CUSTOMER SATISFACTION FROM HOSPITAL SERVICES: A STUDY OF MAJOR PRIVATE HOSPITALS IN LUDHIANA

Research Project Report

S !"#tte$ to the P %ja! A&r#c 't ra' U%#(ers#t) #% part#a' * '*#''"e%t o* the re+ #re"e%ts *or the $e&ree o*

MASTER OF ,USINESS ADMINISTRATION #%

MAR-ETIN. MANA.EMENT /M#%or S !ject: Eco%o"#cs0

,)

Ma%$eep S#%&h .h "a% /L123341,S1561M,A0

CHAPTER 5

INTRODUCTION
The modern age can be called as the Age of Consumers. In todays cut-throat competition the consumer is considered as the king. any policies of !arious

organi"ations are aimed at keeping the consumer happy and satisfied. It is !ery important for each and e!ery organi"ation to keep its consumers satisfied in order to maintain its competiti!eness in the market. #ot only does this help the organi"ation to maintain the si"e of its share in the market$ it might e!en help it to increase the si"e of its share. It might also be instrumental in increasing the o!erall market si"e. This helps in increasing the o!erall profitability of the organi"ation. It also helps the long-term sur!i!al prospects of the organi"ation. Consumers %hen !ie%ed on the macro le!el e&hibit similar traits. 'o%e!er %hen %e take a closer look and come do%n to the micro le!el$ %e find that the consumers !ary as compared to one another on one aspect or the other based on a !ariety of attributes ()otler$ *++,-. In the present business scenario of cutthroat competition$ customer satisfaction has become the prime concern of each and e!ery kind of industry. Companies are increasingly becoming customer focused. Companies can %in customers and surge ahead of competitors by meeting and satisfying the needs of the customers. .orld o!er businesses ha!e reali"ed that marketing is not the only factor in attracting and retaining customers. /ther ma0or factors responsible for the

same are satisfaction through ser!ice 1uality and !alue. 2!en the best marketing companies in the %orld fail to sell products and ser!ices that fail to satisfy the customers needs. 3o customer satisfaction is the key%ord in todays fiercely competiti!e business en!ironment.

CUSTOMER SATISFACTION
.hether the buyer is satisfied after purchase depends on the products performance in relation to the buyers e&pectations. In general$ satisfaction is a persons feelings of pleasure or disappointment resulting from comparing a products percei!ed performance in relation to his or her e&pectations. If the performance falls short of e&pectations$ the customer is dissatisfied. If the performance matches the e&pectations$ the customer is satisfied. If the performance e&ceeds e&pectations$ the customer is highly satisfied or delighted. The link bet%een customer satisfaction and customer loyalty is not proportional. 3uppose customer satisfaction is rated on a scale from one to fi!e. At a !ery lo% le!el of customer satisfaction (le!el one-$ customers are likely to abandon the company and e!en bad mouth it. At le!els t%o to four customers are fairly satisfied but still find it easy to s%itch %hen a better offer comes along. At le!el fi!e$ the customer is !ery likely to repurchase and e!en spread good %ord out of mouth about the company. 'igh satisfaction creates an emotional bond %ith the brand or company$ not 0ust a rational preference.

CUSTOMER E7PECTATIONS 'o% do buyers form their e&pectations4 5rom past buying e&periences$ friends and associates ad!ice$ and marketers and competitors information and promises. If marketers raise e&pectations too high$ the buyer is likely to be disappointed. 'o%e!er$ if the company sets e&pectations too lo%$ it %ont attract enough customers. 3ome of todays most successful companies are raising e&pectations and deli!ering performances to match. These companies are aiming for TC3- total customer satisfaction. A customers decision to be loyal or to defect is the sum of many small encounters %ith the company. The key to generating high customer loyalty is to deli!er high customer !alue. 3o a company must design a competiti!ely superior !alue proposition aimed at a specific market segment$ backed by a superior !aluedeli!ery system. The (a' e propos#t#o% consists of the %hole cluster of benefits the company promises to deli!er6 it is more than the core positioning of the offering. .hether the promise is kept depends on the companys ability to manage its !alue deli!ery system. The (a' e $e'#(er) s)ste" includes all the e&periences the customer %ill ha!e on the %ay to obtaining and using the offering. Customer satisfaction is a feeling of pleasure or disappointment on the offers percei!ed performance in relation to buyers e&pectations. 2&pectation is defined as %hat the customer %ants7re1uires from the product7ser!ice and percei!ed performance is the perception of the customer about the product7ser!ice i.e. e!aluation of the product7ser!ice after using it. 3o perception is %hat the
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customer actually recei!es7gets from the product7ser!ice. The e!aluation is done by comparing the e&pectations %ith the percei!ed performance of the product7ser!ice. Therefore customer satisfaction is a function of percei!ed performance and customer e&pectations. Customers %ho are 0ust satisfied find it easy to s%itch o!er %hen a better offer comes than those %ho are highly satisfied. 5or customer focused companies satisfaction is both a goal as %ell as a marketing tool. .hat a consumer thinks about the product or ser!ices offered by a firm can ha!e a marked effect on the purchase of its products or ser!ices. 3o one of the tasks before the management is to kno% %hat the consumer e&pect and %hat they are getting in return. 3atisfaction is a 0udgment that a product or ser!ice feature$ or the product or ser!ice itself$ pro!ided (or is pro!iding- a pleasurable le!el of consumptionrelated fulfillment$ including le!els of under- or o!er fulfillment. The e&pectations-disconfirmation paradigm pro!ides the most popular e&planation of consumer satisfaction. 'o%e!er$ and as is occasionally noted$ if a customer e&periences disconfirmation after consuming a product$ future e&pectations regarding the product should be re!ised to%ard the performance percei!ed by the customer. If e&pectations do not change in the face of disconfirmation$ the implication %ould be that the customer did not learn from their consumption e&perience (/li!er$ 199:-.

MEASURIN. SATISFACTION
Although the customer oriented companies seek to create high customer satisfaction that is not is main goal. If the company increases customer satisfaction by lo%ering its price or increasing its ser!ices$ the result may be lo%er profits. The company might be able to increase its profitability by means other than increased satisfaction. Also$ company has many stakeholders$ including employees$ dealers$ suppliers$ and stockholders. 3pending more to increase customer satisfaction might $#(erts * %$s *ro" #%creas#%& the sat#s*act#o% o* other part%ers . <ltimately$ the company must operate on the philosophy that it is trying to deli!er a high le!el of customer satisfaction sub0ect to $e'#(er#%& accepta!'e 'e(e's o* sat#s*act#o% to the other sta8eho'$ers9 &#(e% #ts tota' reso rces. Table describes four methods companies use to track and measuring customer satisfaction= Co"p'a#%t a%$ s &&est#o% A customer-centered organi"ation makes it s)ste" C sto"er S r(e)s easy for customers to register suggestion and complaints. Sat#s*act#o% >esponsi!e companies measure customer satisfaction directly by conducting periodic sur!eys. .hile collecting customer

satisfaction data$ it is also useful to ask additional 1uestions to measures repurchase intention and to measure the likelihood or

%illingness to recommend the brand to .host Shopp#%& others. Companies can hire people to pose as potential buyers to report on strong and %eak Lost C sto"er A%a')s#s points e&perienced in buying

companys and competitors products. Companies should contact customers %ho ha!e stopped buying or %ho ha!e s%itched to another supplier to learn %hy this happened.

