Analyzing perceived healthcare service quality on patient related outcomes

Patient engagement behaviors in hospitals: the role of word of mouth and patient helping behaviors

Purpose

The purpose of this study is to investigate patient perceived value as a stimulus of patient engagement behaviors both from the conceptual and empirical perspectives.

Design/methodology/approach

Based on the stimulus–organism–response framework, the authors developed a model to determine the impact of patient perceived value on patient engagement behavior in health care. The data were collected from a sample of 391 patients hospitalized in private hospitals. Structural equation modeling technique was used to test the research hypotheses.

Findings

The findings confirmed relevance of the service quality dimensions reliability, tangibility, responsiveness and empathy as significant antecedents of patient perceived value. Perceived value plays a significant role in shaping word of mouth and patient helping behaviors.

Research limitations/implications

The findings of this study are relevant and applicable to patients in private hospitals.

Practical implications

This study contributes to the literature by providing new evidence on patient perceived value and engagement behaviors as a response to care quality. With adequate focus on perceived value and service quality, service providers can strengthen the relationship with patients and build a sustainable competitive advantage, by stimulating engagement behaviors in patients.

Originality/value

This study is of unique value to the health-care literature, both from the theoretical and managerial point of views. This study proposes a conceptual model of patient perceived value which can be used in the private health sector. Moreover, this study contributes to the health-care literature by introducing patient-helping behavior.

Assessing service quality and the perceptual difference between employees and patients of public hospitals in a developing country

Purpose

This study aims to examine service quality in Nigerian general hospitals and determines possible differences in service quality perceptions between employees and patients.

Design/methodology/approach

Using the Servqual scale, data was collected from 328 employees and patients of two government hospitals in Abuja and Delta states. Analysis was carried out using SPSS 26 package for constructs reliability frequency, mean, standard deviation and t-statistics.

Findings

The study found significant differences in the perception of service quality between employees and patients of the Nigerian general hospitals. While employees gave a high rating to empathy, patients rated it low. Also, the patients’ poor perception of tangible did not match the employees’ high perception. Other specific findings are patients’ unfavourable assessment of the physical facilities and judged the staff to lack professional dressing. Patients felt the hospitals could not provide necessary equipment for their procedures and thus considered their services unreliable.

Practical implications

Reliability was perceived as a significant problem in this study; therefore, the hospitals management should ensure correct diagnoses and treatment results of the highest quality and timely services. Also, the management should invoke strong relationships between the employees and patients to earn patients’ trust. Employees should ensure to listen to patients’ complaints and find solutions promptly. Patients need health-care workers’ support and rely on their abilities; Therefore, health-care workers should be highly dependable and show empathic behaviour in discharging their duties. Health-care managers must access employees‘ and patients’ particular perceptual gaps and reconcile the difference before further quality improvement initiatives.

Originality/value

The findings in this study strengthen the clamour for assessing service quality from both employees and patients’ views in public hospitals. Hospital service quality is complex and primarily judged from the patients’ perspective. This study showed that health-care quality means different things to all stakeholders.

Operations-oriented strategies and patient satisfaction: the mediating effect of service experience

Purpose

The purpose of this study is to explore the direct and indirect effects of perceived provider professionalism and service recovery in enhancing patient satisfaction in a developing country.

Design/methodology/approach

This study used a survey method to investigate satisfaction among health-care consumers. This study used data collected from 210 health-care consumers to empirically test the hypotheses via structural equation modeling

Findings

This study found that service recovery has a significant direct effect on patient satisfaction. Though this study did not find perceived provider professionalism to have a direct effect on patient satisfaction, it found an indirect effect in the relationship via service experience. Thus, service experience fully/completely mediates the relationship between perceived provider professionalism and patient satisfaction, while partially mediating the significant relationship between service recovery and patient satisfaction.

Originality/value

The results further underscore the need for health-care organizations in developing countries to focus on mindfully developing operations-oriented strategies that lead to the delivery of memorable service experiences for patients.

The effects of cancer care pathways on waiting times

Purpose

The Swedish health-care system currently implements cancer care pathways (CCPs) for better and more timely cancer diagnostics. The purpose of this paper is to elucidate and define “crowding out” effects associated with the CCP implementation.

Design/methodology/approach

A document study based on implementation reports and action plans from Swedish county councils (n = 21) and a case study in one county council were conducted. Qualitative data collection and analysis were used to acquire more knowledge about the “crowding out” effects associated with the CCP implementation.

Findings

Three effects discussed under “crowding out” were defined. The first effect, called the push-out effect, occurs when other patients have to wait for care longer in favour of CCP patients. Another effect is the inclusion effect, whereby “crowding out” is reduced for vulnerable patients due to the standardised procedures and criteria in the referral process. The final effect is the exclusion effect, where patients in need of cancer diagnostics are, for some reason, not referred to CCP. These patients are either not diagnosed at all or diagnosed outside CCP by a non-standard process, with the risk of longer waiting times.

Originality/value

“Crowding out” effects are an urgent topic related to CCP implementation. While these effects have been reported in international research studies, no shared definition has been established to describe them. The present paper creates a common base to measure the “crowding out” effects and support further development of CCPs to avoid the negative effects on waiting times.

Assessing service quality and customer behavioral responses in hospital outpatient services

Purpose

In contrast to the reflective approach of service quality measurement, this paper aims to propose and validate a parsimonious multidimensional second-order formatively measured model of service quality for primary health-care services provided by hospital outpatient departments. The index’s empirical validity is examined by investigating the strength of its relationship with certain behavioral responses such as patient satisfaction and behavioral intentions.

Design/methodology/approach

Data were collected through a stratified random sampling from eight hospital outpatient departments in Greece. Covariance-based structural equation modeling techniques were used to validate the proposed service quality index and further investigate its effect on patient satisfaction and behavioral intention.

Findings

The data analysis indicated that the proposed formative index is fully functional with medical care being the factor and mostly contributes to service quality perception, followed by administrative service and staff performance, and facilities condition and nursing care. It, further, confirmed the partial mediating role of satisfaction, as it enhances the high impact of service quality on behavioral intentions.

Research limitations/implications

The relationships among hospital outpatient departments service quality, patient satisfaction and behavioral intentions were validated with data from one country and a health-care system which is state driven and funded.

Practical implications

An understanding of hospital primary health-care service quality formation is important to health-care decision makers because it offers them the opportunity to consider patients’ needs and wants, and takes the appropriate actions for improving the relevant underling procedures in a more efficient manner to achieve favorable behavioral responses.

Originality/value

The paper manages to propose and empirically evaluate a formatively measured approach of service quality and investigate the effects of the proposed index on patient satisfaction and behavioral intention, especially in the hospital outpatient services context in Greece.