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Al-Hilou M, Suifan T. The mediating effect of patient trust on the relationship between service quality and patient satisfaction. Int J Health Care Qual Assur 2023; ahead-of-print. [PMID: 37938922 DOI: 10.1108/ijhcqa-05-2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
PURPOSE The prime aim of this research is to examine the mediating effect of patient trust on the relationship between service quality and patient satisfaction in Amman, Jordan. DESIGN/METHODOLOGY/APPROACH A convenience sample of patients visiting seven out of the 44 private hospitals in Amman was selected. In total, 385 questionnaires were distributed among patients, with a response rate of 91%. Of these, 35 were disregarded, and the data from the remaining 350 questionnaires were analyzed using SPSS. FINDINGS The results showed that service quality has a statistically significant effect on patient satisfaction. Furthermore, service quality has a statistically significant effect on patient trust, while there is also a statistically significant effect of patient trust on patient satisfaction. The findings also revealed that patient satisfaction partially mediates the relationship between service quality and patient satisfaction. ORIGINALITY/VALUE Generating more insights in the areas of service quality, patient trust and patient satisfaction while also extending the findings of earlier studies. The prior studies in the literature that focus on customers are given a more advantageous perspective by using Jordanian hospitals as a population to test the model of this research. The majority of past research on service quality, patient satisfaction and patient trust in the healthcare sector has been conducted in western nations.
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Talukdar IH, Rifat MA, Sarkar P, Saha N, Tessma MK, Miah MI. Perceived difficulties in maintaining menstrual hygiene practices among indigenous adolescents during seasonal water scarcity periods in Bandarban hill district of Bangladesh: A cross-sectional study. Int J Hyg Environ Health 2023; 254:114268. [PMID: 37778165 DOI: 10.1016/j.ijheh.2023.114268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/30/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Access to clean water is important for menstrual hygiene practices, an important aspect of health for adolescent girls. In Bangladesh, adolescent girls represent poor menstrual hygiene practices, whereas the practice is worse among vulnerable population groups living in areas experiencing seasonal water scarcity. This study portrays perceived difficulties in menstrual hygiene practices among indigenous adolescent girls during the period of seasonal water scarcity in Bandarban Hill District, Bangladesh. METHOD Data was collected from 242 indigenous adolescent girls through interviews during the period of water scarcity. Backward stepwise regression model was used to identify factors associated with perceived difficulty in maintaining menstrual hygiene (PD) practices. RESULT The study participants, mainly living in hard-to-reach areas, reported difficulty in getting adequate water during the water scarcity period, and the quality of water was reported to be poor. PD due to water scarcity was found to be significantly associated with water source degradation (β = 0.247, < 0.001), the need for boiling/purifying water before use for menstrual hygiene (β = 0.203, p = 0.005), and experience of water availability when it was necessary to maintain their optimal menstrual hygiene practice (β = 0.449, p < 0.001), time required to collect water (β = 0.209, p < 0.001), taking a bath every day (β = -0.228, p < 0.001), and frequency of washing genitals per day (β = - 0.094, p = 0.040). CONCLUSION Indigenous adolescents perceive difficulty in menstrual hygiene practices during the period of water scarcity. Further research could be carried out to observe to what extent the seasonal water scarcity could be attributable to worsen the menstrual hygiene practices and to identify the need for addressing the problems.
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Affiliation(s)
- Imdadul Haque Talukdar
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 17165, Stockholm, Sweden.
| | - M A Rifat
- Department of Global Public Health, Karolinska Institutet, 17176, Stockholm, Sweden.
| | - Plabon Sarkar
- Caritas Bangladesh, 2, Outer Circular Road, Shantibagh, Dhaka, 1217, Bangladesh.
| | - Nobonita Saha
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Mesfin Kassaye Tessma
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 17165, Stockholm, Sweden.
| | - Md Ibrahim Miah
- Department of Microbiology, University of Dhaka, Bangladesh.
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Gu L, Tian B, Xin Y, Zhang S, Li J, Sun Z. Patient perception of doctor communication skills and patient trust in rural primary health care: the mediating role of health service quality. BMC PRIMARY CARE 2022; 23:255. [PMID: 36175839 PMCID: PMC9520094 DOI: 10.1186/s12875-022-01826-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/21/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
This study aimed to explore the relationship between communication skills, health service quality, and patient trust in primary health services.
Method
This study was conducted in village clinics in rural China. A simple random sampling method was used to select volunteer village clinics and patients. In total, 574 participants from 25 village clinics were selected with the help of local health officers and village doctors. The response rate was 90%. Statistical analyses (hierarchical linear regression analysis and a structural equation model) were performed to analyze the data.
Results
Patient trust in doctors in rural primary health was influenced by patient perceptions of doctors’ communication skills and health service quality. However, health service quality fully mediated the relationship between doctors’ communication skills and patient trust in village clinics. In other words, doctors’ communication skills indirectly influence patients’ trust in doctors.
Conclusions
This study found a link between doctors’ communication skills and patient trust. The findings suggest that health managers and doctors should attach great value to communication skills and health service quality in promoting the rural doctor-patient relationship. Moreover, the relationship between doctors and patients should be considered when reforming the primary health system.