The measurement of customer satisfaction has become !ery important for the health care sector also. The concept of customer satisfaction has encouraged the adoption of a marketing culture in the health care sector in both de!eloped and de!eloping countries. As large numbers of hospitals are opening up and the people are becoming more a%are and conscious of health$ great competition has emerged in this industry. 3o to retain their patients hospitals ha!e to pro!ide better facilities7ser!ices to its customers. @arious factors that can affect the patients satisfaction include beha!iour of doctors$ a!ailability of specialised doctors$ beha!iour of medical assistants$ 1uality of administration$ 1uality of atmosphere$ a!ailability of modern facilities etc. As gre% the competition$ so gre% the trend of pro!iding better facilities to the customers by the hospitals. In last fe% years$ a plethora of hospitals ha!e
:

mushroomed in and around the city. These hospitals are ad!ertising hea!ily about the speciali"ed treatments pro!ided by tthese hospitals. There are !arious hospitals that pro!ide speciali"ed treatments for !arious diseases. Aecause of neck to neck competition bet%een hospitals customers run to these hospitals for speciali"ed treatments. Interestiongly all hospitals claim to ha!e a high success rate. They claim to pro!ide the best treatment and other essential facilities at reasonable cost and in easy %ay to their customers. Aut ho% much of this is true and ho% many of their claims are myth are not kno%n to !ast ma0ority of customers. As competition is increasing$ the hospitals are making their best efforts to pro!ide 1uality health care ser!ices to its customers. They ha!e begun practicing a patient satisfaction strategy comprising consumer-oriented plans$ policies and practices to genuinely meet the needs of customers. Also$ %ith increased a%areness and high e&pectations of the customers hospitals ha!e to pro!ide them better facilities. Batients ha!e begun to demand high 1uality of ser!ices i.e. a consumer oriented approach. These days patients ha!e become more a%are about their rights so they %ant they should be better facilities like responding to their 1ueries promptly$ friendly en!ironment$ understanding their problems$ a!ailability of speciali"ed doctors$ maintaining cleanliness$ regular repots etc. i.e. pro!iding them e!ery type of essential facilities. 3o$ if the hospitals %ant that their customers must be satisfied$ they ha!e to pro!ide not only better treatment but other facilities also.

The current study is focused on e&amining the !arious factors related to patient satisfaction %ith the follo%ing specific ob0ecti!es= 1. To study the customer e&pectations from hospital ser!ices. *. To study the customer perception of hospital ser!ices. ,. To study the degree of satisfaction of customers from hospital ser!ices.

CHAPTER II REVIE: OF LITERATURE

any studies ha!e been conducted on the customer satisfaction. An attempt has been made to present in brief$ a re!ie% of literature on customer satisfaction in general as %ell as on the customer satisfaction from hospital ser!ices. Briscilla et al (19C,- proposed a cogniti!e model to assess the dynamic aspect of consumer satisfaction7 dissatisfaction in consecuti!e purchase beha!ior. They found that satisfaction ha!e a significant role in mediating intentions and actual beha!ior for fi!e product classes that %ere analy"ed in the conte&t of a three- stage longitudinal field study. They found that repurchases of a gi!en brand is affected by lagged intention %hereas s%itching beha!ior is more sensiti!e to dissatisfaction %ith brand consumption. Da!id and .ilton(19CC- ha!e e&tended consumer satisfaction literature by theoretically and empirically e&amining the effect of percei!ed performance using a model first proposed by Churchill and 3urprenant$ in!estigating ho% attracti!e conceptuali"ations of comparison standards and disconfirmation capture the satisfaction formation process and e&ploring possible multiple comparison processes in satisfaction formation. They suggest that percei!ed performance e&erts direct significant influence on satisfaction in addition to those influences from e&pected performance and sub0ecti!e disconfirmation.

1+

3aha (19CC- made an attempt to in!estigate the interrelationships bet%een 0ob-satisfaction$ life satisfaction$ life satisfaction-o!er-time and health. The relationship among these four !ariables and biographical !ariables %ere also e&amined. The study %as conducted o!er the nurses in #igeria. The data %as collected from the full time employees only because statements about 0ob satisfaction and other !ariables are different %hen supplied by retirees$ part-time nurses. Aolton and Dre% (1991- proposed a model of ho% customers %ith prior e&periences and e&pectations assessed ser!ice le!els$ o!erall ser!ice 1uality and ser!ice !alue. They applied the model to residential customers of local telephone ser!ices. Their study e&plored ho% customers integrate their perceptions of a ser!ice to form an o!erall e!aluation of that ser!ice. They de!eloped a multistage model of determinants of percei!ed ser!ice 1uality and ser!ice !alue. The model described ho% customers e&pectations$ perceptions of current performance and disconfirmation e&periences affected their satisfaction or dissatisfaction %ith a ser!ice$ %hich in turn affected their assessment of ser!ice 1uality and !alue. Aoulding et al (199,- stated that the ser!ice 1uality relates to the retention of customers at aggregate le!el. The author has offered a conceptual model of the impact of ser!ice 1uality on particular beha!ior that signal %hether customers remain %ith of defect from a company. The results of the study sho% strong

11

e!idence of their being influenced by ser!ice 1uality. The findings also re!eal difference in the nature of the ser!ice 1uality. Aurora and alhotra (199:- had done a comparati!e analysis of the

satisfaction le!el of customer of public and pri!ate sector banks$ in order to help the bank management to formulate marketing strategies to lure customers to%ards them and hence increase customer base. Ere%al et al had e&panded and integrated prior price percei!ed !alue models %ithin the conte&t of price comparison ad!ertising. ore specifically$ the

conceptual model e&plicates the effects of ad!ertised selling and reference prices on buyers internet reference prices$ perceptions of 1uality$ ac1uisition !alue$ transaction !alue$ and purchase and search intentions. T%o e&perimental studies test the conceptual model. The results across these t%o studies$ both indi!idually and combined$ support the hypothesis that buyers internal reference prices are influenced by both ad!ertised selling and reference price as %ell as buyers perception of product 1uality. The authors also find that effect of ad!ertised selling price on buyers ac1uisition !alue %as mediated by their perceptions of transaction !alue. In addition$ effects of percei!ed transaction !alue on buyers$ beha!ioral intentions %ere mediated by their ac1uisition !alue perceptions. @oss (199C- had e&amined the rule of price$ performance and e&pectations to determine satisfaction in ser!ice e&change. .hen price and performance are consistent$ e&pectations ha!e an assimilation effect on performance and
1*

satisfaction 0udgments6 %hen price and performance are inconsistent$ e&pectations ha!e no effect on performance and satisfaction 0udgments. To e&amine these issues authors de!elop a contingency model that they estimate using data from a multimedia e&perimental design. The results generally support contingency frame%ork and pro!ide empirical support for normati!e guidelines that call for creating realistic performance e&pectations and offering money-back ser!ice guarantees. Earbarino and Fohnson (1999- analy"e that the relationships of satisfaction$ trust and commitment to component satisfaction attitudes and future intentions for the customers of a #e% Gork off-Aroad%ay repertory theater company. 5or the relational customers ( indi!idual ticket buyers and occasional subscribers-$ o!erall satisfaction is the primary mediating construct bet%een the component attitudes and future intentions and for the high relational customers (consistent subscribers-$ trust and commitment$ rather than satisfaction$ are the mediators bet%een component attitudes and future intentions. 3harma and Chahal (1999- had done a study of patient satisfaction in outdoor ser!ices of pri!ate health care facilities. They had done a sur!ey to understand the e&tent of patient satisfaction %ith diagnostic ser!ices. They ha!e constructed a special instrument for measuring patient satisfaction. The instrument captures the beha!iour of doctors and medical assistants$ 1uality of administration$ and atmospherics. The role of graphic characters like gender$ occupation$

1,

education$ and income is also considered. Aased on their findings$ they also suggested strategic actions for meeting the needs of the patients of pri!ate health care sector more effecti!ely. In their study pro!ided suggestions like becoming more friendly and understanding to the problems of patients$ maintaining cleanliness in the units$ both internally and e&ternally$ pro!iding regular report regarding the patients progress %ithout %aiting for them to demand$ conducting sur!eys to kno% about the attitude of the patients %ith regard to the employees and adopting patient-oriented policies and procedures. 3imester et al (*+++- ha!e studied that multinational firm uses sophisticated$ state-of-the-art methods to design and implement customer satisfaction impro!ement programs in the <nited 3tates and 3pain. Their e&periments re!eals a comple& and surprising picture that highlights implementation issues$ a construct of residual satisfaction not captured by customer needs and the managerial need for combining none1ui!alent controls and none1ui!alent dependent !ariables. /fir and 3imonson (*++1- in their study found that customer e!aluations of 1uality and satisfaction are critical inputs in de!elopment of marketing strategies. Ei!en the increasingly common practice of asking such e!aluations$ buyers of products and ser!ices often kno% in ad!ance that they subse1uently %ill be asked to pro!ide their e!aluations. In a series of field and laboratory studies$ the authors demonstrate that e&pecting to e!aluate leads to less fa!orable 1uality and

