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UNIVERSITY OF WALES ID 0811867060434

KENSINGTON COLLEGE OF BUSINESS

An Analysis of the Methods Which Can Be Used to


Increase the Patient Satisfaction at Mayday Hospital,
Croydon
By
JALTESHKUMAR RAMESHBHAI PATEL
Submitted in fulfilment of the requirements of the Taught Masters
Dissertation to the University of Wales, for the degree of Masters in
Business Administration (MBA)

Supervisor: Dr. Randolph Metz-Johnson


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UNIVERSITY OF WALES ID 0811867060434

Copyright by Jalteshkumar R Patel


All Rights Reserved
2010

UNIVERSITY OF WALES ID 0811867060434

Declaration of Original Content


I Jalteshkumar Rameshbhai Patel, hereby declare that this dissertation
titled An Analysis of the methods which can be used to increase the
Patient Satisfaction at Mayday Hospital, Croydon carried out under
the supervision of Dr. Randolph Metz-Johnson, submitted to the
Kensington College of Business has been composed solely by me and is
the result of my personal and independent research and authorship. No
work of third parties, other than those quoted or referenced has been
used and has not been copied or plagiarised from any other
research/dissertation and has not formed the basis for the award of any
other diploma/degree for any other college/university.

Date

27th July 2010

Name of the Student

Mr. Jalteshkumar Rameshbhai Patel

KCB ID

11620

University of Wales ID :

0811867060434

Signature of the Student :

UNIVERSITY OF WALES ID 0811867060434

ACKNOWLEDGEMENT

This dissertation lays our final assignment which will reach in achieving my goal
with the education, a master degree in business administration. Through the past
three months, this dissertation has witnessed some ups and downs. I spent most of
my spare time and energy on the dissertation. And now when I look back I strongly
believe that I have learnt a lot and realized writing a dissertation is good way of
learning.
This is dedicated to my Brother, Mehul, Nimit, and Nikhil. They all have given me
support and love throughout this research work. I am really blessed of being part of
such a sweet family. I thank God for that.
Secondly I would like to express my sincere gratitude and appreciation to my
supervisor and tutor Dr Randolph Metz-Johnson, though being a very busy person
had taken the privilege of reviewing every mail had sent in replies promptly and
giving me a proper guidance with the PowerPoint slides which had driven my
confidence and potential to finish my dissertation at the earliest.
Lastly but not the least a special thanks to all the participants and respondents
involved in my study at Mayday Hospital. Their support was very vital for the whole
research to come true and worthily.

London, July 2010.

UNIVERSITY OF WALES ID 0811867060434

Abstract

This research study is find out the patients satisfaction in terms of patients
expectation and patients perceptions and expectation

at Mayday Hospital. The

researcher has selected the hospital to represents all healthcare professionals. The
researcher has selected the organisation that is Mayday Hospital, Croydon. This
research, the researcher wants toi find out the significant of patients satisfaction at
Mayday hospital. The objective of this research study is to find out the relationship
between the patients and healthcare professionals in terms of patients expectation
and patients perceptions. The other objective is to study about the current status of
the service quality where the researcher research the and explain te SERVQUAL
model, and service quality gaps. The researcher has selected the primary research
method. The researcher has collected the 216 data from respondent. The
questionnaire and mini focused group method is used for this research topic. In focus
group the researcher has selected the 4 to 5 respendent from that survey who had
interested for the interview. Findings which involve this reseach topic are: the
service quality provide by hospitals is quite good to satisfy the patients, patients are
happy with the service and also happy with the healthcare professionals, some
respondent did not satisfy with the tretment because they could not undersatnd the
doctors explanation. This research indicates that the satisfaction from hospitals is
good. The researcher set up the some dimensions in questionnnaire, according to that
result repondents are happy with the service which is provided by hospitals but some
dimension for the patients satisfaction patients expect more.

UNIVERSITY OF WALES ID 0811867060434

Table of Contents
Chapter 1 ..................................................................................................................... 9
Introduction .................................................................................................................. 9
1.1 Operational Definitions: ................................................................................... 10
1.2 Background of Mayday Hospital Croydon....................................................... 11
1.3 Expected Benefits: ............................................................................................ 11
1.4 Scope of the Research: ..................................................................................... 12
1.5 The Conceptual Model: .................................................................................... 12
1.6 PATIENTS SATISFACTION .......................................................................... 13
1.7 Patients Acceptance and Satisfaction ............................................................... 14
1.8 PATIENT EXPECTATIONS ........................................................................... 17
1.9 MEASURING PATIENTS SATISFACTION ................................................. 19
1.10 Research Aim ................................................................................................. 20
1.11 Research Objectives: ...................................................................................... 20
1.12 Conclusions: ................................................................................................... 21
Chapter 2 .................................................................................................................... 22
Literature Review ....................................................................................................... 22
2.1 Introduction ...................................................................................................... 22
2.2 Theoretical Background ................................................................................... 23
2.2.1 Patients Satisfaction ................................................................................... 23
2.3 Customer Relationship Management ............................................................... 25
2.4 Service .............................................................................................................. 26
2.4.1 Intangibility................................................................................................ 26
2.4.2 Inseparability ............................................................................................. 26
2.4.3 Variability .................................................................................................. 27
2.5 Service Quality ................................................................................................. 27
2.5.1 Definitions of Service Quality ................................................................... 28
2.5.2 DIMENSION of Service Quality............................................................... 29
2.5.3 MEASURING Service Quality.................................................................. 30
2.5.4 What is SERVQUAL model? .................................................................... 31
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2.5.6 Model of Service Quality Gaps ................................................................. 32


Chapter 3 .................................................................................................................... 35
Research Methodology............................................................................................... 35
3.1 Introduction ...................................................................................................... 35
3.2 RESEARCH PROCESS ................................................................................... 36
3.3 RESEARCH APPROACHES .......................................................................... 36
3.4 RESEARCH DESIGN ..................................................................................... 37
3.4.1 EXPLORATORY RESEARCH ................................................................ 37
3.4.2 DESCRIPTIVE RESEARCH .................................................................... 37
3.4.3 CAUSAL RESEARCH ............................................................................. 37
3.5 RESEARCH PHILOSOPHY ........................................................................... 38
3.5.1POSITIVISM .............................................................................................. 39
3.5.2 PHENOMENOLOGY OR INTERPRETIVISM ....................................... 39
3.6 RESEARCH STRATEGY ............................................................................... 39
3.7 Focus group ...................................................................................................... 41
3.8 DATA COLLECTION METHODS ................................................................ 42
3.8.1 SECONDARY DATA ............................................................................... 42
3.8.2 VALIDITY AND RELIABILITY OF SECONDARY DATA ................. 44
3.8.3 PRIMARY DATA ..................................................................................... 44
3.8.4 INTERVIEWS ........................................................................................... 45
3.8.5 COMPUTER ASSISTED PERSONAL INTERVIEWING (CAPI) ......... 46
3.8.6 QUESTIONNAIRES ................................................................................. 46
3.9 SAMPLING METHODS ................................................................................. 50
3.9.1 PROBABILITY SAMPLING ................................................................... 50
3.9.2 NON PROBABILITY SAMPLING .......................................................... 50
3.10 DATA ANALYSIS ........................................................................................ 51
3.11 CONCLUSION .............................................................................................. 51
Chapter 4 .................................................................................................................... 52
Analysis of Findings and discussion .......................................................................... 52
4.1 Introduction ...................................................................................................... 52
4.2 Questionnaires .................................................................................................. 52
4.3 FOCUS GROUP............................................................................................... 53
4.4 General demographic sample group data ......................................................... 54
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4.4.1 Gender ........................................................................................................ 54


4.4.2 Age ............................................................................................................. 55
4.4 EXPECTATION OF PATIENTS .................................................................... 56
4.4.1 PATIENT EXPECTATION FROM THE DOCTORS BEHAVIOUR ..... 56
4.4.2 PATIENTS EXPECTATION FROM BEHAVIOUR OF MEDICAL
ASSISTANT ....................................................................................................... 57
4.4.3 Patient expectation from Quality Administration ...................................... 59
4.4.4 Patient Expectation from facilities provided by the hospitals ................... 60
4.6 PATIENTS PERCEPTION FOR VARIOUS FACTORS ............................... 61
4.6.1 Patients Perceptions from the Doctors Behaviour ..................................... 61
4.6.2 Patients perceptions for Medical Assistants .............................................. 63
4.6.3 Patients Perceptions for Quality of Administration ................................... 64
4.6.4 Patients perception for facilities provide by the hospital ........................... 66
4.7 Degree of Patients Satisfaction for the various factors .................................... 67
4.7.1 Degree of Patients Satisfaction for the doctors behavior ......................... 67
4.7.2 Degree of the Patients Satisfactions for the Medical Assistant Behaviour 69
4.7.3 Degree of patients satisfaction from the Quality Administration............. 70
4.7.4 Degree of Patients Satisfaction from facilities provide by Hospitals ........ 71
Chapter 5 .................................................................................................................... 73
Conclusion and Recommendation.............................................................................. 73
5.1 Introduction ...................................................................................................... 73
5.2 Conclusions ...................................................................................................... 74
5.2.1 General Demographic: ............................................................................... 74
5.2.2 Patient Expectation .................................................................................... 74
5.2.3 Patients Perceptions: .................................................................................. 74
5.2.4 Patients Expectation and Perception Relationship: ................................... 75
5.3 Recommendation .............................................................................................. 76
5.4 Limitation of the Study..................................................................................... 77
5.5 Suggestion for further studies........................................................................... 78
References and Bibliography ..................................................................................... 79
Appendix .................................................................................................................... 83

UNIVERSITY OF WALES ID 0811867060434

An Analysis of the methods which can be used to


increase the Patient Satisfaction at Mayday Hospital,
Croydon

CHAPTER 1
INTRODUCTION
Todays hospital has converted from sellers to buyers market where the patients are
most important. Therefore hospitals has to build up itself technologically as well as
get more service oriented. This can be accomplished by build up a brigde of trust
between hospitals and community, so this community may cross over to the hopitals.
As compaire with the other service sector hospita sector is quite different. In other
services customers are happy to spend the money while in the hospital industry
industry is forced to the patient because of their illness. So they can not spen the
money happily. This is the main factor which is differntiate. Second differentiating
factor that the patient are always in contact with the hospitals and in any emergancy
they definately gets the responce. Patients only wants the the nice, peaceful
enviornment with the smilling and the enthusiastic staff, wide range of the selection
of the meal and the fast speed of the service. Nowadays competitive market,
hospitals endurance and successes is depended on satisfaction of customer what they
require and expect. In healthcare services, service quality and customer relationship
are the most important key as successive factor. The main purpose of this study was
analysis method which can be used to increase patient satisfaction.
Health care industry is growing industries compared to the other industries in the
service sector. These changing forces which include Healthcare delivery system ,
change cost structure , competitive pressure, supervising by public and private group,
enhanced information accessibility, and a marked better- information accessibility
business have started out to wield significant pressure on healthcare supplier to re9

UNIVERSITY OF WALES ID 0811867060434

evaluate their strategy. Service quality is the main parameter of patient satisfaction,
expectation. Patient satisfaction is the one of the part of the service quality. So, this
is main parameter which is mainly looking after for the hospital industry. All
hospital industry mainly focused to full fill all the expectation of the patient.
(Andaleeb, 1998)
Delivering patient satisfaction is imperative because nowadays buyers from
healthcare service sector are well trained and become a conscious than the past.
Buyers carefully observe the options available to them, therefore more distinguishing
buyers, know exactly what patients need.
The researcher has studied about the patient satisfaction on hospital and
determination the satisfaction factor to conduct to all providers can understand what
patients want. Researcher trying to evaluate the patients need by using the primary
research parameters. This paper will explore how to satisfy patient in order to full fill
the patients need and to evaluate what is the need of the patient? In this paper mainly
look after the all the different theory of the service quality and the patient satisfaction
and how this theories are implemented by the Mayday hospital to achieve overall
patient satisfaction.

1.1 OPERATIONAL DEFINITIONS:


Hospital is the medical institutions where sick or injured people are given surgical
treatment and nursing care
Satisfaction is defined as Something that satisfaction will adequately fulfilled
expectation, need or desire and giving what is required, leave no room for complain
(Crow et al 2003)
Patients expectation is the services that patients hope to making from hospitals.
Patients perception is the mode that patients looking, realizing and receiving from
hospitals.

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Satisfaction is useful to keep in mind which is considered two points


1. Determining the satisfaction with service does not show that is necessary a
high quality service that it is acceptable or no feeling of dissatisfaction
2. It is relatively and subjectively concept which is evaluated against the
expectation, needs and desires.

1.2 BACKGROUND OF MAYDAY HOSPITAL CROYDON


Mayday Hospital has a huge NHS trust hospital at the Croydon which is also a part
of Mayday University Hospital. It is a district general hospital with 24 hours
accident and emergency service. This hospital is spread around 19 acres site in
Thornton Heath to north of central Croydon. Mayday Hospital includes many
facilities like 670 beds, 8 operating theatres, and a day surgery suit with three
theatres, 2 obstetric theaicetres and recovery room overnight facility for parents.
Mayday is pursuing Foundation Trust status. Mayday hospital is provide services
like blood test services, cancer services, diabetes, vascular and wound care centre,
diagnostic unit, dietetics department, emergency care, radiology, sexual health,
therapies and woman and children services etc.
According to Judith 2009, Patients and families are related with many benefits which
includes reducing healthcare cost, increases the patient and family and staff
satisfaction, improve the clinical results, locations the hospital is more effective in
the market, effectual learning environment.

