A STUDY ON PATIENT SATISFACTION TOWARDS THE QUALITY OF SERVICES

OFFERED IN GOVERNMENT HOSPITALS OF KANYAKUMARI DISTRICT

Dr R SRIDEVI, Assistant Professor, B. Com PA, Sri Ramakrishna College of Arts and Science,
Coimbatore 641006. India.
R. NIVEDITHA, Final Year Student, B. Com PA, Sri Ramakrishna College of Arts and Science,
Coimbatore 641006. India.

ABSTRACT
Service quality and patient satisfaction are important concept according to hospital industry. Most of
the people in India, especially the poor, face the problems of seeking effective health care at a cost
they can afford and at a distance they can travel. Therefore, this study is undertaken to understand the
effects of individual dimensions and the satisfaction level of individuals by the services offered in
government hospitals of Kanyakumari district. The whole country is passing through demographic and
environmental transition which is adding burden of diseases. The health care facilities and services in
the government hospitals are playing a vital role. The data used were gathered from patients who have
experience in visiting government hospitals of Kanyakumari district. A survey has been taken to
analyze the satisfaction level of patients and it is analyzed that the service level is not up to that extend
and still there is lot to improve. The study revealed the most important quality dimension is
responsiveness followed by empathy and reliability.

Key words: Health care, Service quality, Patient satisfaction, responsiveness, empathy, reliability.

INTRODUCTION
The concept of patient satisfaction is not new. Patients are one of the main stake holders in modern
world of medicine. Though the roles of doctor and patients remain same the context and backdrop have
undergone tremendous changes. Earlier there were no boundaries between patient care and cure but
with changing pattern of disease patient’s view of the words care and cure became different. A patient
may never get cured but feel very well cared and sometimes a patient might be cured but not very well
cared. This is quite often nowadays because of various diseases occurring in the country. For this
Covid-19 will be the best example, the one who is affected by corona is given proper care and it is not
necessary that he will be cured there is lot of possibilities that he may die. This virus took off lakhs of
life. By looking at the death rate we can’t say that they haven’t received any proper care.
What patient satisfaction literally mean? It is a measure of the extent to which Patient is satisfied with
the care they received from the health care provider. Patient satisfaction depends on many factors such
as quality of clinical services (experience of the care provider), availability of medicine, cleanliness of
rooms and environment, the duration and efficiency of care, physical comfort, emotional support, how
empathetic and communicative the health care provider is etc. are used to determine the satisfaction
level of patients. Monitoring patient’s satisfaction is very important factor to increase the quality of
services in hospital.
Improving patient satisfaction has become one of the primary goals for lot of health care providers.
The reason is simple by checking the satisfaction we can identify this hospital is good or else this care
provider is best and also; we can improve the quality of services. Nowadays the patients enter the
hospitals with high expectation as though they’ll be cured by the particular doctor’s treatment.
While acknowledging the need to improve patient satisfaction is a first step but what changes will yield
the best result the answer will be the healthcare providers need to have a honest assessment of what
their practice and services look like from when a patient first schedules an appointment. The patient

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will definitely expect a service where there are least side effects. Healthcare organizations are operating
in an extremely competitive environment, where patient satisfaction has become a key to gaining and
maintaining market share. This study was therefore undertaken with the aim to find out the level of
patient satisfaction by the quality of services provided in the government hospitals of Kanyakumari
district.

