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Assessment of service quality dimensions in healthcare
industry “A Comparative study on patient’s satisfaction with
Mayiladuthurai Taluk Government vs. Private Hospitals.
I. Arul Edison Anthony Raj1, S. Karpagam2, Dr. V.S. Rajakrishnan3
1
(Assistant Professor, Department of Management Studies, EGS Pillay
Engineering College, Nagapattinam)
2
(Assistant Professor, Department of Commerce, EGS Pillay Arts & Science
College, Nagapattinam)
3
(Assistant Professor, Department of Management Studies, EGS Pillay
Engineering College, Nagapattinam)
[email protected]

ABSTRACT: Average service quality perception toward Government hospitals lead to increasing demand
for good quality Government health care in Mayiladuthurai Taluk. Observing the growth of private health
care sector, highly number of patients get satisfied with the service quality of private hospitals in
Mayiladuthurai Taluk. This study attempts to identify the service quality factors that influence patient
satisfaction with Government vs. private hospitals. A survey was conducted on patients of nine different
hospitals and ward in Mayiladuthurai Taluk. The Convenient sampling method was used in the research to
obtain information regarding patients’ perceptions toward 13 service quality dimensions of Government and
Private hospitals. Multiple-regression was used to identify the service quality factors that influence patients’
satisfaction. And descriptive statistics represented the patient’s satisfaction level with different service quality
factors.

Keywords: Service quality, health care, hospitals, patients’ perception, patient satisfaction.

I. INTRODUCTION
According to Koichiro Otani, Patient satisfaction has been an important issue for health care managers.
Many studies have developed and applied patient satisfaction as a quality improvement tool for health care
providers. Following increased levels of competition and the emphasis on consumerism, patient satisfaction has
become an important measurement for monitoring health care performance of health plans .This measurement
has developed along with a new feature: the patient's perspective of service quality of care. The relationship
between health care providers and patients has been reported to be the most influential factor for patient
satisfaction. Recommendations from family or friends become an important source of information for selecting
health care providers. Recommendation as well as satisfaction is based on personal experience concerning the
services that, one has received from health providers [1].
Measuring and reporting on patient satisfaction with health care has become a major industry. The
number of Medline articles featuring ―patient satisfaction‖ as a key word has increased more than 10-fold over
the past two decades, from 761 in the period 1975 through 1979 to 8,505 in 1993 through 1997. Patient
satisfaction measures have been incorporated into reports of hospital and health plan quality. Is patient
satisfaction worth measuring? How can it best be measured? And how are we to use the results? These three
questions—one philosophical, one empirical, and one practical—form a framework for evaluating the place of
patient satisfaction in the patient outcomes movement as a whole. From this perspective, viewing care ―through
the patient's eyes‖ is an ethical and professional imperative. Individual clinicians, medical groups, hospitals, and
health plans all have reason to be interested in patient satisfaction, and not only because satisfied customers add
to the bottom line. Indeed, arguments over the place of patient ratings and reports in the catalog of health care
outcomes usually turn not on whether measuring patient satisfaction is important, but on whether satisfaction
can be measured reproducibly and meaningfully. ―Patient satisfaction‖ is not a unitary concept but rather a
distillation of perceptions and values. Perceptions are patients' beliefs about occurrences. They reflect what
happened. Values are the weights patients apply to those occurrences. They reflect the degree to which patients
consider specific occurrences to be desirable, expected, or necessary. [2]
Health care can be divided into a number of different branches. Conventionally these include
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 Hospital care. Hospitals can be distinguished between acute and long-stay care. Acute care covers the
full range of medical specialties: long stay care has principally been used for psychiatric care and
continuing nursing care. The current trend is for long stay to be minimized and for acute hospitals to
offer a full range of care.
 Primary care. Primary care refers to basic medical treatment and non-hospital care, including general
or family practitioners, professions ancillary to medicine (including dentistry, optics and pharmacy)
and domiciliary health care (home nursing, occupational therapy, etc.). In some countries, the preferred
distinction falls between hospital and "ambulatory" care. Ambulatory care includes primary care and
most day care in hospital.
 Public health. This field includes not only preventive medicine (e.g. screening, inoculation or health
education) but also several areas not necessarily linked with conventional health services, including
housing, water supplies, sewerage, and food hygiene.