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Allahham L, Mouselli S, Jakovljevic M. The quality of Syrian healthcare services during COVID-19: A HEALTHQUAL approach. Front Public Health 2022; 10:970922. [PMID: 36033782 PMCID: PMC9403656 DOI: 10.3389/fpubh.2022.970922] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Abstract
Syria is a developing country that face enormous healthcare challenges that aggravated with the outbreak of COVID-19. In the study, we evaluate the perceived healthcare service quality based on hospital type, public and private, using five HEALTHQUAL dimensions. We find that service quality in Syrian private hospitals is perceived better that in public hospitals. However, neither type of hospitals scores exceptionally high in any of the examined HEALTHQUAL dimensions. On the contrary, both hospitals score extremely low in the Improvement dimension. We argue that crowdedness environment, medical staff availability and their low salaries, pricing policies as well as the health insurance system, are to blame for such low perceived quality.
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Affiliation(s)
- Lilas Allahham
- Faculty of Business Administration, Arab International University, Daraa, Syria
| | - Sulaiman Mouselli
- Faculty of Business Administration, Arab International University, Daraa, Syria,*Correspondence: Sulaiman Mouselli ;
| | - Mihajlo Jakovljevic
- Institute of Advanced Manufacturing Technologies Peter the Great St. Petersburg Polytechnic University, Saint Petersburg, Russia,Institute of Comparative Economic Studies, Hosei University, Chiyoda, Japan,Department of Global Health Economics and Policy, University of Kragujevac, Kragujevac, Serbia
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Yusefi AR, Davarani ER, Daneshi S, Bastani M, Mehralian G, Bastani P. Responsiveness level and its effect on services quality from the viewpoints of the older adults hospitalized during COVID-19 pandemic. BMC Geriatr 2022; 22:653. [PMID: 35945488 PMCID: PMC9362974 DOI: 10.1186/s12877-022-03344-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Aging is a sensitive period of life. Attention to the needs of this stage is considered a social necessity. This study is conducted to investigate the responsiveness level and its effect on service quality from the hospitalized older adults’ viewpoints during the COVID-19 pandemic in the south of Iran. Methods It was a cross-sectional descriptive-analytic study that was conducted on 386 old patients. The study instrument was a standard questionnaire that includes three sections of demographic information, World Health Organization Responsiveness, and SERVQUAL. Data were analyzed applying descriptive and inferential statistics the same as Independent T-test, ANOVA, Pearson correlation, and multiple linear regression. Results The mean levels of responsiveness and service quality were 90.72 ± 9.38 (from 160) and 68.01 ± 8.51 (from 110) respectively. This indicates the average level of these variables from the old patients’ viewpoints. There was a significant positive correlation between responsiveness and service quality (r = 0.585). According to the results of multiple linear regression, the dimensions of communication, dignity, prompt attention, primary facilities, social support, information confidentiality, right to choose, and autonomy were identified as the predictors of service quality. Conclusion The average level of responsiveness and service quality perceived from the old patients’ viewpoints during the COVID-19 pandemic can be considered a necessity for supportive planning among the older adults. Meanwhile, according to the impacts of responsiveness on service quality, educational programs are recommended to promote the level of healthcare providers’ responsiveness.
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Affiliation(s)
- Ali Reza Yusefi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Esmat Rezabeigi Davarani
- Health in Disasters and Emergencies Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Salman Daneshi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Misagh Bastani
- Shooshtari Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Peivand Bastani
- Faculty of Health and Behavioral Sciences, School of Dentistry, University of Queensland, Brisbane, Australia
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Impacts of service quality, brand image, and perceived value on outpatient's loyalty to China's private dental clinics with service satisfaction as a mediator. PLoS One 2022; 17:e0269233. [PMID: 35675364 PMCID: PMC9176788 DOI: 10.1371/journal.pone.0269233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 05/17/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study explores the effects and influence paths of service quality, brand image, perceived value, and service satisfaction on outpatients' loyalty to China's private dental clinics. METHODS A cross-sectional survey study was conducted in Dongguan City, Guangdong Province, China in January 2019. The participants were selected using the convenience sampling method. Of the 230 residents surveyed, 125 had received services in private dental clinics, being the valid sample of this study. A multiple linear regression model was used in exploring factors influencing patient loyalty. Subsequently, the path analysis was used in investigating the relationships among service quality, brand image, perceived value, patient satisfaction, and patient loyalty. RESULTS After the effects of demographic and socioeconomic variables were controlled, perceived value and patient satisfaction showed significant influences on patient loyalty. Path analysis indicated that perceived value, perceived quality, and expected quality have direct effects on patient satisfaction and have indirect effects on patient loyalty, and patient satisfaction is a mediator. CONCLUSION Perceived service quality influences patient loyalty through the effect of patient satisfaction, which plays a key role in promoting patient loyalty. This study implies that managers in private dental clinics can gain support from customers by building customer loyalty toward dental clinics.