LITERATURE REVIEW
S.Sharmila, Dr Jayasreekrishnan(2013) studied the patient satisfaction and its determinants,
measurement issues and took analysis among 320 respondents . The result indicates that the quality of
services has to be improved by checking the level of satisfaction of each individual.
Annamalai Solayappan, Dr Jothi Jayakrishnan,Quality measurement of Hospital services. The result is
that the patient expects be neat so it is also important to check the physical appearance.
S.M.Irfan Aamir Ijaz and M.M Farooq(2012) investigated the quality of services delivered to patients
by public hospitals in Pakistan among 350 respondents with the dimensions such as
assurance,responsiveness,empathy,reliability . This study indicated that public hospitals are not
making visible efforts to deliver quality of services to their patients and meet their wants.
Agarwal A and Singh MR (2016) Service quality and patient satisfaction An Exploratory study of
Pathology Laboratories in Jaipur.It came to a conclusion that more innovative methods should be used.
Alghamdi FS (2014) Health care providers should take care of the service gaps. This view was
supported by Alghamdi in his empirical study
M.Ranjithkumar ,K.S.Shobajasmin, examined the analysis on service quality of government hospitals
and private hospitals in Tamil Nadu. The result is that government hospital staffs are negligent in their
work taking this as an advantage private hospitals enter into medical fields and changed medical fields
to revenue generators.
M.R.Chandrasekar,Patients(2015)studied the perception towards service quality of government
hospitals in Nilgiris over 100 respondents it is concluded that overall treatment is satisfied.
Dr.Sathyanarayana, Prof. Veena Shenoy(2019) examined the service quality and patient satisfaction in
rural Karnataka From the study we came to know that Empathy and Assurance indicated that the
perceptions of respondents regarding the quality delivered by the PHC.
AfshanKhattak,Muhammad Ismail Alvi(2012)conducted a cross sectional study among 200patient to
study the difference between private and public hospitals and the result is that patients are more
satisfied from the treatment they received from private hospitals
T.Dheepa, N.Gayathri(2015) studied patient satisfaction by collecting responds from over 280 patients
and it is clear that the patients are well satisfied by the services provided to them but there is little
more to improve.
Ramaiah Itumalla(2012) studied on how the hospitals could better manage their services and control
information to enhance their services among 210 patients who have availed health services from a
private hospital in Hyderabad,India.
In another study by RajanRushender et al(2016) tried to investigate the effective utilization of health
care services provided by PHCs in rural Tamil Nadu with a sample of 3,220 and concluded that PHCs
should be used only for preventive and primary health services rather than for treatment of acute and
chronic illness.

STATEMENT OF THE PROBLEM

The hospitals have been established to provide a healthy well-being and alleviate the health issues of
the people which are faced by them because of various reasons. The hospitals play a vital role in
providing prompt services on time. But the government hospitals are not providing expected quality of

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services today that is they do not have adequate facilities and infrastructure to provide treatment on
time. There is lack of infrastructure, non-availability of advanced medical facilities, limited number of
doctors, nurses and employees are main reasons for delayed treatment. Nowadays hospital sector has
become corporate and the standard of patients has increased and hence the patient doctor relationship
has changed into consumer service provider relationship.
All the study emphasis that service quality measurement can be done on dimensions like
tangibility, assurance, empathy and responsibility. Most studies done are mostly based on the quality
of services offered in abroad and also in private hospitals. The researcher has made an attempt to
measure the quality of service offered in general hospitals with the existing dimensions.

OBJECTIVES OF THE STUDY

• To identify the most dominant service quality dimension that influences consumer satisfaction
in government hospitals of Kanyakumari District.
• To analyze the quality of services and patient satisfaction
• To study the various dimensions of services offered in government hospitals.

NEED FOR THE STUDY

In recent days it become too important to check individual’s health as whole country is suffering from
lot of diseases, we should be more conscious of our own health. It became a vital role to understand
the services provided in government hospitals. This study helps all the government hospitals in
Kanykumari district to understand their position.
Majority of people are from rural background and they fully depend on government hospitals. So it is
important to assess the patient satisfaction of the overall services provided by the doctors and
healthcare staffs. To analyze the quality of rooms, cleanliness of environment, responsiveness of staffs
and doctors.

SCOPE OF THE STUDY

The main aim of this study is to analyze how satisfied the patients are by the quality of services
provided to them, assessing various needs of the patients and to understand the relation between the
doctor and patient.

RESEARCH METHODOLOGY
This study has used both primary data and secondary data. For collecting primary data, a structured
questionnaire was distributed among the respondents in the form of Google Form. The researcher
collected 168 samples by using questionnaires.

