1st National and International Conference on Administration and Management

January 30, 2015, KU Home, Bangkok, THAILAND

Analysis of Pregnant Woman Satisfaction to Hospital Service

by SERVQUAL Method: A Case Study of Mahosot Referral Hospital
Bounsathien Phimmasenh* and Dr.Khamlusa Nouansavanh**

Abstract
The purpose of this research is to investigate the pregnant woman satisfaction to Health care
service in the Department of Mother and Child, Mahosot Referral Hospital by servqual five dimensions.
This survey can give information and evaluation materials to be basis management for improve the
hospital. There are five dimensions SERVQUAL comprising Tangibles, Responsiveness, Reliability, Empathy
and Assurance with theirs 20 attributes which is the evaluation target from service quality factor. The
result of study show that some service quality dimensions need to improve such as regarding tangible
hospital should improve the visual appealing environment and physical facilities, concerning to empathy
dimension hospital should be improved by offering personalized attention to pregnant woman and the
assurance dimension is still need to build up the human source of hospital.
Keywords: Pregnant woman, Health Care, Service Quality, SERVQUAL

Introduction
Referral Hospital Services in Lao People Democratic Republic are as main implementing facility of
Health sector which involving not only for treatment and curative the patients but also for the promotion,
capacity building to the rural hospital and Health centers and in order to prepare for Asian Economic
Community (AEC) membership in the year 2015and supporting the Governments commitment to
achieving the Millennium Development Goals (MDGs)and identifies improved access, equity, quality and
strengthening the health workforce as key goalsespecially the health status of mother and child.
Mahosot Referral Hospital is one of five central hospitals, which established as the first hospital
of Laos since 1930 and located in the Vientiane Capital. This hospital provides the medical serve general
societies as well.The growth of health service awareness in the society is followed by the social economic
*

Ph.D. Student, Faculty of Economics and Business Management, National University of Laos; Email:
bstphimmasenh@gmail.com
**
Professor, Faculty of Economics and Business Management, National University of Laos

1st National and International Conference on Administration and Management

January 30, 2015, KU Home, Bangkok, THAILAND
development, education level, knowledge and Medical technology. Hospitaltherefore should not only
provide a medical aspect, but also the process business to customers, in the hospital should be served
professionally such as registration, administration process, quick responds and warm welcome from the
health providers.
The aim of this research is to investigate the pregnant woman satisfaction as from feminist
perspectives to Health care service in the Department of Mother and Child, Mahosot Referral Hospital by
servqual five dimensions. This survey can give information and evaluation materials to be basis
management for improve the hospital. There are five dimensions SERVQUAL comprising Tangibles,
Responsiveness, Reliability, Empathy and Assurance with theirs 20 attributes which is the evaluation target
from service quality factor. The result of study show that some service quality dimensions need to
improve. The paper proceeds by reviewing the literatures related, methodology used, findings and
discussion and finally conclusions.

Literature Review
Service quality is defined as the discrepancy between customers perceptions of services offered
by the company and their expectations about offering services of the company. The customers
expectations are derived from their perception of the ideal care standards of their previous experiences in
the use of services. According to Grnroos (2001), Service quality is the difference between customer
expectations and perceptions as it is being received by the customer (Parasuraman et al., 1988 &
Ijaz,2011).Thus it is necessary for health care providers to monitor how well the customers expectations
have been met after delivering the services (Zarei, Arab, Froushani, Rashidian, & Tabatabaei, 2012).
Measurement of service quality has been conducted in various service organizations and in
difference service sectors, the SERVQUAL model proposed by Parasuraman et al.(1985,1988) has been
used in awide variety of studies to assesses both the customers service expectations and perceptions of
the providers performance (Zarei et al., 2012; Ladhari, 2009; Pakdil & Aydin, 2007). According to
Parasuraman et al. (1985), the SERVQUAL scale was based on the fifth gap and the original ten dimensions
were further consolidate into five dimensions of service quality namely Tangibles, Reliability,
responsiveness, Assurance and Empathy. These dimensions are described as follows:
1) Tangibles-physical facilities, equipment, appearance of personnel and communication
materials.
2) Reliability-the ability of the service provider to perform the promised service responsibly and
accurately.
3) Responsiveness-the willingness of employees to help and provide prompt service to
customers.
4) Assurance-the knowledge, courtesy and competence of employees and their ability to inspire
trust and confidence in the customer towards the service provider.
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5) Empathy-the caring, individualized and personalized attention provided to customers.
The SERVQUAL scale contained 22 pairs of items spanning across five dimensions covering key
issues of service quality. It comprises two sets of similar statements; the first is a customer expectations
measure (E) and the second is a measure of customers perceptions as to the actual service delivered by
the provider (P). The instrument measures the quality as the difference between expectations and
perceptions (E-P). This tool has been widely applied by researchers in diversity of service settings,
including hospital to assess the difference in service quality between the public and private hospital
(Andaleeb, 2000; Arasli, Ekiz & Katircioglu, 2008; Irfan & Ijaz, 2011; Polsa et al., 2011; Taner & Antony,
2006).

