Patient satisfaction the importance of its measurement in improving the quali...Alexander Decker
This document summarizes a study on measuring patient satisfaction in a public pediatric department. The study aimed to identify factors influencing patient satisfaction related to access and care delivery. Researchers conducted surveys of 105 patients to assess satisfaction with various aspects like wait times, facilities, and staff interactions. Statistical analysis found the main dissatisfaction factors were long wait times and the waiting room conditions. Multiple factor analysis identified different patient profiles. Based on the results, the department implemented several actions to improve patient satisfaction.
This document summarizes a patient satisfaction survey conducted at the Massachusetts General Hospital Cancer Center. It provides background on the importance of measuring patient satisfaction and assessing the interpersonal aspects of care delivery. The literature review discusses factors that influence patient satisfaction, such as health status, age, sex, and specific care experiences. It also describes common treatments for breast cancer and the challenges patients face. The document outlines the study's method, results, and discussion sections to evaluate patient satisfaction at the MGH Cancer Center clinic.
An Overview of Patient Satisfaction and Perceived Care of Qualityijtsrd
This paper aims to audit the patient satisfaction literature, precisely survey methods used, which fundamentally analyses its hypothesis and use at that point to introduce proof for perceived service quality as a discrete and further advanced construct. Findings Patient satisfaction has been widely reviewed and significant efforts have gone into creating survey instruments to estimate it. Although, most surveys have been critical of its utilization, since there is seldomly any hypothetical or calculated development of the patient satisfaction theory. The construct has little normalization, low accuracy and undetermined validity. It keeps on being utilized interchangeably with, and as an intermediary for, perceived health service quality, which is a conceptually extraordinary and predominant construct. Practical Implications The persistent utilization of patient satisfaction to assess the patients perception of the quality of a healthcare service is truly flawed. The way to settling this dilemma might be for the healthcare division to concentrate on perceived healthcare service quality by considering the particular theories and models that can be found in the administrations advertising literature. This literature offers further developed consumer theories which are preferred differentiated and tried over existing healthcare satisfaction models. Conclusion This paper brings up that there is a critical requirement for differentiation and normalization of patient satisfaction and healthcare service quality definitions and constructs, and argues for examination to concentrate on estimating perceived healthcare service quality. Shubham Chaurasia | Shivani Dadwal Salaria | Rakhi Ahuja | Amit Sharma "An Overview of Patient Satisfaction and Perceived Care of Quality" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd31548.pdf Paper Url :https://www.ijtsrd.com/management/public-sector-management/31548/an-overview-of-patient-satisfaction-and-perceived-care-of-quality/shubham-chaurasia
This document outlines concepts related to health care quality assessment. It describes key definitions, such as quality referring to services that increase health outcomes and are consistent with current knowledge. It also discusses perspectives on quality from practitioners, patients, and communities. Additionally, the document outlines different levels of quality analysis from national policies to individual care provision and lists examples of common quality indicators assessed in the US, such as patient satisfaction, mortality rates, and adherence to treatment protocols.
A study on patient satisfaction with special reference to government hospital...Tapasya123
In this study researchers analyse the satisfaction level of patients regard to facilities
available in government hospitals. A sample of 100 patients is taken from Pandit Brij
Sundar Shama Government General Hospital (GGH) at Bundi District in the state
of Rajasthan in India. Four dimensions of perceived quality were identified—Admission
Procedure, Diagnostic Services, Behaviour of the staff, Cleanliness. The developed
scale is used to evaluate perceived quality at a range of various types of facilities
for patients. Perceived quality at public facilities is only marginally favourable, leaving
much scope for improvement. Better staff and physician relations, interpersonal skills,
good diagnostic and cleanliness service can improve the level of satisfaction among
employees.
Keywords:
This document is a thesis presented to the Graduate Faculty at the University of Akron for a Master of Science degree. The thesis assesses patient satisfaction and experience through correlation analysis and the Kano model. A sample of 100 patient satisfaction surveys from a community hospital in Northeast Ohio were obtained and analyzed. The methodology chapter discusses the Kano theory and how it compares customer expectations to customer likes. The data analysis chapter presents the results of analyzing the survey data through correlation analysis and the Kano model to quantify the effects of different service aspects on overall patient satisfaction.
A comparative study on patients’ satisfaction in health care serviceAlexander Decker
This document summarizes a study comparing patient satisfaction levels between a public hospital and a private hospital in Salem, India. A sample of 400 patients from the two hospitals were surveyed using SERVQUAL and Donabedian's frameworks to measure satisfaction. The findings show that patients at the private hospital reported significantly higher levels of satisfaction than those at the public hospital. Specifically, 97% of private hospital patients reported medium satisfaction levels, compared to just 70% at the public hospital. The study concludes that the private hospital is better able to meet patient needs and provide high quality healthcare services.
This document discusses patient satisfaction in healthcare. It begins by introducing patient satisfaction as a concept that considers a patient's needs, expectations of care, and healthcare experiences. Several theories of patient satisfaction are mentioned. The literature review highlights factors that can affect patient satisfaction, including provider characteristics like communication skills and patient characteristics like socioeconomic status. Ensuring patient satisfaction is important for compliance, care-seeking behaviors, and quality improvement. The document then describes a study conducted in Pakistan that assessed patient satisfaction in an outpatient department, finding high satisfaction with doctors, facilities, and a willingness to return. It recommends further studies in other care settings and obtaining ongoing patient feedback.
Patient satisfaction the importance of its measurement in improving the quali...Alexander Decker
This document summarizes a study on measuring patient satisfaction in a public pediatric department. The study aimed to identify factors influencing patient satisfaction related to access and care delivery. Researchers conducted surveys of 105 patients to assess satisfaction with various aspects like wait times, facilities, and staff interactions. Statistical analysis found the main dissatisfaction factors were long wait times and the waiting room conditions. Multiple factor analysis identified different patient profiles. Based on the results, the department implemented several actions to improve patient satisfaction.
This document summarizes a patient satisfaction survey conducted at the Massachusetts General Hospital Cancer Center. It provides background on the importance of measuring patient satisfaction and assessing the interpersonal aspects of care delivery. The literature review discusses factors that influence patient satisfaction, such as health status, age, sex, and specific care experiences. It also describes common treatments for breast cancer and the challenges patients face. The document outlines the study's method, results, and discussion sections to evaluate patient satisfaction at the MGH Cancer Center clinic.
An Overview of Patient Satisfaction and Perceived Care of Qualityijtsrd
This paper aims to audit the patient satisfaction literature, precisely survey methods used, which fundamentally analyses its hypothesis and use at that point to introduce proof for perceived service quality as a discrete and further advanced construct. Findings Patient satisfaction has been widely reviewed and significant efforts have gone into creating survey instruments to estimate it. Although, most surveys have been critical of its utilization, since there is seldomly any hypothetical or calculated development of the patient satisfaction theory. The construct has little normalization, low accuracy and undetermined validity. It keeps on being utilized interchangeably with, and as an intermediary for, perceived health service quality, which is a conceptually extraordinary and predominant construct. Practical Implications The persistent utilization of patient satisfaction to assess the patients perception of the quality of a healthcare service is truly flawed. The way to settling this dilemma might be for the healthcare division to concentrate on perceived healthcare service quality by considering the particular theories and models that can be found in the administrations advertising literature. This literature offers further developed consumer theories which are preferred differentiated and tried over existing healthcare satisfaction models. Conclusion This paper brings up that there is a critical requirement for differentiation and normalization of patient satisfaction and healthcare service quality definitions and constructs, and argues for examination to concentrate on estimating perceived healthcare service quality. Shubham Chaurasia | Shivani Dadwal Salaria | Rakhi Ahuja | Amit Sharma "An Overview of Patient Satisfaction and Perceived Care of Quality" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd31548.pdf Paper Url :https://www.ijtsrd.com/management/public-sector-management/31548/an-overview-of-patient-satisfaction-and-perceived-care-of-quality/shubham-chaurasia
This document outlines concepts related to health care quality assessment. It describes key definitions, such as quality referring to services that increase health outcomes and are consistent with current knowledge. It also discusses perspectives on quality from practitioners, patients, and communities. Additionally, the document outlines different levels of quality analysis from national policies to individual care provision and lists examples of common quality indicators assessed in the US, such as patient satisfaction, mortality rates, and adherence to treatment protocols.
A study on patient satisfaction with special reference to government hospital...Tapasya123
In this study researchers analyse the satisfaction level of patients regard to facilities
available in government hospitals. A sample of 100 patients is taken from Pandit Brij
Sundar Shama Government General Hospital (GGH) at Bundi District in the state
of Rajasthan in India. Four dimensions of perceived quality were identified—Admission
Procedure, Diagnostic Services, Behaviour of the staff, Cleanliness. The developed
scale is used to evaluate perceived quality at a range of various types of facilities
for patients. Perceived quality at public facilities is only marginally favourable, leaving
much scope for improvement. Better staff and physician relations, interpersonal skills,
good diagnostic and cleanliness service can improve the level of satisfaction among
employees.
Keywords:
This document is a thesis presented to the Graduate Faculty at the University of Akron for a Master of Science degree. The thesis assesses patient satisfaction and experience through correlation analysis and the Kano model. A sample of 100 patient satisfaction surveys from a community hospital in Northeast Ohio were obtained and analyzed. The methodology chapter discusses the Kano theory and how it compares customer expectations to customer likes. The data analysis chapter presents the results of analyzing the survey data through correlation analysis and the Kano model to quantify the effects of different service aspects on overall patient satisfaction.
A comparative study on patients’ satisfaction in health care serviceAlexander Decker
This document summarizes a study comparing patient satisfaction levels between a public hospital and a private hospital in Salem, India. A sample of 400 patients from the two hospitals were surveyed using SERVQUAL and Donabedian's frameworks to measure satisfaction. The findings show that patients at the private hospital reported significantly higher levels of satisfaction than those at the public hospital. Specifically, 97% of private hospital patients reported medium satisfaction levels, compared to just 70% at the public hospital. The study concludes that the private hospital is better able to meet patient needs and provide high quality healthcare services.
This document discusses patient satisfaction in healthcare. It begins by introducing patient satisfaction as a concept that considers a patient's needs, expectations of care, and healthcare experiences. Several theories of patient satisfaction are mentioned. The literature review highlights factors that can affect patient satisfaction, including provider characteristics like communication skills and patient characteristics like socioeconomic status. Ensuring patient satisfaction is important for compliance, care-seeking behaviors, and quality improvement. The document then describes a study conducted in Pakistan that assessed patient satisfaction in an outpatient department, finding high satisfaction with doctors, facilities, and a willingness to return. It recommends further studies in other care settings and obtaining ongoing patient feedback.