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Mardaleta M, Lubis AR, Diantimala Y, Fahlevi H. Determinants of patient behavioural loyalty on primary health centres: Evidence from a cross-sectional study in Indonesia. F1000Res 2022; 11:440. [PMID: 35615494 PMCID: PMC9111361 DOI: 10.12688/f1000research.110684.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Patients’ loyalty to visit and use the services provided by the primary health centers (PHCs) is an important requirement of a patient referral system in many countries. The aim of this study was to examine the influence of internal service factors (service provider, service process, and service environment) on service quality and behavioural loyalty of patients in Indonesian PHCs. Methods: A cross-sectional study was conducted in 14 districts in Aceh Province, Indonesia between September and December 2020. Data were collected in 102 PHCs that were selected randomly from 137 PHCs that have an Inpatient Unit in the province. A proportional number of patients were recruited from each PHC and 389 patients were included. The demographic data, three components of internal service factors (service provider, service process, and service environment), the service quality and behavioural loyalty were assessed using a validated questionnaire. Hypothesis testing was conducted by using the structural equation model (SEM). Results: Our data suggested that two elements of internal service factors (service provider and service environment) had a positive and significant influence on service quality of the PHCs with p<0.001 and p=0.021, respectively. Service quality had a positive and significant influence of behavioural loyalty of patients to the PHCs (p=0.003). Service quality however did not serve as an intervening variable between internal service factors (service provider, service process, and service environment) and behavioural loyalty of patients, with p=0.091, p=0.230 and p=0.260, respectively. Conclusions: Service provider and service environment are two main factors that influence the service quality and the service quality directly influence the behavioural loyalty on PHC users. Therefore, to increase the patients’ loyalty to use the PHC services, the quality of the services should be improved by levelling up the quality of providers and both physical and social environments in the PHCs.
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Affiliation(s)
- Mardaleta Mardaleta
- Doctoral Program of Management Science on Public Sector Accounting, Faculty of Economics and Business, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Abdul Rahman Lubis
- Doctoral Program of Management Science, Faculty of Economics and Business, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Yossi Diantimala
- Accounting Department, Faculty of Economics and Business, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Heru Fahlevi
- Accounting Department, Faculty of Economics and Business, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
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Tzadok B, Ben Tov O, Vaispapir V, Shornikov L, Marik O, Martens L, Tal Or E. Lean six sigma and stroke in rural hospital - The case of Baruch Padeh Medical Center. Int J Health Care Qual Assur 2022; ahead-of-print. [PMID: 35075887 DOI: 10.1108/ijhcqa-01-2021-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This case study aims to demonstrate the strengths of the Lean Six Sigma (LSS) methodology to improve the acute ischemic stroke (AIS) treatment rates and reduce process lead time at Baruch Padeh Medical Center (BPMC), a rural hospital in the Galilee region of Northern Israel. The LSS project redefined the BPMC stroke care pathway and increased its efficacy. DESIGN/METHODOLOGY/APPROACH The LSS methodology was implemented in September 2017 by integrating lean principles and the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control). Existing procedures, field observation, ad hoc measurement and in-depth interviews were utilized, and the GEMBA method was implemented to identify root cause and improve actions optimizing the stroke pathway. FINDINGS The presented case shows the usefulness of the LSS methodology in improving quality performance in a rural hospital. The intervention allowed the BPMC to improve the intravenous tissue plasminogen activator (IV-tPA) administration rate (+15.2%), reducing the process lead time. The lead time of door-to-computer tomography decreased from 52 to 26 min, and the door-to-needle time decreased from 94 to 75 min. ORIGINALITY/VALUE The present case study shows the implementation of the LSS methodology aimed to improve the IV-tPA administration rate and reduce the stroke pathway lead time in a rural hospital. The case demonstrates the potential for the LSS methodology to support the AIS pathway optimization and represents a guide for healthcare organizations located in rural areas.
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Affiliation(s)
| | | | | | | | | | - Leon Martens
- Integrated Health Solutions, Medtronic plc, Eindhoven, the Netherlands
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Begum F, Said J, Hossain SZ, Ali MA. Patient satisfaction level and its determinants after admission in public and private tertiary care hospitals in Bangladesh. FRONTIERS IN HEALTH SERVICES 2022; 2:952221. [PMID: 36925832 PMCID: PMC10012818 DOI: 10.3389/frhs.2022.952221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022]
Abstract
Introduction Patient satisfaction is an important indicator of the quality of care provided by health care facilities. The objective of this study was to investigate the rate of satisfaction and its associated factors among the patients admitted to tertiary care hospitals in Bangladesh. Methods This cross-sectional study was conducted in a public and two private tertiary care hospitals in Bangladesh in December 2019, including 923 consecutive patients admitted to medical and surgical departments. Face-to-face interview using a structured questionnaire was conducted to collect patient-level data. Logistic regression models were used to determine the factors associated with patients' satisfaction. Results Patients' overall satisfaction level was 65% (51% in public and 75% in private hospitals) with a satisfaction rate of 63% in hospital staff courtesy, 56.5% in a hospital environment, 67% in physician care, 63% in general patient satisfaction, and 58% in patient's family care. Private hospitals (aOR 3.64, 95% CI 2.2-6.03), conservative management (aOR 3.34, 95% CI 2.10-5.33), shorter hospital stay (aOR 1.58, 95% CI 1.05-2.37) and perceived improvement after treatment (aOR 1.67, 95% CI 1.01-2.76) were associated with patients' satisfaction. In contrast, patients' accommodation on the floor (aOR 0.38, aOR 0.22-0.66) and high health care costs (aOR 0.97, 95% CI 0.95-0.99) were associated with patients' dissatisfaction with the in-patient service they received in both public and private hospitals. Conclusion Almost two-thirds of the patients were satisfied with the inpatient service they received, though, the satisfaction rate was higher in private hospitals. Treatment modality, cost, and outcome, as well as hospital environment like accommodation, were associated with their satisfaction level.
