35 4.65 4 0.6514 4.5 4 0.5 4.75 4 0.7515 4.4 4 0.4 4.7 4 0.716 4.45 4 0.45 4.6 4 0.617 4.45 4 0.45 4.95 4 0.9518 4.3 4 0.3 4.4 4 0.419 4.6 4 0.6 4.3 4 0.320 4.4 4 0.4 4.5 4 0.521 4.35 4 0.35 4.3 4 0.322 4.4 4 0.4 4.4 4 0.4



Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

213

0.625 35.5 22.1875 0.6875 34.5 23.718750.47 30 14.1 0.69 29.5 20.355

0.325 17 5.525 0.4875 14 6.8250.45 11 4.95 0.75 15.5 11.6250.41 6.5 2.665 0.38 6.5 2.47



PRIVATE (PRASHANTH)HOSPITAL

PRIVATE (M.J. NAIDU)HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 5.25 4 1.25 5.55 4 1.552 5.05 4 1.05 5.3 4 1.33 5.15 4 1.15 5 4 14 4.1 4 0.1 4.1 4 0.15 4.95 4 0.95 4.65 4 0.656 5.05 4 1.05 5.15 4 1.157 5.1 4 1.1 5.2 4 1.28 5.05 4 1.05 5.05 4 1.059 5.55 4 1.55 5.85 4 1.85

10 5.1 4 1.1 4.75 4 0.7511 5.05 4 1.05 4.85 4 0.8512 5.15 4 1.15 5.2 4 1.213 4.8 4 0.8 5.1 4 1.114 5.1 4 1.1 5.25 4 1.2515 5.15 4 1.15 5.65 4 1.6516 4.7 4 0.7 5.05 4 1.0517 5.15 4 1.15 4.95 4 0.9518 4.65 4 0.65 4.75 4 0.7519 4.75 4 0.75 4.9 4 0.920 4.65 4 0.65 4.8 4 0.821 4.85 4 0.85 5.4 4 1.422 5.35 4 1.35 5.4 4 1.4

TABLE 1 TABLE 1Avg Tangible SVQ 0.8875 Avg Tangible SVQ 0.9875Avg Reliability SVQ 1.14 Avg Reliability SVQ 1.18Avg Responsiveness SVQ 1.025 Avg Responsiveness SVQ 0.975Avg Assurance SVQ 1.025 Avg Assurance SVQ 1.225Avg Empathy SVQ 0.85 Avg Empathy SVQ 1.05

214



Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

0.8875 38 33.725 0.9875 33.5 33.081251.14 26.5 30.21 1.18 28.5 33.63

1.025 17.5 17.9375 0.975 15.5 15.11251.025 13 13.325 1.225 12.5 15.3125

0.85 5 4.25 1.05 10 10.5AVG WEIGHTED SER


SCRORE 21.52725

Table 5.27 indicates that the gaps found between the ‘Perceptions’ and ‘Expectations’ of

the 22 service quality attributes of SERVQUAL of In-patients of Government Area


and M.J. Naidu Hospital-Vijayawada. Table shows that all 22 service quality attributes

of SERVQUAL are positive of all three category select hospitals i.e. Government Area


and M.J. Naidu Hospital-Vijayawada. 22 service quality attributes met and exceeded In-

patients’ expectation levels which indicates in-patients of these hospitals are happy with

the service quality offer by the select hospitals in three categories. Their perception levels

are equal or more than expectation levels in all 22 service quality attributes.

Above table reveals Average Unweighted and Weighted SERVQUAL scores. Average

Unweighted and Weighted SERVQUAL scores of private hospitals i.e. M.J. Naidu

Hospital-Vijayawada and Prashanth Hospital-Vijayawada are more than the scores of

missionary hospital i.e. Gifford Memorial Hospital-Nuzvid and Government Area

Hospital, Nuzvid. This shows in-patients’ medical services service quality of M.J. Naidu

215

Hospital-Vijayawada and Prashanth Hospital-Vijayawada are good enough than Gifford

Memorial Hospital-Nuzvid and Government Area Hospital, Nuzvid.



given by in-patients of Government Area Hospital-Nuzvid, Gifford Memorial Hospital-

Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital, Vijayawada and the

results are set below.


Hospitals having bed strength 50 to 100ANOVA TEST

N MeanStd.









EMPATHY Government Hospital 20 16.4500 4.17351.111 0.350Missionary Hospital 20 16.3500 4.4636

Private (Prashanth) Hospital, 20 17.7500 3.7539

216

Private (M.J. Naidu) Hospital 20 18.4000 4.5929Total 80 17.2375 4.2672

OVERALL Government Hospital 20 72.4000 21.1645





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13.5513.7514.2014.3516.5017.2018.6518.8012.8013.3014.6014.5013.1014.0514.6515.1016.4516.3517.7518.40

72.4074.6579.8581.15

3.87 3.78 3.65 3.755.40 5.58 4.43 4.20

3.79 4.31 3.47 3.24 4.24 4.56 3.47 3.65 4.17 4.46 3.75 4.59

21.1622.16

18.1918.24

Std. Deviation Mean

F Table value (1, 78, 0.05) = 3.96. The ANOVA table discloses P value is >0.05 i.e.

level of significance is found to be not significant at 95 percent confidence level. This

means that there is no sigficant difference in service quality in the mean variance among

the responses given by in-patients perception of Government Area Hospital-Nuzvid,

217

Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu

Hospital-Vijayawada, because the overall ANOVA value of in-patients is 0.463.


Hospitals having bed strength 50 to 100SATISFACTORYLEVELS Tangibles Reliability Responsiveness Assurance Empathy OverallGovernmentHospital 67.75 66.00 64.00 65.50 65.80 65.82

Missionary Hospital 68.75 68.80 66.50 70.25 65.40 67.86Private (Prashanth)Hospital 71.00 74.60 73.00 73.25 71.00 72.59Private (M.J. Naidu)Hospital 71.75 75.20 72.50 75.50 73.60 73.77




58.00

60.00

62.00

64.00

66.00

68.00

70.00

72.00

74.00

76.00

I/P

ARE

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67.75

68.75

71.0071.75

66.00

68.80

74.6075.20

64.00

66.50

73.0072.50

65.50

70.25

73.25

75.50

65.8065.40

71.00

73.60

65.82

67.86

72.59

73.77


218

The above table and graph represents in-patients’ satisfactory levels of Government Area


and M.J.Naidu Hospital, Vijayawada. Patients of private hospitals (Prashanth Hospital-

Vijayawada with 72.59% and M.J.Naidu Hospital, Vijayawada with 73.77%) are more

satisfied than patients’ of missionary hospital (Gifford Memorial Hospital-Nuzvid with

67.86%) and Government area hospital, Nuzvid with 65.82%.