In 2002, NANDA changed its name to NANDA International (NANDA-I) to further reflect the worldwide interest in nursing diagnosis. In the same year, Taxonomy II was released based on the revised version of Gordon’s Functional health patterns.
As of 2018, NANDA-I has approved 244 diagnoses for clinical use, testing, and refinement.
A Study on the Customer Perceptions of Quality of Services of a large hospita...Mohit Saxena
The document discusses service quality in the healthcare industry. It provides context that service quality is important for customer satisfaction, retention, and financial performance. It then reviews several frameworks for measuring service quality, including SERVQUAL and SERVPERF scales, which assess the gap between customer expectations and perceptions of service performance across key dimensions. The purpose of the study is to evaluate patients' perceptions of service quality at a large hospital in New Delhi using these standardized measurement tools.
The document discusses nursing diagnosis. It begins by defining nursing diagnosis as a clinical judgment about an individual's response to actual or potential health problems. Nursing diagnosis provides the basis for selecting nursing interventions. The document then discusses the purpose of nursing diagnosis, how it is developed and classified. It compares nursing diagnosis to medical diagnosis and outlines the components and process of developing a nursing diagnostic statement.
The document outlines the nursing process, which includes 5 phases - assessment, nursing diagnosis, planning, implementation, and evaluation.
The assessment phase involves collecting client data through various methods like observation, interview, and examination. In the nursing diagnosis phase, the nurse analyzes the assessment data to identify client problems/needs and prioritize them.
The planning phase involves setting goals to address the problems and selecting nursing interventions. Implementation involves applying the planned care. Finally, in the evaluation phase the nurse determines if the goals were met by collecting additional client data. The nursing process provides a systematic framework to plan and deliver individualized nursing care.
This document discusses nursing diagnosis, including its evolution, purpose, definition, components, types, prioritization, case studies, errors to avoid, limitations, and overcoming barriers. Specifically, it outlines how nursing diagnosis evolved from Fry's identification in 1953 as a tool for individualized care to NANDA developing new diagnoses in 1998. The purpose is to identify areas nurses can resolve, demonstrate professional judgment, and promote accountability. A nursing diagnosis is a clinical judgment about an individual's response to health problems.
The first quasiexperiemental study of the ORS/SRS in a telephonic EAP company. Doubled outcomes and improved retension. Set the stage for the RCTs that followed
Nursing Diagnosis is second step of Nursing Process.which is very important and depend on your good assessment.you must make nursing diagnosis skillfully to meet patient's need.
What Is Client Directed Outcome InformedScott Miller
Client Directed Outcome Informed (CDOI) clinical work privileges the client's perspective and uses their feedback to guide treatment in a partnership between client and provider. Several mental health and substance abuse treatment organizations that have implemented CDOI report improved outcomes like higher retention rates and lower costs from reduced sessions and cancellations. Research shows involving clients in decisions about their treatment and focusing on whether treatment is working improves success rates by an average of 65%.
HCAD 660 individual project research paper for Intravalley HealthModupe Sarratt
Intravalley Health conducted patient experience and satisfaction surveys to improve their services. The document discusses two key findings:
1) Patient satisfaction is linked to medical procedures and healthcare services. Providers at Intravalley Health must understand the patient experience regarding the cause of medical care and the effect on patient satisfaction of health services.
2) The cause of negative patient experiences stems from strict regulations, policies, and procedures required to comply with laws like the Affordable Care Act. However, what patients consider quality care does not always align with metrics used to measure provider performance. Surveys cannot fully capture the patient experience of care received during medical procedures.
Intravalley Health conducted patient experience and satisfaction surveys to improve their services. The document discusses two key findings:
1) Patient satisfaction is linked to medical procedures and healthcare services. Providers at Intravalley Health must understand the patient experience regarding the cause of medical care and the effect on patient satisfaction of health services.
2) The cause of negative patient experiences stems from strict regulations, policies, and procedures required to comply with laws like the Affordable Care Act. However, what patients consider to be quality care does not always align with metrics used to measure provider performance. Surveys may not fully capture the patient experience.
The series of questions provided would likely occur during the "Gathering information about the patient's chief concerns" phase of a patient-centered interview. The questions are gathering specific details about the patient's diet and weight, which are important concerns to assess. Setting the stage would involve introducing oneself and explaining the purpose of the interview. Collecting the assessment involves gathering additional assessment data through physical exam or tests. Termination involves concluding the interview.
Critical thinking in nursing involves using a systematic nursing process of assessment, nursing diagnosis, planning, implementation, and evaluation. Nurses collect and analyze data to identify client health problems and formulate diagnoses. Goals and interventions are then planned and implemented, with outcomes evaluated to determine if goals were met and care should be continued, modified, or discontinued. This nursing process framework guides nursing practice and requires ongoing critical thinking.
Service quality and patients satisfaction with healthcare deliveryAlexander Decker
This study examined service quality and patient satisfaction at a public university hospital in Ghana. A survey of 400 outpatients found gaps between perceived and expected quality across all five SERVQUAL dimensions - responsiveness had the widest gap, followed by reliability, tangibility, empathy, and assurance. Correlation analysis revealed perceived responsiveness, empathy, assurance, and tangibility were positively correlated with patient satisfaction, while reliability was not significantly correlated. The study provides insights into improving healthcare quality and patient experiences at public hospitals in Ghana.
The nursing process involves 6 sequential steps: assessment, diagnosis, outcome identification, planning, implementation, and evaluation. It originated as a 3-step process and has evolved over time based on contributions from various nursing theorists. The nursing process provides organized, systematic, and individualized care. It is the foundation of nursing practice and ensures quality care delivery that meets professional standards.
This document summarizes a study that evaluated quality assurance in the emergency department of a tertiary care hospital in India. The study collected data through questionnaires from 80 patients and 20 healthcare professionals. It found that while most patients were satisfied overall, many reported dissatisfaction with physical facilities like drinking water. Healthcare professionals also expressed dissatisfaction with physical facilities. The highest rated quality area was documentation procedures. The study aims to identify areas of improvement to further enhance emergency care quality and patient satisfaction.
This study evaluated the implementation of a value-driven outcomes tool at University of Utah Health Care to measure costs, quality, and outcomes at the individual patient level. The tool identified high variability in costs for certain conditions like sepsis and joint replacements. For three clinical projects using the tool (total joint replacement, hospitalist laboratory testing, and sepsis management), costs decreased 7-11% and quality improved. The tool was associated with reduced costs and better outcomes when used to provide clinicians information on resource use and performance for defined patient populations.
Nursing process -presented by Mrs.Chinchu NithinChinchuBalan
The document discusses the nursing process and its components. It defines the nursing process as a systematic method of providing individualized care to clients. The main components of the nursing process discussed are assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting, organizing, validating, and documenting client data. Nursing diagnosis involves analyzing the data to identify client health problems or risks. Planning involves prioritizing problems, setting goals, and determining nursing interventions. [END SUMMARY]
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
Lannes - Improving health worker performance The patient-perspectivelaurencelannes
PBF programs in developing countries aim to improve health worker performance through financial incentives tied to meeting targets. This document analyzes data from a PBF program in Rwanda to assess its impact on patient satisfaction. It finds that PBF had a positive effect on satisfaction with clinical services by improving productivity, availability, and competencies of health workers. PBF also positively impacted satisfaction with non-clinical dimensions, suggesting it incentivized improvements in those areas as well. The study concludes PBF can be an effective strategy for increasing patient satisfaction if programs include assessing satisfaction in their incentive mechanisms.
Este documento presenta 5 principios clave sobre la comunicación digital y el marketing en la actualidad. Argumenta que los consumidores son personas, no números, y que el marketing digital ya es esencial y está ampliamente adoptado en Colombia. También destaca que el marketing a través de redes sociales ofrece una cobertura amplia a todos los segmentos demográficos y es mucho más rentable que la televisión. Concluye que las marcas deben comprometerse con el cocreación de contenido con los consumidores a través de múltiples canales para tener éxito en
In their preliminary film, the filmmakers used a limited range of camera angles due to their inexperience. They incorporated one pan shot, but it was not smooth. For their final film, they utilized a wider variety of shots including extreme close-ups after gaining more exposure and practice. Additionally, their editing skills improved drastically. Sound was also limited in the preliminary, but for the final film they used foley effects to make the sounds clearer and better synced to the video.
China is a fast growing market for wine. While Chinese wines dominate the domestic market, imported wines make up 10% and this share is expected to grow as Chinese wines improve in quality. Key opportunities for wine importers in China include targeting young urban professionals in major cities through bars, hotels and retail stores. China's large and growing middle class provides potential for imported wines as a premium product.
In 2002, NANDA changed its name to NANDA International (NANDA-I) to further reflect the worldwide interest in nursing diagnosis. In the same year, Taxonomy II was released based on the revised version of Gordon’s Functional health patterns.
As of 2018, NANDA-I has approved 244 diagnoses for clinical use, testing, and refinement.
A Study on the Customer Perceptions of Quality of Services of a large hospita...Mohit Saxena
The document discusses service quality in the healthcare industry. It provides context that service quality is important for customer satisfaction, retention, and financial performance. It then reviews several frameworks for measuring service quality, including SERVQUAL and SERVPERF scales, which assess the gap between customer expectations and perceptions of service performance across key dimensions. The purpose of the study is to evaluate patients' perceptions of service quality at a large hospital in New Delhi using these standardized measurement tools.
The document discusses nursing diagnosis. It begins by defining nursing diagnosis as a clinical judgment about an individual's response to actual or potential health problems. Nursing diagnosis provides the basis for selecting nursing interventions. The document then discusses the purpose of nursing diagnosis, how it is developed and classified. It compares nursing diagnosis to medical diagnosis and outlines the components and process of developing a nursing diagnostic statement.
The document outlines the nursing process, which includes 5 phases - assessment, nursing diagnosis, planning, implementation, and evaluation.
The assessment phase involves collecting client data through various methods like observation, interview, and examination. In the nursing diagnosis phase, the nurse analyzes the assessment data to identify client problems/needs and prioritize them.
The planning phase involves setting goals to address the problems and selecting nursing interventions. Implementation involves applying the planned care. Finally, in the evaluation phase the nurse determines if the goals were met by collecting additional client data. The nursing process provides a systematic framework to plan and deliver individualized nursing care.
This document discusses nursing diagnosis, including its evolution, purpose, definition, components, types, prioritization, case studies, errors to avoid, limitations, and overcoming barriers. Specifically, it outlines how nursing diagnosis evolved from Fry's identification in 1953 as a tool for individualized care to NANDA developing new diagnoses in 1998. The purpose is to identify areas nurses can resolve, demonstrate professional judgment, and promote accountability. A nursing diagnosis is a clinical judgment about an individual's response to health problems.