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Affiliation(s)
| | - Jamaliah Said
- Accounting Research Institute, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Syed Zabid Hossain
- Department of Accounting and Information Systems, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Ayub Ali
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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da Silva NB, Martiniano SG, Cardoso AMR, Cavalcanti YW, Figueiredo N, Padilha WWN. User satisfaction with Dental Specialty Centers in Brazil: Proposal of satisfaction index and associated factors. Community Dent Oral Epidemiol 2021; 50:67-73. [PMID: 34967966 DOI: 10.1111/cdoe.12718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the satisfaction of users of Dental Specialty Centers (CEO) in Brazil employing the Service Satisfaction Index (SSI) and identify associated factors. METHODS This quantitative, evaluative, and cross-sectional study used secondary data extracted from the Second External Evaluation of the Program for the Improvement of Access and Quality of Brazilian Dental Specialty Centers (PMAQ-CEO) held in 2018 in 901 municipalities, accounting for 1097 CEO, of which 1042 were investigated. A total of 10391 users participated in the study. Considering user satisfaction as an aggregate variable, SSI was classified into two categories: Lower Satisfaction (SSI < 20) and Maximum Satisfaction (SSI = 20). Data were analyzed by descriptive and inferential statistics using the SPSS® software. The exploratory factor analysis verified the statistical correlations between attributes and SSI. RESULTS The maximum satisfaction with the service was 21.1%; factors that expressed the most significant influence on SSI were waiting time (OR = 1.17; CI 95%: 1.05-1.31), feeling that CEO has good conditions of use (OR = 7.05; CI 95%: 5.15-9.65), not wishing to be assisted at another CEO (OR = 4.17; CI 95%: 3.12-5.57), not having treatment interrupted due to lack of material (OR = 2.05; CI 95%: 1.70-2.47), age up to 40 years of users (OR = 1.31; CI 95%: 1.18-1.46) and higher education (OR = 1.30; CI 95%: 1.14-1.49). CONCLUSIONS SSI appropriately described the user's satisfaction with the service. The maximum satisfaction with the service was influenced by age, education, waiting time, not having treatment interrupted, and considering CEO clean and hygienic environment.
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Grasso MS, del Carmen Valls Martínez M, Ramírez-Orellana A. Health Policies Based on Patient Satisfaction: A Bibliometric Study. Healthcare (Basel) 2021; 9:1520. [PMID: 34828566 PMCID: PMC8624416 DOI: 10.3390/healthcare9111520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/01/2021] [Accepted: 11/08/2021] [Indexed: 12/30/2022] Open
Abstract
Healthcare decision-makers increasingly face a changing and ever-evolving landscape, forcing them to formulate public policies based on the results from different scientific investigations. This article evaluates the field of research on patient satisfaction as a basis for health policies. The analysis was carried out with a sample of 621 articles published between 2000 and 2020 in the Scopus database. The world's largest producer and research co-operator on patient satisfaction and health policy was the United States. However, the most prolific authors, institutions, and journals are of British origin. Regarding the themes, we find that, in economic and management matters, scientific production is scarce. To study the evolution of keywords, we divided the study period into two periods of an equal number of years. In both sub-periods, the keyword "Human" stands out. In the second sub-period, the word "Perception" stands out, which indicates the current attention paid to the patient's opinion.
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Affiliation(s)
- Mayra Soledad Grasso
- Mediterranean European Center of Economics and Sustainable Development (CIMEDES), University of Almería, 04120 Almería, Spain;
| | - María del Carmen Valls Martínez
- Mediterranean European Center of Economics and Sustainable Development (CIMEDES), University of Almería, 04120 Almería, Spain;
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Sun Z, Wang S, Zhao H, Zhou X, Zhang L, Shi J. Does descending health resources reform impact patient low-level hospital selection behavior? Evidence from Zhejiang, China. Arch Public Health 2021; 79:179. [PMID: 34663478 PMCID: PMC8522119 DOI: 10.1186/s13690-021-00700-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/28/2021] [Indexed: 11/15/2022] Open
Abstract
Background Since 2013, China launched descending resources reform, which is a new attempt to correct unbalanced allocation of health resources through human capital spillovers and brand implantation from high-level hospitals. The purpose of this paper is to explore the patients’ hospital selection response to this reform with the focus of low-level hospitals to better understand the effect of this reform on correcting regional inequality of health resources allocation. Methods The European Consumer Satisfaction Index model (ECSI) was used to design a questionnaire, and cross-sectional data from 17 hospitals were collected through 1287 questionnaires from Zhejiang Province. Patient hospital selection (loyalty) is measured using ordinary variables by considering patient willingness to choose a low-level hospital when suffering an illness or severe illness. Analysis of variance (ANOVA) and the structure equation model are applied to examine the effect of reforms on patient behavior. Results The descending resources reform promotes improvements in the capabilities and medical environment of low-level hospitals, and descending doctors also have high accessibility. Perceived quality, patient expectations, and hospital image have significant positive effects on patient satisfaction, and the explanatory power of brand implantation from cooperative high-level hospitals and descending doctors is stronger than the image of the low-level hospital itself. And descending resources reform and patient satisfaction have significant positive impacts on patient’s choice for low-level hospitals with the existence of mediating effect of satisfaction. Conclusions This paper provides supporting empirical evidence of the descending resources reform’s impact on patients’ low-level hospital selection. This reform has been effective in improving the capabilities of low-level hospitals, and brand implantation of high-level hospitals shows strong explanatory power. China’s reform offers a distinct and valuable approach to correcting the uneven allocation of health resources. Besides, the findings also suggest that policymakers could pay more attention to the importance of information channels in impacting patient awareness, responses, and hospital selection.