Application of SERQUAL Model

Anderson (1995) applied the SERVQUAL model to measure the quality of Health Care Service
offered by a public university of health clinic. The findings of the research pointed out that the clinic was
poor on the assurance dimension.
Lam (1997) examined the validity, reliability and predictive validity of SERVQUAL and analyzed its
applicability to the health sector in Hong Kong. The study result proved that SERVQUAL is a reliable
model to measure health care service quality. However, factor analysis on five dimensions indicated that
the scale could b treated as one-dimensional for the results identified one dominating factor representing
expectations and perceptions.
Karassavidou et.al. (2007) applied SERVQUAL model to measure a services quality on three
dimensions viz. a) human aspects, b) physical environment and infrastructure of the care unit and c)
access.
Mangkolrat (2008), in her recent work on patient satisfaction measurement, suggested a
conceptual framework where she measured the gap between patients expectation and their perception
in the light of service quality.
Akter et.al. (2008), in their research on service quality perception and satisfaction, applied
SERVQUAL model considering three new dimensions viz. communication (a system to convey message to
patients and patient parties), discipline (control of non-performance of prescribed duties and nonadherence to written rules), tips or Baksis (extra compensation in order to receive satisfactory service)
replacing other three dimensions viz reliability, tangibles and empathy suggested by Parasuraman et.al. to
determine the gap between patient expectation and perception of service quality.
Qin et.al. (2009) considered the perceived quality as one of the antecedents of patient
satisfaction and compared perceived quality with the expected service quality on the basis of SERVQUAL
model to measure the satisfaction level of a patient regarding waiting time in a hospital.

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Research Methodology
Method
The study was conducted between March to June 2014 in the Department of Mother and child,
Mahosot Referral Hospital in Vientiane Capital, Lao PDR.
Survey instrument
The study questionnaire was composed of 2 parts; the first part assessed demographic
characteristics of the hospital patient, such as age, education and occupation. In the second part, The
SERVQUAL questionnaire was used to assess the pregnant womans expectation and perceptions of
service quality that included 20 items across 5 dimension: Tangibles (4 items), reliability (4 items),
responsiveness(4 items), assurance(4 items) and empathy(4 items). The SERQUAL scale was translated into
the lao and back-translated into English from Parasuraman et al. (1991).
A 5-point likert-type scale was used, ranging from strongly disagree (1) to strongly agree (5) to
access the level of expectations and perceptions of patient service quality.
The survey questionnaires were collected 242 sets whichtotally distributed 250 sets, 3 sets were
not returned and 5 sets were not completely responses.
The demographic distribution of the pregnant woman indicated as following:

<18
18-30
31-35
>35

Age
F
12
90
120
20

%
5.0
37.2
49.6
8.3

Total

242

100.0

Education
F
Under Primary
6
Primary school 101
Diploma
75
Higher than
60
Diploma
Total
242

%
2.5
41.7
31.0
24.8
100.0

Occupation
F
Housewife
30
Farmer
12
Private Company 100
Civil Servant
100
Total

242

Five Dimensions SERV QUAL Method

SERVQUAL Method divide service quality into 5 dimensions with 20 attributes, they are:

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%
12.4
5.0
41.3
41.3
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1st National and International Conference on Administration and Management