Public health is probably the most important issue for the health of a population; primary care is the
main focus of medical care in practice. Medicine in hospitals is probably the least important in terms of its
impact on health or illness, but it costs the most, has the highest status and is the focus of most political
attention. [25]
Dissatisfaction with public health care sector is shifting demand toward private health care sector in
Mayiladuthurai Taluk. The trend of utilization of public health care services in the area had been declining
downwards past few years, while the rate of utilization of private health care facilities for the same period had
been increasing upwards.
In this study, the researcher intended to identify the impact of service quality dimensions of
Mayiladuthurai Taluk Government and Private hospitals on patient satisfaction.

1.1 Research Objectives:

The objectives of the research are;
1. To analyze the service quality factors that influence patient’s satisfaction with Government vs.
Private Hospitals in Mayiladuthurai Taluk.
2. To identify how patients rate the service quality factors of Government vs. Private Hospitals in
Mayiladuthurai Taluk.
3. To compare the treatment provided level by Government vs. Private Hospital in Mayiladuthurai
Taluk.
4. To offer the valuable suggestions from the findings.

II. REVIEW OF LITERATURE AND RELATED STUDIES

In general, service quality, to which the health sector is no exception, is divided into two main
components; namely they are, technical and functional quality (Gronroos, 1984[15]; Parasuraman et al., 1985[19])
Technical quality (clinical quality) is defined as the technical diagnosis and procedures (e.g., surgical skills),
while functional quality refers to the manner of delivering the services to the patients (e.g. attitudes of doctors
and nurses toward the patients, cleanliness of the facilities, quality of hospital food. Because most patients lack
medical expertise for evaluating the technical attributes, the service marketing approach, which focuses on
functional quality perceived by patients, has been widely used to evaluate the health services, (Buttle, 1996 [10];
Dursun and Cerci, 2004[14]).
Many researchers (Oliver, 1981[17]; Brady and Robertson, 2001[9]; Lovelock, Patterson and Walker,
2001) conceptualize customer satisfaction as an individual’s feeling of pleasure or disappointment resulting
from comparing a product’s perceived performance (or outcome) in relation to his or her expectations.
Generally, there are two general conceptualizations of satisfaction, namely, transaction-specific
satisfaction and cumulative satisfaction (Boulding et al., 1993[7]; Jones and Suh, 2000[16]; Yi and La, 2004[21]).
Transaction-specific satisfaction is a customer’s evaluation of his or her experience and reactions to a particular
service encounter (Cronin and Taylor, 1992 [13]; Boshoff and Gray, 2004[6]), and cumulative satisfaction refers to
the customer’s overall evaluation of the consumption experience to date (Johnson, Anderson and Fornell, 1995).

2.1 What is Patient Satisfaction?

Patient satisfaction is multifaceted and a very challenging outcome to define. Patient expectations of
care and attitudes greatly contribute to satisfaction; other psychosocial factors, including pain and depression,
are also known to contribute to patient satisfaction scores. Historically, physicians, especially surgeons, have
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focused on surgical technique and objective outcomes as measures of ―patient satisfaction,‖ while patients place
great value on the surgeon-patient interaction. [3]

2.2 Improving Patient – Physician Communication:

Patient-physician communication has been shown to be key in improving patient satisfaction. Patient-
physician communication can be challenging, but presents a tremendous opportunity for improvement. [3]

2.3 Improving Patient Satisfaction:

Managing patient expectations and psychosocial factors, such as pain and depression that can drive
patient satisfaction can be difficult. Individualizing patient preoperative counseling and shared decision-making
can help to identify patient-specific factors, such as chronic pain and depression that may negatively impact
patient satisfaction scores. By setting appropriate preoperative expectations and managing pain and depression,
physicians can help patients achieve good outcomes. [3]