On observation the researcher found that patients are positive with service quality offer

by the select hospitals in three categories i.e. Government Area Hospital-Nuzvid, Gifford

Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-

Vijayawada, which indicates these hospitals are creating more awareness among public

by displaying placards, conducting medical camps, offering all specified medical services

supporting with all diagnostic services and have skilled and experienced medical and

paramedical staff. This is positive effect patients show interest to get treatment in these

hospitals for their health needs.

219

4.4.9. Analysis of Service Quality in hospitals having bed strength 50 to 100 – Out &In-patients’ (all together) perception towards Service Quality:

Table 5.30Gaps between perceptions and expectations towards Service Quality opined by Out & In-patients of Government, Missionary and Private Hospitals having bed strength 50 to 100

Government Hospital Missionary Hospital

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.45 4 0.45 4.8 4 0.82 4.275 4 0.275 4.675 4 0.6753 4.55 4 0.55 4.975 4 0.9754 5.25 4 1.25 4.875 4 0.8755 4.125 4 0.125 4.725 4 0.7256 4.375 4 0.375 4.6 4 0.67 4.55 4 0.55 4.725 4 0.7258 4.125 4 0.125 4.725 4 0.7259 4.825 4 0.825 5.325 4 1.325

10 4.375 4 0.375 4.825 4 0.82511 4.175 4 0.175 4.6 4 0.612 4.1 4 0.1 4.65 4 0.6513 4.125 4 0.125 4.825 4 0.82514 4.375 4 0.375 4.725 4 0.72515 4.5 4 0.5 4.75 4 0.7516 4.35 4 0.35 4.8 4 0.817 4.35 4 0.35 5.225 4 1.22518 4.375 4 0.375 4.5 4 0.519 4.325 4 0.325 4.725 4 0.72520 4.3 4 0.3 4.65 4 0.6521 4.225 4 0.225 4.55 4 0.5522 4.275 4 0.275 4.55 4 0.55



Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

220

0.63125 35 22.09375 0.83125 36 29.9250.4 30.25 12.1 0.82 29.5 24.19

0.19375 19 3.68125 0.725 15.5 11.23750.39375 11 4.33125 0.875 11.75 10.28125

0.3 4.75 1.425 0.595 7.25 4.31375AVG WEIGHTED SERSCRORE 8.72625


Private (Prashanth) Hospital Private (M.J NAIDU) Hospital

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 5.125 4 1.125 5.525 4 1.5252 4.875 4 0.875 5.1 4 1.13 6.45 4 2.45 5.2 4 1.24 4.05 4 0.05 4 4 05 4.875 4 0.875 4.825 4 0.8256 4.775 4 0.775 5.125 4 1.1257 4.95 4 0.95 5 4 18 4.95 4 0.95 4.9 4 0.99 5.45 4 1.45 5.725 4 1.725

10 5.125 4 1.125 4.875 4 0.87511 5.025 4 1.025 4.9 4 0.912 4.775 4 0.775 5.075 4 1.07513 4.525 4 0.525 5.075 4 1.07514 4.875 4 0.875 5.275 4 1.27515 4.975 4 0.975 5.35 4 1.3516 4.6 4 0.6 5.05 4 1.0517 5.175 4 1.175 5 4 118 4.325 4 0.325 4.65 4 0.6519 4.575 4 0.575 4.725 4 0.72520 4.825 4 0.825 4.875 4 0.87521 4.825 4 0.825 5.225 4 1.22522 5.25 4 1.25 5.15 4 1.15

TABLE 1 TABLE 1Avg Tangible SVQ 1.125 Avg Tangible SVQ 0.95625Avg Reliability SVQ 1 Avg Reliability SVQ 1.115Avg Responsiveness SVQ 0.8625 Avg Responsiveness SVQ 0.98125Avg Assurance SVQ 0.90625 Avg Assurance SVQ 1.16875Avg Empathy SVQ 0.76 Avg Empathy SVQ 0.925AVG UNWEIGHTEDSVQ SCORE 0.93075


221

Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

1.125 36.5 41.0625 0.95625 35.25 33.70781251 28.25 28.25 1.115 28.75 32.05625

0.8625 16.5 14.23125 0.98125 16.5 16.1906250.90625 10 9.0625 1.16875 10.25 11.9796875



Table 5.30 indicates that the gaps found between the ‘Perceptions’ and ‘Expectations’ of

the 22 service quality attributes of SERVQUAL of overall Out and In-patients of

Government Area Hospital- Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth

Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. Table shows that all 22

service quality attributes of SERVQUAL are positive of three category hospitals i.e.

Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth

Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. This means all 22 service

quality attributes met and exceeded patients’ expectation levels of all three categories of

hospitals. This indicated both Out & In-patients are satisfied with the service quality

offer by the above select category hospitals.


Unweighted and Weighted SERVQUAL scores of private hospitals i.e. M.J. Naidu

Hospital-Vijayawada and Prashanth Hospital-Vijayawada are more than the scores of


Hospital, Nuzvid. This shows patients’ medical services service quality of M.J. Naidu

Hospital-Vijayawada and Prashanth Hospital-Vijayawada are good enough than


Hospital, Nuzvid.

222

Hypothesis testing:




(4.381) is higher than overall mean expectation score (4) of Government Area Hospital,

Nuzvid. Hence formulated Hypothesis – 1 viz., “Overall mean perception score is lower

than overall mean expectation score of Government Hospitals” is rejected.


Private Hospitals.

Further overall mean perception score (4.977) is higher than overall mean expectation

score (4) of Private Hospitals i.e. Prashanth Hospital, Vijayawada and M.J. Naidu

Hospital, Vijayawada. Hence formulated Hypothesis – 2 viz., “Overall mean perception

score is higher than overall mean expectation score of Private Hospitals” is significant.

3. H0. Over all mean Perception score is lower than overall mean expectation score of

Missionary Hospitals.

Based on the above table it is evident that overall mean perception score (4.764) is higher

than overall mean expectation score (4) of Missionary Hospital i.e. Gifford Memorial

Hospital, Nuzvid. Hence formulated Hypothesis – 3 viz., “Overall mean perception score

is lower than overall mean expectation score of Missionary Hospitals” is rejected.



given by patients’ (both I/P & O/P) of Government Area Hospital-Nuzvid, Gifford

223

Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital-

Vijayawada and the results are set below.

Table 5.31ANOVA between patients’ perception towards service quality –

Hospital having bed strength 50 to 100ANOVA TEST

N MeanStd.