1.3 EXPECTED BENEFITS:


From this research, some benefits include:

To determine the strategy of the hospitals to accept the patients want

To understand the degree of service quality in Mayday hospitals

To satisfy the patients need who pays more for care.


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1.4 SCOPE OF THE RESEARCH:

This research will focus on the service quality which can be use to increase
the patient satisfaction.

The secondary origin was searched to obtain penetration into literature on


patient satisfaction with hospital and all this information will collect directly
from hospital.

The questionnaire included perception measurement that was ordered on five


point Likert scale.

1.5 THE CONCEPTUAL MODEL:


According to Parasuraman, in this research, this model is worked in hospital for
customer satisfaction.

Perceived Serviced
Quality
Tangible

Customer
Expectation

Reliability
Customer

Responsiveness

Satisfaction

Assurance
Empathy
Price

Customer
Perception

Source: Parasuraman el al
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Tangible which includes physical facilities utilized to provide the quality of


services to the patients

Reliability is the consistency of dependability and functionality

Responsiveness is the services provided to willingness staff

Competence is the possession of the expected knowledge and skill


performing the services by contact person

Accessibility is the ease approach of contact

Courtesy is the temperament of the contact people, respectful, polite

Communication which includes the keep customers communicate in language


which they can understand

Credibility is the trustworthy, believability and honesty.

Protection is the security, confidential and physical safety

Sympathy which includes understanding the patients what they need

1.6 PATIENTS SATISFACTION


Whether the Patient satisfaction is depend on the performance of the product which
is related to the customer expectation. Generally satisfaction depends on the
customer feelings of delight or disappointing results from comparisons a product
comprehended performance in related expectation. If expectation comes down,
customer does not happy with the service. If expectation meets with the
performance, the customer would be happy. Both satisfaction and loyalty is
relatively linked between customers. Suppose we rate the customer satisfaction one
to five. At degree one, customers are to give up the company because he is not
satisfied. At degree two to four, customer is fairly shifted because they find a better
offer along with them. At degree five, customer likes to buy again even they speak
well about company.

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There is a bit evidence of satisfaction being related with the perception of the patient.
Expectation has an effect on the satisfaction of the patient. The knowledge of
healthcare professional regarding the relationship with the patients plays an
important role in patient satisfaction. Being a good healthcare professional is not
enough but being good healthcare professional with good understanding with patient
is very important. Practically the relationship of expectation and satisfaction depends
on the performance of the healthcare provider, the healthcare organisation and the
hospital staff. If they act very well together then the expectation and the satisfaction
of the patient becomes valuable. If the patients are treated as customers then they can
easily

judge

the

services

provided

by

the

healthcare

organisation

(Zeithaml et al 1996).
The Patients satisfaction can be estimated by different criteria. It depends on the
service quality of particular healthcare organisation. Finally, the healthcare
organization is not homogeneous but it is complex mixture of services, healthcare
professional and the patients. This model shows that satisfaction of patients with
healthcare cannot be understand by reviewing literatures but there should be a
complete research which shows the service quality of healthcare organisation and the
healthcare professional.

1.7 PATIENTS ACCEPTANCE AND SATISFACTION


Patients satisfactions is a crucial standard by patients measure quality of medical
care experienced. Satisfaction is defined as the customer experienced of be filled and
rich by an experience, subjective measurement of expectation fulfil.
In nursing, the patients satisfaction study came out in 1956. Patients satisfaction
appraisal is considered by authors as critical and requirement in healthcare system
due to increasing cost and efficient in process of delivering of healthcare system.
Satisfaction of patients is considered as an important and measurement of efficient in
delivery of health care system.

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They are frequently active and recognizing users subject of delivering impressions
concerning care experienced. Provide satisfaction is considered attract and maintain
patients with competitor arena. Moreover, professions of health care that survive and
expresses require evaluating and realizing they worked and campaigns of staffs.
Rendered data from satisfaction of patients studies may render a technological basis,
which outcomes convinced within the professing.
Merkouris, Infantopouls, Lanara and lemonidou (1999)
Patients satisfactions have with bond to prescribing medical authorities and
accordingly poor effects in the study of dermatologic patients. They resolve that
provider of healthcare able to supply explanation and to show empathy and interest
leads positive to increase satisfaction of patients. Moreover, improve the skills of
practitioner in healthcare which can outcomes the satisfactions of patients with
positive approaches.
Renzi et al (2001)
Satisfaction of patients with advanced staff in hospital found that emotive stand,
obtaining information regarding health, and expert competency positive determined
satisfaction of customer with attention.
Bryant and Graham (2002)
According to Branson, badger and Dobbs (2003) studied on the 52 respondent which
was positive satisfaction. The age and health status were significant determining the
satisfaction of patients. The comparison between the expectation of patients and
level of those expectations were fitted. The patients satisfaction ration is high to
tend considering the health positively. People liked to carry out the appointment.
This study included satisfaction of patient with multiple factors who affects in
service quality. Frequently the main part of the patients satisfaction, manifesting the
educations of patients, communication and feedback delivering of healthcare.
Branson, Badger and Dobbs (2003)

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Healthcare provider found the time is significant by patients waiting for treatment
that was inversely proportional with factors of the patients satisfaction. In this study
select a randomly sampling group either experiencing or not experiencing health
education in waiting room. If patients had delivered education waiting room there
were no effects on satisfaction level but when they experienced the health education.
The degree of patients satisfaction from hospital services where hospital set up at
rural area so at that time to analysis the relationship between satisfaction of patients,
features, expectations, perceptions. Patients satisfactions highly with attention
delivering by staff were established. Patients satisfied with socialize expression of
staffs provide care. Patients demonstrated acceptance of staff and medical assistant
when they work in collaborate with doctors, worked as organisers of caring, and
tried to incorporate into the community.

Donohue (2003)
This study analysed the relationship between the performance of primary care and
hospitals care outcome of doctors. This study analysed the relation between the
hospitals approachability, comprehensive examination, integrate, hospital interaction
with results to doctors advice, satisfaction of patients and improve the health status.
The age between 18 to 25 years satisfied ratio had less with hospital staffs. Patients
were influenced to satisfy with hospital staff interpersonal manner, spending time,
availability.
Phillips, Palmer, Wetting, and Fenwick (2000)
According to Becker, Adams, Howard, Roblin and Roberts proposed about 41,208
respondents from the degree of satisfaction with service provided. They evaluated
satisfaction in three parts, practicing interaction, total experienced, and service
approach and resolved that patients maintain the organisation were satisfied with
doctors interaction by medical assistant and doctors. With accessible satisfaction and
receive do not agree significant by doctors.

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UNIVERSITY OF WALES ID 0811867060434

Hospital included care, contact and willingness to bring back to hospital. The
differences important in statics score were varied age and age group. Under twenty
years patients were came out to satisfy with treatment obtained over the phone men
satisfaction level were lower than female satisfaction.
Benkert, Pohl, Tanner and Nagelkirk (2002)

1.8 PATIENT EXPECTATIONS


How does patient organise their expectations?
Increasing the expectation of marketers is high, patient is disappointed. If hospital
sets up expectation low that means it does not want to patient. Nowadays many
hospitals are enhancing expectation and delivery the performance to correspond.
This type of organization are targeting to Total Patient Satisfaction. Loyalty Patient
is delivered richly consumer value generating. So an organization has to design
competitively value suggestion which is targeted at particular segmentation market,
back up by delivering value system.
The proposition value constitutes of the whole bunch of benefit the hospital promise
to deliver; it is offering more than the setting where organizations ability is kept the
promise which is depending on the value delivery system. The system of value
delivery accepts all receives the patient would have on the direction to obtain and use
the offers. Satisfaction of the customer is the experiencing of joy or disappointing
where comprehends performance offers which are related to purchasers expectation.
Expectation includes what the consumer wants or they need from the services and
comprehends performance is about the service of customer perception i.e. evaluate
of the service which is using after it. Patient receives from the hospital services are
called as perception. This evaluation is performed by comparisons of the expectation
with the comprehended performance of the services. Therefore patient satisfaction is
the function of the comprehended performance and patient expectation. Patients are
switched finding who are highly provided services from hospital. Hospital focused
patient satisfaction as a marketing tool.

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What does patient think about the hospital which provides services from hospital?
And that effect on another people of its services. So whatever task or service which
provides from hospital, they think what patient expects and what they get return.
Patient satisfaction is the judgement that depends on service features or itself,
providing gratifying level of expenditure concerned fulfilment include degree of over
or under fulfilments. The prototype disconfirms expectation furnishes the
explanation of patient satisfaction. If patient experiences disconfirm after taking
services from hospital, services have to be revised which effects on the future
towards the comprehended performance by patients.
(Oliver 1997)
The expectations of the patients are high of the any treatment, service from
healthcare have to be on the optimal level. Otherwise there is a chance of patient
being dissatisfied. The expectation levels are different from one patient to another. It
depends on the severity of the disorder the patient is having. The patients
expectation may also differ for different age groups, sex and communities.
One of the reasons why patient expectation is different is because the patient could
have been told by some other patient about the healthcare services of any healthcare
organisation.
It is better to study different patients of different hospitals so that the researcher can
find out the expectation of patient according to the patient satisfaction. The data
collected from any healthcare organisation should be checked to find out different
ways of patient expectation and this data can also be matched with the patient
satisfaction. In case of general practice the expectation of patient is consider on the
optimal level. So according to this literature new strategies have to be made by
healthcare organisation and by improving such services the healthcare supplier can
understand the expectation and satisfaction of patient

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1.9 MEASURING PATIENTS SATISFACTION


Whilst the patient oriented hospitals attempt to make high patient satisfaction, it is
not main target. If hospitals enhance patient satisfaction by improving services or
increasing services, results might be low profits. The hospitals might be able to
enhance its profit by mean other than enhancing satisfaction. There are many
stakeholders includes dealer, supplier etc. Expenditure more to enhance patient
satisfaction might be divert monetary resource from enhancing to satisfy the other
co-operators.
Patient Satisfaction Surveys measures patient satisfaction responsive reactant
directly by periodical surveys. While collects the patient satisfactions survey, which
is benefits the hospitals to measure willingness and likeliness the services to others.
Lost Patient Analysis hospitals have to provide good quality service to patients
otherwise who switched to another people to learn how this happens. In healthcare
sector, the measurements of patient satisfaction are very important role. Patient
satisfaction concept has promoted the acceptance of a marketing tool in healthcare
services in developing countries.
Nowadays large numbers of hospitals are going to open and community are more
aware, competition has issued in this industry. Hospitals have to furnish better
facilities for retaining the patient. Various types of factors available which affects
patient satisfaction includes behaviour of nurses, doctors, hospital environment,
medical staff, modernize building facilities etc.
Nowadays competitive market provides a good quality service to the patient or
customer by the hospitals. Some hospitals are advertised about some specific
treatment which is provided by hospitals. There are number of hospitals provides
treatment for disease because of cut throat competition between hospitals for
treatments.

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They provide in reasonable cost and giving good service quality in hospitals. But we
dont know how much they true, their assumption are myth unknown to huge
majority of consumers. All hospitals are giving best efforts providing healthcare
service quality to its patients. They have started out practice a strategy of patient
satisfaction which consists of customer oriented planning, practice and policy to
authentically satisfy the demands of customers.
Increasing awareness and expectation of the patients hospitals must provide good
service quality or facilities. Patient must started out service quality that is customer
approach. Nowadays patients are aware because they know their rights so hospital
should be provided service quality like responsive to their questions friendly
environment, cleanliness, reporting regularly etc which providing essential services
from hospital. The current study which is focused on analysis the various methods
which can be used to increase the patient satisfaction

1.10 RESEARCH AIM :


To analysis of the methods which can be used to increase patient satisfaction.

1.11 RESEARCH OBJECTIVES:

To review the literature related to service quality of patient satisfaction

To find out the relationship between patients and healthcare professionals at


Mayday Hospital

To study current status of service quality at Mayday Hospital.

To study patients satisfaction at mayday hospital in terms of patients


perception and expectations.

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1.12 CONCLUSIONS:
The research data is collected from this research may be used to inform, motivate
and assist the healthcare professionals to achieve their goal. This study will also
assist to identify the main problem with patient satisfaction. There are some
limitations in this study which may change the analysis. Satisfaction of the patients
is also supervised by Mayday Hospital to improve the quality of the services in
healthcare sector. As earlier mentioned, here the main focus is given on the quality
of the services and the patient satisfaction. The consideration point of the patients
can be demonstrated by many different processes. This will assist to improve the
healthcare issues like over population, facilities, patient satisfaction, etc. The
researcher will make significant study of patient satisfaction. The study will help to
find out the main difference between services provided by hospital. As mentioned
earlier, taking survey on patient satisfaction particularly in a population like India is
not an easy task. It takes time and cost to reach at the bottom of the research. The
research is going to be done by keeping the patient in the centre and they will play an
active role to assist the author to reach at final conclusion of the study.