2.4 What is services quality?

What do we mean when we speck of services quality? Company personnel need a common
understanding in order to be able to address issues such as the measurement of service quality, the identification
of causes of service quality shortfalls, and the design and implement of corrective actions. [22]

2.5 Different Perspectives of Service Quality:

The word quality means different things to people, according to the context; David Garvin identifies
five perspective on quality. [22]
1. The transcendent view
2. The product – based approach
3. User – based definitions
4. The manufacturing – based approach
5. Value – based definitions

2.6 The Distinction between Service Quality and Customer Satisfaction

A review of the emerging literature suggests that there appears to be relative consensus among
marketing researchers that service quality and customer satisfaction are separate constructs which is unique and
share a close relationship (Cronin and Taylor, 1992 [13]; Oliver, 1993[18]). Most researchers in the services field
have maintained that these constructs are distinct (Bitner, 1990 [5]; Carman, 1990[11]; Boulding et al., 1993[8];
Spreng and Mackoy, 1996[20]). Table 1 identifies a number of key elements that distinguish customer
satisfaction from service quality.
Table 2.1.1.
Table shows the distinction between customer satisfaction and service quality
Customer Satisfaction Service Quality
Customer satisfaction can result from any dimension, The dimensions underlying quality judgements are
whether or not it is quality related. rather specific.
Customer satisfaction judgements can be formed by a
Expectations for quality are based on ideals or
large number of non-quality issues, such as needs,
perceptions of excellence.
equity, perceptions of fairness.
Customer satisfaction is believed to have more
Service quality has less conceptual antecedents.
conceptual antecedents.
Satisfaction judgements do require experience with the Quality perceptions do not require experience with the
service or provider. service or provider.
Source: Adapted from various sources (Oliver, 1993 [18]; Spreng and Mackoy, 1996[20]; Choi et al., 2004[12])

2.7 Service – Based Components of Quality

From focus group research, Valarie Zeithaml, Leonard Berry, and A. Parasuraman identified 10 criteria
used by consumers in evaluating service quality. In subsequent research, they found a high degree of
correlations between several of these variables and so consolidate them into five broad dimensions: [22]
 Tangibles (appearance of physical elements)
 Reliability (dependable, accurate performance)
 Responsiveness (promptness and helpfulness)
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 Assurance (competence, courtesy, credibility and security)
 Empathy (easy access, good communications and customer understanding)
Only one of these five dimensions, reliability, has a direct parallel to findings from Garvin’s research
on manufacturing quality. [22]
2.8 Capturing the Customer’s Perspective of Service Quality:
To measure customer satisfaction with various aspects of service quality, Valarie Zeithaml and her
colleagues developed a survey research instrument called SERVQUAL. It’s based on the premise that customers
can evaluate a firm’s service quality by comparing their perceptions of its service with their own expectations [22]

2.9 Limitations of SERVQUAL:

Although SERVQUAL has been widely used by service companies, doubts have been expressed about
both its conceptual foundation and methodological limitations. [22]
Table 2.1.2.
Table shows the Generic Dimensions Customers Used by Customers to Evaluate Service Quality
Dimensions Definitions
 Trustworthiness, believability, honesty of the
Credibility
service provider
Security  Freedom from danger, risk, or doubt.
Access  Approachability and ease of contact
 Listening to customers and keeping them
Communication
informed in language they can understand.
 Making the effort to know customers and their
Understanding the customer
needs.
 Appearance of physical facilities, equipment,
Tangibles
personnel, and communication materials.
 Ability to perform the promised service
Reliability
dependably and accurately.
 Willingness to help customers and provide prompt
Responsiveness
service.
 Possession of the skills and knowledge required to
Competence
perform the service.
 Politeness, respect, consideration, and friendliness
Courtesy
of contact personnel.