RESEARCH DESIGN
In this study descriptive and analytical research design are made use of which describes the
demographic characteristics of respondents and the frequency of two variables.

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SOURCE OF DATA
• PrimaryData
A well-structured questionnaire was distributed among the respondents for collecting the data across
Kanyakumari District.
• SecondaryData
Secondary data for the study has been collected from Books, Journals, Magazines and Articles.

SAMPLE TECHNIQUE
The study was conducted among the Kanyakumari Government Hospitals Patients by adopting
Convenient Sample Method.

SAMPLE SIZE
The sample size is 168 respondents which have been considered for the study.

AREA OF RESEARCH
The study was conducted among the Kanyakumari Government Hospitals Patients in Tamil Nadu.

TOOLS USED FOR THE STUDY

• Frequency Percentage
• Chi-Square Test
• Factor Analysis

Limitations of the Study

• The study is focused only on the government hospitals patients.
• The respondents are restricted to 168 only.
• The study is conducted within Kanyakumari District in Tamil Nadu.
• The study was conducted during the period of COVID-19. So, the data collection was done as
the convenient of the researcher.

ANALYSIS AND INTERPRETATION:

TABLE 1 SHOWING DEMOGRAPHIC FACTORS
VARIABLE CATEGORY FREQUENC PERCENT VALID CUMMULATI
Y PERCENT VE PERCENT
GENDER Female 85 50.6 50.6 50.6
Male 83 49.4 49.4 100.0
Total 168 100.0 100.0
EDUCATIONAL Schooling 28 16.7 16.7 16.7
QUALIFICATION
Higher 140 83.3 83.3 100.0
education
Total 168 100.0 100.0

Married 64 38.1 38.1 38.1

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 MARITAL Unmarried 104 61.9 61.9 100.0
STATUS Total 168 100.0 100.0
OCCUPATION Student 69 41.1 41.1 41.1
Employee 38 22.6 22.6 63.7
Business 24 14.3 14.3 78.0
Professional 17 10.1 10.1 88.1
Others 20 11.9 11.9 100.0
Total 168 100.0 100.0
INCOME Below 21 12.5 12.5 12.5
10,000
10,001- 35 20.8 20.8 33.3
30,000
30,001- 22 13.1 13.1 46.4
50,000
Above 26 15.5 15.5 61.9
50,000
None 64 38.1 38.1 100.0
Total 168 100.0 100.0

Source: Primary Data

INTERPRETATION:
It is evident from the above table 1 that out of 168 respondent’s majority of the respondents were female
50.6 followed by 49.4 percent male. It also reveals that about 83.3 respondents are from higher
education and 16.7 respondents are from schoolings. About 61.9percent respondents are unmarried and
38.1 percent respondents are married. In the status of occupation level it is shown that 41.1percent
respondents are students followed by 22.6 percent employees 14.3 percent are business men 10.1
percent are professional and rest 10.9 percent are others. Major part of the respondents 38.1 belong to
no income category followed by 20.8 percent belong to income category of 10,001-30,000 ,15.5 percent
belonged to an income of above 50,000, about 13.1 percent respondents belong to income category of
30,001-50,000 and 12.5 percent belongs to income category of below 10,000.