The first quasiexperiemental study of the ORS/SRS in a telephonic EAP company. Doubled outcomes and improved retension. Set the stage for the RCTs that followed
Nursing Diagnosis is second step of Nursing Process.which is very important and depend on your good assessment.you must make nursing diagnosis skillfully to meet patient's need.
What Is Client Directed Outcome InformedScott Miller
Client Directed Outcome Informed (CDOI) clinical work privileges the client's perspective and uses their feedback to guide treatment in a partnership between client and provider. Several mental health and substance abuse treatment organizations that have implemented CDOI report improved outcomes like higher retention rates and lower costs from reduced sessions and cancellations. Research shows involving clients in decisions about their treatment and focusing on whether treatment is working improves success rates by an average of 65%.
HCAD 660 individual project research paper for Intravalley HealthModupe Sarratt
Intravalley Health conducted patient experience and satisfaction surveys to improve their services. The document discusses two key findings:
1) Patient satisfaction is linked to medical procedures and healthcare services. Providers at Intravalley Health must understand the patient experience regarding the cause of medical care and the effect on patient satisfaction of health services.
2) The cause of negative patient experiences stems from strict regulations, policies, and procedures required to comply with laws like the Affordable Care Act. However, what patients consider quality care does not always align with metrics used to measure provider performance. Surveys cannot fully capture the patient experience of care received during medical procedures.
Intravalley Health conducted patient experience and satisfaction surveys to improve their services. The document discusses two key findings:
1) Patient satisfaction is linked to medical procedures and healthcare services. Providers at Intravalley Health must understand the patient experience regarding the cause of medical care and the effect on patient satisfaction of health services.
2) The cause of negative patient experiences stems from strict regulations, policies, and procedures required to comply with laws like the Affordable Care Act. However, what patients consider to be quality care does not always align with metrics used to measure provider performance. Surveys may not fully capture the patient experience.
The series of questions provided would likely occur during the "Gathering information about the patient's chief concerns" phase of a patient-centered interview. The questions are gathering specific details about the patient's diet and weight, which are important concerns to assess. Setting the stage would involve introducing oneself and explaining the purpose of the interview. Collecting the assessment involves gathering additional assessment data through physical exam or tests. Termination involves concluding the interview.
Critical thinking in nursing involves using a systematic nursing process of assessment, nursing diagnosis, planning, implementation, and evaluation. Nurses collect and analyze data to identify client health problems and formulate diagnoses. Goals and interventions are then planned and implemented, with outcomes evaluated to determine if goals were met and care should be continued, modified, or discontinued. This nursing process framework guides nursing practice and requires ongoing critical thinking.
Service quality and patients satisfaction with healthcare deliveryAlexander Decker
This study examined service quality and patient satisfaction at a public university hospital in Ghana. A survey of 400 outpatients found gaps between perceived and expected quality across all five SERVQUAL dimensions - responsiveness had the widest gap, followed by reliability, tangibility, empathy, and assurance. Correlation analysis revealed perceived responsiveness, empathy, assurance, and tangibility were positively correlated with patient satisfaction, while reliability was not significantly correlated. The study provides insights into improving healthcare quality and patient experiences at public hospitals in Ghana.
The nursing process involves 6 sequential steps: assessment, diagnosis, outcome identification, planning, implementation, and evaluation. It originated as a 3-step process and has evolved over time based on contributions from various nursing theorists. The nursing process provides organized, systematic, and individualized care. It is the foundation of nursing practice and ensures quality care delivery that meets professional standards.
This document summarizes a study that evaluated quality assurance in the emergency department of a tertiary care hospital in India. The study collected data through questionnaires from 80 patients and 20 healthcare professionals. It found that while most patients were satisfied overall, many reported dissatisfaction with physical facilities like drinking water. Healthcare professionals also expressed dissatisfaction with physical facilities. The highest rated quality area was documentation procedures. The study aims to identify areas of improvement to further enhance emergency care quality and patient satisfaction.
This study evaluated the implementation of a value-driven outcomes tool at University of Utah Health Care to measure costs, quality, and outcomes at the individual patient level. The tool identified high variability in costs for certain conditions like sepsis and joint replacements. For three clinical projects using the tool (total joint replacement, hospitalist laboratory testing, and sepsis management), costs decreased 7-11% and quality improved. The tool was associated with reduced costs and better outcomes when used to provide clinicians information on resource use and performance for defined patient populations.
Nursing process -presented by Mrs.Chinchu NithinChinchuBalan
The document discusses the nursing process and its components. It defines the nursing process as a systematic method of providing individualized care to clients. The main components of the nursing process discussed are assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting, organizing, validating, and documenting client data. Nursing diagnosis involves analyzing the data to identify client health problems or risks. Planning involves prioritizing problems, setting goals, and determining nursing interventions. [END SUMMARY]
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
Lannes - Improving health worker performance The patient-perspectivelaurencelannes
PBF programs in developing countries aim to improve health worker performance through financial incentives tied to meeting targets. This document analyzes data from a PBF program in Rwanda to assess its impact on patient satisfaction. It finds that PBF had a positive effect on satisfaction with clinical services by improving productivity, availability, and competencies of health workers. PBF also positively impacted satisfaction with non-clinical dimensions, suggesting it incentivized improvements in those areas as well. The study concludes PBF can be an effective strategy for increasing patient satisfaction if programs include assessing satisfaction in their incentive mechanisms.
Este documento presenta 5 principios clave sobre la comunicación digital y el marketing en la actualidad. Argumenta que los consumidores son personas, no números, y que el marketing digital ya es esencial y está ampliamente adoptado en Colombia. También destaca que el marketing a través de redes sociales ofrece una cobertura amplia a todos los segmentos demográficos y es mucho más rentable que la televisión. Concluye que las marcas deben comprometerse con el cocreación de contenido con los consumidores a través de múltiples canales para tener éxito en
In their preliminary film, the filmmakers used a limited range of camera angles due to their inexperience. They incorporated one pan shot, but it was not smooth. For their final film, they utilized a wider variety of shots including extreme close-ups after gaining more exposure and practice. Additionally, their editing skills improved drastically. Sound was also limited in the preliminary, but for the final film they used foley effects to make the sounds clearer and better synced to the video.
China is a fast growing market for wine. While Chinese wines dominate the domestic market, imported wines make up 10% and this share is expected to grow as Chinese wines improve in quality. Key opportunities for wine importers in China include targeting young urban professionals in major cities through bars, hotels and retail stores. China's large and growing middle class provides potential for imported wines as a premium product.
СтройПолимер - утепление ппу и гидроизоляция полимочевинойСтрой Полимер
Основной вид деятельности компании ООО «СтройПолимер» гидроизоляция и теплоизоляция помещений с использованием современных материалов: полимочевина и пенополиуретан. http://stroy-polimery.ru/
El documento describe las 6 fases de un proyecto educativo, incluyendo explorar los intereses de los estudiantes, planificar el proyecto y las tareas, definir los objetivos de aprendizaje, implementar el proyecto, compartir los resultados, analizar el progreso, y dar seguimiento al desarrollo de habilidades.
This document discusses a proposed study to assess factors of patient satisfaction in dermatology practices and link provider reimbursement to patient satisfaction scores. The study would develop and administer a questionnaire to patients at UPMC dermatology clinics to measure satisfaction with various aspects of care. Satisfaction scores would determine Medicare reimbursements to those clinics. The document provides background on pay-for-performance programs and reviews previous studies on factors influencing patient satisfaction in dermatology, such as provider communication and treatment effectiveness. It acknowledges limitations like recall bias but aims to advance quality by incentivizing high patient satisfaction.
The Impact of Quality on Satisfaction: Case Study of Mongolia Private Hospitalsijtsrd
Quality of service is the most important indicator of patient satisfaction. The purpose of this study was to examine the impact of service quality on overall patient satisfaction in private hospitals in Ulaanbaatar, Mongolia. The study sample consisted of 69 patients who were selected from eight private general hospitals in Ulaanbaatar, Mongolia, using a sequential sample. Data analysis was performed using a t test, ANOVA and multivariate regression. This study found a close relationship between quality of service and patient satisfaction. About 45 of the differences in overall satisfaction are due to four aspects of quality of service. In terms of process quality, the waiting time for visits, receptions and operations should be reduced, and services should be provided as soon as possible. The need to strengthen the interpersonal aspects of care and communication skills of service providers should be emphasized. Uugantsetseg Davaadorj | Otgontsetseg Galindev "The Impact of Quality on Satisfaction: Case Study of Mongolia Private Hospitals" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-1 , December 2019, URL: https://www.ijtsrd.com/papers/ijtsrd29711.pdf Paper URL: https://www.ijtsrd.com/management/research-method/29711/the-impact-of-quality-on-satisfaction-case-study-of-mongolia-private-hospitals/uugantsetseg-davaadorj
This document summarizes an article from the International Journal of Management that examines patient satisfaction with medical services provided in the in-patient department of NKS Hospital in India. A patient satisfaction questionnaire was administered to 50 randomly selected in-patients to assess their level of satisfaction across various aspects of care. The results found that patients were generally satisfied with the services and providers, though satisfaction levels varied across different aspects of care. The study aims to help hospitals better understand patient experiences and identify strategies to improve the quality of care provided.
Patient Satisfaction Survey as a Tool Towards Quality Improvement by Dr.Mahbo...Healthcare consultant
A mixed bag of poorly evaluated methods leaves patients frustrated, and doctors little wiser.The best way to ensure that services are responsive to those they aim to serve is to elicit feedback on people’s experiences and encourage providers to deal with any problems thus identified. This has been axiomatic in health policy for many years, but have we got the balance right in primary care? Patients’ experiences have become central to assessing the performance of healthcare systems worldwide and are increasingly being used to inform quality improvement processes. This paper explores the relative value of surveys and detailed patient narratives in identifying priorities for improving breast cancer services as part of a quality improvement process.
Abstract— If job satisfaction is there in employees, work done by these employees is usually of better quality in comparison where the employees are not satisfied with their jobe. So this study to assess job satisfaction and influence of demographic variables on job satisfaction, this study was carried out on 105 doctors of teaching hospitals. Questionnaire method of data collection was adopted. Job satisfaction was measured by six domains: Organizational functioning, Interpersonal relationship, Financial incentives, Non-financial incentives, Physical facilities and Working conditions. Study observed that over all, doctors were moderately satisfied with their job. Domains such as Interpersonal relationship and Working conditions, doctors were highly satisfied, whereas rest of the domains: Organizational functioning, Financial incentives, Non-financial incentives, and Physical facilities doctors were moderately satisfied. It is important to note that even though overall satisfaction is moderate, there were few components, where doctors were highly satisfied were - Communication system between patients and doctors, Involvement in decision making in the department, Rules and regulations of the institution, relationship between the department colleagues and other department colleagues, Provision for leave encashment, reward given for research work, workload of clinical aspect and workload of teaching aspect. Age and sex both shown significant association on level of satisfaction where as experience, designation and marital status of the doctors have not shown significant association.