III. RESEARCH METHODOLOGY

This study identified and obtained information on the patient (outpatient) satisfaction with the service
quality dimensions of government and various private hospitals in Mayiladuthurai Taluk, Tamilnadu, India.
For these reasons, this study can be considered as descriptive research, which is defined as a type of conclusive
research which major objective is to describe existing phenomena.
Many researchers have conducted studies in measuring service quality in the past twenty years. In
1982, McCleary and Weaver indicated that good service is defined on the basis of identification of measurement
behaviors that are important to customers. Zemke and Albrecht (1985) suggested that service plays an
important role in defining a restaurant’s competitive strategies and identified systems and strategies for
managing service. In 1988, Parasuraman, Zeithaml and Berry developed a multiple-item scale for measuring
service quality called SERVQUAL. SERVQUAL is a generic instrument for measuring perceived service
quality that is viewed as the degree and direction of discrepancy between consumers’ perceptions and
expectations. Thus, service quality, as perceived by consumers, stems from a comparison of what they feel
service providers should offer with their perceptions of the performance of service provided by service providers
[4]

4.1 Sampling method:

A non-probability judgment sampling plan was implemented in the study. This method was used in this
research because some judgment on the part of the researcher was necessary in order to make sure the ―right‖
respondents were chosen among the patients in the one government and eight private hospitals in
Mayiladuthurai Taluk. Help was given to those patients who had problems in the interpretation of the
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questionnaire.

4.2 Data collection procedures:

The researcher used a self-administered questionnaire to collect data for the research. Self-administered
questionnaire is the survey in which respondents take responsibility for reading and answering the questions. It
is considered as a superior mode for minimizing bias and improving response rates. The effects of independent
variables on the dependable variable are assessed by the 5-point Likert attitude scale.
Secondary information were gathered from different secondary sources such as books, magazines,
journals, newspapers and online databases via internet etc. These data are usually available, can be obtained
quickly and inexpensive. Sample survey or cross-sectional survey was the main method to explore attitudes of
patients’ satisfaction with government and private hospitals in Mayiladuthurai Taluk. This is a method of
primary data collection in which information is based on communication with a representative sample of target
population at a point in time. In this research, a total of 140 questionnaires were distributed to the patients
visiting one government and eight different private hospitals, who met the sampling requirements. A total of
122 questionnaires were returned to the researcher so the response rate is approximately 87.14%. Data
collection took nearly 2 weeks from September 20th to September 30th, 2013.

IV. PRESENTATION OF DATA AND CRITICAL DISCUSSION OF RESULTS

From the data collection, researcher observe highly number of patients perceptions goes to private
hospital services is better to compare with government hospital services.
Table 4.1.1
Descriptive statistics shows the significant relationship between independent and dependent variables
Mean Std. Deviation N
Satisfied Service Sector 1.5574 0.49875 122
Doctor Qualification & Medicine Updating 1.9590 0.72039 122
Speed in Completing Medical Examination 2.0820 0.73395 122
Expertise Service Providers 2.0410 0.67294 122
Accuracy & Timely Report 2.3770 0.77489 122
Personal Relationship 2.0984 0.72054 122
Cost Feasibility 2.0574 2.02994 122
Modern Equipment for Diagnosis 2.2623 0.77995 122
Environment & Toilet Cleanliness 3.1230 1.15406 122
Care of Nursing 1.9426 0.71926 122
Friendliness & Courtesy of Staff Members 2.0164 0.73837 122
Convenience to Visit 2.1803 0.65576 122
Convenience in Maintaining Timing 2.5328 0.83502 122
Treatment Outcome Level 1.9918 0.75510 122

4.2 Multiple Regression Analysis:

Table 4.2.1-
Regression table shows the significant relationship between Predictor and dependent variables
Model Summary
Adjusted Change Statistics
Std. Error
R R
Model R of the
Square R Square F Sig. F
Estimate df1 df2
Square Change Change Change