0.355 0.786

Missionary Hospital 40 14.1500 3.7248Private (Prashanth)Hospital, 40 13.9500 3.6300Private (M.J. Naidu)Hospital 40 14.3750 3.6563Total 160 14.0063 3.6968


1.843 0.142



2.653 0.051



1.826 0.145


EMPATHY Government Hospital 40 16.0000 4.1633

1.435 0.235

Missionary Hospital 40 16.9750 4.3056Private (Prashanth)Hospital, 40 17.4250 3.9216Private (M.J. Naidu)Hospital 40 17.9000 4.6839

224

Total 160 17.0750 4.2950OVERALL Government Hospital 40 71.2000 20.9801

1.588 0.194



Graph 5.21Patients’ perception towards Service Quality –

Hospital having bed strength 50 to 100

0.00

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13.55 14.15 13.95 14.38 16.23 17.68 18.28 18.6512.40 13.93 14.23 14.55 13.03 14.35 14.38 15.00 16.00 16.98 17.43 17.90

71.2077.08 78.25 80.48

3.86 3.72 3.63 3.665.53 5.02 4.42 4.83

3.61 4.06 3.29 3.77 4.21 4.10 3.54 3.67 4.16 4.31 3.92 4.68

20.98

20.71 18.2319.45

Std. Deviation Mean




among the responses given by patients’ (both O/P & I/P) perception of Government Area


225

and M.J.Naidu Hospital-Vijayawada, because the overall ANOVA value of both out &

in-patients is 0.194.

Table 5.32Patients’ satisfactory levels (both O/P & I/P) towards Service Quality –


MissionaryHospital 70.75 70.70 69.63 71.75 67.90 70.07

Private(Prashanth)Hospital,

69.75 73.10 71.13 71.88 69.70 71.14

Private (M.J.Naidu) Hospital 71.88 74.60 72.75 75.00 71.60 73.16


Graph 5.22Patients’ satisfactory levels (both O/P and I/P) towards Service Quality –


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ARE

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67.7570.75 69.75

71.88

64.90

70.7073.10

74.60

62.00

69.6371.13

72.75

65.13

71.75 71.8875.00

64.00

67.9069.70

71.60

64.73

70.07 71.1473.16


226

The above table and graph represents satisfactory levels of patients (both O/P & I/P) of

Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth

Hospital-Vijayawada and M.J.Naidu Hospital-Vijayawada. Patients of private hospitals

(Prashanth Hospital, Vijayawada with 71.14% and M.J.Naidu Hospital, Vijayawada with

73.16%) and missionary hospital (Gifford Memorial Hospital, Nuzvid with 70.07%) are

more satisfied than patients of Government area hospital, Nuzvid with 64.73%.

Researcher found that all 22 service quality attributes of SERVQUAL are positive of

three category hospitals i.e. Government Area Hospital-Nuzvid, Gifford Memorial

Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada.

This found patients are happy with the medical services offering by three category

hospitals in all service quality attributes of SERVQUAL.

227


HAVING BED STRENGTH 30 TO 50


Community Health Centre, Jaggaiahpet.

Private Hospital:

Latha Superspeciality Hospital, Vijayawada.

228

5.4.10. Analysis of Service Quality in hospitals having bed strength 30 to 50 – Out-patients’ perception towards Service Quality:


patients of Government and Private Hospitals having bed strength 30 to 50GOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.2 4 0.2 4.65 4 0.652 4.05 4 0.05 4.6 4 0.63 4.65 4 0.65 5 4 14 4.9 4 0.9 4.2 4 0.25 3.95 4 -0.05 4.8 4 0.86 3.75 4 -0.25 4.7 4 0.77 4.35 4 0.35 5 4 18 4.5 4 0.5 4.8 4 0.89 4.4 4 0.4 5.35 4 1.35

10 4.45 4 0.45 4.55 4 0.5511 4.35 4 0.35 4.55 4 0.5512 3.75 4 -0.25 4.7 4 0.713 3.8 4 -0.2 4.75 4 0.7514 4.25 4 0.25 5.1 4 1.115 4.4 4 0.4 5.05 4 1.0516 4.15 4 0.15 4.4 4 0.417 4.25 4 0.25 4.7 4 0.718 4.55 4 0.55 4.55 4 0.5519 4.25 4 0.25 4.6 4 0.620 3.85 4 -0.15 4.6 4 0.621 3.9 4 -0.1 4.9 4 0.922 4.2 4 0.2 4.7 4 0.7



Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

229

0.45 35 15.75 0.6125 36.5 22.356250.19 29.5 5.605 0.93 27.5 25.575

0.0875 16.5 1.44375 0.6375 19.5 12.431250.2625 11.5 3.01875 0.8125 7 5.6875

0.15 7.5 1.125 0.67 9.5 6.365AVG WEIGHTED SER


SCRORE 14.483

Table 5.33 gives information that the gaps found between ‘Perceptions’ and

‘Expectations’ of 22 service quality attributes of SERVQUAL of Out-patients of

Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital,

Vijayawada. It indicates that 6 service quality attributes (i.e. 5, 6, 12, 13, 20 and 21) out

of 22 service quality attributes are under expectation remaining 16 service quality

attributes met and exceeded out-patients’ expectation levels of Government Community

Health Centre, Jaggaiahpet. Table shows that all 22 service quality attribute scores of

Latha Superspeciality Hospital, Vijayawada are positive i.e. all 22 service quality

attributes met and exceeded out-patients’ expectation levels. This means patients are

satisfied with the service quality offer by the hospital.


Unweighted and Weighted SERVQUAL scores of Latha Superspeciality Hospital,

Vijayawada are more than scores of Government Community Health Centre, Jaggaiahpet.

This make known that out-patients’ medical services service quality of Latha

Superspeciality Hospital, Vijayawada are good enough than Government Community

Health Centre, Jaggaiahpet.



230

given by out-patients of Government Community Health Centre, Jaggaiahpet and Latha

Superspeciality Hospital, Vijayawada and the results are set below.

Table 5.34ANOVA between out-patients’ perceptions towards Service Quality –



TANGIBLES Government Hospital 20 13.0500 3.74830.195 0.662Private Hospital 20 13.5500 3.4101

Total 40 13.3000 3.5460RELIABILITY Government Hospital 20 15.5000 5.4144

2.487 0.123Private Hospital 20 18.0000 4.5768Total 40 16.7500 5.1078

RESPONSIVENESS Government Hospital 20 12.1500 3.93731.415 0.242Private Hospital 20 13.5000 3.2036

Total 40 12.8250 3.6083ASSURANCE Government Hospital 20 12.8000 3.9947


EMPATHY Government Hospital 20 15.4000 4.29691.587 0.215Private Hospital 20 17.0000 3.7134




231



0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

O/PCHC, JPT

O/PLATHA, VJA

O/PCHC, JPT

O/PLATHA, VJA

O/PCHC, JPT

O/PLATHA, VJA

O/PCHC, JPT

O/PLATHA, VJA

O/PCHC, JPT

O/PLATHA, VJA

O/PCHC, JPT

O/PLATHA, VJA


13.05 13.55 15.50 18.0012.15 13.50 12.80 14.05 15.40 17.00

68.9076.10

3.75 3.415.41

4.58

3.94 3.20 3.99 3.25 4.30 3.71

20.66

17.34

Std. Deviation Mean




among the responses given by out-patients’ perception of Government Community

Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada, because the

overall ANOVA value of out-patients is 0.240.