Chart 1
FACTORS THAT INFLUENCE TO SELECT GOVERNMENT HOSPITALS FOR
TREATMENT

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Source: Primary Data
From the above chart 1 we can understand that out of 168 respondents 56.5% of the patients visit
government hospitals because of free medical treatment, 46% visit government hospital because of the
hospitality and infrastructure, 35.1% visit because they are satisfied with the quality of services
provided to them, 32.7% visit because of the free medical campaign and 30% of patients go to
government hospitals because they are attending the cases on time.
H1: There is a relationship between education qualification of the respondents and patients perception
of service quality in government hospitals.
TABLE 2
HOW LONG DID YOU WAIT (BELONG YOUR APPOINTMENT TIME) TO VISIT
THEDOCTOR?
Chi-Square Tests
Value df Asymp.sig. Exact Sig. Exact Sig.
(2-sided) (2-sided) (1-sided)
a
Pearson Chi- .557 1 .455
Square
Continuity .273 1 .601
b
Correction
Likelihood .575 1 .448
Ratio
Fisher’s Exact .510 .306
Test
Linear-by- .554 1 .457
Linear
Assosciation
N of Valid 168
Cases
Source: Primary data
Interpretation: It is clear from the above table that Pearson Chi-square =0.557,Sig =0.455 are
statistically significant at 5 percent level. This implies that there is a relationship between education
qualification of the respondents and patients waiting time in government hospitals.

TABLE 3
IS THE STAFF EMPATHETIC TO YOUR NEEDS?
Chi-Square Tests
Value df Asymp.Sig.(2-sided)
a
Pearson Chi-Square 9.371 3 .025
Likelihood Ratio 7.110 3 .068
Linear-by-Linear 1.089 1 .297
Association
N of Valid Cases 168

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Source: Primary data
Interpretation: It is clear from the above table that pearson Chi-square =9.371,Sig =.025 are
statistically significant at 5 percent level. This implies that there is a relationship between
education qualification of the respondents and empathy the staffs shown to the patients.
TABLE4
THE PROMPTNESS WITH WHICH THE CALLS ARE ANSWERED?
Chi-Square Tests
Value df Asymp.Sig
(2-sided)
Pearson Chi-Square 4.066a 3 .254
Likelihood Ratio 3.561 3 .313
Linear-by-Linear 2.486 1 .115
Association
N of Valid Cases 168
Source:Primary data
Interpretation: It is clear from the above table that pearson Chi-square =4.066,Sig =.254 are
statistically significant at 5 percent level. This implies that there is a relationship between
education qualification of the respondents and the promptness by which the calls are attended.
TABLE5
DURING THE HOSPITAL STAY HOW OFTEN THE NURSE TREAT YOU WITH
COURTESY AND RESPECT?
Chi-Square Tests
Value df Asymp.Sig.
(2-sided)
a
Pearson Chi-Square 1.691 2 .429
Likelihood Ratio 1.768 2 .413
Linear-by-Linear 1.121 1 .290
Association
N of Valid cases 168
Source: Primary data
Interpretation: It is clear from the above table that Pearson Chi-Square=1.691,sig=.429 are
statistically significant at 5 percent level. This implies that there is a relationship between
education qualification of the respondents and the behavior of the nurses.

TABLE6
HOW LIKELY ARE YOU TO RECOMMEND THE GOVERNMENT HOSPITALS
FACILITIES WITH A FRIEND OR FAMILY?
Chi-Square Tests
Value df Asymp.Sig.
(2-Sided)
a
Pearson Chi-Square .487 2 .784
Likelihood Ratio .504 2 .777
Linear-by-Linear .467 1 .495
Assosciation
N of Valid Cases 168

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Source: Primary data
Interpretation: It is clear from the above table that Pearson Chi-Square=0.487,Sig=0.784 are
statistically insignificant at5 percent level. This implies that there is no relationship between education
qualification of the respondents and likely they recommend the government hospital facilities with a
friend or family.
TABLE7
HOW RESPONSIVE THE DOCTOR HAS BEEN TO YOUR CONCERN ABOUT THE
HEALTH ISSUES?
Chi-Square-Tests
Value df Asymp.Sig.
(2-Sided)
Pearson Chi-Square 3.987a 2 .136
Likelihood Ratio 3.890 2 .143
Linear-by-Linear 3.910 1 .048
Association
N of Valid Cases 168
Source: Primary data
Interpretation: It is clear from the above table that Pearson Chi-Square =3.987,sig=.136 are
statistically significant at 5 per cent level. This implies that there is a relationship between education
qualification of the respondents and the responsibility the doctor shown to the patients concern.