Effects of provider patient relationship on the rate of patient’s recovery am...Alexander Decker
This document discusses a study on the effects of provider-patient relationships on patient recovery and satisfaction rates among inpatients at Wa Regional Hospital in Ghana. The study found that patients had high levels of satisfaction with the care provided, which positively influenced their recovery rates. Satisfied patients were also more likely to comply with medical recommendations. The study aims to examine the psychological impact of provider-patient interactions on patient satisfaction. Effective communication between providers and patients is important for improving patient satisfaction and health outcomes. The theoretical framework is based on the Primary Provider Theory, which states that patient satisfaction is primarily linked to interactions with healthcare providers. Prior research also found relationships between patient satisfaction, treatment compliance, and health outcomes.
International Journal of Business and Management Invention (IJBMI) is an international journal intended for professionals and researchers in all fields of Business and Management. IJBMI publishes research articles and reviews within the whole field Business and Management, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Patient satisfaction surveys are used to gather feedback from patients about their experiences with healthcare services. They can be conducted using paper, online, or mobile formats. The surveys assess aspects of care like staff responsiveness, communication with clinicians, competence, and the treatment environment. When creating a survey, it's important to identify key issue areas and include questions about appointments, interactions with staff, communication with providers, facility features, cleanliness, and overall satisfaction. The results should be effectively used by trying different distribution methods and making multiple attempts to receive responses in order to understand patient experiences and identify areas for improvement.
Analysis Factors of Hospital Services Quality and User Satisfactioninventionjournals
This study aims to identify the factors of service quality and user satisfaction Hospital type B in East Java and constraints the government's efforts in improving the quality of hospital services. Technique of the analysis of data in this study using descriptive analysis and factor analysis and also obtained by interview to director of hospitals. The results showed that hospital users are women with the quality of hospital services is good, but there is still an effort to improve and based on that service quality established by 5 factors; clarity of procedures, employee competence, professionalism, effectiveness and competence. While user satisfaction built by 3 factors are tangible, reliability and empathy. Constraints faced by the government in improving service quality is the limited medical and paramedical personnel, facilities and infrastructure, including the availability of medical equipment, low public awareness of service and the poor public image of hospital services.
Service quality and patients satisfaction with healthcare deliveryAlexander Decker
This study examined service quality and patient satisfaction at a public university hospital in Ghana. A survey of 400 outpatients found gaps between expected and perceived quality across all five SERVQUAL dimensions - responsiveness had the widest gap, followed by reliability, tangibility, empathy, and assurance. Correlation analysis showed perceived responsiveness, empathy, assurance, and tangibility were positively correlated with patient satisfaction, while reliability was not significantly correlated. The study indicates patient satisfaction is best explained by perceived responsiveness, followed by empathy, assurance, tangibility, and reliability.
A study of service quality assessment for patients case of ahi evran universi...aysegul turan
This document summarizes a study that assessed service quality for patients at the emergency services of Ahi Evran University Training and Research Hospital in Turkey. The study aimed to measure patients' expectations of health services and how well those expectations were met. A survey was administered to 501 patients who visited the emergency room between October 2015 and January 2016. The SERVQUAL model was used to assess service quality across five dimensions: empathy, reliability, responsiveness, assurance, and tangibles. Results showed that patients' perceptions exceeded their expectations for responsiveness and assurance, but were similar for empathy. Differences in perceptions were found based on age, income, and education level. The study aimed to identify factors affecting patient satisfaction levels in the emergency room and determine
Role of employee satisfaction in influencing patient satisfactionGovt of India
This document discusses a study on the relationship between employee satisfaction and patient satisfaction in the outpatient department of a hospital. The study found that employee satisfaction is strongly correlated with patient satisfaction and quality of care. When employees are more satisfied, it leads to better quality of care for patients and improved patient satisfaction. Ensuring employee satisfaction is important for hospitals as it can positively influence patient loyalty and experience, as well as reduce costs from issues like employee turnover. The study concluded that improving employee satisfaction should be a priority for healthcare organizations as it benefits both patients and the organization.
CHAPTER 6 Measuring Consumer Satisfaction Shulamit L. Bernard an.docxchristinemaritza
CHAPTER 6 Measuring Consumer Satisfaction
Shulamit L. Bernard and Lucy A. Savitz
“The key to customer feedback is to ask about the few aspects of the customer experience that matter the most … and do something about them!”
—Davis Balestracci (2009)
Measures of consumer satisfaction can serve an important role in monitoring quality and improving health care. Oftentimes overshadowed by measures of clinical process and outcomes in monitoring health care quality, consumer satisfaction has emerged as an important indicator of quality (see Chapter 5). At one time relegated to service improvement efforts by hospitals, measures of patient—or consumer—satisfaction are recognized as the provider’s best source of information about “communication, education, and pain-management process, and they (patients) are the only source of information about whether they were treated with dignity and respect” (Cleary, 2003, p. 33). Consumers’ experiences can stimulate important insights into how a provider is operating and suggest changes that may “close the chasm between the care provided and that care that should be provided” (Cleary, 2003, p. 33). Furthermore, the marketplace in which the providers operate is demanding that data on patient satisfaction be used to empower consumers and foster provider accountability and consumer choice. Measuring consumer satisfaction provides a comprehensive, systematic, and patient-centered approach for analysis, implementation, monitoring, and improving both the perceived and the clinical quality aspects of care (Ford et al., 1997).
This chapter provides an overview of key issues and methods related to measuring consumer satisfaction. The rationale for measurement is discussed and followed by a series of issues: measurement, data capture, timing, and functional responsibility. An example applying patient satisfaction measures as part of the Balanced Scorecard (a measurement system that adds customer and other dimensions to the customary financial measures [Kaplan and Norton, 1996]) is presented. We conclude with a brief overview of the special issue of case-mix adjustment of reported consumer satisfaction measures.
DEFINING CONSUMER SATISFACTION
Obtaining the views of customers has been a key feature of many modern business practices for many years, and the health care sector has adopted this same view, considering the patient as a consumer, which has led to the application of methods for assessing patient views (Wensing and Elwyn, 2002). The idea of patients as consumers stems from a market perspective on health care in which the providers are assumed to be responsive to competition and in which competition can drive increased quality and lower cost. In the context of satisfaction measures, patients are considered as parties to an exchange of goods and/or services. Health consumers’ views can be divided into three types: measures of preferences, evaluations by users, and reports of health care. Preferences are ideas about wh ...
BENCHMARK 1
Evidence-Based Practice Project: PICOT Paper
Daysha Y. Polk
NUR 550
Grand Canyon University
June 1st, 2021
Evidence-Based Practice Project: PICOT Paper
Generally, a high level of patient satisfaction for the clients in the emergency department (ED) is vital, especially at this time when the healthcare system is shifting towards patient-centered care. Prakash (2010) notes that patient satisfaction levels significantly impact on medical malpractice claims, patient retention, and clinical outcomes. That is, it affects quality healthcare’s timely, efficient, and patient-centered delivery, making it both a proxy but a very effective key indicator for measuring the hospitals and doctors’ success. Consequently, supporting the improvements of patient satisfaction levels can positively affect several healthcare organizations’ components, such as preventive possible malpractice lawsuits, securing a positive local reputation, and enhancing patient retention rates. Thus, there is an increased need to develop strategies to improve ED patient’s satisfaction with the provided care services. Increasingly, the use of real-time location systems (RTLS) by hospitals to track patients, instead of relying on the traditional, manually-entered status updates, is increasingly being viewed as a better strategy to decrease the number or rate of Left Without Being Treated (LWBT) patients, and thus, improve ED patient’s satisfaction levels and hospital’s revenue collection (Boulos & Berry, 2012). Thus, the paper will explore whether the utilization of RTLS in the hospital’s ED, compared to manually-entered status updates to tract patients, help decrease the rate of LWBT and to raise revenue collection within 6 months, for ED patients with decreasing satisfaction levels with the provided healthcare services.
A wide array of factors is responsible for the decreased rate of satisfaction levels amongst ED patients. The current delays, long waits, leaving without being treated, decreased revenue collection from the ED unit, and reduced patient satisfaction scores have negatively portrayed the hospital's reputation to the public. As a result, the daily patient visits have continued to decrease as people attribute the facility to poor emergency care services delivery. All these complications result from the use of combined data resources and manual entry status updates when tracking patient records. This manual tracking cannot meet the demand for many patients and leads to overcrowding due to and reduced patient flow in the ED. Therefore, there is a need to install an automatic patient tracking system to increase the flow.
Patient satisfaction level, especially for hospital’s emergency department (ED) is increasingly becoming a key health quality indicator. Patient satisfaction regards the degree to which patients are happy with their healthcare (Heath, 2016). Patient satisfaction levels is a care quality measure and gives healthcare providers infor ...
The document describes the development of the Patient Satisfaction Questionnaire (PSQ), a self-administered survey designed to measure patient satisfaction with medical care. It was developed over several years through multiple field tests. The PSQ contains 55 items measuring satisfaction with various aspects of care, including technical skills, interpersonal skills, access, costs, and outcomes. It assesses satisfaction across 8 dimensions of care. The PSQ was found to have satisfactory reliability and validity for comparing patient satisfaction across groups. It effectively represents the key characteristics of medical care found to influence satisfaction in previous research.
Student Response #1The domain that I believe to be the most si.docxflorriezhamphrey3065
The document discusses the Donabedian model for evaluating healthcare quality, which consists of structure, process, and outcomes. The author argues that the process domain is the most significant because it directly relates to how patients are treated and cared for. Processes like diagnosis, treatment and education have a large impact on patient recovery, satisfaction and outcomes. While all three domains are important, the processes of care delivery are most crucial for ensuring quality. The document also notes that composite measures are now commonly used in addition to the three traditional domains to evaluate overall quality of care.