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CHAPTER 2
LITERATURE REVIEW
2.1 INTRODUCTION
The main aim of this chapter is the theoretical review and applies to theories. The
researcher has tried to analysis the methods which can be used to increase the patient
satisfaction. Satisfaction of the patients topic is not easy to research that everyone
wants to do that easily. There were many literature are available on the web sites,
books and journals. A journey was started in 1980 for the review of satisfaction of
the patients. For the research of satisfaction of patients require knowledge.
This helps the researcher to prepare, design and make an ideal literature. There are
four types which are useful for a good literature review. They are a correct
methodology, correct article the content and at last the relationship of patient with
the healthcare professional. These are the main chapter of a good literature. This is
very useful to analysis the healthcare system of any healthcare organisation. The
literature is incomplete without any of the above chapter.
At present satisfying a patient need has become very important for every healthcare
professional and healthcare organisation as well. In this chapter the author is going to
discuss different literatures of different authors. The main aim is to find out the main
needs of the patient. Theories given by different authors describe the definition of
patient satisfaction and the measurement of patient satisfaction. The needs and
expectation of the patient may be different from one patient to another. By reducing
the gap between expectation of the patient and perception received by the patient,
competition among healthcare organisation may also reduce.
There is a chance for patients perception being reduced when the patient have not
received better treatment. Sometimes even the healthcare service is very less the
perception is being on high rate. So the final analysis cannot be made by taking an
interview between two different patients. There has to be some methodology and
there has to be some good way to analyse the theory of patient satisfaction.
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Sometimes the responses from the patient can also be altered by wrong way of
methodology. By describing the patient satisfaction one should know the prediction
of satisfaction or may be satisfaction which requires prediction. Here all the
literatures are described to make the reader understand about the different
phenomenon and relationship of patient satisfaction.

2.2 THEORETICAL BACKGROUND


2.2.1 PATIENTS SATISFACTION
Patients satisfaction is the vital strategically weapon system and outside for any kind
of organization. It is most important because organization and product is similar,
healthcare system and even institutions of education have to maintain with energetic
and ebullience as that a commonwealth try to maintain our resource.
The delivering a high medical and clinical quality sufficient utilized to think in
healthcare system. Recently, numbers of healthcare system have contributed to
market satisfaction achieving goal list. Many company and organization have
encouraged ensuring money back. A forthcoming organization made every exertion
to sense, assist and satisfy the requirements and desires of its market. Many
healthcare systems would like to be considered as a reactive. Every healthcare
system has to find out, how reactive cares to be and formulate appropriate system for
evaluating and improving satisfaction in market place.
(Kotler and clarke)
Customer satisfaction concept is defined as various ways, according to Parasuraman
and Berry proposed that it is the role of the customer appraisal of the service, product
and price quality, according to Oliva, Oliver and Bearden proposed that it is the role
of product performance related to customer expectation, according Bachelet studied
satisfaction is an emotional reaction by customer which is response with the service,
satisfaction gone through since time of buying and regular using of that services. In
healthcare system mainly requirement is to satisfy the patient by providing the high
standard of the quality.

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According to proposed that due to enhanced consciousness amongst the community


patient satisfaction became very important for the hospitals. The authors studied the
components relative to patient satisfaction in hospital services. Patient satisfaction is
mainly depends on the four factors which included behavior of doctors, medical
supporter, atmosphere and administration quality. They rendered strategically action
required for satisfying the patient needs of the healthcare system in developed
country.

Sharma and Chahal (2003)

According to Folkes and Patrick (2003) studied about convergence show of a


positive impression in customer perceptions about service quality provides.
Customer has feel about the service and share with the employee conducts to
perception that firm who service supplier are confirming to that level than the
disconfirming information extends the perception that the other service supplier firm
are likewise negative. There were four studies carried on that change the amount of
data about the service suppliers, and services. The profitability effect was defended
contempt dispute across study in method as well as evaluates
There were found different effects of CRP [Customer Relationship Perception] and
responsive marketing tools on customers retentively and they share developing
overtime. CRP is studied about the rating of providers offers and relation strength,
and customers contribution growths are the change in customers contribution
between periods of time. This result indicates that emotive loyalty plans that furnish
economic bonuses positive effect both customers share development and retention,
whereas direct postings shapes customers contribution developing. Even, the result
of this variable quantity is quite small and shows that business can utilize the similar
strategy to impact customer satisfaction that having impaction on both side customer
retention and share development.
Developing a theoretic framework that determines how satisfaction involves future
customer behaviour and, changing state, the degree, timing, and cash flow. Empirical
observation, they found a positive connection between customer satisfaction and
shareowner value. They also observed substantial fluctuations across industries and
businesses.
Anderson et al (2004)

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2.3 CUSTOMER RELATIONSHIP MANAGEMENT


Reinartz et al (2004) in their study of CRM (Customer Relationship Management)
work had expressed that it is most significant for preserving healthy relationships
with the customers in ordered to supply them satisfaction. In this study, they (1)
conceptual concept of the CRM processes and its proportion, (2) operating and
formalize the concept, and (3) investigation of the organizational functioning effects
of applying the Customer Relationship Management processes. Their research
questions are covered in industrial areas and companies. The results of this studied
theoretically measuring in three degree: Initiations, maintenances and terminations
Homburg et al (2005) carried on experimental studies on real utilize experience and
lab experimentation

which disclose the creation

customer satisfaction on willingness paying

of a firm, positive affect of

and they render backup for a

nonlinearity, operational construction founded on disappointment theory. In


additional, the second studies dynamical expressions of the relationship and renders
evidence for the stronger affect of accumulative satisfaction instead than of
transaction particular satisfaction on willingness pay. Customer Relation
Management (CRM) is main target for the healthcare industry. Patient satisfaction is
mainly full fill by to satisfy all the customer need.
Mithas et al (2005) measured the consequence of Customer relationship
Management on customer satisfaction and knowledge. They analyzed archival cross
sectional data of U.S business firms which demonstrates that utilize of Customer
Relationship Management programs is positively linked with improving knowledge
and satisfaction of customers. They also determined that reaches in consumer
knowledge are raised when business firm information share customer associated with
their supply chain co-operators.
Gustafsson et al (2005) in their studied, customer satisfaction analyzed the effect of
telecommunication service, emotive, loyalty and calculating consignment on
retentively and the potentiality for situation condition to control the retention of
customer satisfaction relationship. The results ordered outcomes of customer
satisfaction and calculating loyalty.

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Gruca and Rego (2005) proposed that the effect of chain that connects Customer
Satisfaction to shareowner value by demonstrating the links between satisfaction and
cash flows that finds out the value of the business to shareowner: development and
stability.

2.4 SERVICE
Service consists at the centre of economical activity of company which is connected
with many other sectors of economics (Kandampully, 2000) they are not modified to
service manufacturer example like IBM which involved in service firms. Services
acts as processing and performance. Service is an intangibility offering which are
fundamental components of decision. The difference between the healthcare service
and tangible marketing products, healthcare products may be described by the
service quality.

2.4.1 INTANGIBILITY
Intangible is one type of services. Assets that are saleable though are not material or
physical. People cannot be even seen, sensed, experienced before they are purchased.
In this type of the service quality by providing good quality by means of the
infrastructure and providing all the facilities related to the equipment and facilities.
This is the main part of the customer satisfaction. All the patients mainly attracted by
means of the infrastructure. This is the main site of the healthcare industry to achieve
the all the needs of the patient.

2.4.2 INSEPARABILITY
Services are mainly developed and exhausted at the same time. This is not reliable of
physical commodities, which are made up, put into stock list, spread through
multiple render, and ingested still later. If a people deliver the service, then the
supplier is function of the services. When Customers shows as the service is
developed, supplier customer interaction is a special characteristic of market
services. Both the supplier and the customers affect the service effects.

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2.4.3 VARIABILITY
Service is extremely varying because of who supplies them and when supplied.
Services purchasers are mindful of this kind of variance and often speak to other
people before select a service supplier. Quality control is the main part of the any
business firm which is divided into three steps. Step one is the investment in HR
(Human Resources) department and training. Second step is the standardise the
pattern services that describes the event and further process in the flowchart, with
fully mention the objectives. Third objectives is the supervise customer satisfaction
via suggest and complain, survey and comparing, so at that time poor performance
The third is monitoring customer satisfaction through suggestion and complaint
system, customer surveys, and comparison shopping, so that poor service can be
observed and adjusted.

2.5 SERVICE QUALITY


According to Thomas and Brown, in recently study, customer satisfaction, service
quality and recognition of what formed measure to customers were discovered by the
responder company as either important or most important. This reply clarifies the
important invested on service quality and customer satisfaction by organization.
Impact of the marketing strategy had presented a relationship between the
comprehended quality and financial operation to organizations. Organization with
good service quality has high share market, bring back on investment and valuable
quality than organization with comprehended low quality.
Companies with perceived high quality goods and services typically has higher
market share, higher return on investment and asset turnover than companies with
comprehended low quality.
According to Lewis, Service quality is viewed a vital determining of competitive.
Attending to service quality can assist systems to distinguish it from other systems
and through it reach surviving competitive advantages. Service quality is viewed a
requirement as long term profit not only of service systems, but also of constructing
systems. Higher ranking service quality is a fundamental to improve profitability.
Service qualities become a prevalent strategic design of advance organizations.

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Enhancing paid up to service quality; the result is progress and more profit in
systems. Bearing quality service is a requirement strategy for survival and succeeds
in nowadays competitive market. Service quality supplies a competitive boundary
for business that can conduct to organizational development.
Nowadays service quality is an important research topic in study of its important
relationship, profit, customer satisfaction and retention, service ensures financial
performance (Kandampula, 2000)
This research is for the public and private sectors services evidences that
comprehended service quality leads to satisfaction, repetition seen, and strategic
profitability. Thus, realizing what forms quality to imposing publics reserves
managers to supply product and service that will maximise satisfaction.
Service quality impacts the redemption aims of both surviving and potentiality
customers. According to market research, customers are unhappy with a service will
disclose receives to more than four other persons. Hence, it is fair to resolve service

2.5.1 DEFINITIONS OF SERVICE QUALITY


According to Zeithalml, the concept of service quality as conceived in the market
service literature centres on comprehended quality, defined as a users assessment
about an entitys overall excellencies or high quality.
According to Parasuraman et al. proposed three fundamental themes after revising
the previous services:

Service quality is more difficult to measure than commodities quality for the
customers

Comparisons to expectation with performances results service quality


perceptions and

Effect of services Quality evaluations are not formed purely on the they also
affect evaluations of the delivering service processes

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2.5.2 DIMENSION OF SERVICE QUALITY


According to Kandampully disclosed that service quality is essential for the success
of any kind of service organizations. As the client takes part in the product and
ingestion of services, they act nearly with various views of the system. Within this
knowledge contributes them the chance to evaluate severely the services supplied,
especial the service quality. People will evaluate quality of service by comparison
the service they bring with service they want. Thus, quality of services acts a vital
role in contributing value to the overall service receives. Since high ranking quality
is one kind of the essential components within assure of the hospitality supplier
services. Kandampully proposed that increasing service quality at all type of services
delivered therefore become compulsory for company selection.
According to Gronroos applied that quality of services is constituted of three
dimensions: the Effect of technical quality, the Receive of the functional quality,
and the Images of company incorporated. The author also identified quality of
service in condition of physical, synergistic quality and image quality of
incorporates. Physical quality associated to the touchable expression of the service,
Interactional quality requires the interactional nature services and mentions it as flow
that passes between the customer and the service supplier, or his/her illustration,
admitting both automation and animated fundamental interaction. Quality of
corporate mentions to the picture assigned to a service supplier by its current and
possible customers, as well as other people. They also propose that when equated
with the other two quality dimensions, collective quality inclined to be more
unchanging over time.
These researcher indicate that in analysing the determiners of quality, it is essential
to distinguish between quality linked with the procedure of delivery service and
quality linked with the effect of service, guessed by the user after the service is
executed, describe 15 dimensions quality of service

categorised as hygienic

elements, raising factors. Hygienic elements are anticipated by customers and if they
are not delivering to customers so customer will be dissatisfied. The ten dimensions
include:

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In these dimensions were in the well known where five dimensions in the Service
Quality (SERVQUAL) model.
According to Parasuraman et al described five dimensions include: tangibility,
reliability, empathy, reactivity and authority. The perceived quality model with five
dimensions which is operational as the

Q = P E theoretical account i.e. perceived

quality (Q) enhances as perceptions of service (P) transcend expectations of service


(E) for each dimension.

2.5.3 MEASURING SERVICE QUALITY


Service quality is difficult to evaluate quality of service compared to good quality.
When customers buy service, look for properties but receive and acceptance
properties as comparisons with goods that is difficult to measure due to more a
couple of tangibly cue. They expect more consumer involve in the more
consumption. People will evaluate quality of service by comparison the service they
bring with service they want. Quality of services acts a vital role in contributing
value to the overall service experiences. Since high ranking quality is one kind of the
essential components within assure of the hospitality supplier services. Kandampully
proposed that increasing quality of the services at all type of services delivered
therefore become compulsory for company selection.
Satisfaction is measured by comparisons the average evaluations of now and had
improved to identify the services that customer believe the organization as matching
(=), exceeds (>) or fall short up (<) of their expectation. The dissatisfaction is
assumed to develop when services significantly exceed or significantly falls short of
customer expectations. Competitiveness is evaluated by comparisions evaluations,
averaged across customers, of now and other to identify the services that customers
see the organization as matching (=), exceeding (>) or falling short (<) or those of its
competitors (Lee and Lawton 1995)

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2.5.4 WHAT IS SERVQUAL MODEL?