232


Hospitals having bed strength 30 to 50SATISFACTORYLEVELS Tangibles Reliability Responsiveness Assurance Empathy OverallGovernmentHospital

65.25 62.00 60.75 64.00 61.60 62.64





54.00

56.00

58.00

60.00

62.00

64.00

66.00

68.00

70.00

72.00

O/P CHC, JPT O/PLATHA, VJA







65.25

67.75

62.00

72.00

60.75

67.50

64.00

70.25

61.60

68.00

62.64

69.18


The above table and graph represents satisfactory levels of out-patients of Government

Community Health Centre, Jaggaiahpet & Latha Speciality Hospital, Vijayawada.

Patients of Latha Superspeciality Hospital, Vijayawada are more satisfied with 69.18% to

233

22 service quality attributes of SERVQUAL than Government Community Health

Centre, Jaggaiahpet with 62.64%.

On observation the researcher found that the gaps found between ‘Perceptions’ and

‘Expectations’ of Out-patients of Government Community Health Centre (CHC),

Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada. Like all Government

hospitals, Government Community health centre, Jaggaiahpet also offering OPD services

during morning and evening times. All the hospital doctors are available during OPD

timings except scheduled night duty RMO/DMOs to treat OPD patients. CHCs are

referral hospitals for 4 PHCs with specialized services. Because of the reason more

number of patients is coming for treatment every day and every patient has to be treated

by available few medical and paramedical staff. It is not possible to treat all OPD

patients at a time this leads OPD waiting time and waiting time for diagnostic test reports.

In case of emergencies in after noon and nights specialized doctors and specialized

procedures are not available in time leads negative impression on government hospital

services. In the absence of doctors concerned staff pretends busy to patients. Individual

attention limited to nursing staff only not by doctors due to the above reason. On the

other side all service quality attribute scores of Latha Superspeciality Hospital are

positive. This reveals hospital has modern looking equipment, sufficient physical

facilities in hospital, creating awareness among public towards health and diseases by

displaying placards and conducting medical camps, OPD services supporting with

diagnostic services and have skilled and experienced medical and paramedical staff round

the clock.

234

4.4.11. Analysis of Service Quality in hospitals having bed strength 30 to 50 – In-patients’ perception towards Service Quality:

Table 5.36Gaps between perceptions and expectations towards Service Quality opined by In-

patients of Government and Private hospitals having bed strength 30 to 50GOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.35 4 0.35 5.15 4 1.152 4.4 4 0.4 5.05 4 1.053 4.8 4 0.8 4.95 4 0.954 5.9 4 1.9 4 4 05 4.2 4 0.2 5.35 4 1.356 4.2 4 0.2 5.65 4 1.657 4.3 4 0.3 5.3 4 1.38 4.5 4 0.5 5.3 4 1.39 4.9 4 0.9 5.7 4 1.7

10 4.15 4 0.15 4.5 4 0.511 4.05 4 0.05 4.5 4 0.512 4.45 4 0.45 5.2 4 1.213 4.5 4 0.5 5 4 114 4.7 4 0.7 5.35 4 1.3515 4.4 4 0.4 5.75 4 1.7516 4.4 4 0.4 5.2 4 1.217 4.55 4 0.55 5.1 4 1.118 4.25 4 0.25 4.5 4 0.519 4.45 4 0.45 4.65 4 0.6520 4.2 4 0.2 4.4 4 0.421 4.1 4 0.1 5.35 4 1.3522 4.35 4 0.35 5.7 4 1.7

TABLE 1 TABLE 1Avg Tangible SVQ 0.8625 Avg Tangible SVQ 0.7875Avg Reliability SVQ 0.42 Avg Reliability SVQ 1.46Avg Responsiveness SVQ 0.2875 Avg Responsiveness SVQ 0.8Avg Assurance SVQ 0.5125 Avg Assurance SVQ 1.35Avg Empathy SVQ 0.27 Avg Empathy SVQ 0.92AVG UNWEIGHTED SVQSCORE 0.4705


Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

235

0.8625 36 31.05 0.7875 37.5 29.531250.42 32.5 13.65 1.46 31.5 45.99

0.2875 13.5 3.88125 0.8 14.5 11.60.5125 10.5 5.38125 1.35 8.5 11.475

0.27 7.5 2.025 0.92 8 7.36AVG WEIGHTED SER


SCRORE 21.19125

Table 5.36 provide information that the gaps found between ‘Perceptions’ and

‘Expectations’ of the 22 service quality attributes of SERVQUAL of In-patients of

Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital,

Vijayawada. Table indicates that all 22 service quality attribute scores of Government

community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada

are positive i.e. all the 22 service quality attributes met and exceeded In-patients’

expectation levels which indicates both government and private hospitals are actively

participating in offering service quality to its patients round the clock.


Average Unweighted and Weighted SERVQUAL scores of Latha Superspeciality

Hospital, Vijayawada are more than the scores of Government community Health Centre,

Jaggaiahpet. This shows in-patients’ medical services service quality of Latha

Superspeciality Hospital, Vijayawada are good enough than Government community

Health Centre, Jaggaiahpet.



given by in-patients of Government Community Health Centre, Jaggaiahpet and Latha

Superspeciality Hospital, Vijayawada and the results are set below.

236

Table 5.37ANOVA between In-patients’ perceptions towards service quality –













237

Graph 5.25In-patients’ perception towards Service Quality – Hospitals having bed strength 30 to 50

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

I/PCHC, JPT

I/PLATHA, VJA

I/PCHC, JPT

I/PLATHA, VJA

I/PCHC, JPT

I/PLATHA, VJA

I/PCHC, JPT

I/PLATHA, VJA

I/PCHC, JPT

I/PLATHA, VJA

I/PCHC, JPT

I/PLATHA, VJA


14.20 13.90 16.2019.80

12.60 13.90 13.25 15.50 16.00 18.00

72.2581.10

4.72 3.216.27

4.43

4.89 3.48 5.09 3.55 5.94 3.96

26.47

17.81

Mean Std. Deviation




among the responses given by in-patients’ perception of Government Community Health

Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada, because the overall

ANOVA value of in-patients is 0.222.

238



Private Hospital 69.50 79.20 69.50 77.50 72.00 73.73




0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

I/P CHC, JPT I/PLATHA, VJA







71.0069.50

64.80

79.20

63.00

69.50

66.25

77.50

64.00

72.00

65.68

73.73


The above table and graph represents satisfactory levels of in-patients of Government

Community Health Centre, Jaggaiahpet & Latha Speciality Hospital, Vijayawada.

Patients of Latha Superspeciality Hospital, Vijayawada are more satisfied with 73.73% to

239

22 service quality attributes of SERVQUAL than Government Community Health

Centre, Jaggaiahpet with 65.68%.

On observation researcher found that no gaps found between ‘Perceptions’ and

‘Expectations’ of service quality attributes of SERVQUAL of In-patients of Government

Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada.