The Relationship BetweenPatient Satisfaction and Inpatient.docxssusera34210
The Relationship Between
Patient Satisfaction and Inpatient
Imissions Across Teaching
Daniel J. Messina, PhD, FACHE, LNHA, senior vice president and chief operating
officer, CentraState Healthcare System, Freehold, New Jersey; Dennis J. Scotti, PhD,
FACHE, FHFMA, Alfred E. Driscoll Professor, Healthcare and Life Sciences
Management, Fairleigh Dickinson University, Teaneck, New Jersey; Rodney Caney,
PhD, founder. Press Caney Associates, South Bend, Indiana; and Cenevieve
Pinto Zipp, EdD, PT, chair and associate professor, Craduate Programs in Health
Sciences, Seton Hall University, South Orange, New Jersey
E X E C U T I V E S U M M A R Y
The need for healthcare executives to better understand the relationship between
patient satisfaction and admission volume takes on greater importance in this age
of rising patient expectations and declining reimbursement. Management of patient
satisfaction has become a critical element in the day-to-day operations of healthcare
organizations pursuing high performance.
This study is guided by two principal research questions. First, what is the nature
of the relationship between patient satisfaction (as measured by scored instruments)
and inpatient admissions in acute care hospitals? Second, does the relationship
between patient satisfaction (as measured by scored instruments) and inpatient
admissions differ between teaching hospitals and nonteaching hospitals? Although
not suggestive of direct causation, the study findings revealed a statistically significant
and positive correlation between patient satisfaction and admission volume in teach-
ing hospitals only. In contrast, a nonsignificant, negative correlation was seen be-
tween patient satisfaction and admission in nonteaching hospitals. In the combined
teaching and nonteaching sample, a statistically significant, negative correlation was
found between patient satisfaction scores and admission volume.
With financial performance being driven in part by admission volume and with
patient satisfaction affecting hospital patronage, the business case for a strategic focus
on patient satisfaction in teaching hospitals is clearly evident. The article concludes
with a set of recommendations for strengthening patient satisfaction and organiza-
tional performance.
For more information on the concepts in this article, please contact Dr. Messina
at [email protected]
177
JOURNAL OF HEALTHCARE MANAGEMENT 5 4 : 3 M A Y / J U N E 2 0 0 9
n n today's healthcare marketplace,
U providers increasingly compete against
one another for business. In the late
1980s, healthcare executives were
confronted with the realization that
they could not just increase charges to
generate revenue, but rather they had
to contain costs as well. Providers now
compete on business factors other than
price, such as quality, service, reputa-
tion, and other nonmonetary attributes.
Ettinger (1998) stressed that success-
ful competition relies on the provider
retaining awareness of who it wa ...
The Relationship BetweenPatient Satisfaction and Inpatient.docxoreo10
The Relationship Between
Patient Satisfaction and Inpatient
Imissions Across Teaching
Daniel J. Messina, PhD, FACHE, LNHA, senior vice president and chief operating
officer, CentraState Healthcare System, Freehold, New Jersey; Dennis J. Scotti, PhD,
FACHE, FHFMA, Alfred E. Driscoll Professor, Healthcare and Life Sciences
Management, Fairleigh Dickinson University, Teaneck, New Jersey; Rodney Caney,
PhD, founder. Press Caney Associates, South Bend, Indiana; and Cenevieve
Pinto Zipp, EdD, PT, chair and associate professor, Craduate Programs in Health
Sciences, Seton Hall University, South Orange, New Jersey
E X E C U T I V E S U M M A R Y
The need for healthcare executives to better understand the relationship between
patient satisfaction and admission volume takes on greater importance in this age
of rising patient expectations and declining reimbursement. Management of patient
satisfaction has become a critical element in the day-to-day operations of healthcare
organizations pursuing high performance.
This study is guided by two principal research questions. First, what is the nature
of the relationship between patient satisfaction (as measured by scored instruments)
and inpatient admissions in acute care hospitals? Second, does the relationship
between patient satisfaction (as measured by scored instruments) and inpatient
admissions differ between teaching hospitals and nonteaching hospitals? Although
not suggestive of direct causation, the study findings revealed a statistically significant
and positive correlation between patient satisfaction and admission volume in teach-
ing hospitals only. In contrast, a nonsignificant, negative correlation was seen be-
tween patient satisfaction and admission in nonteaching hospitals. In the combined
teaching and nonteaching sample, a statistically significant, negative correlation was
found between patient satisfaction scores and admission volume.
With financial performance being driven in part by admission volume and with
patient satisfaction affecting hospital patronage, the business case for a strategic focus
on patient satisfaction in teaching hospitals is clearly evident. The article concludes
with a set of recommendations for strengthening patient satisfaction and organiza-
tional performance.
For more information on the concepts in this article, please contact Dr. Messina
at [email protected]
177
JOURNAL OF HEALTHCARE MANAGEMENT 5 4 : 3 M A Y / J U N E 2 0 0 9
n n today's healthcare marketplace,
U providers increasingly compete against
one another for business. In the late
1980s, healthcare executives were
confronted with the realization that
they could not just increase charges to
generate revenue, but rather they had
to contain costs as well. Providers now
compete on business factors other than
price, such as quality, service, reputa-
tion, and other nonmonetary attributes.
Ettinger (1998) stressed that success-
ful competition relies on the provider
retaining awareness of who it wa ...
Evaluation of Patient Satisfaction in Relation to Patient Factors in Surgical...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The document discusses various ways to evaluate the effectiveness of advanced practice nurses (APNs) through research. It notes that while some early research found APNs provided safe, effective, and cost-efficient care, more ongoing research is still needed. Specifically, more documentation is required on APN contributions, outcomes, quality of care provided, and how APNs work with other healthcare providers.
Similar to 2008 raposo dimensions of service quality and satisfaction in healthcare a patient’s satisfaction index (20)
Phương pháp nghiên cứu khoa học - Business Research Methods - Lê Văn Huy - Le...LE Van Huy
Phương pháp nghiên cứu trong kinh doanh - Lê Văn Huy, Trương Trần Trâm Anh - NXb Tài chính (2012), 277 trang
Business Research Methods, Huy L. Van, Anh T. T. T., Financial Publishing, 2012, 277 pp.
Phương pháp nghiên cứu khoa học - Hướng dẫn phân tích SPSS - 2019 spss - re...LE Van Huy
Phương pháp nghiên cứu khoa học - SPSS - Regression
Lê Văn Huy, Trương Trần Trâm Anh (2012), Phương pháp nghiên cứu trong kinh doanh, Nhà xuất bản Tài chính, 277 trang.
Phương pháp nghiên cứu khoa học - Hướng dẫn SPSS - 2019 spss - EFALE Van Huy
Phương pháp nghiên cứu khoa học - Hướng dẫn SPSS - 2019 SPSS - EFA
Lê Văn Huy, Trương Trần Trâm Anh (2012), Phương pháp nghiên cứu trong kinh doanh, Nhà xuất bản Tài chính, 277 trang.
Phương pháp nghiên cứu khoa học - Hướng dẫn SPSS - 2019 - gioi thieu - phan t...LE Van Huy
Phương pháp nghiên cứu khoa học - Hướng dẫn SPSS - SPSS - Introduction
Lê Văn Huy, Trương Trần Trâm Anh (2012), Phương pháp nghiên cứu trong kinh doanh, Nhà xuất bản Tài chính, 277 trang.
We are pleased to share with you the latest VCOSA statistical report on the cotton and yarn industry for the month of March 2024.
Starting from January 2024, the full weekly and monthly reports will only be available for free to VCOSA members. To access the complete weekly report with figures, charts, and detailed analysis of the cotton fiber market in the past week, interested parties are kindly requested to contact VCOSA to subscribe to the newsletter.
Discovering Digital Process Twins for What-if Analysis: a Process Mining Appr...Marlon Dumas
This webinar discusses the limitations of traditional approaches for business process simulation based on had-crafted model with restrictive assumptions. It shows how process mining techniques can be assembled together to discover high-fidelity digital twins of end-to-end processes from event data.
Enhanced data collection methods can help uncover the true extent of child abuse and neglect. This includes Integrated Data Systems from various sources (e.g., schools, healthcare providers, social services) to identify patterns and potential cases of abuse and neglect.
Did you know that drowning is a leading cause of unintentional death among young children? According to recent data, children aged 1-4 years are at the highest risk. Let's raise awareness and take steps to prevent these tragic incidents. Supervision, barriers around pools, and learning CPR can make a difference. Stay safe this summer!
2008 raposo dimensions of service quality and satisfaction in healthcare a patient’s satisfaction index
1. ORIGINAL PAPER
Dimensions of service quality and satisfaction
in healthcare: a patient’s satisfaction index
Ma´rio Lino Raposo Æ Helena Maria Alves Æ
Paulo Alexandre Duarte
Received: 20 November 2008 / Accepted: 20 November 2008 / Published online: 11 December 2008
Ó Springer-Verlag 2008
Abstract The assessment of patients’ satisfaction levels, and the knowledge of
what factors influence satisfaction are very important for healthcare managers as it
influences healthcare results and healthcare institutions financial results. The
objective of this research is to analyse patients’ satisfaction levels in a set of four
Portuguese primary Healthcare Centres, through the estimation of a satisfaction
index, which simultaneously explains which dimensions of healthcare quality
influence that satisfaction the most. For that, a conceptual model of patients’ sat-
isfaction in primary healthcare was tested using data from a sample of 414 patients.
Partial Least Squares path modelling (PLS) was the technique chosen to evaluate the
proposed model. The results show that patients’ satisfaction is 60.887 in a scale
from 1 to 100, revealing only a medium level of satisfaction. It is also possible to
conclude that the most important positive effects on satisfaction are the ones linked
to the patient/doctor relationship, the quality of facilities and the interaction with
administrative staff, by this order.
Keywords Primary healthcare Á Satisfaction Á Health care quality Á
Satisfaction index
M. L. Raposo (&) Á H. M. Alves Á P. A. Duarte
Business and Economics Department, University of Beira Interior, Estrada do Sineiro,
Covilha 6200-209, Portugal
e-mail: mraposo@ubi.pt
H. M. Alves
e-mail: hmba@ubi.pt
P. A. Duarte
e-mail: pduarte@ubi.pt
123
Serv Bus (2009) 3:85–100
DOI 10.1007/s11628-008-0055-1
2. 1 Introduction
One of the worries that health managers have is to improve overall system
effectiveness in order to increase customer satisfaction and loyalty. This objective
becomes fundamental, seeing that on one hand it demonstrates the accountability of
institutions and on the other hand it influences healthcare results. Patients’
satisfaction influences the willingness to follow doctor’s prescription, which will in
turn influence patients’ future satisfaction with healthcare results (MacStravic
1991), preventing and avoiding complaints and lawsuits (Ahorony and Strasser
1993) and influences word of mouth (Venkatapparao and Gopalakrishna 1995). As
the American College of Healthcare Executives (2006, p. 6) pointed ‘‘If patients are
highly satisfied with care in the broadest sense, then the most manageable part of the
hospital’s mission is achieved.’’