1 0.613a 0.376 0.301 0.41691 0.376 5.013 13 108a 0.000

a. Predictor: (Constant), Treatment Outcome Level, Cost Feasibility, Personal Relationship, Convenience to
Visit, Expertise Service Providers, Modern Equipment for Diagnosis, Friendliness & Courtesy of Staff
Members, Environment & Toilet Cleanliness, Accuracy & Timely Report, Speed in Completing Medical
Examination, Care of Nursing, Doctor Qualification & Medicine Updating, Convenience in Maintaining
Timing.
ANOVAa
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Table shows the significant relationship between predictor and dependent variables
Model Sum of Squares Df Mean Square F Sig.
Regression 11.327 13 0.871 5.013 0.000b
1 Residual 18.772 108 0.174
Total 30.098 121
a. Dependent Variable: Satisfied Service Sector
b. Predictor: (Constant), Treatment Outcome Level, Cost Feasibility, Personal Relationship, Convenience to
Visit, Expertise Service Providers, Modern Equipment for Diagnosis, Friendliness & Courtesy of Staff
Members, Environment & Toilet Cleanliness, Accuracy & Timely Report, Speed in Completing Medical
Examination, Care of Nursing, Doctor Qualification & Medicine Updating, Convenience in Maintaining
Timing.
Coefficientsa
Table shows the significant relationship between predictor and dependent variables
Standardized
Unstandardized Coefficients
Model Coefficients t Sig.
B Std. Error Beta
(Constant) 1.318 0.179 7.366 0.000
Doctor Qualification &
0.067 0.082 0.097 0.824 0.412
Medicine Updating
Speed in Completing
0.019 0.080 0.029 0.244 0.807
Medical Examination
Expertise Service Providers 0.109 0.079 0.146 1.375 0.172
Accuracy & Timely Report -0.080 0.070 -0.124 -1.143 0.256
Personal Relationship -0.011 0.064 -0.016 -0.170 0.866
Cost Feasibility 0.041 0.020 0.167 2.011 0.047
1 Modern Equipment for
0.083 0.067 0.129 1.235 0.219
Diagnosis
Environment & Toilet
-0.272 0.049 -0.629 -5.588 0.000
Cleanliness
Care of Nursing 0.154 0.078 0.222 1.976 0.051
Friendliness & Courtesy of
-0.058 0.074 -0.086 -0.780 0.437
Staff Members
Convenience to Visit 0.070 0.074 0.093 0.956 0.341
Convenience in Maintaining
-0.025 0.071 -0.041 -0.348 0.729
Timing
Treatment Outcome Level 0.182 0.084 0.276 2.170 0.032
a. Dependent Variable: Satisfied Service Sector

Equation: Y = a + b1X1+ b2X2+ b3X3 + b4X4+ b5X5+ b6X6 +b7X7+ b8X8+ b9X9 +b10X10+ b11X11+ b12X12+
b13X13
Where, Y = Satisfied Service Sector (Dependent Variable)
X1 = Doctor Qualification & Medicine Updating (Independent Variable)
X2 = Speed in Completing Medical Examination (Independent Variable)
X3 = Expertise Service Providers (Independent Variable)
X4 = Accuracy & Timely Report (Independent Variable)
X5 = Personal Relationship (Independent Variable)
X6 = Cost Feasibility (Independent Variable)
X7 = Modern Equipment for Diagnosis (Independent Variable)
X8 = Environment & Toilet Cleanliness (Independent Variable)
X9 = Care of Nursing (Independent Variable)
X10 = Friendliness & Courtesy of Staff Members (Independent Variable)
X11 = Convenience to Visit (Independent Variable)
X12 = Convenience in Maintaining Timing (Independent Variable)
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X13 = Treatment Outcome Level (Independent Variable)

Y = 1.318 + 0.067X1 + 0.019X2 + 0.109X3 - 0.080X4 - 0.011X5 + 0.041X6 + 0.083X7 - 0.272X8 + 0.154X9 -
0.058X10 + 0.070X11 - 0.025X12 + 0.182X13