SERVQUAL model is formulated by Parasuraman and college from U.S.A. This
model is based on discontinuously expectation approach.
Service quality model which made, describes the gap between the expectation and
perception. Five gaps include in this model which mention below:
Gap 1: what customers expectation and what does companies management think
about what customers expectation?
Gap 2: when companies management has failed to design that satisfy customer
expectation
Gap 3: the role of incompatible supervise controlling system, lack of comprehended
control

and teamwork, technology and job fit, dispute and ambiguous.

Gap 4: As result of inadequately communicate and tendency to over assure.


Gap 5: The variance between patients expectation and patients perceptions of the
service deliver: determines maintained from the patients sides and service supplier
gaps. The degree of demands, and service experienced.

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The management of service quality, it is significant to handle the gaps between


expectation and perception with the role of management, leaders and clients. Gap 5
is the most significant gap between expectations and perceptions of the delivering
service. Refer to gap model, it expresses that a customer gap is closed by marketers.
The service suppliers have to close the gaps apart from Gap 5 within the system that
delivering the service have to inhibit.
Zeithaml and Bitner: 2003

2.5.6 MODEL OF SERVICE QUALITY GAPS

According to Lewis proposed that the differences between the abstract how can be
measured. It is a logically that if the researcher evaluate the differences between
expectation and perception that is specified as comprehended quality, we can find
out the degree of satisfaction. This study is standardize with SERVQUAL model
which utilized the expectance disconfirm theory. Parasuraman is defined the quality
of service in five dimensions which are empathy, assurance, availability,
responsibility and tangibility. This SERVQUAL model proposed the quality of
services as the gaps between the patients expectation E and perceptions of the
serving provide performance. Service quality (Q) can be evaluated by deducting
patients perceptions level from patients expectation level.

Q=PE
Q = Service quality
P = Perception
E = Expectation

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2.5.7 Benefits of SERVQUAL


The benefits of Service Quality can be summarised as following:
1. Service quality is good provoking the consideration of patients concerning
service encounter ex: patients relations importance, satisfaction and
expectation.
2. Service quality is capable the management consideration the perceptions of
both patients and management.
3. Covering the service quality gaps can assist as the basis for developing
strategy and tactic in ordering to assure the accomplishing the expectation.
4. Service quality is capable to distinguish particular areas of excellencies and
weakness
5. Service quality is capable to priorities area of weakness services
6. SERVQUAL provides bench mark analytic thinking for organizations in the
same organizations
7. SERVQUAL can suggest the important, perception , expectation utilizing
sporadically
Service quality is used by various type of an organization and various types of
studies had interviewed with conceptual frame work and operational basis.
According to Carman, Finn and Lamb (1991) indicated that the patients perceptions
estimation may include experience of perceptual which is minus with the expectation
process. In other side, patients already have the comparison with the perceptions to
patients expectations where patients had asked the perception according to their
rate.

The Research Related Study


The quality of services in hospital concerned with many researchers studied on this
topic. This concept of the quality of service has been demonstrated and analysed of
the manufacturers, in the service sector which is received lately, services from
hospital has experienced the same care.

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According to Butler et al studied that the demographic level on users and perceivers
of comprehended hospitals in two geographic area for quality which earlier mention
about this studied and results indicated that facility linked with quality is measured
which is high for the female respondents than male. There were found that no
evidence of the hospital quality of services is pretended by age.
The relationship between the management of the hospital quality and the quality of
services had searched the performance for 150 sample hospitals in USA which
utilized path analytical model. The relationship between the quality of service from
hospital performances and analysing the service exposed procedure and developing
work force. Li (1997)
This study the relationship between expectation of the patients and satisfaction of the
patients satisfy with consultant of medical in Ludhiana. A healthcare professional
has higher amongst the patient who has highly expectation satisfied. This is the 460
set up the questionnaire of the analysis.
This study exposed the patients expectation and perceptions of the quality of
services at Vibhavadi hospital. The patients satisfaction level will be benefit for the
future services plan. In this study patient expectation is higher and perception of
quality of services was exposed. Hospital has to supply satisfaction the services.
Kanlaya (2004)

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CHAPTER 3
RESEARCH METHODOLOGY
3.1 INTRODUCTION

The researcher has described the different methods which can be used to increase the
patient satisfaction and tried to know about satisfied or not. The main objective of
this chapter is to observed methodology for primary collection data.
The researcher has set out research process, research philosophy, approaches, and
strategies data collection method, conceptual frame work, location of the study
sample size, data collection and more. The researcher experience many parameters
for each research components. This chapter is mainly facilitated to draw the
collection of overall primary information. In this chapter researcher is describes the
collection of the primary data and how researcher is achieve this information.

Source: Saunders et al., (2003)


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3.2 RESEARCH PROCESS


By the researcher a well organized research process has been used and the topic of
research was selected on the basis of the interest in a particular subject. The review
of literature was done on the basis of broad research which helped the researcher to
obtain and to find out the research objectives. According to Sunders (2003), the
review of literature helped the researcher to get in depth knowledge of the topic from
the current and previous research finding. The next step of the research was research
approach and research design which relies on the data collection methods and
follows the step of research philosophy, research strategy comes and finally the data
collected was analyzed and interpreted and presented in this dissertation which made
to use pharmaceutical industry to improve their sales performance.

3.3 RESEARCH APPROACHES


Research approaches are mainly two approaches two method to conduct research,
quantitative and qualitative. The current study is designed to focus on customers
satisfaction and perception of service quality at Mayday hospital and the initiative
taken by different business strategies to handle this problem. There is mainly divided
in the two types one is the Inductive approach and the second is the Deductive
approach. Research approaches attached to the different research philosophies,
deduction owes more to positivism and induction to interpretive.
There are two different types of approaches that is Induction for building theory and
Deduction for testing theory Due to short period of the study design we will focuses
mainly on the big firms which are rapidly growing in UK and India. An ease
approach to interviewee variety was adopted (Hussey and Hussey, 1997) in which
firms that have an interest and experience in this area and were known to the
researchers were selected. According to Creswell (2002), mention a number of
practical criteria. Inductive research can be long-lasting, data collection takes longer
while Deductive research can be quick to complete as data collection is often based
on one take.

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3.4 RESEARCH DESIGN


Bryman and Bell (2007) states that research design can be qualitative or quantitative
and give idea about a framework for the collection and analysis of data which is
selected based on a range of dimensions of the research process and these
dimensions contain the depiction of causal relationship between variables, the
generalization to larger groups of individuals or the meaning of behaviour in social
context and the understanding of behaviour. According to Saunders et al., (2003), it
has usually been observed that quantitative studies are concerned with numbers
whereas qualitative studies are concerned with words. There are normally three types
of tools for the research design:

3.4.1 EXPLORATORY RESEARCH


According to Davis (2000) exploratory research is to improve the researchers
understanding in the direction of the problem. An exploratory research is useful
when a topic of interest cannot be considered in a quantitative way, or sometimes
when the measurement process itself is not able to signify particular qualities
(Malhotra, 2004).

3.4.2 DESCRIPTIVE RESEARCH


The use of this research is to characterize the exact profile of person, events and
situations (Proctor, 2003). Malhotra (2004), states that different goals can be
achieved by this research. According to Saunders, Lewis & Thornhill (2003), the
study of the descriptive research by which one can easily go further in the
exploratory study and can support anyone to assess the data.

3.4.3 CAUSAL RESEARCH


Maalhotra (2004), suggest that casual research is finished to find out the cause and
the effects of a relationship and the main objective of this research is to find out
effect of one variable on another which helps the marketing manager for future
predictions and enables to test them up in the market.
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The SERVQUAL theory, customer satisfaction and perception with hospital


searched into the literature reviews which were secondary data involved. Now next
step information gathering directly from the patient or customer who using of
hospital. The researcher has tried to follow this method which involved:

Location of the study

Population and sample size

Questionnaire design

Measuring of conducting questionnaire

Location of the study:


The researcher has been chosen location at Mayday hospital, Croydon where
questionnaire would be distributed and collection data in hospital area and some of
from high street of West Croydon.
Population and sample size:
Population: This study will constitute of all the patients and their relatives who have
been in hospital for treatment at Mayday hospital, Croydon.
Sample size: The researcher was collected 216 data of patients and their relatives.

3.5 RESEARCH PHILOSOPHY


A research philosophy determines the way in which the knowledge of the project is
developed. The author referred various research books and analysed the qualitative
and quantitative research methodology. Crossan (2004) describes the philosophy
which helps the researcher to recognize the different research methods and strategies
to be used in a study and it also helps researcher to collect all the evidences, the way
of analysis and it also helps to answer different questions. According to Bryman and
Bell (2007) there are two types of research philosophy include Postivism and
Interpretivism or Phemenology.

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3.5.1POSITIVISM
Fisher (2004), explain Positivism as a value free knowledge of the things and
potentially accurate, the variety of actions and the activities of the human beings can
be studied in a practical manner through certain objectives as a part of the real world.

3.5.2 PHENOMENOLOGY OR INTERPRETIVISM


According to Crossan, (2004), phenomenologist approach use the flexible multiple
methods to learn a small sample in depth over a period of time and create justified
assurance which is different to absolute truth. So, this approach assumes the reality
which is numerous, subjective and mentally constructed by an individual. As Potter
(1996) says that the researcher should focus into the complex reality of the world.

3.6 RESEARCH STRATEGY


According to Saunders et al (2003), it is a common plan that details the way in which
the research questions will be answered.

Saunders (2009) says the power of

quantitative method helps to shape the research problem in very accurate and it helps
to achieve high level of consistency of gathered data. There are different types of
strategies available to conduct researches are:

Action Research

Experiment

Survey

Grounded theory

Ethnography

Case study

Cross sectional and longitudinal studies

Archival research

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UNIVERSITY OF WALES ID 0811867060434

The word action research was first used by the Lewin in 1946 and it has been
recognize subsequently by management researchers in a mixture of ways. Coghlan
and Brannick (2005), focuses and emphasises purpose of research in research action
rather than research about action. According to Eden and Huxham (1996) research
action is more likely to concentrate on the consequent transfer of knowledge gained
from one specific to another.
According to Robson (2002), has been defined as An empirical investigating

present day physical process within real circumstances utilizing multiple beginning
of bear witness. Hussey and Hussey (1997), says that a case study involves
gathering in depth information about a unit of analysis and a unit of analysis can be a
group of worker or a company, a process or an event or sometimes even an
individual.
Glaser and Strauss (1967), describes the grounded theory which is frequently
thought of as the best example of the inductive approach, while conclusion would be
too simplistic. A grounded theory strategy is useful for research to predict and
explain behaviour
(Goulding, 2002).
Ethnography mainly originates from the field of anthropology and rooted in the
inductive approach. Archival research is useful in the administrative records and
documents for the principal source of data. Robson (2002) has defined as a strategy
for behaving research which requires investigating

a present day physical process

within real circumstances utilizing multiple beginning of bear witness.


According to Morris and Wood (1991), the case study has considerable capability to
get answers to the questions like what? How? Why? According to Denscombe
(1998), survey is a strategy for the research and it includes methods such as
questionnaires, interviews and so on. Survey are related with the analytical approach
and it is the common strategy utilized in firms and management research and also
grants you to gather the data which you can analyst quantitatively by using of
descriptive and inferential statistics.

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UNIVERSITY OF WALES ID 0811867060434

One of the form of research is experiments which is commonly owed on social


science and main purpose of the experiment is to study fundamental links whether a
change in one independent variable makes a change in another dependent variable
and used normally in explanatory research to find out the answer How? Why?

3.7 FOCUS GROUP

This is the second method for the data collection. For the better quality of the
research author will using this method for the collection of primary data. It is also
know as a group discussion. In this type of method all the participants are comes
together and discuss their ideas on particular subject area and share their feelings as
well.
chisnall
There are various types of method for focused grouped are available. The reliability
of all the research is highly depends on a size of sample and times spend by all of
group members. The researcher will use the mini focused group interview for the
collection of qualitative information or data. According to Chisnall, Mini group is
defined as a gather 4 to 5 people who are involved with each other to achieve that
target.
Due to the short period of time researcher will decide to use five interviews for each
focused group. In one focused group, there are five members. The details of focused
group member are collected from questionnaire sheet. In this sheet at the bottom
there is space for who would like to join the interviews for further research.
The information collected from focused group interviews are not quantified so the
researcher have to note down the all the important comments of group member and
finally brings all together in narrative form.

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3.8 DATA COLLECTION METHODS


According to Kumar (1999), there are two types of sources for the data collection i.e.
primary sources and secondary sources. The data and information are two diverse
things and they say that information is a knowledge which is acquired from useful
structured data and determines how the data will look like and how it will be used in
the context (Collis & Hussey, 2003). It was necessary to collect both kind of data to
meet the aim and objectives.

