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Impact of Service Quality on Patient Satisfaction in Pun Hlaing Essay

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Paper type: Essay

Service Quality and Patient Satisfaction in Pun Hlaing Silom Hospital, Yangon, Myanmar

Chapter 2

Literature Review

Traditionally, health care quality has been evaluated from the point of view of service provider CITATION Ber97 l 1033 (Berwick, 1997) CITATION Kra97 l 1033 (Kramer, 1997). Because many health care professionals accepted that patients did not have enough knowledge and intelligent level to evaluate the quality of health care CITATION Ber97 l 1033 (Berwick, 1997) CITATION Dec99 l 1033 (Decker, 1999). In recent years, the evaluation has focused to patient’s perception of care delivery quality because it is accepted that health care service quality indicators are the most influential determinants of patient satisfaction (Batbaatar et al., 2016). By monitoring and evaluating patient satisfaction, health care providers are able to identify service factors that need further improvementCITATION Aha93 l 1033 (Aharony & Strasser, 1993).

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2.1 Dependent Variables

Patient Satisfaction

Satisfaction is demonstrated as a state of mind that felt by a person when experienced performance or an outcome that fulfill his or her expectation CITATION Kot87 l 1033 (Kotler & Clarke, 1987). This definition has been supported by another author who stated that customer satisfaction is the customer’s emotional response towards services and products, their opinion on compliance with requirements and feelings related to acquisition of goods and service CITATION Bis09 l 1033 (Biseok & Jolanta, 2009). In healthcare settings, patient satisfaction is widely used in determination of service quality. Naidu( 2009) found that the relationship between patient satisfaction and health-care quality is significant. Patient satisfaction mainly reflected a hospital’s functional service quality rather than technical outcome CITATION Hal88 l 1033 (Hall & Dornan, 1988) CITATION Pas83 l 1033 (Pascoe, 1983) CITATION Ros97 l 1033 (Rosenthal & Shannon, 1997). Shabbir et al (2016) has demonstrated that there is a positive association between health care service quality and patient satisfaction. Another study has found that service quality has a significant relationship with patient satisfactionCITATION Kes11 l 1033 (Kessler & Mylod, 2011). According to the studies of Oliver (1997) and Zeithaml & Bitner (2000), customers are said to be satisfied if perceived performance is greater than their expectations while if it does not, then the customers are said to be dissatisfied. In addition, it is recognised that patients and their satisfaction are seen as the most basic point in the organising, execution and appraisal of service delivery CITATION Bad09 l 1033 (Badri, Attia, & Abdulla, 2009). Patient satisfaction is one of the critical determinants in healthcare care setting because it measures the quality of services provided by the hospital CITATION Sal05 l 1033 (Salisbury , et al., 2005).

2.2 Independent Variables

Service Quality

Lewis and Booms suggested that “service quality is a measure of how well the service level delivered matches customers’ expectations CITATION Lew83 l 1033 (Lewis & Booms, 1983). Health care service can be broken down into two quality dimensions: technical quality and functional quality CITATION Gro84 l 1033 (Gronroos, 1984). Research has shown that consumers tend to evaluate the quality of the health care services by focusing on more functional issues like physical facilities, interactions with receptionists or brochures rather than hard-to evaluate technical aspects of the service delivery CITATION Swa89 l 1033 (Swartz & Brown, 1989) CITATION Gro84 l 1033 (Gronroos, 1984). CITATION Pol08 l 1033 (Pollack, 2008) demonstrated that there is a direct relationship between health care service quality and patient satisfaction. It is shown that the more the significant the health care service quality improve, the more the prominent will be the patient satisfaction. CITATION Cro92 l 1033 (Cronin Jr & Taylor, 1992) have also suggested a solid causal relationship between the positive service quality and satisfaction. CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988) stated that there are five service quality dimensions that affect customers’ satisfaction:

Reliability is related to ability to perform the promised service dependably and accurately

Responsiveness is related to willingness to help customers and provide prompt service.

Assurance is related to knowledge and courtesy of employees and their ability to convey trust and confidence

Empathy is related to caring, individualized attention

Tangibles is related to physical facilities, equipment and appearance of personnel.

2.2.1 Reliability

Reliability indicates that the employees are able to provide the services accurately, consistently and dependably CITATION LeB97 l 1033 (LeBlanc & Nguyen, 1997).. The reliability is the most important factor in guaranteeing both customers’ satisfaction and dissatisfaction CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988). In 1990, also held that service reliability is the most significance variables in the SERVQUAL model CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988). In healthcare service industry, the reliability dimension had the greatest influence on patient satisfaction CITATION AlD17 l 1033 (Al-Damen, 2017).