All service quality attribute scores of Government community Health Centre, Jaggaiahpet

and Latha Superspeciality Hospital, Vijayawada are positive. Patients are satisfied with

the services offered by both Government and Private hospitals as result of sufficient

equipments and physical facilities, creating health awareness among public, offering

medical services as stated by them supporting with all diagnostic services, have skilled

and experienced medical and paramedical staff.

4.4.12. Analysis of Service Quality in hospitals having bed strength 30 to 50 – Out &In-patients’ (all together) perception towards Service Quality:

Table 5.39Gaps between perceptions and expectations towards Service Quality opined by Out & In-

patients of Government and Private hospitals having bed strength 30 to 50GOVERNMENT HOSPITAL PRIVATE HOSPITAL

Q.NO.MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

MEANPERCEPTION

MEANEXPECTATION

SERVQUALSCORE

1 4.275 4 0.275 4.9 4 0.92 4.225 4 0.225 4.825 4 0.8253 4.725 4 0.725 4.975 4 0.9754 5.4 4 1.4 4.1 4 0.15 4.075 4 0.075 5.075 4 1.0756 3.975 4 -0.025 5.175 4 1.1757 4.325 4 0.325 5.15 4 1.158 4.5 4 0.5 5.05 4 1.059 4.65 4 0.65 5.525 4 1.525

10 4.3 4 0.3 4.525 4 0.52511 4.2 4 0.2 4.525 4 0.52512 4.1 4 0.1 4.95 4 0.9513 4.15 4 0.15 4.875 4 0.875

240

14 4.475 4 0.475 5.225 4 1.22515 4.4 4 0.4 5.4 4 1.416 4.275 4 0.275 4.8 4 0.817 4.4 4 0.4 4.9 4 0.918 4.4 4 0.4 4.525 4 0.52519 4.35 4 0.35 4.625 4 0.62520 4.025 4 0.025 4.5 4 0.521 4 4 0 5.125 4 1.12522 4.275 4 0.275 5.2 4 1.2



Score fromTable 1


WeightedScore

Score fromTable 1


WeightedScore

0.65625 35.5 23.296875 0.7 37 25.90.305 31 9.455 1.195 29.5 35.2525

0.1875 15 2.8125 0.71875 17 12.218750.3875 11 4.2625 1.08125 7.75 8.3796875



Table 5.39 provides information that the gaps found between ‘Perceptions’ and


of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality

Hospital, Vijayawada. It shows that 1 service quality attributes i.e. 6 out of 22 service

quality attributes is under expectation and remaining 21 service quality attributes met and

exceeded both In & Out-patients’ expectation levels of Government Community Health

241

Centre, Jaggaiahpet. All 22 service quality attributes of Latha Superspeciality Hospital

are positive i.e., all service quality attributes met and exceeded patients’ expectations.


Unweighted and Weighted SERVQUAL scores of Latha Superspeciality Hospital,

Vijayawada are more than the scores of Government Community Health Centre,

Jaggaiahpet. This shows patients’ service quality of Latha Superspeciality Hospital,

Vijayawada are good enough than Government Community Health Centre, Jaggaiahpet.

Hypothesis testing:




(4.341) is higher than overall mean expectation score (4) of Government Community

Health Centre, Nuzvid. Hence formulated Hypothesis – 1 viz., “Overall mean perception

score is lower than overall mean expectation score of Government Hospitals” is rejected.


Private Hospitals.


score (4) of Private Hospitals i.e. Latha Superspeciality Hospital, Vijayawada. Hence

formulated Hypothesis – 2 viz., “Overall mean perception score is higher than overall

mean expectation score of Private Hospitals” is significant.



242

given by patients (both O/P & I/P) of Government Community Health Centre,

Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada and the results are set

below.

Table 5.40ANOVA between patients’ perceptions towards Service Quality –













243

Graph 5.27Patients’ perception towards Service Quality –


0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA


13.63 13.73 15.85 18.9012.38 13.70 13.03 14.78 15.70 17.50

70.5878.60

4.25 3.275.79

4.54

4.39 3.31 4.52 3.44 5.13 3.82

23.50

17.53

Std. Deviation Mean

F Table value (1, 78, 0.05) = 3.98. The ANOVA table discloses P value is >0.05 i.e.


means that there is no significant difference in service quality in the mean variance

among the responses given by patients’ (both O/P & I/P) perception of Government

Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada,

because the overall ANOVA value of both out & in-patients is 0.087.

244






0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA

GOVTCHC, JPET

LATHAHOSP, VJA


68.13 68.63

63.40

75.60

61.88

68.50

65.13

73.88

62.80

70.00

64.16

71.45



Government Community Health Centre, Jaggaiahpet & Latha Speciality Hospital,

Vijayawada. Patients of Latha Speciality Hospital, Vijayawada are more satisfied with

245

71.45% to 22 service quality attributes of SERVQUAL than Government Community

Health Centre, Jaggaiahpet with 64.16%.

On study researcher found that one service gap between perceptions’ and expectations’ of

both In & Out-patients of Government Community Health Centre, Jaggaiahpet. Even it

is a one service quality gap it creates negative impression on government hospital

services. This is due to all the time doctors are not available except OPD timings. In

absence of admin staff and doctors, nursing and paramedical staff pretends busy and not

showing interest in solving the problems of patients. On the other side researcher found

no service gaps between perceptions and expectations of patients of Latha

Superspeciality Hospital, Vijayawada. Patients are happy with the services offer by the

hospital in all manners.

246


IRRESPECTIVE OF BED STRENGTH

(ALL TOGETHER)

GOVERNMENT HOSPITALS:

NTR University General Hospital, Vijayawada

Government District Hospital, Machilipatnam.

Area Hospital, Nuzvid

Community Health Centre (C.H.C), Jaggaiahpeta

PRIVATE HOSPITALS:

Pinnamaneni Siddhartha Medical College & Hospital, Chinaoutapalli.