From the table 5.2.1, it can be observed that Patient Satisfied Service Sector have high positive
relationships with Doctor Qualification & Medicine Updating, Speed in Completing Medical Examination,
Expertise Service Providers, Cost Feasibility, Modern Equipment for Diagnosis, Care of Nursing, Convenience
to Visit, Treatment Outcome as R is equal to 0.613 which is near to ―2= Good‖. Moreover, patient service
satisfaction was explained by all Independent variables equal to 37.6% ( R 2 = 0 . 3 7 6 ) . From the F-test,
the Null hypothesis can be accepted, which means there is no relationship among the independent variables has not
influence on Patient service sector satisfaction (F = 5.013, Sig. = 0.000) at 0.05 confidence levels.
Table 4.2.3:
List of Hypothesis
Hypothesis Sig. Result
H10 There is no Sig. relationship between Doctor Qualification & Medicine
Accept H0
Updating in Govt. & Pvt Hospital influence patients satisfaction
0.412
H1a There is a Sig. relationship between Doctor Qualification & Medicine
Reject Ha
Updating in Govt. & Pvt Hospital influence patients satisfaction
H20 There is no Sig. relationship between speeds in completing medical
Accept H0
examination in Govt. & Pvt Hospital influence patients’ satisfaction.
0.807
H2a There is a Sig. relationship between speeds in completing medical examination
Reject Ha
in Govt. & Pvt Hospital influence patients’ satisfaction.
H30 There is no Sig. relationship between expertise service providers in Govt. &
Accept H0
Pvt Hospitals influence patients satisfaction.
0.172
H3a There is a Sig. relationship between expertise service providers in Govt. & Pvt
Reject Ha
Hospitals influence patients satisfaction.
H40 There is no Sig. relationship between Accuracy & Timely Report in Govt. &
Accept H0
Pvt Hospitals influence patients satisfaction.
0.256
H4a There is a Sig. relationship between Accuracy & Timely Report in Govt. & Pvt
Reject Ha
Hospitals influence patients satisfaction.
H50 There is no Sig. relationship between Personal Relationship in Govt. & Pvt
Accept H0
Hospitals influence patients satisfaction.
0.866
H5a There is a Sig. relationship between Personal Relationship in Govt. & Pvt
Reject Ha
Hospitals influence patients satisfaction.
H60 There is no Sig. relationship between Cost Feasibility in Govt. & Pvt Hospitals
Fail to
influence patients satisfaction.
0.047 Reject Ha/
H6a There is a Sig. relationship between Cost Feasibility in Govt. & Pvt Hospitals
Accept Ha
influence patients satisfaction.
H70 There is no Sig. relationship between modern equipment for diagnosis in Govt.
Accept H0
& Pvt Hospitals influence patients satisfaction.
0.219
H7a There is a Sig. relationship between modern equipment for diagnosis in Govt.
Reject Ha
& Pvt Hospitals influence patients satisfaction.
H80 There is no Sig. relationship between Environment & Toilet Cleanliness in
Fail to
Govt. & Pvt Hospitals influence patients satisfaction.
0.000 Reject Ha/
H8a There is a Sig. relationship between Environment & Toilet Cleanliness in
Accept Ha
Govt. & Pvt Hospitals influence patients satisfaction.
H90 There is no Sig. relationship between cares of nursing in Govt. & Pvt Hospitals
Accept H0
influence patients satisfactions.
0.051
H9a There is a Sig. relationship between cares of nursing in Govt. & Pvt Hospitals
Reject Ha
influence patients satisfactions.
H100 There is no Sig. relationship between Friendliness & Courtesy of Staff
Accept H0
Members in Govt. & Pvt Hospitals influence patients satisfaction.
0.437
H10a There is a Sig. relationship between Friendliness & Courtesy of Staff Members
Reject Ha
in Govt. & Pvt Hospitals influence patients satisfaction.