Data collection

Primary Data

Interview

Questionnaire

Secondary Data

Books

Internet

Journals and
Articles

Source: The figure drawn by researcher

3.8.1 SECONDARY DATA


According to Malhotra (2004), secondary data are those which have been collected
by various people and researchers and shared among them for specific purpose to
solve a problem. As per the Proctor (2003), secondary data includes both qualitative
and quantitative information and easily accessed with less investment. The data are
of two types i.e. internal and external data. Amongst this two internal data is
collected from the internal study or analysis of organization for research is being
conducted while the external data is collected from outside of organization i.e. desk
research (Malhotra, 2004). The secondary data is collected legally and faster than the
primary data (Sharp et al., 2002).
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There are different sources for secondary data like journals, books, articles,
publications, computer source, internet but the survey based data, documentary data
and data from multiple sources are the main categories for collecting secondary data.
(Saunders, Lewis & Thornhill, 2003).
The main advantage of secondary data for research observed by Saunders et al.
(2003) i.e. it gives a higher quality than primary data (Stewart and Kamins, 1993)
and frequently useful to compare with primary data. According to Denscombe
(1998), this leads to unexpected discoveries and has a power of being permanent and
checked easily by others.
The secondary data was also collected from the published government websites,
online documents and also through the University of Wales Library. According to
Ghauri and Gronhaug (2005), the most useful advantage of secondary data is savings
time and money and it is quickly available.
Secondary data is mainly design to collect the information from the past or the
history. This information is collected from the history and out of date so it is not
reliable in this current situation. There is the some chance of the criticism in this data
but this is the main part for the researcher to start the research. It is the base for the
researcher to conduct research.
The secondary data includes both qualitative and quantitative information and easily
accession with less investment. The data are of two types i.e. internal and external
data. Amongst this two internal data is collected from the internal study or analysis
of organization for research is being conducted while the external data is collected
from outside of organization i.e. desk research.
(Malhotra, 2004).

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3.8.2 VALIDITY AND RELIABILITY OF SECONDARY DATA


According to Kervin (1999), the most vital criteria is measurement of validity for the
suitability of data set and secondary data fail to prove you the data or information
you need to answer your research question or aim and objective may be result in
invalid answers and there is not proper solution for the problem of measurement
invalidity. Dochaartaigh (2002) refers to this as assessing the reputation of a source
and the data collected from government organisation are likely to be well accurate
and reliable.

3.8.3 PRIMARY DATA


According to Lancaster (2002), if secondary data doesnt give proper information or
there is insufficient secondary data which doesnt fulfil researchers then primary data
is collected. So, primary data always bear the secondary data and as Proctor (2003)
says the market researchers are interested in primary data from socioeconomic
character, knowledge, opinions, motivation, behaviour and intentions.
There are mainly two types of primary data i.e. quantitative and qualitative.
According to Davis (2000), quantitative research contains large sample size and also
involves numerical and statistical analysis and consists of data collected from
questionnaire surveys, database, emailed, etc. and then there are most general or a
common method which is used for qualitative research are Surveys and
Questionnaire.
Langvin (1998) says that qualitative research consists of exploring and focusing on
fewer elements like attitude, values and perceptions and so to get qualitative data
different methods like depth interview, projective methods and focus groups are
used. According to Proctor (2003), focus mainly on customers behaviour and
provides the data on why people buy specific product and what motivate them to buy
them.

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The primary data collection was based on the questionnaire and on telephonic
interview during the research and the questionnaire answer was analyzed
quantitatively while the response will be analyzed qualitatively and the rest of data
will source from interviews taken and literature was qualitative. For primary data
collection questionnaire was made by the researcher and distributed to respondents
in two parts that is one to managers and other to medical representatives. Researcher
has used two types of questionnaire.

Open ended questionnaire and

Close ended questionnaire.

In open ended question, the respondent does not have multiple choice to select the
answer this questionnaire gives the qualitative information about the research. Where
on the other end the close ended question, respondent has multiple choices to give
the answer and this questionnaire gives quantitative data for the research. For
improvement all over quality of the research paper researcher is using the both type
of the questions in this research paper.
For this research researcher designed 16 question (refer appendix) for the qualitative
purpose and 12 question (refer appendix) for the quantitative purpose. The reason
why researcher has chosen this kind of questions has been given below:

3.8.4 INTERVIEWS
The researcher asks a standard set of questions and not more than that.

a. Face to Face Interview


In the survey method, this is the highest reply rate on this method. The
researcher has to clarify the all unclear answer and capture, try to follow the
information. The researcher has approach to anyone on the planet has a
telephone.

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b. Telephonic Interview
In these type of interview, less time taking and expensive also cheap and the
researcher has these are less time consuming and less expensive and the researcher
has ready access to anyone on the planet that has a telephone. It has some advantages
and disadvantages which explain below:
Advantages

Less expensive.

Quick and takes less time.

Easily can tape the answers.

Wide geographic area.

Able to cover large number of people.

Disadvantages

Must ask simple questions.

Sometimes disturbance in the line can be observed.

Many times repeat the calls.

One must have good telephone manner.

Most of times questionnaire is required.

3.8.5 COMPUTER ASSISTED PERSONAL INTERVIEWING (CAPI)


It is a form of personal interviewing, but instead of completing a questionnaire, the
interviewer brings along a laptop or hand-held computer to enter the information
directly into the database. This method saves time involved in processing the data, as
well as saving the interviewer from carrying around hundreds of questionnaires.

3.8.6 QUESTIONNAIRES
Questionnaire is the easiest way to collect the primary data. But the main problem is
to make the questionnaire. Some advantage and disadvantages are explained below:

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Advantage:

When interviewing is not possible questionnaire is used.

It is less expensive.

Its very easy to posted, faxed or E-mails straight to the respondent.

Less costly and can cover wide geographic area.

Disadvantages:

Time consuming process.

Designing problem.

The questionnaires should be simple and easily be understandable.

Many times the questionnaire is not completely filled thus there are problems
with the incomplete questionnaires. There are two types of questionnaire:

a. Paper Pencil Questionnaire: Sending a huge number of people and spares


the researcher time and money.
b. Questionnaire from Web sites: The researcher is used the internet which
is developed a new and helpful for research methodology. If you will click
on that site, you have received the questionnaire.

Primary Data

Interviews

Managers
(Structured)

Questionnaire

Employees
(Semi
structured)

Managers

Source: Figure drawn by researcher

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There are two main types of interviews i.e. semi structured and structured (FAO,
1990). The structured interviews include the managers of the company and semi
structured will be employees working in different departments of the pharmaceutical
industry. In case due to some reason interviews were not held then methods like post
or mailed can be mode of communication. Furthermore, a questionnaire will be
asked to be filled from the managers to

find out the current international marketing

strategies used by the company.


The first method of data collection is Questionnaire. The researcher has to ask
question according to research objectives after that research question the researcher
has to notice the respondent response. This method is oldest method for data
collection. A questionnaire is defined as the data collection documents and has two
types of different for that. One types is that the researcher wants to ask the question
to respondents and the second thing is that the space which is used to notice
responses of them.
The questionnaire is design by the researcher have the list of questions. The question
is selected in order to two types of question included. One type is closed question
and second is open ended question. In the close types of questions, the respondent
just only tick out the questionnaire and fill up that questionnaire which are on the
sheet. It is very simple and quick method and easy to analyse and collecting the
information quickly. In the open ended question respondents have give their
suggestion and idea of their knowledge. So it improves the quality of the information
and from this information researcher develops the new ideas and view. The
researcher is generally used the two types of the question.
According to Kent the closed ended questionnaire is again divided in two types. One
type is knows as single answering and the second is the multiple answering. In the
first type of type which is single answering respondents have to select only one
option which is mention in the sheet. For example: the researcher selects the some
parameter which set up in the questionnaire and that parameter which are related to
the expectation, perception and differences between expectation and perception. So
respondents have tick out that parameter only.

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The second type is open ended questions which generally using the force to people
and encourage them and explain about the research questions.

These types of

question are different than close ended questions. Open ended questions are to allow
the respondents to explain their story in their own words. This is not going to in
particular direction. When this type of question respondent has to ready filled up the
answer and the researcher willingness to listen responses of the respondent.
According to Saunders, (2003) the differences between the closed ended questions
and open ended questions have the questionnaire. Both types of method in the closed
ended questions are single and the multi answer questions which help to collect the
quantitative data. It is described as the numerical data or the data that is quantified.
In open ended questions are useful for the collection of qualitative data.

Pilot Questionnaire
The quantitative data from the questionnaire gathering the data, the researcher has
decided to conduct the pilot questionnaire to test the reliability, validity and marking
the questionnaire. A pilot questionnaire had taken place at Mayday Hospital,
Croydon. The questionnaire was considered for its response format, questionnaire
design, the sequence of the questions and legibility as well. Respondents made their
response in the evaluation box located in the bottom of the questionnaire sheet. The
comments are shown in the later part of the paper. From that comments researcher
made some chances in the questionnaire list and it is now reliable source for the
gathering the quantitative data.
Pilot Questionnaire:
Response 1: the overall questionnaire is quite good but presentation is not up to date.
It requires the some changes.
Response 2: the overall questionnaire is good but in between the question is not
good it is easy to complete which was really nice because I was in hurry. I was
realizing that all the questions are related to the topic.
Response 3: you have selected more parameter so you have to sort out them and
select according to your objectives.
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Response 4: this questionnaire is so simple and easy to understand. And it is very


effective to this research topic. It has to be improved the terms of giving the more
options like agree, disagree, strongly agree and strongly disagree instead of yes or
no.
Response 5: the overall questionnaire is quite long. Many parameter uses for this
research topic.

3.9 SAMPLING METHODS


Sampling usually implies studying a representative subsection of a precisely
defined population in order to make inferences about the whole population Kumar
(1999, p.148) has defined sampling as the select a few sample from a bigger group
the sampling population to become the basis for guessing or predicating a fact,
situation or effect regarding the bigger group. According to Churchill and
Lacobucci (2002), there are two sampling methods for sampling that is probability
and non-probability.

3.9.1 PROBABILITY SAMPLING


These sampling methods are normally used for large research as required probability
mathematics and mostly used by American bureau census and government surveys
(Chisnall, 1997) and these methods enables to analyse the standard mean error and
avoid easily available informant. This is further divided by the systemic sample,
stratified sampling, and cluster sampling.

3.9.2 NON PROBABILITY SAMPLING


According to Malhotra (1999), the probability of any member of the population
being selected is an unknown non probability sampling which finally gives a
qualitative estimation of population characteristics. This method is less costly,
convenient, and fast and also used widely by many researchers. There is various
types of the methods are available for non probability of sample and this is divided
by the convenience sample, judgement sample, quota sample and the snowball
sampling.
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3.10 DATA ANALYSIS


The difficulty of analysis will depend on the research question and objectives.
According to Davis (2000), for the analysis and answer of research researcher must
think about the strategies used to analyze the data in a proper way and also stop
developing useless. Researcher should analyze data in a proper format and for data
editing and if necessary then statistical adjustment as well (Aaker et al., 2004). The
data analysis will see in detail in the next chapter.
Mean value had calculated for the questions asking of 1 to 9 scale. In case of 9-point
scale

where

the

respondents

were

asked

to

indicate

their

degree

of

importance/unimportance for expectations and degree of bad/good for the


perceptions, scores were assigned from 1 to 9. Frequencies were multiplied with
their respective weights and aggregate values found out.
Mean Score = (Wifn)/n
i = 1 to 5
n = 216
Where, Wi = Weight attached for degree of importance/unimportance and good/bad.
fn = Associated frequency
n = Number of respondents
Likert scale used for each factor which is rated scale of 1to 9

3.11 CONCLUSION
The research methodology chapter gives a perfect idea about the data collection
methods used by the researcher and at the same time it also useful to understand the
concept and idea behind the data collection methods. This chapter also gives one to
understand easily for how to collect the data, how research objectives and theoretical
errors can be eliminate with the help of analytical methods and strategies. So,
methodology gives clear picture to researcher for how to find the data for research.
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CHAPTER 4
ANALYSIS OF FINDINGS AND DISCUSSION
4.1 INTRODUCTION
This chapter is mainly based on analysis of the results which is done by the
researcher. This chapter is related to the previous chapter of research methodology.
The researcher collected primary data results from respondent at Mayday hospital
Croydon. Afterwards that is related to the research objectives and correlation with
literature review and get appropriate conclusion. The results provide the researcher
explored the key issues in this topic and draw appropriate conclusion. The
researchers have two options for analysis software one is SPSS and second one is
Microsoft Excel. The researcher have knowledge regarding Microsoft excel which is
used by researcher. Due to that the researcher can analyze data quickly.
As earlier mentioned in research methodology there are two methods for collection
of data by primary research. The first method is the questionnaire which is mainly
collected the quantitative information. Second method is focus group interview
which is collected the qualitative information. The researcher has described both
methods below and how it is conducted.

4.2 QUESTIONNAIRES
As above mention in research methodology, questionnaire is related question to the
subjects. All questions are found out the patient satisfaction how hospital does
provide the service quality to patients?

As a result of patient satisfaction and

perception, this question is divided into three parts, expectation of the patient, and
perception of patient and satisfaction level of patient. Each question is important for
research these questions prepare in order to increase the patient satisfaction at
Mayday hospital Croydon.

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The collection of quantitative data was completed on 4thjuly at Mayday hospital,


Croydon. The researcher completed the questionnaire on that day. The researcher
accomplished the aim populations which were set out into the methodology. It was
difficult to collect 216 patients data in a day because Mayday hospital has huge
building construction and there are many ward in hospitals. The researcher had
divided the study in different ways. Because many people did not give any response
so the researcher decided to take some wards and area so the researcher decided to
take first accident and emergency department when patient has come any time and
they got suffered from some injuries so researcher decided to give them one flower
or chocolate who fills this questionnaire . Then the researcher completed that work
within three and half days.