18

satisfaction e!aluations and reduces customers %illingness to purchase and recommend the e!aluated ser!ices. The negati!e bias of e&pected e!aluations is obser!ed %hen actual 1uality is either lo% or high$ and it persist e!en %hen buyers are told e&plicitly to consider both the positi!e and negati!e aspects. Dholakia and or%it" (*++*- ha!e e&amined the scope and persistence of

the effect of measuring satisfaction on consumer beha!ior o!er time. In an e&periment conducted in a financial ser!ices setting$ they found that measuring satisfaction changes one-time purchase beha!ior$ changes relational customer beha!iors and results in effects that increase for months after%ard and persist e!en a year later. Their results raised 1uestions concerning the design$ interpretation and ethics in the conduct of applied marketing research studies. 3harma and Chahal (*++,- stated that due to increased a%areness among the people patient satisfaction had become !ery important for the hospitals. The authors e&amined the factors related to patient satisfaction in go!ernment outpatient ser!ices in India. They said that there are four basic components %hich had impact on the patient satisfaction namely$ beha!iour of doctors$ beha!iour of medical assistants$ 1uality of atmosphere$ and 1uality of administration. They also pro!ided strategic actions necessary for meeting the needs of the patients of the go!ernment health care sector in de!eloping countries. 5olkes and Batrick (*++,- in their study sho%ed con!erging e!idence of a posti!ity effect in customers perceptions about ser!ice pro!iders. .hen the

1;

customer has little e&perience %ith the ser!ice$ positi!e information about a single employee leads to perception that the firms other ser!ice pro!iders are positi!e to a greater e&tent than negati!e information leads to perception that the firms other ser!ice pro!iders are similarly negati!e. 5our studies %ere conducted that !aried in the amount of information about the ser!ice pro!ider$ the firm$ and the ser!ice. The positi!ity effect %as supported despite differences across studies in methods as %ell as measures. @ernoer (*++,- had in!estigated the different effects of customer relationship perceptions and relationship marketing instruments on customer retention and customer share de!elopment o!er time. Customer relationship perceptions are considered e!aluations of relationship strength and a suppliers offerings$ and customer share de!elopment is the change in customer share bet%een t%o periods. The results sho% that affecti!e commitment and loyalty programs that pro!ide economic incenti!es positi!ely affect both customer retention and customer share de!elopment$ %hereas direct mailings influence customer share de!elopment. 'o%e!er$ the effect of these !ariables is rather small. The results also indicate that firms can use the same strategies to affect customer satisfaction that can ha!e impact on both customer retention and customer share de!elopment. Anderson et al (*++8- de!eloped a theoretical frame%ork that specifies ho% customer satisfaction affects future customer beha!iour and$ in turn$ the le!el$

1?

timing$ and risk of future cash flo%s. 2mpirically$ they find a positi!e association bet%een customer satisfaction and shareholder !alue. They also find significant !ariation across industries and firms. >einart" et al (*++8- in their study of Customer >elationship anagement

Brocess had stated that it is !ery important for maintaining healthy relations %ith the customers in order to pro!ide them satisfaction. In their study$ they (1conceptuali"e a construct of the C> process and its dimensions$ (*-

operationali"e and !alidate the construct$ and (,- empirically in!estigate the organi"ational performance conse1uences of implementing the C> processes.

Their research 1uestions are addressed in t%o cross-sectional studies across four different industries and three countries. The key outcome is a theoretically sound C> process measure that outlines three key stages= initiation$ maintenance$ and

termination. 'omburg et al (*++;- conducted t%o e&perimental studies (a lab e&periment and a study in!ol!ing a real usage e&perience o!er time- %hich re!eal the e&istence of a strong$ positi!e impact of customer satisfaction on %illingness to pay and they pro!ide support for a nonlinear$ functional structure based on disappointment theory. In addition$ the second e&amines dynamic aspects of the relationship and pro!ides e!idence for the stronger impact of cumulati!e satisfaction rather than of transaction-specific satisfaction on %illingness to pay.

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ithas et al (*++;- e!aluates the effect of customer relationship management (C> - on customer kno%ledge and customer satisfaction. They analy"e archi!al data of a cross-section of <.3 firms %hich sho%s that the use of C> applications is positi!ely associated %ith impro!ed customer kno%ledge and

impro!ed customer satisfaction. They also found that gains in customer kno%ledge are enhanced %hen firms share their customer related information %ith their supply chain partners. Eustafsson et al (*++;- in their study of telecommunications ser!ices e&amine the effect of customer satisfaction$ affecti!e commitment$ and calculati!e commitment on retention and the potential for situational conditions to moderate the satisfaction-retention relationship. Their results support consistent effects of customer satisfaction$ calculati!e commitment and prior-churn on retention. Eruca and >ego (*++;- strengthen the chain of effects that link customer satisfaction to shareholder !alue by establishing the link bet%een satisfaction and t%o characteristics of future cash flo%s that determine the !alue of the firm to shareholders= gro%th and stability. Ay using the longitudinal American Customer 3atisfaction inde& and C/ B<3TAT data and hierarchical Aayesian estimation they found that satisfaction creates shareholder !alue by increasing future cash flo% gro%th and reducing its !ariability. They also test the stability of findings across se!eral firm and industry characteristics and assess the robustness of the results using multi-measure and multi-method estimation

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Thompson (*++;- in his study had sho%n that consumers often mis0udge their health risks o%ing to a number of %ell-documented cogniti!e biases. These studies assume that consumers ha!e trust in the e&pert systems that culturally define safe and risky beha!iours. Conse1uently$ this research stream does not address choice situations %here consumers ha!e refle&i!e doubts to%ard pre!ailing e&pert risk assessments and gra!itate to%ard alternati!e model of risk reductions. This study e&plores ho% dissident health risk perceptions are culturally constructed in the natural childbirth community$ internali"ed by consumers as a compelling structure of feeling$ and enacted through choices that intentionally run counter to orthodo& medical risk management norms.

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CHAPTER III

RESEARCH METHODOLO.Y
The present chapter describes the research methodology of the study. It includes the >esearch 5rame%ork$ 3ample design and selection$ Collection of Data$ >esearch !ehicle and ethods for analysis of data. It also points out the

limitations of present study. To study consumers e&pectations$ perception and their satisfaction le!el it %as re1uired to e&amine the follo%ing aspects (i(ii(iii(i!(!(!i(!iiBatients e&pectations from the beha!iour of the doctors$ Batients e&pectations from the beha!iour of the medical assistants$ Batients e&pectations from the 1uality of administration of hospitals$ Batients e&pectations from the ser!ices pro!ided by the hospitals$ Batients perceptions for the beha!iour of the doctors$ Batients perceptions for the beha!iour of the medical assistants$ Batients perceptions for the 1uality of administration of hospitals$

(!iii- Batients perceptions for the ser!ices pro!ided by the hospitals$ (i&(&(&i(&iiBatients satisfaction le!el for the beha!iour of the doctors$ Batients satisfaction le!el for the beha!iour of the medical assistants$ Batients satisfaction le!el for the 1uality of administration of hospitals and Batients satisfaction le!el for the ser!ices pro!ided by the hospitals$

*+

;<5 RESEARCH FRAME:ORThe present study is based on e&plorati!e and descripti!e research design %ith the ob0ecti!e of measuring the satisfaction le!el of patients of fi!e ma0or pri!ate hospitals in Hudhiana. The study uses both primary and secondary information. As it is clear from the ob0ecti!es of the study$ the study %as di!ided into three parts i.e. patients e&pectations$ perceptions from the hospital ser!ices and then measuring their satisfaction le!el from the hospital ser!ices. 5or both the first and second ob0ecti!e of study i.e. the customers e&pectations and their perceptions of hospital ser!ices$ primary data %as collected through a structured 1uestionnaire. Then to meet the third ob0ecti!e of the study proper statistical tools %ere used on the information collected for the first t%o ob0ecti!es of the study.