Given that healthcare Centres constitute the primary element of the healthcare
system which patients turn to, it becomes fundamental to assess patients’
satisfaction with the service they offer. A better knowledge of what causes patients’
satisfaction is valuable for managers in order to make changes in the process.
In Portugal, initiatives to measure patients’ satisfaction in Primary Healthcare
Centres are still scarce and not very systematic, with the exception of the project for
Monitoring Organizational Quality of Healthcare Centres carried out by the Institute
for Quality in Health, while however is not focalized solely and exclusively on the
measurement of satisfaction.
This investigation intends to analyse the patients’ level of satisfaction in Primary
Healthcare Centres belonging to the District of Castelo Branco, an interior region of
Portugal, through the estimation of a satisfaction index and simultaneously trying to
explain which dimensions of healthcare quality influence satisfaction the most.
2 Literature review
2.1 Satisfaction in healthcare
For some researchers patient satisfaction is the result of the gap between expected
and perceived characteristics of a service (Fitzpatrick and Hopkins 1983). For
Woodside et al. (1989) patient’s satisfaction is a special form of attitude; in other
words, it is a post-purchase phenomenon which reflects the extent to which a patient
liked or disliked the service after having experienced it.
According to Wilton and Nicosia (1986), the most recent models of customer’s
satisfaction have already stopped handling satisfaction as a static variable, rather
conceiving it as an enlarged process or an interaction system around purchase, use
and repurchase acts. This new perspective recognizes that the customer psycho-
logical reaction to a product cannot be represented as the result of one only episode,
but as a series of activities and continuous reactions along time.
In this way, the aggregation of individuals, occasions, stimuli and measurements
is a good way to surpass some of the problems related to traditional analysis
(Johnson 1995; Johnson et al. 1995). This aggregation is also useful to reduce the
86 M. L. Raposo et al.
123
3. measurement error of the main variables related to satisfaction (Johnson et al.
1995). The Customer Satisfaction Indexes are based on that principle.
According to Anderson and Fornell (2000a, b), a customer satisfaction index
measures the quality of goods and services as experienced by those that consume
and feel them. It represents the global evaluation of the total experience of purchase
and consumption, either actual or anticipated (Fornell 1992; Andersen et al. 1994).
This global satisfaction is an important indicator of the past, present and future
performance of a business (Anderson et al. 1994).
Customer’s satisfaction can be analysed under two different perspectives: as a
result or as a process. Satisfaction as a result is concerned with the nature of
satisfaction (Oliver 1997). From the other point of view, satisfaction as a process is
essentially concerned with its causes (Oliver 1997; Anderson 1993).
For John (1991), patients’ satisfaction concept includes both approaches. In this
way, patients’ satisfaction can be viewed as an attitude resulting from the
confirmation or disconfirmation of expectations (result perspective) or as a process,
resulting from the level of expectations the patient takes to the service experience
(process perspective). Thus, it is not only important to know the result from the
service experience, but also what are the causes and dimensions that give rise to
satisfaction.
From the literature review on this issue, we can see that the satisfaction formation
process is not very consensual either in services, in general, or in healthcare. The
conclusions from various studies about customer satisfaction in services found
different antecedents in the formation of satisfaction, namely, perceived image,
perceived value, expectations, and quality (functional and technical) (ECSI 1998;
Anderson and Fornell 2000a, b).
However in the healthcare context some of these antecedents lose influence. For
instance, Taylor and Cronin (1994) found that expectations fail to demonstrate a
consistent direct relationship with patient’s satisfaction. Also, perceived value can
be difficult to apply in the healthcare context, since as Peyrot et al. (1993) pointed,
usually patients do not know the treatments’ real cost, it is difficult for them to
evaluate perceived value of healthcare services.
The weakness of some variables in the relationship with satisfaction may be one
reason why most of the studies focus, above all, on service quality variables, either
functional or technical. However, the most important elements of service quality to
each patient may vary depending on the situation each one faces (Mowen, Licata
and Mcphail 1993).
2.2 Service quality dimensions
Garland and Westbrook (1989) referred four generic dimensions to assess
satisfaction in non-profitable services, namely, service policy, the supplier, the
surrounding social environment and the surrounding physical environment, with a
superior importance to interpersonal dimensions.
For Donabedian (1980) service quality in health should include an analysis of the
structure to achieve a given level of healthcare quality (the characteristics of
doctors, hospitals and staff); of the process (interaction with the structure) and of the
Dimensions of service quality and satisfaction in healthcare 87
123
4. result (what happens to the patient after the medical act). Exploring the conjoint
effect of the structure and process, Carr-Hill (1992) found that patient’s satisfaction
can be influenced by six dimensions: medical care and information, food and
physical facilities, non-tangible environment, nursing care, quantity of food and
appointment bookings.
Nevertheless, it is noticeable that the majority of studies about the service quality in
healthcare focus only upon one of the elements. The result dimension suggested by
Donabedian (1980) is one of the elements that is not very well studied, which could be
due to difficulties in measuring results in healthcare service quality. The problem with
measuring healthcare results according to Choi et al. (2005) could be a consequence of
the very large period of time between the moment when service is provided and the
arising of results. For Boller et al. (2003), the results are a consequence of the service’s
quality and not a component of it, stressing the importance to focus the structure and
the process when analysing service quality in health.
For some researchers it is appropriate to measure the service quality in health
using the SERVQUAL scale (Headley and Miller 1993).
According to Parasuraman et al. (1985) the global quality of a service depends on
the encounter between expectations and performance level perceptions and can be
measured through the five SERVQUAL underlying dimensions: tangible elements
(physical facilities, equipment and appearance of personnel), reliability (ability to
perform the promised service dependably and accurately), responsiveness (willing-
ness to help customers and provide prompt service), empathy (caring and
individualized attention that the firm provides to its customers) and assurance
(including competence, courtesy, credibility and security).
The application of SERVQUAL in health service quality analysis showed that
intangible elements tend to be more influential than the tangible ones (Kara et al.
2005), although one should always take into account the need to adapt the scale for
specific situations.
The study of Venkatapparao and Gopalakrishna (1995) revealed that aspects related
to technical quality (the service outcome) were the most important for patients.
However, for Peyrot et al. (1993) it is possible to improve patients’ satisfaction
through the improvement of aspects that are not related to the service’s technical
quality, but, through aspects related to the quality of processes (functional quality).
For other researchers, patients’ satisfaction is better represented through a
multidimensional construct, having the evaluations influenced by three principal
sources: doctors, the institution rendering the service and the health system (Singh
1990).
We also find that several studies only point to some of these aspects, namely,
staff behaviour (Alford 1998), doctor’s communication skills (Trumble et al. 2006),
patient-perceived nurse caring, nurse/physician collaboration (Larrabee et al. 2004)
and good outcomes results (Amyx et al. (2000). Yarnold et al. (1998) in an
extensive study on two Emergency Departments found that overall patient
(dis)satisfaction with care received is nearly perfectly predictable on the basis of
patient-rated expressive qualities of physicians and nurses.
Nevertheless, when dealing with primary healthcare, above all, the doctor’s
characteristics (Carr-Hill 1992), such as the explanation of what is being done, as
88 M. L. Raposo et al.
123
5. well as the time spent with the patient, is what has the greatest influence upon
patients’ satisfaction. The second most influential factor on patients’ satisfaction is
the characteristics of support personnel, where nurses are included and the third are
the characteristics concerning access (Otani et al. 2005). In turn, in other studies it
was noticeable that the elements related to nurses had the greatest influence upon
patients’ satisfaction (Otani and Kurz 2004; Carr-Hill 1992).
Bryant et al. (1998) grouped all these variables into four categories:
– socio-emotional variables, referring to the perceptions that patients have of the
communication capacities and interpersonal capacities of healthcare services
(affection, empathy, politeness);
– system variables, referring to the physical or technical aspects of the local in
which the service is provided, such as, the waiting time for the appointment,
access to services, technical quality of services, costs, comfort of equipment and
the appointment’s duration;
– influential variables, such as, list of contacts (family and friends);
– moderating variables, referring to socio-demographic variables and state of
health.
3 Method
3.1 Research design
According to Bruhn and Grund (2000), literature about consumer satisfaction/
dissatisfaction suggests that the measuring process, apart from measuring satisfac-
tion, should also identify the principal antecedents of satisfaction, its consequences
and also, the existing relations among the various variables of the process.
Literature review shows that satisfaction can be influenced by different variables.
This study proposes a theoretical model to test which variables have greater
influence on patient’s satisfaction in primary healthcare. Using the theoretical
guidelines provided by literature, the model suggests facilities, administrative staff
interaction and the relationship with the doctor and nursing care (see Fig. 1) as main
antecedents of patients’ satisfaction.
3.2 Sample and data collection
The target population were patients of primary healthcare centres from the District
of Castelo Branco, Portugal. Given the information provided by ARS—Regional
Health Administration, the entity that manages these primary healthcare centres, we
selected Castelo Branco, Funda˜o, Covilha˜ and Belmonte health centres to collect
data, because they were the four most significant in terms of number of patients.
Data were collected through a questionnaire developed to understand patients’
perception, experience and feelings towards the healthcare centre service. The
questionnaire was divided in five blocks; the first addressing general information
about the individual, frequency and motives for using the healthcare centre. The
Dimensions of service quality and satisfaction in healthcare 89
123
6. next four blocks addressed specific questions about their satisfaction with the
centre’s facilities, administrative staff, nursing and doctor care. Finally, a question
was included to evaluate global satisfaction with the service provided by the centre.
The scales used resulted in part from scales already tested in various studies,
despite the verbal context being adapted many times to the reality of healthcare. In
this way, scales of multiple items were used in the entire questionnaire, as this
allows a reduction in standard error and the dimension of the sample required (Ryan
et al. 1995), as well as measurement with greater validity subjective constructs
(Hayes 1998; Anderson and Fornell 2000a). Interval scales of seven points were
used, since the enlargement of the number of points in the scale allows a reduction
in skewness (Fornell 1992).
To measure patients satisfaction, scales already tested by Oliver (1977, 1980),
Oliver and Bearden (1983), and Westbrook and Oliver (1981) were used. Those
included a measurement of satisfaction, a disconfirmation of expectations, a
disconfirmation of needs, a measurement of disconfirmation faced with an ideal
healthcare centre.
So, the questions used to question patients’ satisfaction were:
1. Considering the global experience with this primary health centre, in general
what is your level of satisfaction
2. Until what point has this primary health centre corresponded to your
expectations?
3. Until what point has this primary health centre corresponded to your current
needs?
4. Imagine a primary health centre, perfect in all aspects. From what distance
would you place this health centre to that ideal one.