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Affiliation(s)
- Zesheng Sun
- School of Finance and Business, Shanghai Normal University, Shanghai, China
| | - Shuhong Wang
- Department of Stomatology, Tongde Hospital of Zhejiang Province, Hangzhou, China. .,Department of Stomatology, Songjiang Hospital of Shanghai, Shanghai, China.
| | - Hongjun Zhao
- School of Finance and Business, Shanghai Normal University, Shanghai, China
| | - Xu Zhou
- School of Finance, Zhejiang Gongshang University, Hangzhou, China
| | - Ludan Zhang
- School of Finance and Business, Shanghai Normal University, Shanghai, China
| | - Jiongping Shi
- School of Finance and Business, Shanghai Normal University, Shanghai, China
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Safdar KA, Emrouznejad A, Dey PK. An optimized queue management system to improve patient flow in the absence of appointment system. Int J Health Care Qual Assur 2021; ahead-of-print. [PMID: 33179461 DOI: 10.1108/ijhcqa-03-2020-0052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this research study is to develop a queue assessment model to evaluate the inflow of walk-in outpatients in a busy public hospital of an emerging economy, in the absence of appointment systems, and construct a dynamic framework dedicated towards the practical implementation of the proposed model, for continuous monitoring of the queue system. DESIGN/METHODOLOGY/APPROACH The current study utilizes data envelopment analysis (DEA) to develop a combined queuing-DEA model as applied to evaluate the wait times of patients, within different stages of the outpatients' department at the Combined Military Hospital (CMH) in Lahore, Pakistan, over a period of seven weeks (23rd April to 28th May 2014). The number of doctors/personnel and consultation time were considered as outputs, where consultation time was the non-discretionary output. The two inputs were wait time and length of queue. Additionally, VBA programming in Excel has been utilized to develop the dynamic framework for continuous queue monitoring. FINDINGS The inadequate availability of personnel was observed as the critical issue for long wait times, along with overcrowding and variable arrival pattern of walk-in patients. The DEA model displayed the "required" number of personnel, corresponding to different wait times, indicating queue build-up. ORIGINALITY/VALUE The current study develops a queue evaluation model for a busy outpatients' department in a public hospital, where "all" patients are walk-in and no appointment systems. This model provides vital information in the form of "required" number of personnel which allows the administrators to control the queue pre-emptively minimizing wait times, with optimal yet dynamic staff allocation. Additionally, the dynamic framework specifically targets practical implementation in resource-poor public hospitals of emerging economies for continuous queue monitoring.
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Rumi MH, Makhdum N, Rashid MH, Muyeed A. Patients' Satisfaction on the Service Quality of Upazila Health Complex in Bangladesh. J Patient Exp 2021; 8:23743735211034054. [PMID: 34395848 PMCID: PMC8361520 DOI: 10.1177/23743735211034054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article attempts to measure the state of satisfaction of patients over the quality of health care as well as identify the crucial factors that affect the patients' satisfaction in Upazila Health Complex (UHC). The quantitative approach was used following a structured questionnaire survey method. Four hundred visitors of 2 UHCs in Meherpur district were randomly selected as respondents for the study. The Statistical Package for Social Science IBM version 24 and R software (version 4.0.2) were used to run descriptive statistics, χ2 test, confirmatory factor analysis, and principal component analysis for quantitative data analysis. The data reveal that the overall satisfaction score is (2.75 ± 0.943). A 3-dimension model of service quality is found to have a significant relationship with patients' satisfaction at the rural level. Care providers' attitude and responsiveness in service delivery are found to be the most vital factor, while the tangibles and accessibility factors moderately influence the patient's satisfaction on the service quality at UHCs.
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Affiliation(s)
- Maruf Hasan Rumi
- Department of Public Administration, University of Dhaka, Dhaka, Bangladesh
| | - Niaz Makhdum
- Department of Public Administration, University of Dhaka, Dhaka, Bangladesh
| | - Md Harunur Rashid
- Department of Public Administration and Governance Studies, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
| | - Abdul Muyeed
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
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15
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Bezerra de Oliveira LA, Gonzaga de Albuquerque AP, de Carvalho RC, de Medeiros DD. What determines patient loyalty in health services? An analysis to assist service quality management. TOTAL QUALITY MANAGEMENT & BUSINESS EXCELLENCE 2021. [DOI: 10.1080/14783363.2021.1960500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Coutinho S, Prasad CVVSNV, Prabhudesai R. Antecedents and outcomes of patient satisfaction in healthcare: A conceptual model. Health Mark Q 2021; 37:300-315. [PMID: 34218755 DOI: 10.1080/07359683.2021.1947068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study develops a conceptual model and establishes the relationships between the variables, both influencing and affected by patient satisfaction. The authors conducted a thorough search for peer-reviewed articles obtaining a final sample of 64 studies. Service quality was found to be the only antecedent influencing patient satisfaction, while patient satisfaction was found to impact trust, loyalty and word of mouth, also mediating the influence of service quality on these variables. While the study integrates the scattered literature, from a practical standpoint it exhibits how increased patient satisfaction plays a key role in influencing patient trust, loyalty and word-of-mouth.
