A study on factors ò service quality afecting the satisfaction ò patients in thanh hoa general hópital

Thesis for the Degree of Master A Study on Factors of Service Quality Affecting the Satisfaction of patients in Thanh Hoa General Hospital June 2017 Department of Business Administration Graduate School of Soongsil University DO MANH HUNG Thesis for the Degree of Master A Study on Factors of Service Quality Affecting the Satisfaction of patients in Thanh Hoa General Hospital June 2017 Department of Business Administration Graduate School of Soongsil University DO MANH HUNG Thesis for the Degree of Master A Study on Factors of Service Quality Affecting the Satisfaction of patients in Thanh Hoa General Hospital A thesis supervisor: Prof Park, Jong-Woo Thesis submitted in partial fulfillment of the requirement for the Degree of Master June 2017 Department of Business Administration Graduate School of Soongsil University DO MANH HUNG To approve the submitted thesis for the Degree of Master By DO MANH HUNG Thesis Committee Chair Gim Gwang Yong (signature) Member Park Jong Woo (signature) Member Hoang Dinh Hai (signature) June 2017 Graduate School of Soongsil University TABLE OF CONTENTS ABSTRACT viiii CHAPTER INTRODUCTION 1.1 Research background 1.2 Research objectives: 1.3 Research Subject 1.4 Research process 1.5 Structure of thesis: CHAPTER THEORETICAL BACKG ROUND 2.1 Definition of service and features of service 2.2 Service quality 10 2.3 Customer satisfaction 11 2.4 Relationship between service quality and customer satisfaction 11 2.5 Research models on service quality and cutomer satisfaction 12 2.5.1 5-distance model .12 2.5.2 SERVQUAL model .144 2.6 Some recent studies on customer satisfaction in healthcare sector 15 CHAPTER RESEARCH METHODOLOG Y 18 3.1 Research Model 18 3.2 Research Hypothesis 19 3.3 Measuring factors 23 - i- 3.4 Research Design 26 CHAPTER RESEARCH RESULTS 29 4.1 Descriptive statistics 29 4.1.1 Classification of samples of age of patients 30 4.1.2 Education-base classification of patients .30 4.1.3 Occupation-based classification 31 4.1.4 Income-based classification .32 4.2 Results of answers to survey questionnaires 33 4.3 Evaluation of reliability of scale of factors 35 4.4 Exploratory factor analysis 37 4.4.1 Results of exploring analysis of independent variables 38 4.4.2 Exploring factor anlaysis of dependent variable 42 4.5 Correlation analysis 43 4.6 Regression analysis 46 4.6.1 Results of regression analysis method by Enter method .46 4.6.2 Testing of research hypothesises 48 Testing of difference between groups of patients under indicia .50 4.7.1 Testing of difference between group of patients with different ages 51 4.7.2 Testing of difference between groups of patients under their education 52 4.7.3 Testing of difference between group of patients under their occupation 54 4.7.4 Testing of difference between groups under income of patients .56 4.8 Discussion from the research result 58 - ii - CHAPTER CONCLUSION 61 5.1 Summary of the study 61 5.2 Recommendations from the research result 63 5.3 Contributions and meaning of the research 67 5.3.1 Contributions of the research 67 5.3.2 The significance of the study 67 5.4 Limitations of the research 68 5.5 Research directions in the future 68 REFERENCES 70 APPENDICES 77 - iii - LIST OF TABLES [Table 2- 1] Summary of some studies on patient satisfaction in healthcare srervices 16 [Table 2-2] Observed variables 23 [Table 4-1] Results of sample size ………………………………………………29 [Table 4-3] Summary of answers to questionnaires 33 [Table 4-4] Results of testing reliability of scale of factors .35 [Table 4-55] KMO and Bartlett's Test of independent variables 39 [Table 4-6] Total Variance Explained of independent variables 39 [Table 4- 7] Rotated Component Matrix of independent variables 40 [Table 4- 8] KMO and Bartlett's Test of dependent variable 42 [Table 4-9] Total variance explain of……………………………………………42 [Table 4- 10] Component Matrix of dependent variables 43 [Table 4-11] Pearson correlation coefficient .44 [Table 4-12] Summary of information of estimation method by enter method 46 [Table 4- 13] ANOVA by enter method 46 [Table 4- 14] coefficients of estaimation model by Enter method 47 [Table 4- 15] Statistics of average value under the age of patients 51 [Table 4- 16] Result of variance analysis under ages of patients 52 [Table 4-17] Statistics of average value of education of parents of patients 52 [Table 4-18] Result of variance analysis of education of patients 53 [Table 4- 19] Statistics of average value of group under occupation of patients 54 [Table 4-20] Results of variance of ……………………………………………54 - iv - [Table 4- 21] Statistics of average value of groups under income of patients 57 [Table 4- 22 ] Analysis of variance under income of parents of patients 57 [Table 4-23] Statistical value of factors 59 - v- not affecting customer satisfaction (reliability factor) In addition, the research suggests that we can also add other elements to the evaluation model of customer satisfaction in order to better explain the variability of the dependent variables on overall satisfaction In terms of practical aspects,, the research result also helps managers (hospital) identify the current state of service quality and the level of patient satisfaction on hospital quality Answers to these questions are what factors influence patient satisfaction? How it influence? It also suggested measures for improving service quality and patient satisfaction in hospitals 5.4 Limitations of the research Like any other researches, this study has certain limitations as follows: Firstly, the research is focused on a hospital and patients are inpatient ones Therefore, there is no basis to compare the feeling between hospitals and between two groups of inpatients and outpatients Secondly, the sample size is relatively small, non- probability sampling methods can lead to uncontrolled errors, affecting the results of the study Thirdly, the research is carried out at point of time, not yet repeated, so we cannot evaluate the trend of changes in the patient's perception of the quality of hospital services 5.5 Research directions in the future From the above limitations, the author suggest some research directions for the following researches: - 68 - Firstly, to expand the scope of research to a group of different hospitals to make comparisons between groups of public hospitals and private hospitals as well as hospitals in different areas Secondly, to expand the sample size, we can determine the sample size through the theory of probability and taking of samples for many times (determining minimum sample size according to the standard deviation of the sample size for the first time) to increase accuracy for statistical processing Thirdly, to conduct studies to detect trends of changes in the long-term and “sustainability" factors on patient satisfaction Fourthly, to add more new factors into the model research to improve the interpretation of existing models - 69 - REFERENCES Ahuja.M, Mahlawat.S & Masood.R Z Study of service quality management with SERVQUAL model: An empirical study of GOVT/NGO`S eye hospitals in Haryana, Indian journal of comerce and management studies, 2(2), 310-318, 2011 Ahmad.R & Samreen.H Assesing the service quality of some selected hospitals in Karachi based the SERVQUAL model, Pakistan review, 266 – 314, 2011 Al Ries and Jack Trout Positioning: The Battle for Your Mind, Edition 1, McGraw-Hill, 1983 Atilgan.E, Akinci.S & Arsoy.S Mapping service quality in the tourism industry, Managing service quality, 13(5), 412 – 422, 2003 Andaleeb.S.S & Conway.S Customer satisfaction in the restaurant industry:an examination of transaction - specsific model, Journal of services marketing, 20(1), – 11, 2006 Anderson, E W & Fornell, C Foundation of the American Customer Satisfaction Index, Total Quality Management, 11, 7, 8869-8882 2000 - 70 - Babakus.E & Mangold.W.G Adapting the SERVQUAL scale to hospital services: An empirical investigation, Heath service research, 26(6), 767 – 786, 1992 