2.2.2 Responsiveness

Another important factor that has an influence on customer satisfaction is responsiveness. Responsiveness refers to how fast an organization can react to customer demand or changes in the marketplace, to bring about or maintain competitive advantage. CITATION Kri99 l 1033 (Kritchanchai & MacCarthy, 1999). Responsiveness has a positive relation with customer attitudes in terms of customer satisfaction CITATION Lok11 l 1033 (Loke, Taiwo, Salim, & Downe, 2011). This statement has also been supported by another study which stated that responsiveness had a positive outcome in customer activities which leads to satisfaction CITATION Pan11 l 1033 (Pandey & Devasagayam, 2011). Hospital responsiveness had a strong effect on overall patient satisfaction, therefore hospitals should not only focus on clinical aspects of care, but also consider including efforts to responsiveness improvement in their strategic plans. CITATION Zar17 l 1033 (Zarei & Daneshkohan, 2017)2.2.3 Assurance

Assurance can be known as the organization offers the credible and secure service to its customers CITATION Don95 l 1033 (Donnelly , Wisniewski, Dalrymple, & Curry, 1995). In healthcare service industry, perceived competency of health professionals had one of the most significant impact on the variations in patient satisfaction CITATION Che03 l 1033 (Cheng, Yang, & Chiang, 2003) CITATION And98 l 1033 (Andaleeb, 1998). Assurance was the dimension most strongly associated with overall patient’s satisfaction CITATION You13 l 1033 (Yousaprompaiboon & Johnson, 2013).

2.2.4 Empathy

Empathy plays a critical interpersonal and societal role, enabling sharing of experiences, needs, and desires between individuals and providing an emotional bridge that promotes prosocial behavior. CITATION Rie17 l 1033 (Riess, 2017). Furthermore, providers’ communication skills and listening skills were found to be positively associated with level of patient satisfaction. CITATION Xia08 l 1033 ( Xiao & Barber, 2008). Most of the variables that have been found to affect satisfaction with health care can be positively influenced by doctors’ and nurses treating patient with courtesy and respect, being helpful, listening, explaining understandably and spending time with their patients. CITATION Bra02 l 1033 (Braunsberger & Gates, 2002). Uncompassionate care and treatment devoid of empathy results in dissatisfied patients who are unlikely to follow through with treatment recommendations CITATION Rie17 l 1033 (Riess, 2017).

2.2.5 Tangibles

Tangibles can be defined as the physical evidence in the industry. CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988). The setting of the facility greatly determines quality and customer satisfaction and this can create a sustainable competitive niche for the healthcare organisation CITATION Tay94 l 1033 (Taylor, 1994) . The physical setting in which services are delivered has been found to influence customer service performance evaluations, including customer satisfaction.CITATION Bit90 t l 1033 (Bitner, 1990)CITATION Bit92 t l 1033 (Bitner, 1992) CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988).

Chapter 3

Research Framework

The chapter divides up the detail of conceptual framework, research hypotheses and operationalization of independent and dependent variables.

3.1 Conceptual Framework

The conceptual framework consists of independent variables and dependent variable. In this research, the independent variables (reliability, responsiveness, assurance, empathy and tangibles) have been selected from the theoretical frameworks and showed that these variables have an influence on patient satisfaction hence hypotheses (H1 to H5) have been produced.

Independent VariablesDependent Variables

2040813219106H1

00H1

018415Reliability

Responsiveness

Assurance

Empathy

Tangibles

Patient Satisfaction

Reliability

Responsiveness

Assurance

Empathy

Tangibles

Patient Satisfaction

202496420642H2

00H2

2039620134462H3

00H3

2105533201519H4

00H4

2103679315951H5

00H5

3.2 Research Hypothesis

Based on the conceptual framework, different hypothesis for this research has been developed.

There are a total of five hypotheses which focuses on the influence of different independent variables (reliability, responsiveness, assurance, empathy and tangibles) on dependent variables (patient satisfaction).

H1a: Reliability has a significance influence on patient satisfaction.

H1o: Reliability has no significance influence on patient satisfaction.

H2a: Responsiveness has a significance influence on patient satisfaction.

H2o: Responsiveness has no significance influence on patient satisfaction.

H3a: Assurance has a significance influence on patient satisfaction.

H3o: Assurance has no significance influence on patient satisfaction.

H4a: Empathy has a significance influence on patient satisfaction.

H4o: Empathy has no significance influence on patient satisfaction.

H5a: Tangibles has a significance influence on patient satisfaction.

H5o: Tangibles has no significance influence on patient satisfaction.