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Affiliation(s)
| | - Ch V V S N V Prasad
- Birla Institute of Technology and Science (BITS) Pilani, KK Birla Goa Campus, Sancoale, India
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17
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Yarimoglu E, Ataman G. How service quality in hospitals varies based on hospital ownership and demographics: a study on Turkish patients living urban areas. TOTAL QUALITY MANAGEMENT & BUSINESS EXCELLENCE 2021. [DOI: 10.1080/14783363.2021.1890576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Emel Yarimoglu
- Faculty of Business, Department of Business Administration, Yasar University, Izmir, Turkey
| | - Gorkem Ataman
- Faculty of Business, Department of Business Administration, Yasar University, Izmir, Turkey
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18
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Abstract
PurposeThis paper aims to understand the popular themes of coronavirus disease 2019 (COVID-19)-related online misinformation in Bangladesh and to provide some suggestions to abate the problem.Design/methodology/approachThis paper discusses online COVID-19-related misinformation in Bangladesh. Following thematic analyses, the paper discusses some dominant misinformation themes based on the data collected from three fact-checking websites of Bangladesh run by media professionals and scholars.FindingsCOVID-19-related online misinformation in Bangladesh has six popular themes: health, political, religious, crime, entertainment and miscellaneous. To curb misinformation, many initiatives have been taken so far that have produced little success. This paper briefly proposes the implementation of an experimental two-way misinformation prevention technique for a better result.Originality/valueAcknowledging previous initiatives, this paper discusses the major themes and offers additional solutions to reduce online misinformation which would benefit academics as well as policymakers.
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19
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Yu Y, Chen Z, Zhao Y, Wang Y, Zhang R, Zhou X. Medical service quality, psychological contract, and patient loyalty: An empirical study among patients in China. Medicine (Baltimore) 2020; 99:e21079. [PMID: 33235054 PMCID: PMC7710247 DOI: 10.1097/md.0000000000021079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study is to examine the mediating effect of psychological contracts (including relational and transactional psychological contracts) on the relationship between medical service quality and patient loyalty.A cross-sectional survey was conducted between September and December 2017. Questionnaires assessing medical service quality, the psychological contract, and patient loyalty were distributed to a random sample of 600 patients across 6 hospitals. The final sample consisted of 469 participants. Hierarchical regression analyses were conducted to examine the mediating effect of psychological contracts on the relationship between medical service quality and patient loyalty.The mean scores of medical service quality, psychological contracts, and patient loyalty were 3.497 ± 0.571, 3.699 ± 0.503, and 3.342 ± 0.724, respectively. Medical service quality is positively related to psychological contract (β = 0.612, 95% confidence interval [CI] = 0.476-0.603) and patient loyalty (β = 0.676, 95% CI = 0.773-0.944). Further, psychological contract is positively related to patient loyalty (β = 0.599, 95% CI = 0.757-0.968). Both relational psychological contract and transactional psychological contract mediate the relationship between medical service quality and patient loyalty.Our findings reveal that medical service quality is associated with patient loyalty and that this association is mediated by relational and transactional psychological contracts. Therefore, in order to improve patient loyalty, psychological contracts should be reinforced, and medical service quality should be improved.
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Affiliation(s)
- Yanghang Yu
- School of Public Finance and Management, Yunnan University of Finance and Economics, Kunming, Yunnan Province
| | - Zhixia Chen
- College of Public Administration, Huazhong University of Science and Technology, Wuhan, Hubei Province
| | - Yuanyuan Zhao
- Tourism and Cultural Industry Research Institute, Yunnan University of Finance and Economics, Kunming, Yunnan Province
| | - Yanan Wang
- School of Public Health,Kunming Medical University, Kunming, Yunnan Province
| | - Rong Zhang
- School of Economics, Yunnan University of Finance and Economics, Kunming, Yunnan Province
| | - Xining Zhou
- Yunnan International Trade Association, Kunming, Yunnan Province, China
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20
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Chawla K, Kibreab A, Scott V, Lee EL, Aduli F, Brim H, Ashktorab H, Howell CD, Laiyemo AO. Association of Patients' Perception of Quality of Healthcare Received and Colorectal Cancer Screening Uptake: An Analysis of 2 National Surveys in the USA. Med Princ Pract 2020; 30:331-338. [PMID: 33049736 PMCID: PMC8436667 DOI: 10.1159/000512233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE It is not known whether patients' ratings of the quality of healthcare services they receive truly correlate with the quality of care from their providers. Understanding this association can potentiate improvement in healthcare delivery. We evaluated the association between patients' ratings of the quality of healthcare services received and uptake of colorectal cancer (CRC) screening. SUBJECTS AND METHODS We used 2 iterations of the Health Information National Trends Survey (HINTS) of adults in the USA. HINTS 2007 (4,007 respondents; weighted population = 75,397,128) evaluated whether respondents were up to date with CRC screening while HINTS 4 cycle 3 (1,562 respondents; weighted population = 76,628,000) evaluated whether participants had ever received CRC screening in the past. All included respondents from both surveys were at least 50 years of age, had no history of CRC, and had rated the quality of healthcare services that they had received at their healthcare provider's office in the previous 12 months. RESULTS HINTS 2007 data showed that respondents who rated their healthcare as good or fair/poor were significantly less likely to be up to date with CRC screening compared to those who rated their healthcare as excellent. We found comparable results from analysis of HINTS 4 cycle 3 data with poorer uptake of CRC screening as the healthcare quality ratings of respondents reduced. CONCLUSION Our study suggests that patients who reported receiving lower quality of healthcare services were less likely to have undergone and be compliant with CRC screening recommendations. It is important to pay close attention to patient feedback surveys in order to improve healthcare delivery.