4.3 FOCUS GROUP


As earlier described in chapter 3 focused groups is selected from the questionnaire
sheet. When the respondent filled the questionnaire at that time questionnaire filled
of name, address, phone number and e-mail address so researcher selected some
group member from that questionnaire sheet who interested in focus group. The
researcher had decided to divide the sample in the 5 different groups and each group
had the five members. Interviews were started from the introduction.

Then

researcher introduced himself and gave the some information regarding research
topic. The researcher tried to include every research question in the discussion. The
researcher kept friendly environment to all customer or patients. Sometime
discussion were going out from main topic at that time researcher smartly to turned
and kept the main topic but sometime it was required because the researcher wanted
to pull out some feeling from patients.
The researcher accepted the qualitative and quantitative data after completed
questionnaire and focused group interviews w. All survey were collected in one
sheet of paper then entered into Microsoft Excel then converted into tables and
calculate average , mean, median produced the table and put the figure in tables.
Sometimes the researcher got to difficult but the researcher used Likert scale table.

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4.4 GENERAL DEMOGRAPHIC SAMPLE GROUP DATA

4.4.1 GENDER
Distribution of respondent

Male, 45.83%

Female, 54.16
%

Table: No. of Patient Respondent


Gender

Frequency

Percentage

Male

99

45.83

Female

117

54.16

Total

216

100

According to this table and results, group of sample reveal that Male is 45.83%,
while female is 54.16%. The researchers found that female were taking more
interested than male for this study.

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4.4.2 AGE

Percentage
35
30

Age

25
20
15

Percentage

10
5
0
18-29

30-39

40-49

50-59

60 and
above

Numbers of respondent by Age


Age (years)

Frequency

Percentage

18-29

18

8.33

30-39

54

25

40-49

52

24.07

50-59

64

29.62

60 and above

28

12.96

Total

216

100

According to this table, sampling groups of ages reveal those ages between 50 to 59
years old is 29.62%, ages between 30 to 39 years is 25%, ages Between 40 to 49 is
24.07%, ages between 60 and above old people is 12.96%, ages between 18 to 29
years of young people is 8.33%

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UNIVERSITY OF WALES ID 0811867060434

According to this result, the researcher found that ages between 50 to 59 years
admitted at Mayday hospital Croydon and all of above 50 years so hospitals have to
take carefully. So as per this result the researcher concept is good, and suggested
good topic.

4.4 EXPECTATION OF PATIENTS


The researcher has study about the service quality which is going at Mayday hospital
where different parameter involves for patient satisfaction. An analysis of the patient
satisfaction from doctors behaviour, medical assistant, and service provided by
hospitals is done.
PATIENT EXPECTATION FROM THE DOCTORS BEHAVIOUR

Dimensions

Expectation Mean Value)

Availability

8.97

Knowledge

8.95

Handle of queries

8.44

cooperation

8.63

Politeness

8.58

Attitude

8.38

Check-up

8.77

empathy

7.21

experience

8.55

considerations

6.52

Average

8.3

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An analysis of the patient expectation from the doctors behaviour, the researcher is
given various types of dimension quality of services which patients asked to rate
their expectation scale of 1to 9 and depends upon the dimension the mean rate is
calculated which is given below in the table.
According to this table, the dimension of patient expectation from behaviour of
doctors is gain that means scores for the doctors availability, doctors knowledge
and check up process are respectively 8.97, 8.95 and 8.77 which indicate that
patients consideration these dimensions very significant. So that shows dimensions
of patients expectation level is very high.
Apart from that dimensions, the mean value of cooperation, politeness, experienced,
handle of queries and attitude are respectively 8.63, 8.58, 8.55, 8.44 and 8.38 which
proves that patients consideration these dimensions very important. So, doctors
from hospital have to try satisfying these expectations in effective manners. The
dimensions of empathy and individual consider means scores are respectively 7.21
and 6.52 which are compare to other dimension lowest but patients even considered
these dimensions important.
According to this dimension means value, it is clear that dimensions availability and
knowledge having maximum means value of 8.97 and 8.95 respectively and
dimension of individual consider and empathy having minimum means value of 7.21
and 6.52 respectively. The dimension of patient expectation from doctors behavior
means value is high on the scale of 9 which is calculated 8.3; patient expectations
from doctors are very high.
4.4.2 PATIENTS EXPECTATION FROM BEHAVIOUR OF MEDICAL
ASSISTANT
An analysis of the patient expectation from medical assistant, the researcher is given
various types of dimension quality of service which patients asked to rate their
expectation scale of 1to 9 and depends upon the dimension the mean rate is
calculated which is given below in the table

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Table: Patients expectation from the behaviour of medical assistants


Dimensions

Expectations
(Mean Value)

Availability

8.91

Knowledge

8.57

Cooperation

8.65

Politeness

8.79

Attitude

8.49

Maintenance of Record 8.71


Experience

7.41

Handle of Queries

8.44

Dresses

6.9

Average

8.31

The mean value for dimension in quality of service, availability of medical staff is
respectively 8.91 which are very high, patient are given 8.91 because they think this
parameter is very significant and expectation level is high for this dimensions.
Patients had given the means value for the dimensions of politeness, cooperates and
maintenances record are respectively 8.79, 8.65 and 8.71 which shows patient
satisfaction considered these elements very significantly. The dimension experience
mean value is 7.41, this indicates that patients believe this dimension important but
not like as above dimension compare to that dimension is lowest amongst all other
dimensions. According to this explanation, patients do not count this dimensions
very significantly but patients had not valued this dimension low which is an
important dimension. The means value of patients satisfaction from medical assistant
behavior is 8.31.
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4.4.3 PATIENT EXPECTATION FROM QUALITY ADMINISTRATION


An analysis the patient expectation from the quality administration, the researcher is
given various types of dimension quality of service which patients asked to rate their
expectation scale of 1 to 9 and depends upon the dimension the mean rate is
calculated which is given below in the table
Table: Patients expectation from the Quality of the Administration
Dimensions

Expectations
(Mean Value)

Convenient Office Hours 6.12


Check Up Process

8.49

Over Crowd

8.19

Welcome Your Ideas

7.28

Handling system

7.02

Billing Procedure

8.68

Check Out Procedure

8.77

Clerical Staff behaviour

8.98

Security Staff behaviour

8.87

Average

8.04

The average mean value for the dimension for this factor is 8.04. That is reliable to
say patients think the Quality Administration a significant prospect of hospitals
which is high expectation.

Clerical staff behavior is highest expectation level

amongst other dimensions which is respectively 8.98. The patients are also
considered the check up process, security staff behavior, check out process and
billing process high expectations which are the means value respectively 8.49, 8.87,
8.77 and 8.68. Patients are not complex they said that procedure is quite easy.
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The average value for the dimension welcome your idea is respectively 7.28 that
means hospitals carefully listen ideas from patients. The lowest means value for the
dimension of convenient office hours which is respectively 6.12 that means patient
do not think this dimension is significant than other dimensions.
4.4.4 PATIENT EXPECTATION FROM FACILITIES PROVIDED BY THE
HOSPITALS
An analysis of the patient expectation from the facilities provide by hospitals, the
researcher is given various types of dimension quality of service which patients
asked to rate their expectation scale of 1to 9 and depends upon the dimension the
mean rate is calculated which is given below in the table
Table: Patient Expectation from the facilities provide by the hospitals
Dimensions

Expectations
(Mean Value)

Sitting Arrangement

8.94

Bed Arrangement

Staff Appearance

6.99

Light

8.39

Dust Boxes

Outer & Inner

7.42

Appearing
Parking

8.71

Equipped Units

8.29

Marking On Walls

8.12

Eating Places

8.93

Average

8.21

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The degree of patients expectation for the dimensions bed arrangement and dust
boxes are highest expectation amongst other dimensions as two dimensions having
the average mean value 9. Here the researcher found that patients has rate the
dimensions with means value 9. The average value of 8.94 for the sitting
arrangement also indicates that patients considered the dimensions as significant as
previously mention two dimensions.
According to patients, parking, lights, eating place, equip units and noticing walls are
significant dimensions. The average values for these dimensions are respectively
8.71, 8.39, 8.93, 8.29 and 8.12. The average mean of outer and inner appearance is
7.42 which are compared to other dimensions lower. The lowest means value
amongst the dimensions 6.99 which is staff appearance.

4.6 PATIENTS PERCEPTION FOR VARIOUS FACTORS

4.6.1 PATIENTS PERCEPTIONS FROM THE DOCTORS BEHAVIOUR

An analysis the patient perception from the doctors behaviour, the researcher is
given various types of dimension quality of services which patients asked to rate
their perceptions scale of 1to 9 and depends upon the dimension the mean rate is
calculated which is given below in the table.

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UNIVERSITY OF WALES ID 0811867060434

Table:Patients perceptions from the doctors behaviour

Dimensions

Perceptions
(Mean Value)

Availability

7.68

Knowledge

7.16

Handling of

6.52

Queries
Cooperation

6.69

Politeness

6.81

Attitude

7.41

Examination Comfort

7.72

Check-Up

7.89

Empathy

5.79

Individual

6.01

Consideration
Experience

6.70

Average

6.94

According to this table, the highest average mean value for the dimension check up
is 7.89 which indicate that patients perception about this dimension is good. The
doctors availability, comfort examination and doctors attitude where the average
values for these dimensions are respectively 7.68, 7.72, and 7.41. Patients
perception about knowledge is quite good where the average value for this
dimension is 7.16.
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UNIVERSITY OF WALES ID 0811867060434

The average means value for the dimensions experience, cooperation, politeness and
handle queries are respectively 6.70, 6.69, 6.81 and 6.52 which shows that patient
perception of the dimensions are not good. The empathy and individual
consideration having the average mean value 5.79 and 6.01 respectively amongst the
other dimensions. Patient perceptions for these all dimensions the average value is
6.94 which indicates that patient perceptions for doctors behavior is not very good it
is quite good
4.6.2 PATIENTS PERCEPTIONS FOR MEDICAL ASSISTANTS
An analysis of the patient perceptions for the medical assistant behavior, researcher
is given various types of dimension quality of services which patients had asked to
rate their perception scale of 1to 9 and depends upon the dimension the mean rate is
calculated which is given below in the table.
Table: Perceptions of patients from the behaviour of medical assistants
Dimensions

Perceptions
(Mean Value)

Availability

7.86

Knowledge

6.42

Cooperation

6.75

Politeness

6.89

Attitude

7.01

Maintenance of Record 7.92


Experience

6.31

Dress

9.00

Handle of queries

6.09

Average

7.13
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The average value for the dimension dress is 9 which shows highest rating
dimension. From these patients perceptions about dresses of medical staff are very
good so that means patients think medical assistant wear neat and clean dress. The
average value of the dimensions maintenance record and availability are 7.92 and
7.86 respectively.
This value is good means on the scale of 9 which shows patient had comprehended
these dimensions of medical assistant. Attitude has the means value 7.01 which is
not very good. The dimensions politeness and cooperation having the average mean
value 6.89 and 6.75 respectively. This indicates assistant deals with patients are not
good.
The average means value for the dimension experience and knowledge are 6.31 and
6.42 respectively which indicate that medical assistant are deficient on this
parameter. The average mean value for the dimension handles of queries has the
lowest degree amongst the other dimension which shows the query of the patients
are not properly handle by medical assistant. Patients perception from medical
assistant, overall average means value came out 7.13. The researcher can calculated
the patients perception for medical assistant behavior is fairly good so medical
assistants need to improve their behavior.

4.6.3 PATIENTS PERCEPTIONS FOR QUALITY OF ADMINISTRATION

An analysis the patients perceptions for quality Administration, researcher is given


various types of dimension quality of services which patients had asked to rate their
perception scale of 1to 9 and depends upon the dimension the mean rate is calculated
which is given below in the table.

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Table: Perceptions of patients from the quality of the administration


Dimensions

Perceptions
(Mean Value)

Convenient Hours

8.25

Check Up Procedure

6.31

Over Crowd

7.97

Welcome Your Ideas

6.21

Handle the System

6.01

Billing Procedure

7.68

Check Out Procedure

7.79

Clerical Staff behaviour

7.18

Security Staff behaviour

8.48

Average

7.32

The average value for the security staff behavior and convenient hours are
respectively 8.48 and 8.25 where patients perceptions are very high. According to
these dimensions hospitals provide good service on these dimensions. The average
means for the dimensions over crowd, check out process are 7.97 and 7.79
respectively which indicate patients perception on these dimensions are good.
Clerical staff behavior is quite less than previous factor which indicate hospitals
should improve on this. The average value for the dimensions check up process,
welcome idea and handle system are respectively 6.31, 6.21 and 6.01. According to
that average mean patient perceptions is fairly good compared to other factors. The
total dimensions average mean is 7.32 which indicates that patients perception from
Quality Administration tend to be good.