The estimation of this index was based on the methodology of the European
Customer Satisfaction Index (Fornell et al. 1996; Fig. 2).
Facilities
Staff
Nursing
care
Medical
care
Patient’s
Satisfaction
Fig. 1 Conceptual model
90 M. L. Raposo et al.
123
7. To measure perceived quality, scales were based on the SERVQUAL (Parasur-
aman et al. 1988) scale and the attributes were chosen to capture both technical and
functional quality.
Data were collected in May 2007 and the final sample size was 414 patients for
the four centres.
3.3 Data analysis
To assess the predictive power of the theoretical model, we use Partial Least
Squares (PLS) (using SmartPLS 2.0 M3). Partial Least Squares path modelling is a
structural equation modelling technique (SEM) that can simultaneously test the
measurement model (relationships between indicators or manifest variables and
their corresponding constructs or latent variables) also called the outer model and
the structural model (relationships between constructs) also called the inner model.
According to Jo¨reskog and Wold (1982) PLS is primarily intended for causal-
predictive analysis. The choice of PLS in this study is due to its nature and the
specific objective of finding a better and different approach to understand patient
satisfaction with focus on maximizing the explained variance. The PLS algorithm
generates loadings between reflective constructs and their indicators and weights
between formative constructs and their indicators. It also produces standardized
regression coefficients between constructs, and coefficients of multiple determina-
tion (R2
) for all endogenous constructs in the model.
A crucial step to test the theoretical model is assessing the accuracy of the
measurement model. The objective is to ensure that the measures used are valid and
that they adequately reflect the underlying theoretical constructs. The strength of the
measurement or outer model for constructs with reflective measures is assessed by
looking at individual item reliability; internal consistency and discriminant validity.
4 Results
The measurement model evaluation parameters are presented in Table 1. Individual
item reliability is evaluated by examining the loadings (Table 1) of the measures
with the construct they intend to measure.
100
9
1
1 1
×
−
=
∑
∑ ∑
=
= =
n
i
i
n
i
n
i
iii
w
wxw
on IndexSatisfacti
Were:
Wi - are the unstandardized weights
Xi - are the measurement variables
n - is the number of measurement variables
Fig. 2 General form of the
customer satisfaction index
Dimensions of service quality and satisfaction in healthcare 91
123
10. Using the rule of thumbs of accepting items with loadings of 0.707 or more, we
notice that only two indicators (med_esp and med_pont) of the 31 did not reach the
level of acceptable reliability. However, as pointed by Chin (1998); Barclay et al.
(1995); Falk et al. (1992), loadings of at least 0.5 might be acceptable if some other
questions measuring the same construct present high reliability scores. Upon
examination of loadings and cross-loadings matrix the med_esp and med_pont
indicators were retained for the analysis, as they presented loadings [0.5 and they
do not show higher loadings in any other constructs than in the one they were
intended to measure.
The significance of loadings was checked with a bootstrap procedure (500 sub-
samples) for obtaining t-statistic values. All loadings were significant at 0.999 level
(based on t(499), two-tailed test).
The internal consistency for a given block of indicators can be assessed using the
composite reliability index from Fornell and Larcker (1981). Based on the
guidelines provided by Nunnaly and Bernstein (1994); Hair et al. (1998) who
suggests 0.7 as a benchmark, the measurement model reveals adequate internal
consistency for all constructs since all have measures of internal consistency that
exceed 0.92.
Average variance extracted (AVE) (Fornell and Larcker 1981) assesses the
amount of variance that a construct captures from its indicators relative to the
amount due to measurement error. Average Variance Extracted by the constructs is,
in all cases, above the minimum threshold of 0.5, meaning that 50% or more
variance of the indicators is accounted for.
The next stage is discriminant validity evaluation. Discriminant validity indicates
the extent to which a given construct is different from all other latent constructs.
One criterion for adequate discriminant validity is showing that the construct shares
more variance with its measures than it does with other constructs in the model
(Barclay et al. 1995). This was assessed comparing the square root of the AVE
(diagonal values) with the correlations among reflective constructs to ensure that the
square root of the AVE was greater than the correlation between a construct and any
other construct (Chin 1998). All constructs were more strongly correlated with their
own measures than with any other of the constructs, suggesting good convergent
and discriminant validity (Table 2).
After assuring the validity of the measures, we can look at the structural model
that represents the relationships between constructs or latent variables hypothesized
in the theoretical model. Figure 3 provides a graphical representation of the results.
Since the primary objective of PLS is prediction, the goodness of a theoretical
model is established by the strength of each structural path (the hypotheses) and the
combined predictiveness (R2
) of its exogenous constructs (Chin 1998). Our model
has an R2
of 0.597 meaning that 59.7% of the variance of patient satisfaction is
explained by the constructs proposed.
In PLS, the hypotheses are tested by examining path coefficients and their
significance levels. Following Chin (1998), bootstrapping (with 500 resamples) was
performed to obtain estimates of t-statistic values for examining the statistical
significance of path coefficients. The results show that only nursing care is not
significant at 0.05 level.
94 M. L. Raposo et al.
123
11. Looking only at statistical significant relationships, we notice that medical care
holds the greatest path coefficient suggesting that patient perception of quality and
empathy of medical care delivered to them is the stronger predictor of satisfaction.
The perception about facilities appears as the second most important factor to
patients’ satisfaction. Though all indicators of the facilities perception construct
present high loadings, special attention should be given to temperature, comfort and
cleanness, as they present the stronger correlations with the factor.
The perception of the service provided by administrative appears to be the
weakest predictor of satisfaction in our model. Looking at the construct indicators,
Table 2 Discriminant validity coefficients
Constructs Staff Facilities Medical Nursing Satisfaction
Staff 0.88
Facilities 0.60 0.75
Medical care 0.57 0.57 0.84
Nursing care 0.59 0.59 0.56 0.89
Satisfaction 0.60 0.65 0.68 0.59 0.90
Fig. 3 Final structural model
Dimensions of service quality and satisfaction in healthcare 95
123
12. we see that empathy with administrative staff is important to determine the patient’s
perception.
In order to globally evaluate our model, a Goodness of Fit (GoF) index was
computed (Table 3). This GoF measure is the geometric mean of the average
communality and the average R2
. Its value ranges from 0 to 1, where greater values
indicate better predictive ability. For our model, the GoF was 0.661, as can be seen
in Table 3. The Stone–Geisser (Stone 1974; Geisser 1975) test of predictive
relevance was also used as an additional assessment of model fit. According to Chin
(1998) the Q2
statistic is a jackknife version of the R2
statistic, and represents a
measure of how well observed values are reconstructed by the model and its
parameter estimates. Models with Q2
greater than zero are considered to have
predictive relevance and models with higher positive Q2
values are considered to
have more predictive relevance. All Q2
coefficients are greater than zero showing
that the model has predictive power.
Having estimated and analysed the model we proceed with the estimation of the
satisfaction index, to quantify patients’ global level of satisfaction with healthcare
centres. The formula adopted for its calculation was that proposed by the methodology
of the National Customer Satisfaction Indexes (Fornell et al. 1996; ECSI Technical
Committee 1998; see Fig. 2). As one can observe in Table 4, the global index of
patients’ satisfaction with healthcare centres is 60 points, on a scale of 1–100.
5 Conclusions
The purpose of this research was to examine patients’ satisfaction at primary
healthcare centres through the estimation of a satisfaction index, and simultaneously
Table 3 Communality and
GoF
Construct Communality R2
Staff 0.78
Facilities 0.56
Medical care 0.70
Nursing care 0.80
Satisfaction 0.81 0.60
Average 0.73 0.60
GoF 0.661
Table 4 Satisfaction index
Index
indicators
Non-standardised
regression weights (Wi)
Indicators
mean (Xi)
RWi*Xi RWi Index value
(1–100)
Sat_Glob 0.179 4.900
Sat_nece 0.177 4.900 3.250 0.698 60.887
Sat_expe 0.166 4.640
Sat_idea 0.177 4.170
96 M. L. Raposo et al.
123
13. analyse the main contributors to the process of satisfaction formation. This index of
satisfaction gives healthcare managers the ability to evaluate patients’ satisfaction
and improve service quality and user satisfaction throughout the management of the
relevant antecedents identified by the proposed model.
In general, the results support the emerging literature concerning patient
satisfaction, service quality and consumer satisfaction. Together, the set of four
constructs used in this study explain 59.7% of the variance in satisfaction, results that
can be considered satisfactory given the complex nature of consumer satisfaction.
The results show that patients’ satisfaction in this group of Portuguese healthcare
centres is of 60,887 in a scale from 1 to 100, which reveals only a medium level of
satisfaction.
A large part of patient satisfaction in this study could be attributed to the
perception of patient/doctor relationship. The model shows that doctors’ care
construct presents a much larger positive impact on satisfaction than any of the
other constructs. Thus, we concluded that doctor care is more important in
improving overall satisfaction than are other constructs. These findings support
research results from Otani et al. (2005), Rao et al. (2006) that point out that
doctor’s interaction with patients has a significant influence on their satisfaction.
Patient perceptions of doctor’s competence and concern about their problems are
important determinants of patient experiences and should be considered in future
studies that are designed to assess the evaluation of satisfaction.
An examination of the path coefficients reveals that all four constructs are
positively related with patients’ overall satisfaction. Three of the four constructs
show a statistically significant prediction effect on patient satisfaction and only
nursing care fails the significance test. These results concerning nursing care are
somehow surprising, as they differ from other research findings regarding the
importance of nursing care on satisfaction (Otani et al. 2005). A possible explanation
to this lies in the fact that in a primary healthcare centre, patients interact much more
with doctors and administrative staff than with nursing personnel. In this type of
healthcare centres, the doctor is the focus of the patient’s experience. The loadings in
Table 1 suggest that the doctors’ ability to explain how treatment should be done, the
effort they made to solve patients problems and the concern showed with patients’
problems are the main contributors to satisfaction with doctors.
The second most important dimension seems to be the perception about the
centre’s facilities. Several studies have pointed to the importance of facilities quality
in patient satisfaction with healthcare services (Carr-Hill 1992). Present findings
suggest that facilities’ cleanness, temperature and comfort have the largest impact
on positive perception about facilities and consequently on satisfaction. However, it
is interesting to note that all the attributes used in this research have a high
predictive value.
The other two constructs (administrative staff and nursing care) have the lowest
path coefficient. Looking at the loadings for the nursing construct, we notice that
waiting time for nursing services appears to be the least important attribute to
patient perception. This effect constitutes a rather interesting point that can possibly
be explained by the low level of patients’ expectations about the willingness to wait
or that patients do not interact so much with nurses. In both cases, further
Dimensions of service quality and satisfaction in healthcare 97
123
14. exploration of this result is needed in order to provide managers with the knowledge
to optimize human resources in nursing care.