3.3 Operationalization of independent and dependent variables

No Variables Concept of variables Operationalize Components Sources Measurement Scale

1. Reliability Reliability indicates the employees are able to provide the services accurately, consistently and dependably CITATION LeB97 l 1033 (LeBlanc & Nguyen, 1997) CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988). Pun Hlaing Silom hospital performs service and procedures correctly as they promised.

Pun Hlaing Silom Hospital provides services within time.

Pun Hlaing Silom Hospital is consistent in its performance. (Their service quality is the same at every visit)

Pun Hlaing Silom Hospital keeps the medical record properly and error free.

The patients feel confident when receiving treatment. CITATION Soh03 l 1033 (Sohail, 2003) CITATION AlD17 l 1033 (Al-Damen, 2017)CITATION But10 l 1033 (Butt & Cyril de Run, 2010) CITATION Soh03 l 1033 (Sohail, 2003) CITATION AlD17 l 1033 (Al-Damen, 2017)Interval Scale

2. Responsiveness The meaning of responsiveness is the willingness to help the customers, to provide prompt and well service to the clients, problem resolution when the customers faced and complaint handling.

CITATION Rei90 l 1033 (Reichheld & Sasser, 1990). 24 hrs Helpline from Pun Hlaing Silom Hospitals are easy to contact and offer prompt response.

At the hospital, the staff meet promptly the patients’ needs.

Patients are observed according to the appointments

Doctors/staff efficiently respond to the patient’s requests. Researcher

CITATION AlD17 l 1033 (Al-Damen, 2017) CITATION AlD17 l 1033 (Al-Damen, 2017) CITATION AlD17 l 1033 (Al-Damen, 2017)Interval Scale

3. Assurance  Assurance shows the knowledge that the employees posses and how the employees conveys the trust and confidence CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988)The hospital is able to handle

patients’ problems.

Doctors and other employees are able

to instil confidence in patients.

Doctors and other employees must

be courteous at all times.

Doctors should have the knowledge

to answer patients’ question

The hospital is able to handle

patients’ problems.

Doctors and other employees are able

to instil confidence in patients.

Doctors and other employees must

be courteous at all times.

Doctors should have the knowledge

to answer patients’ question

The patients trust Doctor’s expertise and skills

The patients trust Nurses and other staffs expertise and skills.

The doctors and other employees from Pun Hlaing Hospital are courteous at all time.

At the hospital, the patients feel secure in using its service.

CITATION AlD17 l 1033 (Al-Damen, 2017) CITATION AlD17 l 1033 (Al-Damen, 2017) CITATION Soh03 l 1033 (Sohail, 2003) CITATION AlD17 l 1033 (Al-Damen, 2017)Interval Scale

4. Empathy Empathy is described as a provision of caring, individualized attention to customer CITATION AlD17 l 1033 (Al-Damen, 2017). Patients are given individual attention at Pun Hlaing Silom Hospital.

Doctors and nurses deal with patients in caring fashion.( Understand their special needs and Explain the diagnosis and give informed treatment)

The hospital prioritize the interest of patients. Sohail (2003)

Sohail (2003)

CITATION AlD17 l 1033 (Al-Damen, 2017)Interval Scale

5. Tangibles  Tangibles is the physical facilities and equipment, employees’ appearance, physical representations of services and the physical environment CITATION Par88 l 1033 (Parasuraman, Zeithaml, & Berry, 1988).  Pun Hlaing Silom Hospital has modern equipment for diagnosis and treatment.

Pun Hlaing Silom Hospital has visually appealing facilities and infrastructure.

Pun Hlaing Silom Hospital have clean and healthy environment.

Doctors and other employees from Pun Hlaing Silom Hospital have professional appearance. CITATION Soh03 l 1033 (Sohail, 2003) CITATION Soh03 l 1033 (Sohail, 2003)Researcher

CITATION Soh03 l 1033 (Sohail, 2003)Interval Scale

6. Patient Satisfaction Patient satisfaction is referred to patients’ emotion, feelings and their perception of delivered healthcare services CITATION Moh11 l 1033 (Mohan & Saikumar, 2011)I’m satisfied with the reliability of Pun Hlaing Silom Hospital.

I’m satisfied with the responsiveness of Pun Hlaing Silom Hospital.

I’m satisfied with the assurance of Pun Hlaing Silom Hospital.

I’m satisfied with the empathy of Pun Hlaing Silom Hospital.

I’m satisfied with the tangibles of Pun Hlaing Silom Hospital. Researcher

Researcher

Researcher

Researcher

Researcher

Interval Scale

About the author

This sample essay is completed by Harper, a Social Sciences student. She studies at the University of California, Santa Barbara. All the content of this paper is just her opinion on Impact of Service Quality on Patient Satisfaction in Pun Hlaing and should not be seen as the way of presenting the arguments.

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