Dr. Ramesh Cardiac & Multispeciality Hospital, Vijayawada

Prashanth Hospital, Vijayawada

M.J. Naidu Hospital, Vijayawada

Latha Super Speciality Hospital, Vijayawada

MISSIONARY HOSPITAL:

Gifford Memorial Hospital, Nuzvid

247

4.4.13. Analysis of Service Quality in hospitals all together irrespective of bedstrength – Out-patients’ perception towards Service Quality:


patients of Government, Private and Missionary Hospitals irrespective of bed strength

GovernmentHospitals

PrivateHospitals

MissionaryHospital

Q.NO.SERVQUALSCORE

SERVQUALSCORE

SERVQUALSCORE

1 0.46 0.92 0.852 0.35 0.72 0.853 0.55 1.54 1.14 1.04 -0.11 1.15 0.00 0.38 0.956 0.09 0.65 0.97 0.36 0.72 0.78 0.14 0.54 0.99 0.55 1.43 1.3

10 0.48 0.68 1.3511 0.26 0.51 0.8512 0.10 0.50 0.6513 -0.01 0.50 114 0.25 0.80 0.715 0.50 0.84 0.816 0.24 0.54 117 0.36 0.92 1.518 0.21 0.38 0.619 0.20 0.55 1.1520 -0.01 0.71 0.821 0.06 0.71 0.822 0.23 0.75 0.7

Unweighted Score Unweighted ScoreTangibles 0.60 0.77 0.975Reliability 0.23 0.744 0.95Responsiveness 0.21 0.547 0.9625Assurance 0.34 0.78 1Empathy 0.14 0.62 0.81

Total 0.30 0.6908 0.9395

Weighted Score Weighted Score

248

Tangibles 19.69 27.13 36.5625Reliability 6.69 21.358 28.025Responsiveness 3.57 9.845 16.3625Assurance 4.06 6.41 8Empathy 0.93 5.52 6.48

Total 6.99 14.05185 19.086

Table 5.42 provides information that the gaps found between the ‘Perceptions’ and

‘Expectations’ of the 22 service quality attributes of SERVQUAL of Out-patients of

select Government, Private and Missionary owned hospitals. The above table indicates 2

service quality attributes (i.e. 13 and 20) out of 22 service quality attributes are under

expectation and remaining 20 service quality attributes met and exceeded Out-patients’

expectation levels of select Government Hospitals. In Private hospital except one service

quality attribute no. 4 is under expectation and remaining 21 attributes met and exceeded

Out-patients’ expectation levels. All 22 service quality attribute scores of missionary

hospital are positive and this shows missionary hospital i.e. Gifford Memorial hospital

courtesy is enough to offer all service quality attributes to its patients so as to meet their

expectations.


Average Unweighted and Weighted SERVQUAL scores of Missionary hospital are more

than the scores of Private and Government hospitals. Private hospitals scores are more

than Government hospitals scores. This makes known that out-patients’ medical services

service quality of missionary hospital are good enough than private hospitals and private

hospitals service quality is good enough than that of government hospitals.

249



given by out-patients of Government, Private and Missionary hospitals and the results are

set below.


Government, Private and Missionary Hospitals all together irrespective of bed strengthANOVA TEST

Patient type N Mean Std. Deviation F Sig.

OUT-PATIENTS

GOVERNMENTHOSPITALS 80 69.68 22.082

2.570 0.079PRIVATE HOSPITALS 100 75.56 20.828MISSIONARY HOSPITAL 20 79.50 19.411Total 200 73.60 21.377


Graph 5.29Out-patients’ perception towards Service Quality – Government, Private and

Missionary Hospitals all together irrespective of bed strength

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

GOVERNMENT HOSPITALS PRIVATE HOSPITALS MISSIONARY HOSPITAL

69.68

75.5679.50

22.08220.828

19.411

Mean Std. Deviation

250




among the responses given by out-patients’ perception of all Government, Private and

Missionary Hospitals, because the overall ANOVA value of out-patients is 0.079.

Table 5.44Out-patients’ satisfactory levels towards Service Quality - Government, Private and


% OFSATISFACTION :OUT-PATIENTS

GOVERNMENTHOSPITALS 63.34

PRIVATE HOSPITALS 68.69MISSIONARY HOSPITAL 72.27Total 66.91


Graph 5.30Out-patients’ satisfactory levels towards Service Quality - Government, Private and


58.00

60.00

62.00

64.00

66.00

68.00

70.00

72.00

74.00

GOVERNMENT HOSPITAL PRIVATE HOSPITAL MISSIONARY HOSPITAL Total

63.34

68.69

72.27

66.91

% of satisfaction

251

The above table and graph represents satisfactory levels of out-patients of Government,

Private and Missionary Hospitals. Patients of Missionary hospital are satisfied with

72.27%, Private hospitals with 68.69% and Government hospitals with 63.34%. This

shows patients of Missionary hospitals are more satisfied than patients of Private and

Government hospitals. On average 66.91% of out-patients are satisfied with the service

quality of all select Government, Private and Missionary hospitals.

On study the researcher found gaps between the ‘Perceptions’ and ‘Expectations’ of Out-

patients of select Government, Private hospitals and no gaps found in Missionary

hospitals. In general in Government hospitals OPD services are offered during morning

and evening times only, all the time specialized doctors are not available except OPD

timings and also administrative department works in day time only. In absence of

administrative staff and doctors, nursing and paramedical staff pretends busy to patients

and not showing sincere interest in solving patient problems. Individual attention limited

to nursing staff only not by the doctors. This is due to more number of patients are

coming for treatment and every patient has to be treated by available few medical and

paramedical staff. In Private hospitals all service quality attributes of SERVQUAL are

positive except one service quality attribute i.e. attribute no.4. This is for the reason that

unlike government hospitals, private hospitals want to keep their hospital buildings and

premises clean and neat with well furnished, fully equipped and round-the-clock services

but not with materials associated with the services such as pamphlets, statements, boards

which are visually appearing to bring health and disease awareness among public.

Another side all service quality attribute scores of Missionary hospital are positive and

252

this shows missionary hospital i.e., Gifford Memorial hospital management taking care of

the services offering by them are up to the mark and to reach expectations of the patients.

4.4.14. Analysis of Service Quality in hospitals all together irrespective of bedstrength – In-patients’ perception towards Service Quality:


In-patients of Government, Private and Missionary Hospitals irrespective of bed strengthGovernmentHospitals Private Hospitals

MissionaryHospital

Q.NO.SERVQUALSCORE

SERVQUALSCORE

SERVQUALSCORE

1 0.23 1.13 0.752 0.48 1.07 0.53 0.73 1.01 0.854 1.26 -0.22 0.655 0.16 0.68 0.56 0.29 1.00 0.37 0.50 0.98 0.758 0.19 0.78 0.559 0.66 1.53 1.35

10 0.54 0.81 0.311 0.18 0.60 0.3512 0.14 0.91 0.6513 0.11 0.66 0.6514 0.43 0.90 0.7515 0.41 1.10 0.716 0.53 0.74 0.617 0.59 1.03 0.9518 0.24 0.54 0.419 0.54 0.72 0.320 0.26 0.54 0.521 0.14 0.86 0.322 0.18 1.00 0.4

Unweighted Score Unweighted Score Unweighted ScoreTangibles 0.67 0.75 0.6875Reliability 0.36 0.99 0.69Responsiveness 0.24 0.75 0.4875Assurance 0.49 0.94 0.75

253

Empathy 0.27 0.73 0.38

Total 0.41 0.83 0.599

Weighted Score Weighted Score Weighted ScoreTangibles 24.17 26.95 23.71875Reliability 10.68 28.30 20.355Responsiveness 4.19 12.62 6.825Assurance 5.46 10.26 11.625Empathy 1.53 5.75 2.47

Total 9.20 16.77 12.99875

Table 5.45 indicates that the gaps found between ‘Perceptions’ and ‘Expectations’ of 22

service quality attributes of SERVQUAL of In-patients of Government, Private and

Missionary Hospitalss. It shows that all 22 service quality attributes of SERVQUAL are

positive i.e. 22 service quality attributes met and exceeded In-patients’ expectation levels

in select Government Hospitals and Missionary Hospital except Private Hospitals. 1

Service quality attribute of Private hospitals i.e. attribute no. 4 is negative out of 22

service quality attributes remaining 21 attributes are met and exceeded in-patients’

expectation levels. This means Private hospitals management showing interest on

modern equipment, medical services, and skilled medical and paramedical staff but not

on materials associated with the services to bring awareness among public towards health

and diseases.