Brahmbohatt.M, Barser.N & Joshi.G.N Adapting the SERVQUAL scale to hospital service: An empirical investigation of patients` perception of service quality, International Journal of Multidisciplinary Research, 1(8), 27 -42, 2011 Butle F SERVQUAL review, critique, research agenda, European Journal of Marketing, 30 (1), -32, 1996 Chakraborty.R & Majumdar.A Measuring consumer satisfaction in heath care sector: The applicability of SERVQUAL, International refereed research journal, 2(4), 149 -160, 2011 Cronin & Taylor Measuring service quality ; A reexamination an extention, Journal of Marketing, 56 (3), 55 -68 1992 Chow.C.C & Luk.P A strategic service quality approach using analytic hierarchy process, Management service quality, 15(3), 278 – 289, 2005 - 71 - Durvasula.S & Lysonski.S Diagnosing service quality in retailing; The case of Singapore, Journal of international business entrepreneurship development, 5(1), 1-17, 2010 Garson G D Guide to Writing Empiricel Pappers, Theses, and Dissertations, New York: Marcel Dekker, 2002 Gerbing WD and Anderson JC An udate paradigm for scale development incorporating unidimensionality and its assessments, Journal of Marketing Research, 25(2), 186 -192, 1988 Grönroos,.G A Service Quality Model and its Marketing Implications, European Journal of Marketing, 18(4), 36 – 44, 1984 Hoang Trong & Chu Nguyen Mong Ngoc Analysis of research data with SPSS – Vol 1, Hong Duc Publisher, Ho Chi Minh, Vietnam, 2008 Harford.T The Undercover Economist (Vietnamese version, 2008), Social Labor publishing house, 2006 - 72 - Mostafa.M M An empirical study of patients expectations and satisfactions in Egyptian hospitals, International journal of health care quality assurance, 18 (7), 516 – 532, 2005 Mankiw N G Principles of Economics, International Student Edition, 3th ed, Thomson, 2005 Martensen A., Gronholdt, L & Kristensen, K The drivers of customer satisfaction and loyalty Cross-industry findings from Denmark, Total Quality Management, 11, 8544-8553, 2000 Maccallum.R.C, Widaman.K.F, Zhang.S & Hong.S Sample size in factor analysis, Psychological Methods, 4, 84 -99 1999 Nunally and Bernstein Psychometric Theory, 3th ed, Mc Graw – Hill, New York, 1994 Nguyen Thi Phuong Tram Master dissertation, the Quality of E-bank: Comparison of SERVQUAL model and Gronroos model, Ho Chi Minh city University of Economics, Vietnam, 2008 - 73 - Nguyen Dinh Phan, Truong Doan The and Dang Ngoc Su Textbook of Quality Control in organization, Social Labor Publishing House, 2006 Nguyen Trung Kien Evaluation of satisfaction of students on training quality in Unviersity of Economics and Business Adminsitration – Thai Nguyen University, Master dissertation, Thai Nguyen University, 2005 Nguyen Dinh Tho The scientific method in business research, Labour – Social Publisher, Vietnam, 2011 Nguyen Quang Dong Econometric lecture, Statistics Publisher, Hanoi Vietnam, 2003 Oliveira.O.J.D Adaptation and application of the SERVQUAL scale in higher education, POMA 20th Annual Conference Orlando Florida USA, 2009 Pham Nhat Yen Evaluation of satisfaction of patiets on the quality of examination and treatment services in request-based examination and treatment department, Bach Mai Hospital 2008, Dissertation of Public Health , Public Health university, 2008 - 74 - Parasuraman, A V A Zeithaml, & L.L.Berry A conceptual Model of Service Quality and its Implications for Future Research, Jounal of Marketing, 49, 41-50, 1985 Soita.P.W Measuring perceived service quality using SERVQUAL: A case Uganda Health and Fitness sector, International Journal of Business and Social Sciene, 3(5), 261 – 277, 2012 Spreng, R A., and Mackoy, R D., An Empirical Examination of a Model of Perceived Service Quality and Satisfaction, Journal of Retailing, 72(2), 201-214, 1996 Seth.A, Momaya.K & Gupta.H.M Managing the customer perceived service quality for Cellular mobile Telephony: An Empirical investigation, VIKALPA, 3(1), 19 – 34, 2008 Wheelan C Naked Economics, Vietnamese version, Social labor publishing house, 2002 