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KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY

INSTITUTE OF DISTANCE LEARNING


COMMONWEALTH EXECUTIVE MASTER IN BUSINESS ADMINISTRATION

RESEARCH METHODOLOGY
TOPIC: AN EVALUATION OF WAITING TIME AND SERVICE QUALITY DELIVERY ON OUTPATIENT SATISFACTION IN GHANAIAN PUBLIC HOSPITALS: CASE STUDY OF SELECTED PUBLIC HOSPITALS IN THE KUMASI METROPOLIS.

DZIFAH MANTEAU Index no: PG6383011

Background of the study Studies on the quality of medical care are increasing in importance as a component of health care research. The consumer's opinion of services is being taken into account in assessments of quality. Thus, evaluating the quality of medical care involves the measurement of its benefits to patients and the community at large. The emerging health care literature suggests that patient satisfaction is a dominant concern that is intertwined with strategic decisions in the health services. Patient satisfaction should be as indispensable to assessments of quality as to the design and management of health care systems. Care assessed to be high quality according to clinical, economic or other provider-defined criteria is far from ideal if as a result of that care the patient is unhappy or dissatisfied. There is, then, a sound rationale for making the organization and delivery of health care responsive to consumer opinion. Thus, interest in the patient's point of view is increasing and consumer satisfaction being adopted as a standard component of evaluative research. Satisfaction with care is an important influence determining whether a person seeks medical advice, complies with treatment and maintains a continuing relationship with practitioners.

In hospitals patients are confronted with waiting for a variety of services. Barlow (2002) found that one of the hardest waiting experiences is the one which happens in a hospital's outpatient clinic for a prearranged appointment which is described as "appointment syndrome". Waiting is a negative experience especially when patients have high expectations of service quality. The amount of time patients spend waiting and the distress in waiting long times before being seen by the doctors, in addition to their anxiety can considerably influence their

evaluation of service delivered and consequently their satisfaction with service (De Man et al. 2004).

The time spent waiting for a service can be physically painful and stressful because it leads the customer to sacrifice more productive activities and may increase the cost in order to obtain service or a product from alternative providers. Waiting time is more inherent in healthcare situations: waiting for a call to be answered to set an appointment, waiting to see the doctor, waiting for nurses, waiting for the laboratory results etc. Most of these waiting fall in the negative experience confronted in the healthcare sector (Midttun and Martinussen, 2005).

Moreover, the same researchers confirmed that customer satisfaction is not only affected by the waiting time but also by the customers' expectations or determination of the causes of waiting time. So it is very important to understand the direct effect of waiting time on patients waiting for services. In recent years, the concern for service quality reached unprecedented level in many service industries throughout the world. Service quality has been identified as the difference between the customers' expectations of service and their perceptions of the service delivery (Zeithaml et al., 2006). The study of Parasuraman et al. (1988) established the SERVQUAL, a multi-item scale to measure service quality through five different dimensions that are adequately generic to cover a wide range of services in different sectors such as manufacturing and services industries. The

researcher defined ten dimensions, which then diminished by subsequent studies to five service quality dimensions that are applicable to service providing organization in general: tangibles (physical facilities, equipment and appearance of personnel), reliability (ability to perform the promised service dependably and accurately), responsiveness (willingness to help customers and provide prompt service), assurance (knowledge and courtesy of employees and their ability to inspire trust and confidence), empathy (caring and individualized attention provided to m the customers). Due to the lack of empirical research into health care practices in Ghana, this study investigates the relationship between waiting time, service delivery and customer satisfaction in Ghanaian public hospitals.

Statement of the Research Problem Waiting time for public hospital care is a regular matter for debate. Waiting for a service is representing the first direct interaction between customer and service delivery process (Duckett, 2005). In the healthcare sector, waiting time for service is a major concern for patients. In hospitals, patients are more likely confronted with long waiting for different services. In addition, it is found that one of the hardest waiting experiences occurs in outpatients' clinics for prearranged appointments, before being seen by a doctor and/or before or during examinations by the doctor. Long waiting times in clinics appears to have been a consistent source of dissatisfaction (Barlow, 2002). So the amount of time spent waiting can significantly influence their evaluation of service provided and their overall satisfaction.

It has been noticed that many people main criticism of outpatient services was the lengthy waiting time. When they were questioned, many patients testified the excellence of treatment which they have received from the out-patient clinics. Nonetheless, the one consistent feature of dissatisfaction which has been expressed with the out- patient service is the length of waiting time. As a result, patients routinely are made to wait minutes or hours in some cases before receiving services. The vast majority of patients wait are ranging from 30 minutes to an hour, after which time their tolerance understandably diminishes. Consequently this may specify the outpatient's perception of service delivery process and the outpatient level of satisfaction can therefore be affected. In highly competitive healthcare sectors, public hospitals should begin to provide outpatients with high quality services and manage long waiting time in out-patients clinics, and that require hospitals to understand various variables that the outpatient use to judge service quality delivered.

Research Objectives Following the discussion above, the current study will seek to: investigate into the effect of waiting time on outpatient satisfaction in Ghana; Identify the relevant service quality dimensions used by outpatients to evaluate service quality;

determine the overall satisfaction amongst outpatients in public hospitals in the Kumasi metropolis. determine what satisfied/dissatisfied outpatients do with respect to their relationship with the public hospitals in Ghana

Research Questions In order to fulfill the objectives, the following research questions will be posed. Is the waiting time a key factor in outpatient overall satisfaction in Ghana? What is the overall level of outpatient satisfaction in the public hospitals in Ghana? What do satisfied/dissatisfied out-patients do with respect tom their relationship with the public hospitals in Ghana? Brief Overview of Research Methodology

In this study, primary data would be explored to acquire the required data for the analysis. Questionnaires would be administered to solicit for information from respondents mainly the outpatient customers of the selected cases.

Non-probabilistic sampling techniques with reference to convenient sampling would be employed for the selection of the respondents. In all 600 respondents made up of outpatient customers of the selected public health facilities in Ghana. Data obtained will be analyzed using statistical tools such as SPSS and Excel application software.

Relevance of the Study A study of this nature is every important because it is going to enlighten the government and its agencies as well as other health service providers on how to design effective customer satisfaction programmes and health care policies towards patients. Thus, policy makers both at the national and district levels would find the findings of this work useful in developing and designing health schemes aimed at providing quality service to the general public. Researchers and academicians who are interested in customer satisfaction studies will also find this work useful as this work would add to the body of knowledge already accumulated in the chosen study area.

Scope of the Study / Limitation

This study will be focused on analyzing data from the Kumasi Metropolis; which is the Ashanti regional capital. Data will be gathered from four public hospitals within the Kumasi metro. Data from Komfo Anokye Teaching Hospital, South Suntreso government hospital, Manhyia government hospital and Tafo government hospital will be used for the analysis in this study. Plan of the Study This thesis will be divided into five chapters. In the first chapter, we will present a background of the selected research area followed by the problem area discussion, research objectives, research questions, methodology, and ends with research limitations. In chapter two, there will be a presentation of literature review of the previous studies and theories and previous studies in order to get a deeper insight of the subject matter. Chapter three will explain the methodology and

describe the technique used in the collection and analysis of the survey data. In chapter four the empirical data will be presented. In addition, chapter four will contain an analysis of the empirical data followed by a discussion of the survey finding. Chapter five will be the last chapter in the thesis which will show whether the aims and objectives of the study were achieved. More, a summary and conclusion of the research will be presented and ends with discussion of the implication of the finding. It will conclude with some recommendations for management and future research.

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