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4.6.4 PATIENTS PERCEPTION FOR FACILITIES PROVIDE BY THE


HOSPITAL
An analysis of the patients perceptions for the facilities or service provide by
hospital, researcher is given various types of dimension quality of services which
patients had asked to rate their perception scale of 1to 9 and depends upon the
dimension the mean rate is calculated which is given below in the table.
Table: Patients Expectation from the services and facilities provided by the
hospitals
Dimensions

Perceptions
(Mean )

Sitting Arrangements

8.57

Bed Arrangements

8.61

Staff Appearance

7.62

Lights

7.21

Dust Boxes

8.59

Outer & Inner Appearance

7.42

Parking

8.09

Equip Units

7.04

Marking On Walls

7.71

Eating Places

8.47

Average

7.93

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The average mean for the bed arrangement, sitting arrangement, eating place, dust
boxes and parking area are respectively 8.61, 8.57, 8.47,8.59, and 8.09 which shows
that patients perceptions on this dimensions are very good so hospital are doing good
service to patients in good manner.
Other dimension staff appearance, inner and outer appearance and marking on walls
and lights are respectively 7.62, 7.42, 7.71 and 7.21 which indicates patients
perceptions are good towards this dimensions. The lowest average of the dimension
is equip units is respectively 7.04 but the researcher is think its not bad. Patients
perceptions for the facilities supply by hospital, the overall average means is 7.93.

4.7 DEGREE OF PATIENTS SATISFACTION FOR THE


VARIOUS FACTORS
4.7.1 DEGREE OF PATIENTS SATISFACTION FOR THE DOCTORS
BEHAVIOR
An analysis the measurement of the degree of patient satisfaction from doctors
behavior, where differences between the average mean value of expectation and
perception, where each dimensions are computed and then the researcher is applied
t-test whether distinguish between the two means average is important or not at 0.05
degree of important. The computed values are given below in the table.
This table indicates that distinguish between the average value of expectation and
perceptions for the dimensions experience, politeness, knowledge, handle queries,
empathy and cooperation are respectively 1.85, 1.77, 1.79, 1.92, 1.42 and 1.94. TValue for the dimensions at 0.05 degree of significance indicates that there are
important difference in the mean value of perceptions and expectation for the
dimensions. For the dimensions check up, and availability difference between
expectation and perceptions are respectively 1.29 and 0.88.

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Table: Degree of Patients Satisfactions for Doctors behaviour

Dimensions

Expectations

Perceptions

Difference

(Mean Value) (Mean Value)


Availability

8.97

7.68

1.29

Knowledge

8.95

7.16

1.79

Handle of Queries

8.44

6.52

1.92

Cooperation

8.63

6.69

1.94

Politeness

8.58

6.81

1.77

Attitude

8.38

7.41

0.97

Check-Up

8.77

7.89

0.88

Empathy

7.21

5.79

1.42

Individual Consideration

6.52

6.01

0.51

Experience

8.55

6.70

1.85

Significant difference at 0.05 degree of significance


t- Critical: 1.66
There comparing t-values shows important differences 0.97 and 0.51 are the attitude
and individual consideration differences respectively and T-value for these
dimensions indicates that important difference between the means value of
expectation and perceptions. In this calculation which is clear the highest difference
for the dimension is in the handle queries and the lowest for the dimension
individual consideration

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4.7.2 DEGREE OF THE PATIENTS SATISFACTIONS FOR THE MEDICAL


ASSISTANT BEHAVIOUR
An analysis the measurement of the degree of patient satisfaction from medical
assistant behavior, where differences between the mean value of expectation and
perception, where each dimensions are computed and then the researcher is applied
t-test whether differences between the two means values are important or not at 0.05
degree of important. The computed values are given below in the table.
Table: Degree of the patients satisfactions from the medical assistant behaviour
Dimensions

Expectations

Perceptions

Difference

(Mean Value) (Mean Value)


Availability

8.91

7.86

1.05

Knowledge

8.57

6.42

2.15

Cooperation

8.65

6.75

1.90

Politeness

8.79

6.89

1.90

Attitude

8.49

7.01

1.48

Maintenance of Record

8.71

7.92

0.79

Handling of Queries

8.44

6.09

2.35

Experience

7.41

6.31

1.10

Dress

6.9

9.00

-2.1

Significant difference at 0.05 degree of significance


T- critical: 1.66

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This table indicates that differences between the mean value of expectations and
perceptions for the dimension handle queries is 2.35 and the t- value is very high
which indicates the differences between the values are significant which shows
patients had not experienced what they having expected from the dimension. The
differences of the dimensions cooperation, knowledge, and politeness are
respectively 1.90, 2.15 and 1.90 where respectively t-value indicates the differences
are quite important, dimensions of the perceptions are lower than patients
expectation from these dimensions. The mean value for the dimensions availability,
experience, and attitude are respectively 1.05, 1.10 and 1.48 and at 0.05 degree of
significance t-value is larger than t-critical which indicates differences are important.
The difference of the dimension of maintenance record is 0.79. It is quite
significance which indicates perception of the patients for this factor is not higher
than expectation. The difference for the dimension dresses has -2.1 which indicate
the perceptions of the patients are more than expectations.
4.7.3 DEGREE OF PATIENTS SATISFACTION FROM THE QUALITY
ADMINISTRATION
An analysis the measurement of the degree of patient satisfaction from Quality
Administration, where difference between the

mean value of expectation and

perception, where each dimensions are computed and then the researcher is applied
t-test whether differences between the two means values are important or not at 0.05
degree of important. The computed values are given below in the table.
The difference between the means score of expectation and perceptions for the
dimensions handling system and check up are respectively 1.01 and 2.18 which are
huge differences. So researcher can say that patients expectations from the
dimensions are higher than perceptions. The dimensions clerical staff behavior of
the difference between expectations is 1.80 respectively which is quite small. Thats
reliable; expectation is high compare to the perceptions for this dimension. 1.00, 1.07
and 0.98 respectively which are the differences for the dimension billing process,
welcome idea and check out process. The differences of the clerical staff behavior
and over crowd have the 1.80 and 0.22 respectively between the mean for
expectations and perceptions.

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Table: Degree of Patients Satisfaction for the Quality Administration


Dimensions

Expectations

Perceptions

Difference

(Mean Value) (Mean Value)


Convenient Office Hours

6.12

8.25

-2.13

Check Up Process

8.49

6.31

2.18

Over Crowd

8.19

7.97

0.22

Welcome Your Ideas

7.28

6.21

1.07

Handling System

7.02

6.01

1.01

Billing Procedure

8.68

7.68

1.00

Check Out Process

8.77

7.79

0.98

Clerical Staff Behaviour

8.98

7.18

1.80

Security Staff behaviour

8.87

8.48

0.38

Significant difference at 0.05 degree of significance


T- Critical =1.66
The dimensions convenient office hours have the -2.13 which is negative difference
between the expectations and perceptions which indicates that perception of the
patients dimension is higher than expectation.
4.7.4 DEGREE OF PATIENTS SATISFACTION FROM FACILITIES
PROVIDE BY HOSPITALS
An analysis the measurement of the degree of patient satisfaction from facilities
provide by Hospitals, where differences between the mean value of expectation and
perception, where each dimensions are computed and then the researcher is applied
t-test whether differences between the two means values are important or not at 0.05
degree of important. The computed values are given below in the table.
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Table: Degree of Patient Satisfaction for the facilities provide by hospital


Dimensions

Expectations

Perceptions

Difference

(Mean Value) (Mean Value)


Sitting Arrangements

8.94

8.57

0.36

Bed Arrangements

9.00

8.61

0.39

Staff Appearance

6.99

7.62

-0.63

Natural Light

8.39

7.21

1.18

Dust Boxes

9.00

8.59

0.41

Outer & Inner Appearance

7.42

7.42

0.00

Parking

8.71

8.09

0.62

Equip Units

8.29

7.04

1.25

Marking On Walls

8.12

7.71

0.40

Eating Places

8.93

8.47

0.45

Significant difference at 0.05 degree of significance


T- Critical =1.66
The differences between expectation and perceptions for the dimension 1.25 and
1.18 equip units and lights respectively amongst the other dimensions which indicate
that patient expectation are higher than patient perceptions for these dimensions
0.36, 0.62, and 0.41 respectively where the differences for the dimensions parking,
sitting arrangement and dust boxes. The dimensions bed arrangement, eating place
and marking on walls have small differences of 0.39, 0.45 and 0.40 respectively
between the means score of patients expectations and perception. The dimensions for
the inner and out appearance are 0.00 which is lowest and patients perceptions and
expectation for these dimensions are same. Here staff has negative value -0.63 and
for this dimension patients expectation are lower than patients perceptions
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CHAPTER 5
CONCLUSION AND RECOMMENDATION
5.1 INTRODUCTION
In the current scenario, cutthroat competition is going on; healthcare sector has
become important for the measurement of patient satisfaction. This concept of
patient satisfaction has promoted the acceptance the culture of market in healthcare
sector in developed and developing countries. Nowadays, numbers of hospitals are
going to open and people are going to be aware and conscious about health.
Hospitals must provide good service quality to retain the patients. There are various
factors affect the patients satisfaction, doctors behavior, medical assistant behavior,
doctors availability, administration quality, modern facility availability etc. if
hospitals satisfy the patients, they should provide service quality, facilities and
treatment as well. The researcher is focused on analyzing the various factors which is
related to satisfaction of patients with particular research objectives:

To analyse the patients expectation from hospitals this provides service


quality

To analyse the patients perceptions from hospital services.

To analyse the degree of patients satisfaction from hospital service.

The research objective of the study which is in order to accomplish, the primary data
collected from respondent. There were two types of data used in this study. The
primary data was gathered from questionnaire which was filled from respondent. The
secondary data was gathered from books, journal articles, and websites. The
researcher was used quantitative methods for the analysis of the received data.
The researcher was used one of the best method for measuring service quality that
was SERVQUAL model which is developed Parasuraman, and Berry adopt for the
service quality Gap 5 which express the customer satisfaction level from customer
expectation and perceptions

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In this study, population constituted of the indoor patients at Mayday Hospitals,


Croydon. There were many respondents either patients or their relatives. The
information collected from the primary research data are comparing with the
literature review and from this researcher draw the conclusion. There are certain
recommendation is drawn by the researcher in the end of this section.

5.2 CONCLUSIONS
5.2.1 GENERAL DEMOGRAPHIC:
This study involved 216 respondents, there were 45.83% of respondent were Male
and 54.16% of respondent were Female.
5.2.2 PATIENT EXPECTATION
Patients expectation is high where same for all factors, doctors behaviour, medical
assistant, and quality administration and facilities provide. The patients expectation
mean value is 8.18 which is high on scale of 1to 9. The patients expectations are
highest under doctors behaviour where the dimensions availability, knowledge and
checkups are respectively 8.97, 8.95 and 8.77. The dimension of offices hours has
lower expectations mean of 6.52. And clerical staff behaviour has highest 8.98
amongst the all dimensions of Quality Administration. The expectations of facilities
provide by hospital have the average mean for the dimension bed arrangement and
dust boxes 9 respectively.
5.2.3 PATIENTS PERCEPTIONS:
The four factors for patients perceptions the mean value is 7.33. It is quite good on
the scale of 9. The dimension empathy has very lowest value 5.79 and check up has
7.89 which is high value amongst the dimension of factor doctors behaviour. The
dimension dresses for the factor medical assistant has 9 which are better amongst all
other dimensions. Handle queries has lowest means value is 6.09. The dimension
handling the system has mean value 6.01 which is the lowest, and security staff
behaviour has 8.48 which is highest dimension for the factor of Quality
administration.

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5.2.4 PATIENTS EXPECTATION AND PERCEPTION RELATIONSHIP:


The differences between expectations and perceptions are1.94 and 1.92 for the
dimension cooperation and handle of queries 1.94 and 1.92 respectively and 0.51
mean values which is the lowest dimensions individual consideration factor doctors
behaviour, for factor medical assistant behaviour, the highest differences is 2.35 for
the dimension handle of queries and lowest record maintenance -2.1 mean value for
dimension dresses which is negative indicates perceptions are higher than
expectation. Quality of administration has negative dimension convenient office
hours, a highest difference is for the dimension checkups and lowest differences for
security staff behaviour. The lowest differences outer and inner appearance is 0.00
and highest equip units is 1.25 and one difference has negative which is staff
appearance -.0.63 respectively.
The researcher found that the patients are not satisfied in reliability which is
significant of service quality. It expresses that the patients wanted to service quality
guarantee which is more than all hospital staff communicate to the patients. This is
focused on the hospitals that trying to communicate to patients about services in
hospitals but sometimes create misunderstanding between doctors and patients.
Sometimes patients do not understand the doctors explain. It depends upon the
culture, back ground, and patients education. Conclusion that patient wants good
service quality. High quality systemically is difficult but useful for service
organizations.
The researcher compares the study between the research of this study and previous
study which the researcher mentioned in chapter two. The researcher found that
different conclusion between this study and study about the quality of hospital in
southern and west U.S.A. for this study, demographic level aspect about gender, it is
not different for the patients satisfaction and other side butler et al proposed that
facilities in hospitals relate quality is evaluated high for female than male
respondent. Butler et al studied that perception of hospital quality were affecting by
age

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As the age, Butler et al (1996) said that no found that hospital quality perceptions
are affected by age but from this research the result showed that age is the influence
factor on tangible, assurance, empathy and price. Parasuraman (1985) determinants
five service quality: tangible, reliability, responsiveness, assurance and empathy. For
the research of Kanlaya Damrongsak revealed that importance level of service
quality was reliability, tangible and responsiveness respectively. And for customer
satisfaction part, the reliability and assurance dimension was dissatisfied. For this
research, the most important level is reliability and assurance dimension. And for
customer satisfaction part is the same as Kanlaya research that the reliability and
assurance was dissatisfied.