January 30, 2015, KU Home, Bangkok, THAILAND
No

SERVQUAL Attribute

1
2
3
Strongly Disagree Uncertain
disagree

4
Agree

5
Strongly
agree

Tangibles
1
Physical building are visually appealing
2
Up to date equipment and in good working condition
3
Hospital Employee are appeal neat
4
Availability of Medical devices
Assurance
5
Hospital employee attitude to pregnant woman
6
Having great confidence and safe in their interaction
with Doctors
7
Attention and patience of the nurses
8
Experience and knowledge of doctors
Empathy
9
Politeness of the staff to pregnant woman
10 Ease of communication
11 Doctor know what type of problem arises to pregnant
woman
12 Doctor know what type of pregnant woman suffering
Responsiveness
13 Speed of service
14 Speed of registration
15 Telling pregnant woman exactly when services will be
performed
16 Desire for helping
Reliability
17 Handling and comprehensive action
18 Reputation of doctors
19 Qualification of staff
20 Accuracy of treatment

Research Framework
Research framework had shown in this following figure. This research used primary data collected
directly through questionnaire given to pregnant woman from three group demography from age,
education and occupation. Indicators in the questionnaire were taken from the five dimensions of
servqual tangible, assurance, empathy, responsiveness and reliability, each of which contains four
statements

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The Study Findings and Discussion

The SPSS for Windows was used to analyze data. The mean expectation and perception scores
for all 5 dimensions and 20 attributes are presented in the table for the service of Department of Mother
and child, Mahosot referral Hospital to the pregnant woman satisfaction with the mean service quality
gap score calculated using Service Quality (SQ).The result are shown in the following table:
Service Quality (SQ) =Perception (P)-Expectation (E)
Tangibles

This table shows the mean service quality for four attributes in the tangible dimension for
Department of mother and child, Mahosot referral Hospital. The first and second highest of gap score of
20 attributes occurring in this dimensions such as SQ1 =3, 47 and SQ2 =3.03. The result for items
measuring that the pregnant woman need the hospital urgent improve for physical facility and medical
equipments supporting visual appealing and good working condition. In addition the remain two items,
i.e.,SQ3 and SQ4 representative to the appeal neat of staff and medical devices are request to looking
after by the Director and Manager of Hospital. The tangible dimension is the priority to making better of
the service in the feminist views.

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Assurance

There are two mean significant gap score in the Assurance Dimension, SQ5=1.27 and SQ7=1.35
which representative to hospital staff attitude, attention and patience to pregnant woman. One gap score,
SQ8=0 which indicate that the experience and knowledge of Doctor are accepted. This assurance
dimension is still need to build up the human source of hospital.
Empathy

Measuring the empathy dimension show that the gap score SQ10= 1.01 as representative of
attribute on easy of communication and SQ9=0.77 as representative of the attribute of politeness of staff
to customers are suggested for adjustment the service mechanism and concerning to be more pay
attention and polite to patients.
Responsiveness

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In the dimension of responsiveness, the measuring of gap score of quality service indicate that
three attributes are essential improvement to meet the first helping of the pregnant woman required
while arriving the hospital such as SQ13=1.56 as speed of service, SQ16=1.27 as desire for helping and
SQ14=0.29 as speed of registration. These attributes are related to routine performance of hospital staff.
Reliability

The result in testing for measuring on reliability was 0.31 in average while the biggest number of
gap score of service quality is 0.84 for the SQ17 which representative of the handling and comprehensive
action of hospital staff to the pregnant woman.
Overall Service Quality

The overall mean values of service quality gap score for the Mahosot Referral Hospital was 0.86
respectively. Among the five dimensions, the highest mean values was tangible (1.94); followed by
assurance (0.82), responsiveness (0.78), empathy (0.53) and the lowest for reliability (0.31).
Concerning to the measuring of the service quality gap score on the 20 attributes, the highest
mean values was physical building to be visually appealing (SQ1 =3, 47) and the lowest was the
qualification of staff (SQ19=0.13). Additionally there are four attributes having the testing gap score equal
zero such as SQ8 as experience and knowledge of doctors, SQ11 as in which doctor know what type of
problem arises to pregnant woman, SQ15 as the telling exactly when service will be performed and the
final attribute SQ18 as reputation of doctor. It was note that no positive means values of service quality
gap score in any attributes.

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Conclusion
The findings from this study show that some service quality dimensions and attributes of the
department of mother and child, Mahosot hospital need to improve in order to meet the required of the
customer satisfaction and expectation as well as the pregnant woman. The respond of the performance
in 16 attribute are not strong agree and not agree while service attribute which is the main priority has not
implement yet. Only four performance attribute are acceptable and should be kept to serve the
customer. It is important for service organization to know how well they are serving customer and they
therefore could improve and maintain the quality of hospital services.

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