TABLE8
DID YOU FEEL THE STAFF RESPECTED YOUR PRIVACY?
Chi-Square Tests
Value df Asymp.Sig.
(2-sided)
a
Pearson Chi-Square 4.184 1 .041
Continuity 3.023 1 .082
Correctionb
Likelihood Ratio 3.602 1 .058
Fisher’s Exact Test
Linear-by-Linear 4.159 1 .041
Association
N of Valid cases 168
Source: Primary sources
Interpretation: It is clear from the above table that Pearson Chi-Square =4.184,sig=.041 are
statistically significant at 5 percent level. This implies that there is relationship between education
qualification of the respondents and the way the staffs respected the patients privacy.

FACTOR ANALYSIS
TABLE 9
KMO and Bartlett's Test
Kaiser-Meyer-Olkin Measure of Sampling Adequacy. .926
Bartlett's Test of Sphericity Approx. Chi-Square 867.356
df 45
Sig. .000

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Interpretation: It is evident from the above table that the KMO measure of sampling adequacy 0.926,
Bartlett‘s test of sphericity with approximate chi-square value 867.356 are statistically significant at 5
per cent level. It implies that sample size is adequate to classify the 10 variables into predominant
factors in the following communalities table.

TABLE 10
Communalities
Initial Extraction
Is the staffs empathetic to your needs 1.000 .538
The promptness with which the calls are answered 1.000 .661
The nurse treats you with courtesy and respect 1.000 .496
Recommend the government hospital facilities with friend or family 1.000 .573
Responsiveness of the doctor to your concern 1.000 .484
Staff respected your privacy 1.000 .357
Doctor’s treatment 1.000 .564
Cleanliness of the rooms 1.000 .620
Care in the government hospital 1.000 .720
Politeness of the Doctors 1.000 .560
Interpretation: The above table manifests that the 10 variables possess the variance ranging from
0.484 to0 .720 and the variance of 10 variables ranges up to 72 per cent. This leads to factor
segmentation process as shown in the total variance table
TABLE 11
Total Variance Explained
Component Initial Eigenvalues Extraction Sums of Squared
Loadings
Total % of Cumulative Total % of Cumulative
Variance % Variance %
Is the empathetic to your needs 5.572 55.719 55.719 2.385 18.350 38.422
The promptness with which the calls .800 7.999 63.719 5.572 55.719 55.719
are answered
The nurse treats you with courtesy and .773 7.731 71.449
respect
Recommend the government hospital .561 5.605 77.055
facilities with friend or family
Responsiveness of the doctor to your .540 5.396 82.451
concern
Staff respected your privacy .468 4.677 87.128
Doctor’s treatment .416 4.165 91.293
Cleanliness of the rooms .338 3.382 94.675
Care in the government hospital .277 2.766 97.441
Politeness of the Doctors .256 2.559 100.000

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Interpretation: It becomes clear from the below table that the 10 variables explain 55.719 per cent
variance as well as transforming it into 2 predominant factors. The are 2 factors possess the variance
between 55.719 per cent and 38.422 which are all statistically significant at 5per cent level. This leads
to the following variable loadings to each factor.

The first factor consists of 6 variables. They are empathetic to your needs (5.572, promptness with
which the calls are answered (0.800), nurse treats you with courtesy and respect (0.773), recommend
the government hospital facilities with friend or family (0.561), responsiveness of the doctor to your
concern (0.540) and staff respected your privacy (0.468). Therefore, this factor can be called “service
dimension”.

The second factor consists of 4 variables. They are doctor’s treatment (0.416), cleanliness of the rooms
(0.338), care in the government hospital (0.277) and politeness of the doctors (0.256). Hence this factor
is called “patient fulfillment”

CONCLUSION
This study has focused on the importance of quality of services and Patient’s satisfaction and it is found
that the patients are very well satisfied by the services offered to them.The government hospitals in
Kanyakumari District are performing well. They are satisfied with the dedication the doctor is showing
for each treatment. Majority of the patients visit government hospitals because they are getting free
medical treatment, free medical campaign, and are satisfied with the Infrastructure, Hospitality and the
way by which they attend the cases on time. As everything is developing the patient’s expectation is
also growing in a high level. It is important for the government to take necessary actions which would
enhance patient’s satisfaction.