5.3 RECOMMENDATION
The measurement of the patients satisfaction level can change the alleviate hospital
services supplying and management as well as enhance and keep the service quality
providing which focus on patients wants and expect(Babakus).
The results come out from this result that respondents dissatisfied with some service
quality so now hospitals have to improve the service quality. For this study, the
researcher set up the solving the patients dissatisfaction attribute. The researcher
found that from this study many respondents satisfy with the service quality. But
some respondent does not satisfy with the doctors because they could not solve the
problem and they have taken a time. Patients satisfaction is more tangible and less
related with measurement unit of good. Some process required for setting up
patients expectation needs to be more rigorously and have to include different types
of approached. Service quality essential have to cover hospital procedure as well as
measurable quality factor, because of service extending and delivery of service is
looped. Nowadays hospital market has become competitive, all hospitals have
realized to improve the service quality. Equally Thailand, need to be health touristy
hub of Asia. To reply the customer satisfaction is most important path to pull out the
customer from the different country.

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To construct the reliability is the essential way for all hospitals. To decrease the
mistakes or errors this affects on hospital. Expressing physician image competent to
patients is possibly a more challengeable job. Grow up and maintained image of
hospital, medical assistant have to reliable on the experienced places. Patients will
make an impression the degree of the staff as patients experienced the services
during their visiting. Attempts have to be committed to make all patients experience
build up positive response and reward the impression amongst them that staff is
efficient. To integrate the mode of think amongst hospital staff, accomplishing this is
via training programme that have to design to reward.
Empathy, from this study results indicates that the improve the communication
quality with patient by explain medical process, discuss the business concern
question, consult with them concerning their care may increase patients satisfaction.
Patients are satisfied with masters who give patient individual attention and realized
their demands. Hospital staffs dealing with patients in care fashion have their interest
are significant services issue.
The factors responsiveness and price should refer. Hospitals bill raised the react that
they are extraordinary high, it contribute to patients dissatisfaction. Hospital staff
has to work with patients expectation, their instruction to assist them dealing with
potentiality shocking cost. Todays people shifting from curative to preventive
medicines, preventive medicines concentrated on individual health. Hospitals have to
apply the approach strategies to reaction of the marketing trend, new effort to serve
patients who interested their healthy.

5.4 LIMITATION OF THE STUDY


This study is focused on patients survey through pre designed questionnaire endures
from the limitation of possible difference between what is truth and record, no issue
how the questionnaire is design and area investigate has been conduct. Because of
respondent may not intentionally that report true orientations. These types of
problems has been minimise by taking interview personally, no validation of
avoiding the possible of crawling error in. From this study, following limitation has
to be considered.

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1. As study had finished in short time, time factor acting as significant limit and
extensive of the study
2. Questionnaire is quite long respondents who filled up the questionnaire may
not be accurate because of inescapable bias.
3. Group of sampling come from several backgrounds which is affect on
questionnaire due to respondent do not understand questionnaire and
someone wants more explanation.

5.5 SUGGESTION FOR FURTHER STUDIES


1. Next research have to repeat this study because the patients satisfaction always
changes mind when the customer have always used service for the next time they
will expect more.
2. The patients satisfaction is on the background, culture and experience. Next
research has to analysis the patients satisfaction of each nation to customise the
patients expectations.
3. Next research has to focus on the individual hospitals that having many foreigners
utilized the service to measure the significant factor to meet patients satisfaction.

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REFERENCES AND BIBLIOGRAPHY


Andaleeb, S.S. (1998), Determinants of customer satisfaction with hospitals: a
managerial model, International Journal of Health Care Quality Assurance, Vol.11
No.6, pp 181-7.
Anderson, E.W. and Sullivan, M.W. (1993), The antecedents and consequences of
customer satisfaction for firms, Marketing Science, Vol. 12 No. 2, pp.125-43.
Anderson E W, Fornell C and Mazvancheryl S K (2004) Customer satisfaction and
shareholder value. J Mktg 68: 172-85.
Andaleeb, S.S. (1998), Determinants of customer satisfaction with hospitals: a
managerial model, International Journal of Health Care Quality Assurance, Vol.11
No.6, pp 181-7.
Aurora S and Malhotra M (1997) Customer satisfaction: A comparative analysis of
the satisfaction level of customer of public and private sector banks. Decision 24:
109-30.
Babakus, E. and Boller, G.W., An empirical assessment of the SERVQUAL scale,
Journal of Business Research, Vol. 24, pp. 253 68.
Babakus, E. & Mangold, G.W., Adapting the SERVQUAL scale to the health care
environment, in: P. Bloom(Ed.)Enhancing Knowledge Development in Marketing
(Chicago, IL: American Marketing Association), 1989
Baker, J.A. and Lamb, C.W. Jr (1993), Measuring architectural design service
quality, Journal of Professional Services Marketing, Vol. 10 No.1, pp. 89-106.
Bolton R and Drew J H (1991) A multistage model of customers assements of
service quality and value. J Consumer Res 17: 375-84.
Boulding W, Kalra A, Staelin R and Zeithmal VA (1993) A dynamic process model
of service quality: from expectations to behavioral intentions. J Mktg 30: 7-27.
Butler, D., Oswald, S. and Turner, D. (1996), The effects of demographics on
determinants of perceived health care service quality: the case of users and
observers, Journal of Management in Medicine, vol. 10 No.5, pp. 8-20.
Buttle, F. (1996), SERVQUAL: review, critique and research agenda, European
Journal of Marketing , Vol. 30 No.1, pp.8-10.

79

UNIVERSITY OF WALES ID 0811867060434

Buzzel, R.D. and Gale, B.T., The PIMS Principles Linking Strategy to
Performance,
Free Press, New York, NY, 1987
Coulson- Thomas, C. and Brown, R., Beyond Quality Managing the Relationship
with the Customer, British Institute of Management, London, 1990.

Finn, D.W. and Lamb, C.W. (1991), An evaluation of the SERVQUAL scales in a
retailing setting, Advances in Consumer Research, Vol. 18, pp.483-90.
Gronroos, C.(1984), A service quality model and its marketing implications,
European Journal of Marketing, Vol. 18 No. 4, pp. 36-44.
Gustafsson W, Johnson M D and Roos I (2005) The effects of customer satisfaction,
relationship, commitment, dimensions and triggers ion customer retention. J Mktg
69: 210-215
Homburg C, Koschate N and Hoyer W D (2005) Do satisfied customers really pay
more? A study of the relationship between customer satisfaction and willingness to
pay. J Mktg 69: 84-96

Horovitz, J., How to Win Customer Using Customer Service for a Competitive
Edge, Longman, Harlow, 1990.
Kanlaya, D. (2001). A Comparative Study of Client Expectations and Perception of
Service Quality to Assess satisfaction level: A case study of Vibhavadi Hospital
Kandampully, J. (2000). The impact of Demand Fluctuation on the Quality of
Service: a Tourism Industry Example, Managing Service Quality. Vol. 10, pp. 1018.
Kotler, P.,& Clarke, R., Marketing for Health Care Organization Prentice Hall,
1987., P. 133
Labarbera P A and Mazursky (1983) A longitudinal assessment of customer
satisfaction/dissatisfaction: The dynamic aspect of the cognitive process. J Mktg Res
2: 393-404
Lamb, C.W., hair, J.F., & McDaniel, C. (2000). Marketing (5th ed.). Ohio: SouthWestern College Publishing.

80

UNIVERSITY OF WALES ID 0811867060434

Lehtinen, J.R. and lehtinen, U., Service quality: a study of quality dimensions,
unpublished Working Paper, Service Management Institute, Helsinki, 1982.
Lewis, B.R. Quality in the Service Sector A Review., International Journal of
Bank Marketing, Vol. 7 No. 5, 1989.
Lewis, B.R. and Mitchell, V.W. (1990), Defining and measuring the quality of
customer service, Marketing Intelligence & Planning, Vol.8, No.6, pp. 11-17
Li, L. (1997), Relationships between determinants of hospital quality management
and service quality performance a path analytic model, Omega, Vol. 25 No. 3,
Lithuaria, International Journal for Quality in Health Care, Vol. 16 No.3, pp.8389.
Lim, P.C., Tang. Nelson, N.H., Peter, M.J. (1999), Innovation and strategy, An
innovative framework for health care performance measurement, Journal of
Managing Service Quality, Vol. 9, No.6, pp. 423-433
Ofir C and Simonson I (2001) In search of negative customer feedback: The effect of
expecting to evaluate on satisfaction evaluations. J Mktg Res 38: 170-182
Parasuraman, A., Zeithaml, V.A. and Berry, L.L. (1985), A conceptual model of
service quality and implications for future research, Journal of Marketing, Vol 49,
Fall, pp.42-50.
Parasuraman, A., Zeithaml, V.A. and Berry, L.L. (1988), SERVQUAL: a
multipleitem
scale for measuring consumer perceptions of service quality, Journal of Retailing ,
Spring, pp.12-40.
Reidenbach, E.R. and Sandifer-Smallwood,B. (1990),Exploring perceptions of
hospital operations by a modified SERVQUAL approach, Journal of Health Care
Marketing, Vol. 10 No.4, pp.47-55
Roderick. M Mcnealy., Making Customer Satisfaction Happen-A Strategy for
delighting customers, Chapman&Hall, P.1-3, 1996.
Royal Danish Council., Section overview the health section in Thailand., 2004
Rust, R. and Zahorik, A. (1993), Customer satisfaction, customer retention and
market share, Journal of Retailing, Vol. 69 No.1, pp. 193-215.
Saha A.K. (1988) Satisfaction with life- A study of nurses Nigeria. Decision 15: 6164
Sharma R D and Chahal H (1999) A study of patient satisfaction in outdoor services
of private health care facilities. Vikalpa 24: 69-76

81

UNIVERSITY OF WALES ID 0811867060434

Simester D I, Hauser J H, Wernerfelt B and Rust R T (2000) Implementing quality


improvement programs designed to enhance customer satisfaction : Quasi
Experiment in United States and Spain. J Mktg Res 37: 102-112
Sharma R D and Chahal H (2003) Patient satisfaction in government outpatient
services in India. Decision 30: 109-28.
Sesser, W.E., Olsen, R.P. and Wyckoff, D.D. (1978), Management of Service
Operations, Allyn&Bacon, Boston, M.A.
Thompson C J (2005) Consumer risk perceptions in a community of reflexive doubt.
J Consumer Res 32: 235-245
Voss D (1998) Role of price performance and expectation in service. J Mktg Res 36:
45-51.
Zebiene, E., Razgauskas, E., Basys, V., Baubiniene, A., Gurevicius, R., Padaif, Z.
And Svab, L.(2004), Meeting patients expectations in primary care consultations in
Zeithaml, V.A., Berry, L.L. and Parasuraman, A. (1993) The Nature and
Determinants of Customer Expectations of Service, Journal of the Academy of
Marketing Science, Vol. 21, No.1, pp. 1-12
Zeithaml, V.A., & Bitner, M.J. (2003). Service Marketing: Integrating
CustomerFocus Across the Firm., NY: McGraw-Hill.

Web References
http://www.maydayhospital.org.uk/page.asp?pageid=90
http://www.maydayhospital.org.uk/page.asp?pageid=4

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APPENDIX
Questionnaire
Thank you very much for spending your time and extending your effort to fill
this form. Your support will help the researcher gather data on the patients
satisfaction at Mayday hospital and will complete the research paper in Master
of Master Of Business Administration in Healthcare Management
___________________________________________________________
The questionnaire is divided into 3 parts:

Demographic

The important level

Patients expectation and Patients perception

Demographics
1. Gender
Male
Female

2. Age
Under 18

40 - 49

18 29

50 - 59

30 39

60 and above

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UNIVERSITY OF WALES ID 0811867060434

The researcher would like to have your opinions on the following service issue
related to the important level of medical treatment at Mayday Hospital that you
use to use it, Please circle one number for each statement that best reflects how
You feel.
1= strongly disagree, 2 = disagree, 3 = Fair, 4 = agree, 5= strongly agree
Degree of Important
Beautiful organized and clean place

Provide convenient and adequate parking lot

Accurate diagnosis and medical treatment

Conducts a through physical check up


before treatment
Provides treatment of good quality medical
academic
Reliability of the physician, nurses and staff

Nurses assist promptly

Rapid Service

Knowledge Staff

Friendly, kind, and polite staff in treating


patients
Respect customer privacy

Customers ensured that they would be safe


from any complications and other incidents
Customers ensured of recovery; i.e., illness
would relieved after treatment
Physicians sufficiently clarify the treatment,
such as mode of examination, reason of
examination, outcome, and treatment

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Focus Group Interview Questionnaire


We would like to have your opinions on the following service issue related to the
expectation and the perception at Mayday hospital, Croydon that you use to use
it, Please circle one number for each statement that best reflects how you feel.
1= strongly disagree, 2 = disagree, 3 = Fair, 4 = agree, 5= strongly agree
Dimension

Expectation

Perception

Place to be clean, beautiful,


and Organized
Providing with convenient
and adequate parking lot
Accurate diagnosis and
medical treatment
Having a through physical
check up before treatment
Physician checking patients
on schedule
Nurses assisting promptly

Serving rapidly

Staff every level to


knowledge
Respecting paying Attention

Respect to customer privacy

Physicians Paying attention to


customers problems
Physicians willing to answer
any customer inquires

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