;<2 SAMPLE DESI.N AND SELECTION

;<2<5 Pop 'at#o% a%$ Sa"p'e:
In !ie% of the fact that this %as a one person sur!ey to be completed %ithin limited resources the present study %as restricted to only those hospitals %hich %ere located in Hudhiana. The population of this study comprised of the indoor patients only. 5i!e ma0or pri!ate hospitals in Hudhiana %ere selected namely= 1. Dayanand *. Christian edical College and 'ospital edical College and 'ospital

,. 3atguru Bartap 3ingh Apollo 'ospital

*1

8.

ohan Dai /s%al Cancer 'ospital

;. Euru Teg Aahadur Charitable 'ospital

;<2<; Se'ect#o% o* Respo%$e%ts

5rom these hospitals primary data %as collected from the respondents. The respondents %ere either the patients themsel!es or their relati!es. 5or sample selection$ a multistage sampling procedure %as follo%ed. At the first stage$ sample units consisted of total number of general %ards and pri!ate %ards in the hospital. 1+I of the general %ards and 1+I pri!ate$ %ards %ere selected randomly. Then from each selected general %ard , to ; patients %ere chosen and from each selected pri!ate %ard one patient %as chosen. The information %as collected through a pre-designed$ structured 1uestionnaire. A sample of C+ respondents selected from these hospitals on the basis of their con!enience for the first ob0ecti!e and the second ob0ecti!e. To suggest solutions to the problems obser!ed during the sur!ey is done through secondary data.

Ta!'e ;<5 Sa"p'#%& P'a%

SELECTION OF :ARDS
HOSPITAL /A0 TOTAL .ENERAL :ARDS APOLLO .RU TE. ,AHADUR DMC SELECTED .ENERAL :ARDS /53= OF A0 /,0TOTAL PRIVATE :ARDS SELECTED PRIVATE :ARDS /53= OF A0

? ; 1:

1 1 *

:1 8? 9C

: ; 1+

**

OS:AL CANCER CMC

TOTAL

*? 1? >3

, * 6

?C :? ;?6

: 1C 4>

SELECTION OF RESPONDENTS
HOSPITAL RESPONDENT FROM .ENERAL :ARD /; TO ? FROM EACH0 RESPONDENTS FROM PRIVATE :ARD /5 FROM EACH0 APOLLO .RU TE. ,AHADUR DMC OS:AL CANCER CMC TOTAL RESPONDENTS

1J;K; 1J;K; *J;K1+ *J; L 1J,K1, *J;K1+

:J1K: ;J1K; 1+J1K1+ :J1K: CJ1KC

1* 1+ *+ *+ 1C

TOTAL

4;

;>

@3

In this %ay data %as collected from C+ respondents that comprise of the indoor patients themsel!es or their attendants.

;<; DATA COLLECTION

Aefore an attempt %as made to collect the information from the sample$ the desk research %as conducted to see the literature and other library material a!ailable on the sub0ect. @arious studies %ere re!ie%ed to ha!e a through kno%ledge before considering ho% to collect the information from the respondents. After ha!ing the background kno%ledge a structured 1uestionnaire

*,

%as prepared to obtain ans%er pertinent to the ob0ecti!es of the study. 5or the purpose of the study$ eighty indoor patients %ere selected and inter!ie%ed from the fi!e pri!ate hospitals. 3econdary data %as also collected from !arious books$ 0ournals$ maga"ines etc.

;<4 ANALYSIS OF DATA

The data 7 information contained in the 1uestionnaire %ere first transferred to master table %hich facilitated tabulation of data in desired form. The collected data %as then grouped into tables and analy"ed using !arious statistical tools like mean scores. /ther statistical tool used includes T-test for measuring %hether there is significant difference bet%een the mean scores of attributes i.e. bet%een e&pectations and perceptions of a factor. >eaction of the respondents to%ards the different factors gi!en %as studied using a structured$ non-disguised and %elldefined 1uestionnaire designed for the patients or their attendants. The 1uestionnaire contained rating 1uestions. 2ach factor %as rated o!er a scale of 1 to 9 i.e. likert scale %as used. The respondents %ere asked to rate the factors according to %hat they e&pect and %hat they had percei!ed from the hospital ser!ices. ean score %as calculated for the 1uestions asked on a 9-point scale. In case of 9point scale %here the respondents %ere asked to indicate their degree of importance7unimportance for e&pectations and degree of bad7good for the
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perceptions$ scores %ere assigned from 1to 9. 5re1uencies %ere multiplied %ith their respecti!e %eights and aggregate !alues found out. calculated using the formula= Mea% Score A /B:#*%0C% i K 1 to 9 n K C+ .here$ .i K .eight attached for degree of importance7unimportance and good7bad. fn K Associated fre1uency n K #umber of respondents T1test %as used to see %hether there is significant difference bet%een the means of a factor for the t%o data samples at ;I le!el of significance. T-test %as used because the both the data samples %ere collected from the same selected indi!iduals. 5irst the data %as collected from a patient for his e&pectations from the !arious factors taken for the study and then from same patient data is collected for his perceptions for the hospital ser!ices. 3imilarly$ the data %as collected from the other patients. 3o$ the data in t%o samples %as dependent as data in one sample %as collected from the same indi!idual as in other sample. ean score %as

;<? LIMITATIONS OF THE STUDY

Any study based on consumer sur!ey through a pre-designed 1uestionnaire suffers from the basic limitation of the possibility of difference bet%een %hat is recorded and %hat is the truth$ no matter ho% carefully the 1uestionnaire has been designed and field in!estigation has been conducted. This is because the consumers may not deliberately report their true preferences and e!en if they %ant to do so$ there are bound
*;

to be differences o%ing to problems in filters of communication process. The error has been tried to be minimi"ed by conducting inter!ie%s personally yet there is no full proof %ay of ob!iating the possibility of error creeping in. 3o$ the study suffers from some limitations also. As such generali"ing the results$ the follo%ing limitations of the study should be taken into the account.

1. As the study %as to be completed in a short time$ the time factor acted as a considerable limit on the scope and the e&tensi!eness of the study. *. The information pro!ided by respondents may not be fully accurate due to una!oidable biases. ,. The lack of corporation sho%n by the respondents$ because of this optimum number of responds not collected$ so the sample %as to be shortened.

*?

CHAPTER IV

RESULTS AND DISCUSSIONS

This chapter contains the analysis and discussion of the primary data collected from the respondents. The study is conducted to see the satisfaction le!el of the patients from the ser!ices pro!ided by the hospitals. This chapter is di!ided into three parts=

/50 EDpectat#o%s o* the pat#e%ts

In this part analysis of e&pectations of patients regarding the beha!ior of doctors$ medical assistants$ 1uality of administration and ser!ices pro!ided by the hospitals is done.

(*- Percept#o% o* the pat#e%ts /i.e. %hat they had actually recei!edIn this part analysis of perceptions of patients regarding the beha!ior of doctors$ medical assistants$ 1uality of administration and ser!ices pro!ided by the hospitals is done.
(,-

Sat#s*act#o% 'e(e' o* the pat#e%ts

In this part satisfaction le!el of the patients regarding the beha!ior of doctors$ medical assistants$ 1uality of administration and ser!ices pro!ided by the hospitals is found. To find the satisfaction le!el

difference bet%een the mean scores of attributes of e&pectations and perceptions are calculated.

*:

8.1 2&pectations of the Batients

4<5<5 EDpectat#o%s o* Pat#e%ts *ro" the ,eha(#o r o* Doctors
To study the e&pectations of patients from the beha!iour of doctors$ patients %ere asked to rate their e&pectations in the scale of 1 to 9 for the !arious attributes gi!en belo% in the table 8.1.1 for this factor. The mean rating for each attribute is gi!en in this table. Table 8.1.1 2&pectations of patients from the beha!iour of doctors

Attr#! tes
A!ailability )no%ledge 'andling of Mueries Cooperation Boliteness Impartial attitude 2&amination Comfort Thorough Check-<p 2mpathy Indi!idual Consideration 2&perience

EDpectat#o%s /Mea% Va' e0

C.9C C.98 C.;1 C.;, C.:1 C.,9 C.:9 C.9C :.,1 ?.:+ C.?8 C.8?