Average Unweighted and Weighted SERVQUAL scores of Private hospitals are more

than the scores of Missionary hospital and Government Area Hospital. The table shows

in-patients’ medical services service quality of private hospital are good enough than

missionary and government hospitals.

254



given by in-patients of Government, Private and Missionary Hospitals and the results are

set below.

Table 5.46ANOVA between In-patients’ perceptions towards service quality –



IN-PATIENTS

GOVERNMENTHOSPITALS 80 71.45 23.657

1.901 0.152PRIVATE HOSPITALS 100 77.79 19.878MISSIONARY HOSPITAL 20 74.65 22.156Total 200 74.94 21.785



Government, Private & Missionary Hospitals all together irrespective of bed strength

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

GOVERNMENT HOSPITALS PRIVATE HOSPITALS MISSIONARY HOSPITAL

71.45

77.7974.65

23.65719.878 22.156

Mean Std. Deviation

255

F Table value (1, 178, 0.05) = 3.89. Above ANOVA table discloses P value is >0.05 i.e.


means that there is no significant difference in service quality in the mean variance

among the responses given by in-patients’ perception of all Government, Private and

Missionary Hospitals, because the overall ANOVA value of in-patients is 0.152.



% OFSATISFACTION :

IN-PATIENTS






62.00

63.00

64.00

65.00

66.00

67.00

68.00

69.00

70.00

71.00


64.95

70.72

67.8668.13

% of satisfaction

256

The above table and graph represents satisfactory levels of in-patients of Government,

Private and Missionary Hospitals. Inpatients of Private hospitals are more satisfied with

70.72% than patients of Missionary hospital with 67.86% and patients of Government

Hospital with 64.95%. Overall 68.13% of inpatients are satisfied with the services

offered by different category hospitals.

On study researcher found that no gaps between select Government and Missionary

owned Hospital except Private Hospitals. This reveals efforts of Government and

Missionary hospital management to give best possible treatment to their patients by

creating more awareness among public towards disease and health by displaying

placards, offering stated medical services in IPD supporting with diagnostic services,

skilled and experienced medical and paramedical. On the other side researcher found that

Private hospital management does not show interest on materials associated with the

services are visually appearing i.e. placards/boards or statements on walls to keep their

hospital and premises clean and neat.

4.4.15. Analysis of Service Quality in hospitals all together irrespective of bedstrength – Out & In-patients’ perception towards Service Quality:


Patients of Government, Private and Missionary Hospitals

OVERALLPATIENTS

GIVERNMENTHOSPIALSPATIENTS

PRIVATEHOSPITALSPATIENTS

MISSIONARYHOSPITALPATIENTS

Q.NO.SERVQUALSCORE

SERVQUALSCORE

SERVQUALSCORE

1 0.34 1.03 0.82 0.41 0.90 0.6753 0.64 1.28 0.9754 1.15 -0.17 0.8755 0.08 0.53 0.7256 0.19 0.83 0.6

257

7 0.43 0.85 0.7258 0.16 0.66 0.7259 0.61 1.48 1.325

10 0.51 0.75 0.82511 0.22 0.56 0.612 0.12 0.71 0.6513 0.05 0.58 0.82514 0.34 0.85 0.72515 0.46 0.97 0.7516 0.38 0.64 0.817 0.48 0.98 1.22518 0.23 0.46 0.519 0.37 0.64 0.72520 0.13 0.63 0.6521 0.10 0.79 0.5522 0.20 0.88 0.55

Unweighted Score Unweighted Score Unweighted ScoreTangibles 0.64 0.76 0.83125Reliability 0.29 0.87 0.82Responsiveness 0.22 0.65 0.725Assurance 0.41 0.86 0.875Empathy 0.20 0.68 0.595

Total 0.35 0.76 0.76925

Weighted Score Weighted Score Weighted ScoreTangibles 21.93 27.04 30.140625Reliability 8.68 24.83 24.19Responsiveness 3.88 11.23 11.59375Assurance 4.76 8.33 9.8125Empathy 1.23 5.63 4.475

Total 8.10 15.41 16.042375

Table 5.48 indicates that the gaps found between ‘Perceptions’ and ‘Expectations’ of 22

service quality attributes of SERVQUAL of both Out and In-patients of select

Government, Private and Missionary Hospitals. Table shows that all 22 service quality

attributes of SERVQUAL are positive in Government and Missionary Hospitals except

258

Private Hospitals. Patients of Government and Missionary Hospitals are satisfied with

the service quality offer by these hospitals means their perceptions levels are equal or

more than expectation levels. In Private Hospitals service quality attribute no. 4 is

negative remaining 21 attributes met and exceeded patients’ expectation levels. Private

Hospitals management do not show interest on materials associated with the services,

awareness among public towards health and diseases by displaying placards, statements

on walls.


Average Unweighted and Weighted SERVQUAL scores of Private and Missionary

hospitals are more than the scores of Government hospitals. This makes the known

patients’ medical services service quality of Private and Missionary hospitals good

enough than Government hospitals.

Hypothesis testing:




(4.34) is higher than overall mean expectation score (4) of select Government Hospitals.

Hence formulated Hypothesis – 1 viz., “Overall mean perception score is lower than

overall mean expectation score of Government Hospitals” is rejected.


Private Hospitals.

259


score (4) of select Private Hospitals. Hence formulated Hypothesis – 2 viz., “Overall

mean perception score is higher than overall mean expectation score of Private Hospitals”

is significant.

3. H0. Over all mean Perception score is lower than overall mean expectation score of

Missionary Hospitals.

Based on the above table it is evident that overall mean perception score (4.7636) is

higher than overall mean expectation score (4) of Missionary Hospital i.e. Gifford

Memorial Hospital, Nuzvid. Hence formulated Hypothesis – 3 viz., “Overall mean

perception score is lower than overall mean expectation score of Missionary Hospitals” is

rejected.



given by patients’ (both O/P & I/P) of Government, Private and Missionary Hospitals and

the results are set below.