SUGGESTION
From this study it is observed that the patients felt almost satisfied by the services
but there are few suggestions which would make the patients to improve their satisfaction level. Survey
has to be taken every 6 months to check the patient’s satisfaction and accordingly the changes can be
made. Inspection should be carried out in a regular basis by the concerned authority. Ward should be
allocated properly as patients are facing little difficulties in finding them. Some patients felt few nurses
behavioral are rude so to change that some motivational classes can be made. But from the overall
study it is understood that the services are good and satisfiable.

REFERENCES
1. S.Sharmila, Dr.JAYASREE Krishnan (2013)A study about hospital Quality in Chennai(Asia
Pacific journal of Marketing & Management Review-----ISSN2312836 Vol.2(1),January(2013).
2. Annamalai Solayappan 1,Dr Jothi Jayakrishna 2,Sethu Velmani(2011)Quality Measurement
for Hospital services(2011 3rd International Conference on Information and Financial
Engineering IPDER vol.12 (2011)
3. S.M. Irfan,Aamir,Ijaz,andM.M.Farooq(2012)Patient satisfaction and service quality of Public
hospitals in Pakistan:An Empirical Assessment –A conceptual Paper (middle east Journal of
scientific Research 12).
4. Dr Ingy Mohammed FikryFarid(2008)Development of a model for Healthcare Service
Quality(I.M.F.Farid,Development of a model for Healthcare Service Quality).
5. Anuradha Agarwal,Maithili RP Singh (2016)Service quality and patient satisfaction:An
Exploratory Study of Pathology Laboratories in Jaipur.
Utkal Historical Research Journal, ISSN : 0976-2132 Vol.-34(X), 2021 155
6. Faris Alghamdi FS(2014)The impact of service quality perceptions on patient satisfaction in
Government hospitals in Southern Saudi Arabia.Saudi Medical Journal 35.
7. M.Ranjith Kumar, K.S.Shobajasmin ; A analysis on service quality of government and private
Hospitals in Tamilnadu(International Journal of Pure and Applied Mathematics).
8. MR Chandrasekar, Global Journals inc.USA(2015) Patients Perception towards service
quality of Government Hospitals an Empirical study in Nilgiris District; Online ISSN:2249-
4618& Print ISSN:0975-5888
9. Dr.Sathyanarayan, Prof. Veena Shenoy and Prof.SudhindraGargesa; Service Quality and
Patient Satisfaction: Primary Health care centers in Rural Karnataka.(2019)Journal of Xi’an
University of Architecture&Technology.
10. AfshanKhattak, Muhammad Ismail Alvi ,Muhammad AwaisYousaf,Syed Zain-ul-
AbideenShah,DivaTurial,Sohail Akhter. Patient satisfaction- A Comparison between Public
& Private Hospitals of Peshwar Vol.4 International Journal of Collaborative Research on
Internal Medicine &Public Health.
11. T. Dheepa, N. Gayathri,P.Karthikeyan Patient Satisfaction towards the quality of service
offered in government Hospitals in western Districts of TamilNadu(2015). International
Research Journal of Business and Management-IRJBM; ISSN-2322-083X.
12. Rizwan Ahmed,HinaSamreen(2011)Assessing the service quality of some selected Hospitals
in Karachi Based on the servqual model(Pakistan business review july 2011)
13. Woolley, Kane,R.,Hughes,c.and Wright(1978)” The effects of Doctor-Patient Communication
of satisfaction and outcome of care”Social Science and Medicina.
14. Chang CS,Chen SY and Lan YT(2013)”Service quality,trust, and patient satisfaction in
interpersonal-based medical service encounters”.BMC Health Service Research.
15. L.Ganesan, R. SenthamizhVeena(2018),”Make in India’For Healthcare Sector in
India”International Journal of Health Sciences & Research Vol,2.

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