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Affiliation(s)
- Karan Chawla
- Department of Medicine, George Washington School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Angesom Kibreab
- Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Victor Scott
- Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Edward L. Lee
- Department of Pathology, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Farshad Aduli
- Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Hassan Brim
- Department of Pathology, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Hassan Ashktorab
- Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Charles D. Howell
- Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Adeyinka O. Laiyemo
- Department of Medicine, Howard University College of Medicine, Washington, District of Columbia, USA
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21
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Wartiningsih M, Supriyanto S, Widati S, Ernawaty E, Lestari R. Health promoting hospital: A practical strategy to improve patient loyalty in public sector. J Public Health Res 2020; 9:1832. [PMID: 32728573 PMCID: PMC7376481 DOI: 10.4081/jphr.2020.1832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2020] [Indexed: 11/23/2022] Open
Abstract
Background: The Health-Promoting Hospital (HPH) aims to improve the overall quality of health services for patient, families, and the community as a whole, with assessment and intervention as the essential components. In hospitals, this activity needs to be vigorously developed through interdisciplinary teamwork, shared decision-making process, and by involving patients and families during treatment and through the delivery of an evidence-based health promotion process. Previous studies analyzed some steps to improve patient loyalty through the HPH. However, limited studies were carried out on its use in the public sector. This study, therefore, aims to analyze the impact of HPHs to improve patient loyalty in the public sector. Design and Methods: The simple random sampling method was used to obtain data from 101 respondents in a public hospital, with the cross-sectional design used to gain a better understanding of patient loyalty. Results: The result showed that HPHs influenced patient expectations (P=0.030), which in turn affected perceived value (P=0.014) and satisfaction (P=0.002). In addition, perceived value and satisfaction have effects on patients’ loyalty (P=0.001). Conclusion: In conclusion, HPHs have a positive impact on patient loyalty. Therefore, the public sector needs to enhance its services in accordance with the standards and guidelines. Significance for public health Health-promoting hospital (HPH) aims to improve the quality of health services for patients, families, visitors, stakeholders, and the community as a whole. In Indonesia, the current implementation of HPH is not yet optimal. Limited studies analyzed some steps to improve patient loyalty through the health-promoting hospital, and its use in the public sector. This study describes the impact of HPH to improve patient loyalty in the public sector through expectations, perceived value, and satisfaction.
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Affiliation(s)
| | | | - Sri Widati
- Department of Health Promotion and Behavioral Sciences, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya
| | - Ernawaty Ernawaty
- Department of Health Policy and Administration Faculty of Public Health
| | - Retno Lestari
- Study Program of Nursing Science, Faculty of Medicine, University of Brawijaya, Malang, Indonesia
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22
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Wang Y. Correlation analysis of empathy satisfaction and empathy, mental resilience, and social support in elderly patients with functional dyspepsia. Shijie Huaren Xiaohua Zazhi 2020; 28:70-75. [DOI: 10.11569/wcjd.v28.i2.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The development direction of empathic satisfaction as helping industry is gradually shifting from medical personnel to patients. The level of empathy satisfaction is closely related to the levels of empathy ability, social support, and mental resilience.
AIM To explore the correlation among empathy satisfaction, empathy ability, mental resilience, and social support in elderly patients with functional dyspepsia (FD).
METHODS One hundred and thirty elderly patients with FD who were admitted to our hospital from June 2017 to August 2019 were selected as the study subjects. The professional quality of life scale, the Chinese-version Jefferson empathy scale, the comprehension social support scale, and the self-recovery strength scale were used for investigations.