Table 5.49ANOVA between patients’ perception towards Service Quality –



BOTH IN & OUT-

PATIENTS

GOVERNMENTHOSPITALS

160 70.56 22.828

4.006 0.019PRIVATE HOSPITALS 200 76.68 20.338

MISSIONARY HOSPITAL 40 77.08 20.706

Total 400 74.27 21.566


260

Graph 5.33Patients’ perception (both O/P & I/P) towards Service Quality –

Government, Private and Missionary Hospitals all together irrespective of bed strength

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

GOVERNMENT HOSPITAL PRIVATE HOSPITAL MISSIONARY HOSPITAL

70.56

76.68 77.08

22.828 20.338 20.706

Mean Std. Deviation

F Table value (1, 398, 0.05) = 3.86. The above ANOVA table discloses P value is <0.05

i.e. level of significance is found to be significant at 95 percent confidence level. In other

words, there is significant difference in service quality in the mean variance among the

responses given by overall patients’ (both O/P & I/P) perceptions of all Government,

Private and Missionary Hospitals, because the overall ANOVA value of overall out & in-

patients is 0.019.



% OFSATISFACTION :BOTH IN & OUT-

PATIENTS



261


Graph 5.34Patients’ satisfactory levels (both I/P & O/P) towards Service Quality –


61.00

62.00

63.00

64.00

65.00

66.00

67.00

68.00

69.00

70.00

71.00


64.15

69.7070.07

67.52

% of satisfaction


select Government, Private and Missionary Hospitals. Over all patients of select

Missionary and Private Hospitals are more satisfied than patients of Government

Hospitals. Patients of Missionary hospital are more satisfied with 70.07% and Private

hospitals with 69.70% than patients of Government Hospitals with 64.15%.

On observation the researcher found no gaps between ‘Perceptions’ and ‘Expectations’ of

22 service quality attributes of SERVQUAL for both Out and In-patients of select

Government and Missionary Hospitals except one gap in Private Hospitals. All 22

service quality attributes of SERVQUAL are positive in Government and Missionary

Hospitals except Private Hospitals. This shows Government and Missionary hospital

262

have sufficient equipment, physical facilities, neat appearance and behaviour of hospital

staff, creating awareness among public by conducting medical camps, displaying

placards, offering stated medical services in supporting with diagnostic services with

skilled and experienced medical and paramedical staff. This is because of Demographic

factors such as age, gender and socio-economic status (SES). These demographic factors

are often closely interrelated to patients’ satisfaction levels. Because of the reason

patients of low SES have low expectations on service quality of health care services

provided by the Government hospital and they are getting satisfied with the same.

Patients of high SES have high expectations on serviced quality of health care and are

being fulfilled by the private hospitals.

On the other hand Private hospitals management shows interest on modern equipment,

appearance and behaviour of personnel, hospital promises to do something by a certain

time, show sincere interest in solving patients’ problems, gets things right the first time,

error free records, prompt service and skilled medical and paramedical staff, conduct

medical camps to show their specialties, services and facilities to public not to bring

awareness among public towards health and disease. Private hospitals management

wants to keep their hospital premises clean, neat with fully equipped and well furnish

wards, operation theatres but not with materials associated with the services such as

pamphlets, statements, boards which are visually appearing. Management feels placards /

writing statements on walls, put boards associated with the services disturbs hospital

elevation, spoils wall paintings and looks. Due the reason management does not show

interest on it.

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4.5 Priority wise Service Quality dimensions opined by surveyed patients:

4.5.1 Priority wise Service Quality dimensions opined by Out-patients:

Table 5.51 reveals priority wise SERVQUAL scale service quality dimensions opined by

Out-patients of select hospitals of Krishna District of Andhara Pradesh. As per the

priorities opined by out-patients of present study, Tangibles prioritized 1st place,

Reliability 2nd, Responsibility 3rd, Assurance 4th and Empathy prioritized 5th place.

Table 5.51Priority wise Service Quality dimensions opined by Out-patients

Dimensions

GOVERNMENTHOSPITALSOVERALLOUT-PATIENTS

PRIVATEHOSPITALSOVERALLOUT-PATIENTS

MISSIONARYHOSPITALOVERALLOUT-PATIENTS

OVERALLOUT-PATIENTSOF SELECTHOSPITALS

Tangibles 82.81 88.00 93.75 88.19Reliability 72.50 72.50 73.75 72.92Responsibility 47.19 47.25 42.50 45.65Assurance 30.31 20.25 20.00 23.52Empathy 17.19 22.00 20.00 19.73


264

Graph 5.35Priority wise Service Quality dimensions opined by Out-patients

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

Tangibles Reliability Responsibility Assurance Empathy

GOVERNMENT OVERALL O/P

PRIVATE OVERALL O/P

MISSIONARY OVERALL O/P

OVERALL HOSPITALS O/P

4.5.2 Priority wise Service Quality dimensions opined by In-patients:

Priority wise SERVQUAL scale service quality dimensions opined by In-patients are

given in Table 5.52. Priorities for SERVQUAL scale service quality dimensions opined

by In-patients are same as responses given by Out-patients. Tangibles occupied 1st place,

Reliability 2nd, Responsibility 3rd, Assurance 4th and Empathy 5th place as per conducted

survey.

Table 5.52Priority wise Service Quality dimensions opined by In-patients

DimensionsGOVERNMENTHOSPITALS

PRIVATEHOSPITALS

MISSIONARYHOSPITAL

OVERALLIN-PATIENTSOF SELECTHOSPITALS



265

Graph 5.36Priority wise Service Quality dimensions opined by In-patients

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00


GOVERNMENT OVER ALL I/P

PRIVATE OVER ALL I/P

MISSIONARY OVER ALL I/P

OVERALL HOSPITALS I/P

4.5.3 Priority wise Service Quality dimensions opined by all surveyed patients (bothO/P & I/P):

Table 5.51 and Table 5.52 calculated priorities of service quality dimensions of

SERVQUAL scale opined by overall Out-patients and In-patients are averaged and

presented in Table 5.53 to have overall patients including both O/P & I/P of select

Government, Private and Missionary hospitals towards SERVQUAL scale service quality

dimensions.

Table 5.53Priority wise Service Quality dimensions opined by all surveyed patients (both O/P&I/P)

DimensionsGOVERNMENTHOSPITALS

PRIVATEHOSPITALS

MISSSIONARYHOSPITAL

OVERALLPATIENTSOF SELECTHOSPITALS



266

Graph 5.37Priority wise Service Quality dimensions opined by all surveyed patients (both O/P&I/P)

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00


GOVERNMENT OVERALL PAT

PRIVATE OVERALL PAT

MISSIONARY OVERALL PAT

OVER ALL HOSPITALS PAT

As per the Table 5.53 Tangibles secure 1st priority, Reliability 2nd, Responsibility 3rd,

Assurance 4th and Empathy secured 5th priority of SERVQUAL scale service quality

dimensions.

chapter – 5 an analysis of service quality in...

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