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H110 There is no Sig. relationship between conveniences to visit in Govt. & Pvt
Accept H0
Hospitals influence patients satisfaction.
0.341
H11a There is a Sig. relationship between conveniences to visit in Govt. & Pvt
Reject Ha
Hospitals influence patients satisfaction.
H120 There is no Sig. relationship between conveniences in Maintaining Timing in
Accept H0
Govt. & Pvt Hospitals influence patients satisfaction.
0.729
H12a There is a Sig. relationship between conveniences in Maintaining Timing in
Reject Ha
Govt. & Pvt Hospitals influence patients satisfaction.
H130 There is no Sig. relationship between treatment outcomes in Govt. & Pvt
Fail to
Hospitals influence patients satisfaction.
0.032 Reject Ha/
H13a There is a Sig. relationship between treatment outcomes in Govt. & Pvt
Accept Ha
Hospitals influence patients satisfaction.

From the data collection, researcher observed that, highly patients are preferred Private Hospitals
because Beta value shown the table 5.2.1 (coefficient) treatment outcome level has the greater impact on patient
satisfaction in both government and private hospital by beta value is equal to 0.276, followed by care of nursing
at beta value is equal to 0.222, cost feasibility at beta value is equal to 0.167, expertise service providers at beta
value is equal to 0.146, modern equipment for diagnosis at beta value is equal to 0.129, doctor qualification &
medicine updating at beta value is equal to 0.097, convenience to visit at beta value is equal to 0.093, speed in
completing medical examination at beta value is equal to 0.029.

According to impact based on the beta values the dimensions can be ranked as:
1. Treatment Outcome, 2. Care of Nursing, 3. Cost Feasibility, 4. Expertise Service Providers, 5.
Modern Equipment, 6. Doctor Qualification & Medicine Updating, 7. Convenience to Visit, 8. Speed in
Completing Medical Examination.

VI. CONCLUSION
The need for continuous improvement of quality and safety in the provision of patient care has become
axiomatic. The resultant paradigm shift from an acceptance of the status quo to a drive for constant
improvement in clinical practice has required the engagement of multiple monitoring and improvement
strategies. The purpose of this report is to identify and review the literature that examines patient satisfaction in
the context of clinical practice improvement especially in Mayiladuthurai Taluk. The research was conducted to
identify the key service quality factors of g o v e r n m e n t a n d private hospitals that affect patients’
satisfaction and assess how patients rate the service quality dimensions of both government and private
hospitals. Out of Thirteen, Eight service quality dimensions comparison have positive impacts on patient
satisfaction. It identifies the important service quality dimensions of the g o v e r n m e n t a n d private hospitals
to better understand the requirements of the patients to increase their satisfaction. Therefore, the study suggests
that the Chiefs of Government and Private hospitals should pay adequate attention to the service quality
dimensions which are critical influencer of patients’ satisfaction, eventually increase overall patient satisfaction
with their services. Correct treatment and delivering promised service are critical issues to increase reliability in
health care setting. Researcher found that the patients were satisfied with Cost Feasibility, Environment &
Toilet Cleanliness and Treatment Outcome of the service quality factors in both Government and Private
Hospitals. Both Government and Private hospitals must consider this issue with greater importance.
Knowledge, skills, credentials inspire patients’ trust and confidence. If a patient feels alienated, uninformed or
uncertain about his / her health status and outcomes, it may affect the healing process. When the nature of the
treatment is clearly explained, patients’ queries are responded, and it may alleviate patients’ feelings of
uncertainty. Thus the communication between service providers and patients has to be improved. Along with
that the appearance of the physical facilities, modern and advanced equipment of the hospitals increase
customer satisfaction. Cost is perceived as the least important factor influencing patients’ satisfaction. That
reflects that their priority is excellent service from private hospitals for which they are ready to pay fair price.
Thus the government hospitals have to put emphasis on the above mentioned important factors to be more
competitive in local and regional market. Health is universally regarded as an important index of human
development.
In this study data were gathered from the patients in nine (one government & eight private) hospitals in
Mayiladuthurai Taluk. The results may not be generalizable to all the patients in other hospitals in and around

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www.iosrjournals.org
area. Further study may include more number of hospitals and also may target hospitals located in different in
Mayiladuthurai and other regional areas.