A(era&e

5orm the table8.1.1 it is clear that the mean scores for the attributes a!ailability of

doctors$ kno%ledge of doctors$ thorough check-up and e&amination comfort are C.9C$ C.9,$ C.9C and C.:C %hich sho% that patients consider these attributes !ery important. 3o$ their e&pectation le!el for these attributes is !ery high. ean scores

*C

for the attributes politeness$ e&perience$ cooperation$ handling of 1ueries and impartial attitude are C.:1$ C.?8$ C.;8$ C.;1 and C.,9 respecti!ely also sho%s that patients also consider these attributes !ery important. 3o$ a doctor must try to fulfill these e&pectations in an efficient manner. 5or the attributes empathy and indi!idual consideration mean scores are :.,1 and ?.:+ respecti!ely %hich are not !ery high but patients still consider these attributes important. 3o$ it is clear that attributes a!ailability and kno%ledge ha!e ma&imum mean score of C.9C and attribute indi!idual consideration has minimum mean score of ?.:+. The o!erall mean score for e&pectations from the factor NAeha!iour of Doctors comes out to be C.8? %hich is !ery high on the scale of 9. 3o$ it can be concluded here that the e&pectations of patients from the doctors are !ery high

4<5<2 EDpectat#o%s o* Pat#e%ts *ro" the ,eha(#o r o* Me$#ca' Ass#sta%ts

To study the e&pectations of patients from the beha!iour of medical assistants$ patients %ere asked to rate their e&pectations in the scale of 1 to 9 for the !arious attributes gi!en in the table8.1.* for this factor. The mean rating for each attribute is gi!en in this table. Table 8.1.* 2&pectations of patients from the beha!iour of medical assistants

Attr#! tes

EDpectat#o%s /Mea% Va' e0

*9

A!ailability )no%ledge Cooperation Boliteness Impartial attitude aintenance of >ecord 'andling of Mueries 2&perience Dress

9 C.;? C.?; C.:9 C.89 C.:1 C.88 :.8; ?.9

A(era&e

@<;;

ean score for the attribute a!ailability of medical assistants is 9$ %hich means all the patients had gi!en rating 9 to this attribute i.e. they consider this factor !ery important and their le!el of e&pectations for this attributes are !ery high. Boliteness$ maintenance of records and cooperation %ith patients are gi!en the mean scores as C.:9$ C.:1 and C.?; respecti!ely %hich means that patients also consider these factors !ery important. Attribute e&perience has the mean score :.8;. 3o this sho%s that patients consider this attribute important but not as much as the abo!e mentioned attributes and the mean score for the attribute dress of medical assistants is lo%est among all the other attributes %hich is ?.9. This e&plains that patients do not consider this attribute !ery important but they had not rated this attribute lo%. 3o this is also an important attribute. The o!erall mean score for the factor Aeha!iour of medical assistants is C.,, and this is high.

4<5<;

EDpectat#o%s

o*

Pat#e%ts

*ro"

the

E a'#t)

o*

A$"#%#strat#o%s
To study the e&pectations of patients from the Muality of Administration$ patients %ere asked to rate their e&pectations in the scale of 1 to 9 for the !arious attributes
,+

gi!en belo% in the table 8.1., for this factor. The mean rating for each attribute is gi!en in this table. Table 8.1., 2&pectations of patients from the 1uality of the administration

Attr#! tes
Con!enient /ffice 'ours Check <p Brocedure /!er Cro%ding .elcome Gour Ideas 5ee Erie!ances 'andling 3ystem Ailling Brocedure Check /ut Brocedure Aeha!iour of Clerical 3taff Aeha!iour of 3ecurity 3taff

EDpectat#o%s /Mea% Va' e0

?.;, C.C; C.*? :.,1 :.1+ C.8; C.:C C.:C C.C9 C.C;

A(era&e

@<5>

The o!erall mean score for all the attributes for this factor is C.1:. 3o it is true to say that patients consider the NMuality of Administration an important aspect of the hospitals and their le!el of e&pectation from this factor is also high. 2&pectation le!el for the attribute beha!iour of clerical staff is highest among all the other attributes %ith the mean score C.C9. Check up procedure$ beha!iour of security staff$ check out procedure$ billing procedure %as also considered !ery important by the patients. The mean scores for these attributes are C.C;$ C.C;$ C.:C and C.:C respecti!ely. Batients said that these procedures must be simple i.e. they are not !ery comple&. Erie!ances handling system i.e. ho% the complaints of patients are handled %as also gi!en high rating of C.8;. ean score for the

attributes %elcome your ideas$ %hich means that %hether the hospitals listen their ideas

,1

carefully or not and fee are :.,1 and :.1 respecti!ely. Con!enient office hours had been rated lo%est among all the attributes %ith the mean score ?.;,. This means that patients did not consider this attribute as important as other attributes.

4<5<4 EDpectat#o%s o* Pat#e%ts *ro" the Ser(#cesC Fac#'#t#es pro(#$e$ !) the hosp#ta's
To study the e&pectations of patients from the ser!ices and facilities pro!ided by the hospitals$ patients %ere asked to rate their e&pectations in the scale of 1 to 9 for the !arious attributes gi!en in the table8.1.8 for this factor. The mean rating for each attribute is gi!en in this table. Table 8.1.8 2&pectations of patients from the ser!ices and facilities pro!ided by the hospitals

Attr#! tes
Broper 3itting Arrangements Aedding Arrangements 3taff Appearance #atural Hight Dust Ao&es 5lies O os1uitoes /uter O Inner Appearance Barking .ell 21uipped <nits arking /n .alls 2ating Blaces
,*

EDpectat#o%s /Mea% Va' e0

C.9C 9 ?.;; C.,? 9 9 :.88 C.:1 C.,, C.+: C.?9

A(era&e

C.,:

The table8.1.8 sho%s that e&pectation le!el of patients for the attributes bedding arrangements$ dust bo&es and flies and mos1uitoes is highest among all the other attributes as all the three attributes has a mean score of 9. 'ere it is also clear that all the patients had rated these attributes %ith a score 9. ean score of C.9C for the

proper sitting arrangements also sho%s that patients consider this attributes as important as the abo!e mentioned three attributes. Batients also thought that parking$ eating places$ natural light$ %ell e1uipped units and marking on %alls are other important attributes. ean scores for these attributes are C.:1$ C.?C$ C.,?$

C.,, and C.+: respecti!ely. /uter and inner appearance of the hospital has a!erage score of :.88 %hich is 1uiet lo%er than other attributes. Attribute staff appearance has got the lo%est mean score of ?.;; among all the attributes.

4<2< Percept#o%s o* the Pat#e%ts *or (ar#o s Factors

4<2<5 Percept#o%s o* Pat#e%ts *or the ,eha(#o r o* Doctors

,,

To study the perceptions of patients from the beha!iour of doctors$ patients %ere asked to rate their perceptions in the scale of 1 to 9 for the !arious attributes gi!en belo% in the table 8.*.1 for this factor. The mean rating for each attribute is gi!en in this table. Table 8.*.1 2&pectations of patients from the beha!iour of doctors

Attr#! tes
A!ailability )no%ledge 'andling of Mueries Cooperation Boliteness Impartial attitude 2&amination Comfort Thorough Check-<p 2mpathy Indi!idual Consideration 2&perience

Percept#o%s
/Mea% Va' e0 :.:C :.11 ?.?+ ?.:; ?.C? :.8? :.:? :.CC ;.C; ?.1+ ?.C+ ?.99

A(era&e

Table 8.*.1 sho%s that attribute thorough check-up has the ma&imum mean score :.CC. It is 1uiet high score %hich means that patients perception about this feature is good. Then this follo%ed by attributes a!ailability of doctors$ e&amination comfort and impartial attitude of the doctors. The mean scores for these attributes are :.:C$ :.:? and :.8? respecti!ely. )no%ledge has the a!erage score :.11 %hich sho%s that patients perception about this factor also tends to be 1uiet good. ean

scores for the politeness$ e&perience$ cooperation %ith the patients and handling of
,8

1ueries are ?.C?$ ?.C+$ ?.:; and ?.?+ respecti!ely %hich means that perception of the patients of the attributes are not so good. Indi!idual consideration and empathy has moderate scores ?.1+ and ;.C; respecti!ely among all the attributes. 3o it means that perception of the patients regarding these attributes is neither good nor bad. The o!erall mean score for all these attributes is ?.99 %hich means that perception of the patients for the factor beha!iour of doctors is not !ery good but it is mildly good.