Zarei.A, Arab.M, Froushani.A.R, Rashidian.A & Tabatabaei.S.M.G Service quality of private hospitals: The Iranian patients` perpective, BMC Health service Research, -7, 2012 - 75 - Zeithaml, V.A., and Bitner, M J Services Marketing; integranting customer focus across the Firm, 2nd ed, Mc Graw Hill New York, 2000 Zekiri J Applying SERVQUAL Model and factor analysis in assessing customer satisfaction with service quanlity: The case of Mobile Telecommunications in Macedonia, International Bulletin of Business Administration, 10(11), 86 -101, 2011 - 76 - APPENDICES - 77 - APPENDIX QUESTIONNAIRE Hi everybody I, Do Manh Hung, am a Masters student, – Korean Soongsil University At present, I am performing the topic: “Study of factors affecting the satisfaction of patients on quality of health care services in Thanh Hoa General Hospital” Please take your time to answer some following questions Your opinions are useful information to the research Sincere thanks Contents of questions Please answer the following questions by circling respective boxes reflecting your agreement on statements (the higher the level is, the higher the agreement is) Of which: Strongly disagree Disagree Normal (neutral) Agree Strongly agree - 78 - Level of agreement No Code I Reliability Rel1 Rel Contents of questions You believe in the diagnose results and treatment methods of the hospital Do you realize hospital staff try not to make errors In treatment of patients 5 5 5 5 5 Do you feel the quality of treatment and Rel3 examination is ensured as notified by the Hospital Rel4 Rel5 II Assurance Do you feel the treatment and examination? Is conducted correctly Do you see any commitment from hospital staff? Do you feel that doctors are not too busy Ass1 to Meet requirements of patients (for example: examination procedures, place of testing) Time of services to be rendered (for Ass2 example: the time of returning Results of testing ) Ass3 Ass4 Do you feel the willingness to help patients Do you feel services are always met on a timely basis - 79 - III Empathy 10 Emp1 Do you feel that doctors and nurses know 5 5 5 of 5 to to provide health care to patients Do you feel that doctors and nurses 11 Emp2 understand concerns and special demands of patients Do you feel that patients are treated and 12 Emp3 13 Emp4 IV Responsiveness 14 Res1 15 Res2 16 Res3 cared enthusiastically Do you feel that time of examination and treatment is convenient to patients Do you feel that attitude of doctors and nurses create confidence in patients Do you feel safe when having treatment and examination in the hospital Do you say that the hospital always has good doctors and nurses Do you say that medical staff has good 17 Res4 knowledge to answer questions patients V Tangibles 18 Ta1 19 Ta2 Do you see that the hospital is always clean Do you see that uniforms of the hospital staff are net and polite - 80 - 20 Ta3 Do you see that the facilities of the hopistal are eye-catched 5 5 5 Do you see that equipment for treatment 21 Ta4 and examiantion is modern and welloperated VI Satisfaction on the examination and treatment service 22 Sa1 23 Sa2 Are you satisfied with facilities of the hospital Are you satisfied with services of the hospital Will you use the examination and 24 Sa3 treatment service for your children when having demand 25 Sa4 26 Sa5 Will you introduce this hospital to others Generally, are you satisfied with the service quality of the hospital Please answer the following questions - Are you included in the following group of age?: < 30 years olds; From 30 to 40 years olds; From 40 to 50 years olds; From 50 to 60 years olds; > 60 years olds - Is your education included in the following groups?: High school; Vocational school; College; Unviersity and above; Others - 81 - - Is your occupation included in the following groups? Farmer; Worker; Office staff; Others - The average income of your family in the following group < VND5 million per month; From VND to VND 10 million; From VND 10- VND 15 million; 4.> VND15 million Thank you for your help! - 82 -