REFERENCES
Journal Papers:
[1] Otani Koichiro et al, Patient Satisfaction: focusing on “excellent”, Journal of Healthc Manag, Vol.54 Issue 2, Mar/Apr 2009, pp. 93–103
[2] Kravitz Richard, Patient Satisfaction with Health Care, Journal of General Internal Medicine; Vol. 13 Issue 4 April 1998: pp. 280–282.
[3] Morris J. Brent et al, Patient Satisfaction: An Emerging Health Policy Issue, Journal of the American Academy of Orthopaedic
Surgeons (AAOS), Jun 2013, Vol. 7 Issue 6, p. 29
[4] Allan Yen-Lun Su, Service Quality in a Chain-operated Steakhouse, p. 234,
https://web.nkuht.edu.tw/master/conference/2001/html/papers/3-a-2.doc
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[6] Boshoff, C., and Gray, B. (2004). The Relationships between Service Quality, Customer Satisfaction and Buying Intentions in the
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[7] Boulding, W., Kalra, A., Staeling, R., and Zeithaml, V. A. (1993). A Dynamic Process Model of Service Quality: From Expectation to
Behavioral Intentions. Journal of Marketing Research, 30(1), pp. 7–27.
[8] Op.cit: Boulding, W et.al,
[9] Brady, M. K., and Robertson, C. J. (2001). Searching for a consensus on the antecedent role of service quality and satisfaction: An
exploratory cross-national study. Journal of Business Research, 51(1), pp. 53–60.
[10] Buttle, F., (1996), "SERVQUAL: review, critique, research agenda", European Journal of Marketing, Vol. 30, No. 1, pp. 8-32.
[11] Carman, J. M. (1990). Consumer Perceptions of Service Quality: An Assessment of the SERVQUAL Dimensions. Journal of Retailing,
66(1), pp. 33–55.
[12] Choi, K. S., Cho, W. H., Lee, S. H., Lee, H. J., and Kim, C. K. (2004). The Relationships among Quality, Value, Satisfaction and
Behavioral Intention in Health Care Provider Choice: A South Korean Study. Journal of Business Research, 57(8), pp. 913–921.
[13] Cronin, J. J., and Taylor, S. A. (1992). Measuring Service Quality: A Reexamination and Extension. Journal of Marketing, 56(3),
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[14] Dursun, Y. and Cerci, M., (2004), " Perceived Quality: A Study on Patient Satisfaction and Behavioral Factors", Erciyes Universitesi
Iktisadi ve Idari Bilimler Fakiltesi Dergisi, Vol. 23, pp. 1- 16.
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[16] Jones, M. A., and Suh, J. (2000). Transaction-Specific Satisfaction and Overall Satisfaction: An Empirical Analysis. Journal of
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[17] Oliver, R. L. (1981). Measurement and Evaluation of Satisfaction Processes in Retail Settings. Journal of Retailing, 57(3), pp. 25–48.
[18] Oliver, R. L. (1993). Cognitive, Affective, and Attribute Bases of the Satisfaction Response. Journal of Consumer Research, 20,
pp. 418–430.
[19] Parasuraman A., Zeithaml, V.A. & Berry, l. l., (1985),"A Conceptual Model of Service Quality and its Implications for Future
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[20] Spreng, R. A., and Mackoy, R. D. (1996). An empirical examination of a model of perceived serviced service quality and satisfaction.
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[21] Yi, Y. J., and La, S. N. (2004). What Influences the Relationship between Customer Satisfaction and Repurchase Intention?
Investigating the Effect of Adjusted Expectations and Customer Loyalty. Psychology and Marketing, 21(5), pp. 351–373.

Books:
[22] Lovelock Christopher et al, ―Service Marketing‖, Pearson Publications, pp.: 400-403.
[23] Sharma Anand, ―Statistics for Management‖, Himalaya Publishing House Private Limited.
[24] Kothari C.R., ―Research Methodology‖, New Age International (P) Limited Publishers, 2nd Revised Edition.
[25] Spicker Paul, An introduction to Social Policy, http://www2.rgu.ac.uk/publicpolicy/introduction/health.htm

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