4<2<2 Percept#o%s o* Pat#e%ts *or the ,eha(#o r o* Me$#ca' Ass#sta%ts

To study the perceptions of patients for the beha!iour of medical assistants$ patients %ere asked to rate their perceptions in the scale of 1 to 9 for the !arious attributes gi!en in the table*.* for this factor. The mean rating for each attribute is gi!en in this table. Table 8.*.* Berceptions of patients from the beha!iour of medical assistants

Attr#! tes
A!ailability )no%ledge Cooperation Boliteness Impartial attitude aintenance of >ecord
,;

Percept#o%s
/Mea% Va' e0 :.C9 ?.8? ?.:1 ?.CC :.+8 :.99

'andling of Mueries 2&perience Dress

?.1+ ?.,; 9.++

A(era&e

><5F

It is clear from the abo!e table that attribute dress is the highest rated attribute %ith mean score 9. 5rom this it is clear that patients perception about the dress of medical assistants is !ery good i.e. they think medical assistants %ear neat and clean dresses. ean scores of the attributes maintenance record and a!ailability

are :.99 and :.C9 respecti!ely. These are !ery good score on a scale of 9 %hich means that patients had percei!ed these attributes of medical assistants as good. Impartial attitude has the a!erage score :.+8 %hich is not bad. Boliteness and cooperation ha!e the scores ?.C9 and ?.:1 respecti!ely. This means that medical assistants dealing %ith patients is not !ery good. ean scores ?.8? and ?.,; for

kno%ledge and e&perience sho%s that medical assistants are lacking on these attributes. 'andling of 1ueries has the least score among all the other factors and it is 1uiet less %hich means that the 1ueries of patients are not properly handled by the medical assistants. /!erall a!erage score for all the attributes comes out to be :.1?. so it can be concluded that patients perception about the beha!iour of medical assistants is moderately good i.e. there is need for the medical assistants to impro!e their beha!iour.

4<2<; Percept#o%s o* Pat#e%ts *or the E a'#t) o* A$"#%#strat#o%

,?

To study the perceptions of patients for the Muality of Administration$ patients %ere asked to rate their perceptions in the scale of 1 to 9 for the !arious attributes gi!en belo% in the table8.*., for this factor. The mean rating for each attribute is gi!en in this table. Table 8.*., Berceptions of patients from the 1uality of the administration

Attr#! tes
Con!enient /ffice 'ours Check <p Brocedure /!er Cro%ding .elcome Gour Ideas 5ee Erie!ances 'andling 3ystem Ailling Brocedure Check /ut Brocedure Aeha!iour of Clerical 3taff Aeha!iour of 3ecurity 3taff

Percept#o%s
/Mea% Va' e0 C.*? ?.,; :.9; ?.*, ;.8C ?.+1 :.?? :.C+ :.1; C.8C

A(era&e

><54

A!erage scores for the beha!iour of clerical staff and con!enient office hours are C.8C and C.*? respecti!ely$ %hich are !ery high and so it can be conluded that hospitals are doing %ell on these t%o attributes. /!er cro%ding and check out procedure ha!e the scores :.9;$ :.C+ and :.?? %hich means that patients perception about these attributes are good. :.1; is the score of attribute Aeha!iour of clerical staff %hich is less than the abo!e mentioned factors. 3o hospitals need to impro!e on this. ean scores for the check up procedure$ %elcome your ideas and grie!ances handling system are ?.,;$ ?.*, and ?.+1 respecti!ely. 3o %e can say that perception of patients for these is moderately good. The lo%est mean score ;.8C is scored by the attribute fee %hich is not good and this sho%s that

,:

patients thought the fee of the hospitals are high. It is clear from the table that o!erall mean score for all the attributes is :.18 %hich sho%s that perception of the patients to%ards the 1uality of administration tends to be good.

4<2<4 Percept#o%s o* Pat#e%ts *or the Ser(#cesC Fac#'#t#es pro(#$e$ !) the hosp#ta's
To study the perceptions of patients for the ser!ices and facilities pro!ided by the hospitals$ patients %ere asked to rate their perceptions in the scale of 1 to 9 for the !arious attributes gi!en belo% in the table8.*.8 for this factor. The mean rating for each attribute is gi!en in this table. Table8.*.8 2&pectations of patients from the ser!ices and facilities pro!ided by the hospitals

Attr#! tes
Broper 3itting Arrangements Aedding Arrangements 3taff Appearance #atural Hight Dust Ao&es 5lies O os1uitoes /uter O Inner Appearance Barking .ell 21uipped <nits arking /n .alls 2ating Blaces

Percept#o%s
/Mea% Va' e0 C.;8 C.?? :.?? :.*8 C.;; C.8, :.81 C.+; :.+9 :.:C C.8,

A(era&e

><66

,C

ean scores for the bedding arrangements$ dust bo&es$ proper sitting arrangements$ flies O mos1uitoes $ eating places and parking are C.??$ C.;;$ C.;8$ C.8*$ C.8* and C.+; respecti!ely %hich means that perception of the patients about these attributes are !ery good. 3o %e can say that hospitals are pro!iding these facilities to the patients in a proper %ay. arking on %alls$ staff appearance$ outer

and inner appearance and natural light scores are :.:C$ :.??$ :.81 and :.*8 respecti!ely and it sho%s that patients perception about these attributes are good. :.+9 is the lo%est score scored by the attribute %ell e1uipped units but this score is not bad and %e can say that perception of the patients to%ard this tends to be good. :.99 is the o!erall mean score for perception of patients about the ser!ices7facilities pro!ided by the hospitals.

4<; Sat#s*act#o% Le(e' o* the Pat#e%ts *or the (ar#o s Factors

4<;<5 Sat#s*act#o% Le(e' o* the Pat#e%ts *or the ,eha(#o r o* Doctors
,9

To measure the satisfaction le!el of patients from the beha!iour of doctors$ the differences bet%een the mean scores of e&pectations and perceptions for each attribute is calculated and then t-test is applied to see %hether the difference bet%een the t%o mean !alues is significant or not at ;I le!el of significance. The calculated !alues are gi!en in the table8.,.1. Table8. ,.1 3atisfaction le!el of patients for the beha!iour of doctors

Attr#! tes A!ailability )no%ledge 'andling of Mueries Cooperation Boliteness Impartial attitude 2&amination Comfort Thorough Check-<p 2mpathy Indi!idual Consideration 2&perience

EDpectat#o%s Percept#o%s D#**ere%ce

( ean @alue( ean @alue-

T1(a' e ?.8CJ :.11J C.81J 1+.+1J 1+.+;J ;.8CJ :.9*J 9.*;J ;.9,J ;.+8J C.,1J

C.99 C.9C C.;1 C.;8 C.:1 C.,9 C.:9 C.9C :.,1 ?.9C C.?8

:.:C :.11 ?.?+ ?.:; ?.C? :.8? :.:? :.CC ;.C; ?.1+ ?.C+

1.*1 1.C, 1.91 1.:9 1.C; +.9, 1.+, 1.1+ 1.8? +.CC 1.C8

Jthere #s s#&%#*#ca%t $#**ere%ce at ?= 'e(e' o* s#&%#*#ca%ce (t-critical K1.??The table8.,.1 sho%s that difference bet%een the mean !alues of e&pectations and perceptions for the attributes handling of 1ueries$ politeness$ e&perience$ kno%ledge$ cooperation and empathy are 1.91$ 1.C;$ 1.C8$ 1.C*$ 1.:9 and 1.8? respecti!ely. The t!alues for these attributes at ;I le!el of significance sho% that there is significant difference in the mean !alues of e&pectations and perceptions for these attributes. 5or the attributes a!ailability$ thorough check up and e&amination comfort differences bet%een there mean !alues for e&pectations and perceptions are 1.*1$ 1.1 and 1.+* respecti!ely.

8+

There corresponding t-!alues indicates this is a significant difference. +.9, and +.CC are the differences for the impartial attitude and indi!idual consideration respecti!ely and t!alues for these attributes also sho%s that there is significant difference bet%een the means scores of e&pectation and perceptions. 3o$ it is clear that highest difference is for the handling of 1ueries and lo%est for the attribute indi!idual consideration.