The measurement of the construct satisfaction presented a very high composite
reliability (0.94) and the results show in agreement with Oliver (1977, 1980) that
measures such as correspondence to patients’ expectations, correspondence to
patients’ needs, a global satisfaction measure and distance to an ideal healthcare
centre are valid measures to measure satisfaction in healthcare as shown in Table 1.
Correspondence to patients’ expectations and needs were the ones that explained
more variance in the construct satisfaction. Bearing this in mind this it is important
that healthcare managers first analyse patients’ expectations and needs about the
healthcare service.
In conclusion, the present study found that constructs related to the facilities’
quality and relationships with doctors have the most important positive effects on
satisfaction. For healthcare managers this investigation emphasizes the need to
maintain high standard facilities and work closely with doctor in order to find ways
to perfect the relationship between doctors and patients. Finally, from these results
and from previous studies reviewed, we think that, although current constructs seem
to explain a fair part of satisfaction, it is therefore recommended that deeper and
innovative investigations should be made to explore new variables in order to get
better predictions, for example, through a deeper understanding of the effects of
government health policies on patients perceptions and expectations of healthcare
services.
5.1 Limitations and future research
In spite of the contribution that this research may offer in deepening the study of
patients’ satisfaction in primary healthcare in Portugal, this study has several
limitations. First it should be taken into consideration that this was an exploratory
model, and that it is important for other researchers to consolidate some of the
concepts and confirm or reject the conclusions drawn. Second, this study only
focuses on quantitative results, but it will be important to improve this research with
qualitative data, possibly about patients’ expectations in order to compare those
with present results. Third, our ability to draw causal inferences is limited by the
cross-sectional nature of the study. Finally, it should be noticed that the conclusions
of our investigation are limited by the sample size and the geographical
representation of the study.
Acknowledgement The authors would like to thank to Dr. Manuel Nunes and Dr. Ana Correia,
manager of the Castelo Branco Regional Health Administration, for the authorization given for this study.
References
Ahorony I, Strasser S (1993) Patient satisfaction: what we know about and what we still need to explore.
Med Care Rev 50:49–79
Alford BL (1998) Affect, attribution, and disconfirmation: their impact on health care service evaluation.
Health Mark Q 15:55
98 M. L. Raposo et al.
123
15. Amyx D, Mowen JC, Hamm R (2000) Patient satisfaction: a matter of choice. J Serv Mark 14:557–572
Anderson, EW (1993) Firm, industry and national indices of customer satisfaction: implications for
services in advances In: Swartz T, Bowen D, Brown S (eds) Services marketing and management,
1993, vol 2. JAI Press, Hampton Hill, pp 87–108
Anderson E, Fornell C (2000a) Foundations of the American customer satisfaction index. Total Qual
Manag 11:S869–S882
Anderson E, Fornell C (2000b) The customer satisfaction index as a leading indicator. In: Swartz T,
Iacobucci D (eds) Handbook of service marketing and management. Sage publications, London,
pp 255–267
Anderson E, Fornell C, Lehmann D (1994) Customer satisfaction, market share, and profitability: findings
from Sweden. J Mark 58:53–66
Barclay D, Ronald T, Christopher H (1995) The partial least squares (PLS) approach to causal modeling:
personal computer adoption and use as an illustration. Technol Stud 2:285–309
Boller C, Wyss K, Mtasiwa D, Tanner M (2003) Quality and comparison of antenatal care in public and
private providers in the United Republic of Tanzania. Bull World Health Organ 81:116–122
Bruhn M, Grund M (2000) Theory, development and implementation of national customer satisfaction
indices: the Swiss Index of Customer Satisfaction (SWICS). Total qual Manag 11(7):S1017–S1028
Bryant C, Kent E, Lindenberger J, Schreiher J (1998) Increasing consumer satisfaction. Mark Health Serv
18:4–18
Carr-Hill R (1992) The measurement of patient satisfaction. J Public Health Med 14:236–249
Chin W (1998) The partial least squares approach to structural equation modeling. In: Marcoulides GA
(ed) Modern methods for business research. Laurence Erlbaum Associates, New Jersey, pp 295–336
Choi KS, Lee H, Kim C, Lee S (2005) The service quality dimensions and patient satisfaction relationships
in South Korea: comparisons across gender, age and types of services. J Serv Mark 19:140–149
Donabedian A (1980) Explorations in quality assessment and monitoring: the definition of quality and
approaches to its assessments, vol 1. Health Administration Press, Ann Arbor
ECSI Technical Committee (1998) European Customer Satisfaction Index: Foundation and Structure for
Harmonized National Pilot Projects. Report prepared for the ECSI Steering Committee, October
Falk RF, Miller NB (1992) A primer for soft modeling. The University of Akron Press, Ohio
Fitzpatrick R, Hopkins A (1983) Problem in the conceptual framework of patient satisfaction research: an
empirical exploration. Social Health Illn 5:297–311
Fornell C (1992) A national customer satisfaction barometer: the Swedish experience. J Mark 56:6–21
Fornell C, Larcker D (1981) Evaluating structural equation models with unobservable variables and
measurement error. J Mark Res 118:39–50
Fornell C, Johnson M, Anderson E, Cha J, Bryant B (1996) The American customer satisfaction index:
nature, purpose, and findings. J Mar 60:7–18
Foundation of the American College of Healthcare Executives (2006) Patient satisfaction: understanding
and managing the experience of care, 2nd edn. Irwin Press
Garland B, Westbrook R (1989) An exploration of client satisfaction in a nonprofit context. J Acad Mar
Sci 17(4):297–303
Geisser S (1975) The predictive sample reuse method with applications. J Am Stat Assoc 70:320–328
Hair JF Jr, Anderson ER, Tatham RL, Black WC (1998) Multivariate data analysis, 5th edn. Prentice Hall
International, London
Hayes B (1998) Measuring customer satisfaction: survey design, use, and statistical analysis methods, 2nd
edn. ASQ Quality Press, Milwaukee
Headley D, Miller S (1993) Measuring service quality and its relationship to future consumer behavior.
J Health Care Mark 13:32–41
John J (1991) Improving quality through patient-provider information. J Health Care Mark 12:56–64
Johnson M (1995) The four faces of aggregation in customer satisfaction research. Adv Consumer Res
22:89–93
Johnson M, Anderson E, Fornell C (1995) Rational and adaptive performance expectations in a customer
satisfaction framework. J Consumer Res 21:695–707
Jo¨reskog KG, Wold H (1982) The ML and PLS techniques for modeling with latent variables: historical
and comparative aspects. In: Wold H, Jo¨reskog K (eds) Systems under indirect observation:
causality, structure, prediction, vol I. North-Holland, Amsterdam, pp 263–270
Kara A, Lonial S, Tarim M, Zaim S (2005) A paradox of service quality in Turkey—the seemingly
contradictory relative importance of tangible and intangible determinants of service quality. Eur Bus
Rev 17:2–20
Dimensions of service quality and satisfaction in healthcare 99
123
16. Larrabee JH, Ostrow L, Withrow Mary L, Janney MA, Hobbs RG Jr, Burant C (2004) Predictors of
patient satisfaction with inpatient hospital nursing care. Res Nurs Health 27:254–268
MacStravic R (1991) Beyond patient satisfaction: building patient loyalty. Health Administration Press,
Ann Arbor
Mowen J, Licata J, Mcphail J (1993) Waiting in the emergency room: how to improve patient satisfaction.
J Health Care Mark 13:26–33
Nunnaly Jum C, Bernstein IH (1994) Psychometric theory, 3rd edn. McGraw-Hill, New York
Oliver RA (1977) Theoretical reinterpretation of expectation and disconfirmation effects on posterior
product evaluation: experience in the field. In: Day R (ed) Consumer satisfaction dissatisfaction and
complaining behavior. School of Business, Indiana University, Bloomington, pp 2–9
Oliver R (1980) A cognitive model of the antecedents and consequences of satisfaction decisions. J Mark
Res 17:460–469
Oliver R (1997) Satisfaction—a behavioral perspective on the consumer. McGraw-Hill/Irwin, New York
Oliver R, Bearden W (1983) The role of involvement in satisfaction processes. Adv Consumer Res
10:250–255
Otani K, Kurz R (2004) The impact of nursing care and other health care attributes on hospitalized patient
satisfaction and behavioral intentions. J Healthc Manag 49:181–197
Otani K, Kurz R, Harris L, Byrne F (2005) Managing primary care using patient satisfaction measures.
J Healthc Manag 50:311–325
Parasuraman A, Zeithaml V, Berry L (1985) A conceptual model of service quality and its implications
for future research. J Mark 49:41–50
Parasuraman A, Zeithaml V, Berry L (1988) SERVQUAL: a multiple-item scale for measuring consumer
perceptions of service quality. J Retail 64(1):12–40
Peyrot M, Cooper P, Schnapt D (1993) Consumer satisfaction and perceived quality of outpatient health
services. J Health Care Mark 13:24–33
Rao K, Peters D, Bandeen-Roche K (2006) Towards patient-centered health services in India—a scale to
measure patient perceptions of quality. Int J Qual Health Care 18:414–421
Ryan M, Buzas T, Ramaswamy V (1995) Making CSM a power tool: composite indices boost the value
of satisfaction measures for decision making. Mark Res 7:11–16
Singh JA (1990) Multifacet typology of patient satisfaction with a hospital. J Health Care Mark 10:8–21
Stone M (1974) Cross-validatory choice and assessment of statistical predictions. J R Stat Soc: Ser B
(Methodological) 36:111–147
Taylor SA, Cronin JJ Jr (1994) Modeling patient satisfaction and service quality. J Health Care Mark
14:34
Trumble SC, O’Brien ML, O’Brien M, Hartwig B (2006) Communication skills training for doctors
increases patient satisfaction. Clinical Gov Int J 11:299–307
Venkatapparao M, Gopalakrishna P (1995) Mediators vs moderators of patient satisfaction. J Health Care
Mark 15:16–21
Westbrook R, Oliver R (1981) Developing better measures of consumer satisfaction: some preliminary
results. Adv Consumer Res 8:94–99
Wilton P, Nicosia F (1986) Emerging paradigms for the study of consumer satisfaction. Eur Res 14(1):4–11
Woodside A, Frey L, Daly R (1989) Linking service quality, customer satisfaction and behavioral
intention. J Health Care Mark 9:5–17
Yarnold PR, Michelson EA, Thompson DA, Adams SL (1998) Predicting patient satisfaction: a study of
two emergency departments. J Behav Med 21:545–563
100 M. L. Raposo et al.
123