RESULTS The scores of empathy competence, mental resilience, social support, and empathy satisfaction in elderly FD patients were 106.94 ± 9.36, 35.72 ± 6.87, 67.83 ± 8.34, and 33.94 ± 4.90, respectively, all of which were positively correlated [r = 0.765- (-0.423), P < 0.05]. Regression analysis was conducted with empathy ability as the independent variable, mental resilience as the mediating variable, and empathy satisfaction as the dependent variable. The results showed that both empathy (β = 0.189, P < 0.01) and resilience (β = 0.282, P < 0.01) positively predicted empathy satisfaction, and the predictive effect of empathy on empathy satisfaction was decreasing (β = 0.153, P < 0.01), indicating that psychological resilience has a mediating effect between empathy ability and empathy satisfaction. The moderating effect test program of the mediating variable was used for multiple regression analysis, and equation 1 and equation 2 were established, respectively, with mental resilience and empathy satisfaction as the dependent variables. The results showed that in equation 1, the moderating effect of mental resilience on empathy × social support was not significant (β = -0.031, P > 0.05). In equation 2, empathy satisfaction had a significant moderating effect on psychological resilience × social support (β = 0.179, P < 0.01).
CONCLUSION The level of empathy in elderly FD patients is low, which may be related to age and course of disease. Empathy ability, psychological resilience, social support, and empathy satisfaction are positively correlated, so we should attach importance to the role of psychological resilience in clinical work and provide a high level of social support, so as to improve the empathy satisfaction of elderly FD patients.
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Affiliation(s)
- Yong Wang
- the Second Hospital of Jinhua City, Jinhua 321000, Zhejiang Province, China
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23
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Jameel A, Asif M, Hussain A, Hwang J, Bukhari MH, Mubeen S, Kim I. Improving Patient behavioral Consent through Different Service Quality Dimensions: Assessing the Mediating Role of Patient Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234736. [PMID: 31783526 PMCID: PMC6926908 DOI: 10.3390/ijerph16234736] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 11/26/2022]
Abstract
This study aimed to examine the impact of the five-dimensional health care service quality (SQ) on patient behavioral consent (PBC). This study further explored the mediating role of patient satisfaction (PS) on the SQ–PBC relationship. A survey questionnaire was used to collect the data from public sector hospitals situated in Bahawalpur division, Punjab, Pakistan. We used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to test the hypotheses. This study found positive and significant relationships between SQ and PBC, SQ and PS, and PS and PBC. Our results further revealed that PS partially mediates the relationship between SQ and PBC. Our study offers a comprehensive theoretical framework of several service quality attributes (SQs) affecting patient behavioral consent (PBC) and patient satisfaction (PS) in health care institutions. Testing these above relationships via a mediation approach is novel and contributed to the current study on service quality.
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Affiliation(s)
- Arif Jameel
- School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China or or or
| | - Muhammad Asif
- School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China or or or
| | - Abid Hussain
- School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China or or or
| | - Jinsoo Hwang
- The College of Hospitality and Tourism Management, Sejong University, 98 Gunja-Dong, Gwanjin-Gu, Seoul 143-747, Korea
- Correspondence: (J.H.); (M.H.B.)
| | - Mussawar Hussain Bukhari
- Department of Political science, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
- Correspondence: (J.H.); (M.H.B.)
| | - Sidra Mubeen
- Government College University, Faisalabad 38000, Pakistan;
| | - Insin Kim
- Department of Tourism and Convention, Pusan National University, Busan 43241, Korea;
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24
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Javed SA, Ilyas F. Service quality and satisfaction in healthcare sector of Pakistan- the patients' expectations. Int J Health Care Qual Assur 2018; 31:489-501. [PMID: 29954278 DOI: 10.1108/ijhcqa-08-2016-0110] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to assess the influence of patients' expectations from healthcare service quality on their satisfaction with nursing in public and private hospitals of Pakistan. Design/methodology/approach Data ( n=456) were collected from three public sector hospitals and three private sector hospitals of Lahore, the capital of Pakistan's most populous province. Male and female patients who have experience of both sectors were surveyed using a self-administered questionnaire developed using the original SERVQUAL approach. Data were analyzed using the statistical techniques and the Laplace criterion. Findings This paper attempts to explain degree of influences of five service quality constructs (empathy, responsiveness, tangibility, reliability and assurance) on Pakistani patients' expectations from the private and public sector hospitals and thus patient satisfaction. Further, this work can offer several intuitions into the effect of five constructs of service quality on patients' expectations of healthcare service quality and patient satisfaction with the service providers/nursing. The results reveal that the patient satisfaction is most strongly related to empathy in public sector and to responsiveness in private sector. Research limitations/implications In light of the previous studies and the current research findings, the study anticipates no apparently significant improvement in healthcare sector of Pakistan in near future considering various factors discussed in the study. The study will also help the service providers and the policy makers in understanding the deteriorating situation of the Pakistani healthcare sector and will guide them in identifying the areas by improving which not only the healthcare service quality in the country can be improved but also the image of healthcare sector among the masses and competitiveness of the healthcare sector can be enhanced. Originality/value The value of the study rests in its critical analysis of the current status of the healthcare sector of Pakistan with a view to suggest the areas that need to be worked on by the service providers and policy makers. Also, the study tries to settle a controversy within Pakistani healthcare literature concerning the question that who is producing more satisfied patients: private hospitals or their public counterparts?
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Affiliation(s)
- Saad Ahmed Javed
- Institute for Grey Systems and Decision Sciences, GreySys Foundation, Lahore, Pakistan.,College of Economics and Management, Nanjing University of Aeronautics and Astronautics , Nanjing, P.R. China
| | - Fatima Ilyas
- Academy of Young Researchers and Scholars, GreySys Foundation, Lahore, Pakistan
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