4<;<2 Sat#s*act#o% Le(e' o* the Pat#e%ts *ro" the ,eha(#o r o* Me$#ca' Ass#sta%ts
To measure the satisfaction le!el of patients from the beha!iour of medical assistants$ the differences bet%een the mean scores of e&pectations and perceptions for each attribute is calculated and then t-test is applied to see %hether the difference bet%een the t%o mean !alues is significant or not at ;I le!el of significance. The calculated !alues are gi!en in the table8.,.*. Table 8.,.* 3atisfaction le!el of patients from the beha!iour of medical assistants

Attr#! tes A!ailability )no%ledge Cooperation Boliteness Impartial attitude aintenance of >ecord 'andling of Mueries 2&perience Dress

EDpectat#o%s Percept#o%s D#**ere%ce T1(a' e

( ean @alue( ean @alue-

9.++ C.;? C.?; C.:9 C.89 C.:1 C.88 :.8; ?.9+

:.C9 ?.8? ?.:1 ?.C9 :.+8 :.99 ?.1+ ?.,; 9.++

1.11 *.1+ 1.98 1.91 1.8; +.:, *.,8 1.1+ -*.1+

;.9+J C.9CJ 9.8,J 9.9,J ;.9,J 8.98J 11.11J ,.99J -1,.*,J

Jthere #s s#&%#*#ca%t $#**ere%ce at ?= 'e(e' o* s#&%#*#ca%ce (t-critical K1.??-

81

It is clear from the table8.,.* that difference bet%een the mean !alues for e&pectations and perceptions are highest for the attribute handling of 1ueries %hich is *.,8 and its corresponding t-!alue is !ery large and it sho%s that this difference bet%een the !alues is significant. This means that patients had not recei!ed %hat they ha!e e&pected from this particular attribute. Differences for the kno%ledge$ cooperation and politeness are *.1$ 1.98 and 1.91 respecti!ely and there respecti!e t-!alues indicate that these differences are 1uiet significant %hich means that perceptions of these attributes are less than the e&pectation of patients from these attributes. 1.8;$ 1.11 and 1.1+ are the differences bet%een the mean scores of e&pectations and perceptions for the attributes impartial attitude$ a!ailability and e&perience respecti!ely and t-!alues corresponding to these attributes are larger than the t-critical at ;I le!el of significance. This means that differences are significant. The difference for the attribute maintenance of record is +.:, and t-!alue for it sho%s that difference is 1uiet significant i.e. patients perception about this factor is lo%er than their e&pectations. Dress has the difference -*.1$ %hich sho%s that patients perception for this attribute is higher than their e&pectations.

4<;<; Sat#s*act#o% Le(e' o* the Pat#e%ts *or the E a'#t) o* A$"#%#strat#o%

To measure the satisfaction le!el of patients from the 1uality of administration$ the differences bet%een the mean scores of e&pectations and perceptions for each attribute is calculated and then t-test is applied to see %hether the difference bet%een the t%o mean !alues is significant or not at ;I le!el of significance. The calculated !alues are gi!en in the table8.,.,.

8*

Table 8.,.1 3atisfaction le!el of patients for the beha!iour of doctors

Attr#! tes Con!enient /ffice 'ours Check <p

EDpectat#o%s Percept#o%s
/Mea% Va' e0 /Mea% Va' e0

D#**ere%c e

T1(a' e -:.*:J

?.;, C.C; C.*? :.,1 :.1+ C.8; C.:C C.:C C.C9 C.C;

C.*? -1.:8 ?.,; :.9; ?.*, ;.8C ?.+1 :.?? :.C+ :.1; 1.:8 C.8C +.,C *.;+ +.,1 1.+C 1.?* *.88 1.11 +.9C

9.C8J 1.9*J 8.99J 8.89J 11.19J :.8:J :.+CJ :.CCJ ,.1+J

Brocedure /!er Cro%ding .elcome Gour Ideas 5ee Erie!ances 'andling 3ystem Ailling Brocedure Check /ut Brocedure Aeha!iour Clerical 3taff Aeha!iour 3ecurity 3taff of of

Jthere #s s#&%#*#ca%t $#**ere%ce at ?= 'e(e' o* s#&%#*#ca%ce (t-critical K1.??This table sho%s that differences bet%een the mean !alues of e&pectations and perceptions for the check up procedure and grie!ances handling system are *.;+ and *.88 respecti!ely %hich are 1uiet big differences. 3o %e can say that e&pectations of patients from these attributes are higher than their perceptions. 5or the attributes beha!iour of clerical staff and fee difference bet%een e&pectations and perceptions are 1.:8 and 1.?, respecti!ely %hich are not small. 3o it is true to say that e&pectations are higher than perceptions of these attributes. 1.11$ 1.+C and +.9C are the differences for the billing procedure %elcome your ideas and check out procedure respecti!ely. Aeha!iour clerical

8,

staff and o!er cro%ding has the difference +.,C and +.,1 bet%een the mean !alues for e&pectations and perceptions. Attribute con!enient office hour has the negati!e difference bet%een mean !alues of e&pectations and perceptions %hich means that patients perception about the attributes is higher than their e&pectations.

4<;<4 Sat#s*act#o% Le(e' o* the Pat#e%ts *or the Ser(#ces a%$ Fac#'#t#es Pro(#$e$ !) the Hosp#ta's
To measure the satisfaction le!el of patients from the ser!ices and facilities pro!ided by the hospitals$ the differences bet%een the mean scores of e&pectations and perceptions for each attribute is calculated and then t-test is applied to see %hether the difference bet%een the t%o mean !alues is significant or not at ;I le!el of significance. The calculated !alues are gi!en in the table8.,.8. Table 8.,.8 3atisfaction le!el of patients for the beha!iour of doctors

Attr#! tes Broper

EDpectat#o%s
/Mea% Va' e0

Percept#o%s
/Mea% Va' e0

D#**ere%ce

T1(a' e ;.+8J

3itting C.9C 9.++ ?.;; C.,? 9.++ 9.++

C.;8 +.88 C.?? :.?? :.*8 C.;; C.8, :.81 C.+;

88

Arrangements Aedding Arrangements 3taff Appearance #atural Hight Dust Ao&es 5lies O

8.8CJ +.,8 -1.11 1.1, +.8; +.;C +.1+ +.+, +.?? ,.C+J -8.88J 8.;*J ;.+:J ?.1,J

os1uitoes /uter O Inner :.88 Appearance Barking C.:1

.ell <nits arking

21uipped C.,, /n C.+C C.?9

:.+9 1.*8 :.:C C.8, +.,+ +.*?

;.?,J 1.;? *.:+J

.alls 2ating Blaces

Jthere #s s#&%#*#ca%t $#**ere%ce at ?= 'e(e' o* s#&%#*#ca%ce (t-critical K1.??This table sho%s that largest differences bet%een e&pectations and perceptions are 1.*8 and 1.1* for the attributes %ell e1uipped units and natural light respecti!ely among all the other attributes. This means that e&pectations of patients are higher than their perceptions for these attributes. +.??$ +.;C$ +.8; and +.88 are the differences for the parking$ flies O mos1uitoes$ dust bo&es and proper sitting arrangements respecti!ely. The attributes bedding arrangements$ marking on %alls and eating places ha!e small differences of +.,8$ +.,+ and +.*? respecti!ely bet%een the mean !alues of e&pectations and perceptions. 5or inner and outer appearance the difference is .+*; %hich is !ery small and it can be concluded that patients perception and e&pectation for this attribute are appro&imately same. Aut attribute staff appearance has negati!e !alue %hich is -1.11 and it is true to say that patients e&pectations are lo%er for this attribute than their perceptions.

CHAPTER V

SUMMARY AND CONLUSIONS

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In the present business scenario of cutthroat competition$ customer satisfaction has become the prime concern of each and e!ery kind of industry. Companies are increasingly becoming customer focused. Companies can %in customers and surge ahead of competitors by meeting and satisfying the needs of the customers. .orld o!er businesses ha!e reali"ed that marketing is not the only factor in attracting and retaining customers. /ther ma0or factors responsible for the same are satisfaction through ser!ice 1uality and !alue. 2!en the best marketing companies in the %orld fail to sell products and ser!ices that fail to satisfy the customers needs. 3o customer satisfaction is the key%ord in todays fiercely competiti!e business en!ironment. The measurement of customer satisfaction has become !ery important for the health care sector also. The concept of customer satisfaction has encouraged the adoption of a marketing culture in the health care sector in both de!eloped and de!eloping countries. As large numbers of hospitals are opening up and the people are becoming more a%are and conscious of health$ great competition has emerged in this industry. 3o to retain their patients hospitals ha!e to pro!ide better facilities7ser!ices to its customers. @arious factors that can affect the patients satisfaction include beha!iour of doctors$ a!ailability of speciali"ed doctors$ beha!iour of medical assistants$ 1uality of administration$ 1uality of atmosphere$ a!ailability of modern facilities etc. 3o$ if the hospitals %ant that their customers must be satisfied$ they ha!e to pro!ide not only better treatment but other facilities

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also. The current study is focused on e&amining the !arious factors related to patient satisfaction %ith the follo%ing specific ob0ecti!es= 1. To study the customer e&pectations from hospital ser!ices. *. To study the customer perception of hospital ser!ices. ,. To study the degree of satisfaction of customers from hospital ser!ices. In order to accomplish the ob0ecti!es of the study$ the primary data %as collected. The population of this study comprised of the indoor patients only. 5i!e ma0or pri!ate hospitals in Hudhiana %ere selected namely= 1. Dayanand *. Christian edical College and 'ospital$ edical College and 'ospital$

,. 3atguru Bartap 3ingh Apollo 'ospital$ 8. ohan Dai /s%al Cancer 'ospital$ and

;. Euru Teg Aahadur Charitable 'ospital 5rom these hospitals primary data %as collected from the respondents. The respondents %ere either the patients themsel!es or their relati!es. 5or sample selection$ a multistage sampling procedure %as follo%ed. At the first stage$ sample units consisted of total number of general %ards and pri!ate %ards in the hospital. 1+I of the general %ards and 1+I pri!ate$ %ards %ere selected randomly. Then from each selected general %ard , to ; patients %ere chosen and from each selected pri!ate %ard one patient %as chosen. The information %as collected through a pre-designed$ structured 1uestionnaire. A sample of C+ respondents
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selected from these hospitals on the basis of their con!enience for the first ob0ecti!e and the second ob0ecti!e. To suggest solutions to the problems obser!ed during the sur!ey is done through secondary data. The collected data %as then grouped into tables and analy"ed using !arious statistical tools like mean scores. /ther statistical tool used includes T-test for measuring %hether there is significant difference bet%een the mean scores of attributes i.e. bet%een mean !alues of e&pectations and perceptions of an attribute.

Major F#%$#%&s G Co%c' s#o%s

1. 2&pectation le!el is !ery high and nearly same for almost all the factors i.e. for beha!iour of the doctors$ beha!iour of medical assistants$ 1uality of administration and ser!ice7facilities pro!ided. *. ean score for the e&pectations from all the four factors is C.,+ %hich is !ery high on the scale 9. ,. <nder beha!iour of doctors attribute a!ailability and thorough check up has the highest score C.9C and empathy and indi!idual consideration ha!e :.,1 and ?.:+ respecti!ely. 8. Attribute con!enient office hours has lo%est e&pectation score of ?.;, and beha!iour of clerical staff has the highest C.C9 among all the attributes of factor 1uality of administration.

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;. Aedding arrangements$ dust bo&es and flies and mos1uitoes has score 9 for e&pectations for these attributes of factor ser!ices pro!ided by the hospitals. ?. /!erall mean score for perceptions of patients about the four factor is :.,1 %hich is considered good on the scale of 9. :. 2mpathy %ith score ;.C; has the minimum score and thorough check up %ith score :.C9 has highest score among all the attributes of factor beha!iour of doctors. C. Berception about the dress of medical assistant is !ery good %ith score 9 and handling of 1ueries is lo%est %ith score ?.1. 9. 5ee has the lo%est le!el of perception and beha!iour of security staff has the highest le!el of perception. 1+. Berceptions of patients about the attributes of factor ser!ices7facilities pro!ided by the hospitals are almost good. 11. The largest difference bet%een e&pectations and perceptions is 1.91 for attribute handling of 1ueries and lo%est for indi!idual consideration +.CC under factor beha!iour of doctors. 1*. 5or beha!iour of medical assistants the largest difference is for the attribute handling of 1ueries and lo%est for maintenance of record. Also dress has negati!e difference %hich means perceptions are larger than e&pectations. 1,. Attribute con!enient office hours of factor 1uality of administration is negati!e$ largest difference is for the attribute check up procedure and lo%est for beha!iour of security staff.
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18. /uter O inner appearance has the lo%est difference +.+*; and %ell e1uipped units ha!e the highest 1.*8. and attribute staff appearance has the negati!e difference of 1.11.

Re*ere%ces

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Aurora 3 and alhotra (199:- Customer satisfaction= A comparati!e analysis of the satisfaction le!el of customer of public and pri!ate sector banks. Decision 24= 1+9-,+. Anderson 2 .$ 5ornell C and a"!ancheryl 3 ) (*++8- Customer satisfaction and shareholder !alue. J Mktg F@= 1:*-C;. Aolton > and Dre% F ' (1991- A multistage model of customers assements of ser!ice 1uality and !alue. J Consumer Res 5>= ,:;-C8. Aoulding .$ )alra A$ 3taelin > and Peithmal @A (199,- A dynamic process model of ser!ice 1uality= from e&pectations to beha!ioral intentions. J Mktg ;3= >-*:. Da!id ) and .ilton B C (19CC- odels of consumer satisfaction formation= An e&tension. J Mktg Res 2?= *+8-1+ Dholakia A and or%it" E (*++*- The scope and persistence of meremeasurement effects= 2!idence from a field study of consumer satisfaction measurement. J Consu Res 26= 1;9-?: 5olkes @ 3 and Batrick @ (*++,- The posti!ity effect in perceptions of ser!ices= 3een one$ seen them all4 J Consumer Res ;3= 1*;-1,:. Ere%al D$ onroe ) A and )rishnan > (199C- The effects of price-comparison ad!ertising on buyers$ perceptions of ac1uisition !alue$ transaction !alue$ and beha!ioral intentions. J Mktg F2= 8?-;9 Earbarino 2 and Fohnson 3 (1999- The different roles of satisfaction$ trust and commitment in customer relationships. J Mktg F;= :+-C: Eruca T 3 and >ego H H (*++;- Customer satisfaction$ cash flo%$ and shareholder !alue. J Mktg F6= 11;-1,+ Eustafsson .$ Fohnson D and >oos I (*++;- The effects of customer satisfaction$ relationship$ commitment$ dimensions and triggers ion customer retention. J Mktg F6= *1+-*1; 'omburg C$ )oschate # and 'oyer . D (*++;- Do satisfied customers really pay more4 A study of the relationship bet%een customer satisfaction and %illingness to pay. J Mktg F6= C8-9?
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Habarbera B A and a"ursky (19C,- A longitudinal assessment of customer satisfaction7dissatisfaction= The dynamic aspect of the cogniti!e process. J Mktg Res 2= ,9,-8+8 /fir C and 3imonson I (*++1- In search of negati!e customer feedback= The effect of e&pecting to e!aluate on satisfaction e!aluations. J Mktg Res ;@= 1:+1C* @ernoer B C (*++,- <nderstanding the effect of customer relationship management efforts on customer retention and customer share de!elopment. F Mktg F>= ,+-8; >einart" .$ )rafft $ and 'oyer . D (*++8- The customer relationship management process= Its measurement and impact on performance. J Mktg Res 42= *9,-,+;. 3aha A.). (19CC- 3atisfaction %ith life- A study of nurses #igeria. Decision 5?= ?1-?8 3harma > D and Chahal ' (1999- A study of patient satisfaction in outdoor ser!ices of pri!ate health care facilities. Vikalpa 24= ?9-:? 3imester D I$ 'auser F '$ .ernerfelt A and >ust > T (*+++- Implementing 1uality impro!ement programs designed to enhance customer satisfaction = Muasi Q 2&periment in <nited 3tates and 3pain. J Mktg Res ;>= 1+*-11* 3harma > D and Chahal ' (*++,- Batient satisfaction in go!ernment outpatient ser!ices in India. Decision ;3= 1+9-*C. @oss D (199C- >ole of price performance and e&pectation in ser!ice. J Mktg Res ;F= 8;-;1. Thompson C F (*++;- Consumer risk perceptions in a community of refle&i!e doubt. J Consumer Res ;2= *,;-*8;

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