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Service Quality in Private Hospitals in Delhi NCR : A SERVQUAL Analysis

Sharad Khattar, Associate Professor, Amity International Business School, Amity

University, Noida

Prof. (Dr.) Gurinder Singh, Group Vice Chancellor, Amity Universities, Director

General, Amity International Business School

Abstract

The service industry in the recent two decades has gone through an un-precedent

change. Because of the vast competition in nearly all the various different service

industries the focus has shifted to the customer who rules and decides the success

of any service organization. Health care industry has also been affected in a similar

way. In India, the main stay of this industry is the hospitals which are either under

the government control or in private hands. Delhi NCR with population of over 46

million has a number of world class hospitals both in the government and private

control. With positive policies on medical tourism, these hospitals also cater for

patients from neighboring countries and countries from South East Asia, Middle

East and Africa. Healthcare businesses to gain a competitive advantage, aim to

build a long term relationship with its patients. This translated means ensuring

customer satisfaction and loyalty with the services provided to ensure repeat use

of the service. SERVQUAL model as advocated by Parsuraman , Zeithamal and

Berry (1988) which measures the service expectations and perceptions to evaluate

the perceived service quality has been used to determine the service quality in

hospitals of Delhi National Capital Region (NCR).

International Journal of Pure and Applied MathematicsVolume 119 No. 17 2018, 727-752ISSN: 1314-3395 (on-line version)url: http://www.acadpubl.eu/hub/Special Issue http://www.acadpubl.eu/hub/

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Keywords: SERVQUAL, healthcare, service quality, customer satisfaction

1. Introduction

The well-being and health of people is one of the most important aspects of life

and society. The need and the demand for health related services have seen

tremendous growth in past years. The World Health Organization (WHO, 1948 )

has given the definition of health as: “a state of complete physical, psychological

and social well-being and not the absence of disease”.

That‟s not just all to what health really is, instead health is a broader concept and

can also constitute to other things. Health in the marketing perspective clearly

means to identify and seek to meet people who are healthy and not only to that but

also to continue and want to keep on being healthy. Health marketing is equally

essential in many ways: It is global and competitive, societal in nature and

overflowing with regulations.

The application and aspects of health care are different in all the countries and

this basically depends upon the socio-economic and political forces of the country

and the society. There are basically there broad categories of provisions: First,

there are countries in which the state provides the finance, provision and

administration of services but there are private interests in the form of individual

practice, hospitals and other supportive services. Second, there are countries where

the state is the one that provides medical care and no private hospital provides such

services. Third, there are countries which completely rely on the market for the

availability of services.

International Journal of Pure and Applied Mathematics Special Issue

728

2. Healthcare in India since Independence

One of the earliest policies related to health services at the time of independence

of the country was the resolutions of the National Planning Committee on the

report of the Sub-Committee on National Health. It envisaged setting up of a

Health organization giving a broad idea of the organization at various levels that is

at state and district level. In addition they recommended the enactment of

consolidated public health acts by the Central and Provincial Legislatures. The

Bhore committee of 1946 known as Health survey and Development committee

laid emphasis on curative and preventive medicines at all levels. It made

recommendations of remodeling of health services in India. It emphasized the

organizational aspect, the development of health centres and the way ahead of

medical education.

The Government of India has in last so many years since independence drafted a

number of policies related to health services in India. Two such policies drafted in

year 1983 and 2002 as part of five year plans served fairly well. After 2002

because of changes in the context of how health services are looked at; namely

change in health priorities , emergence of health care industry with private players

, increasing cost of availing health services and rising economic growth has given

inputs for formulation of a new Health Policy of 2017.

The primary aim of the National Health Policy (NHP), 2017, is to inform,

clarify, strengthen and prioritize the role of the Government in shaping health

systems in all its dimensions - investments in health, organization of healthcare

services, prevention of diseases and promotion of good health through cross

sectoral actions, access to technologies, developing human resources, encouraging


729

medical pluralism, building knowledge base, developing better financial protection

strategies, strengthening regulation and health assurance.

NHP 2017 builds on the progress made since the last NHP 2002. The

developments have been captured in the document “Backdrop to National Health

Policy 2017 - Situation Analyses”, Ministry of Health & Family Welfare,

Government of India.

The Health Policy also gives importance to AYUSH systems of healthcare –

Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy. A separate

department of Indian system of Medicines and Homeopathy was established in

1985 to promote its development. Aim is to promote Indian and other traditional

systems of medicine in modern healthcare.

Healthcare industry in India is witnessing an immense growth. The growth is

very rapid in terms of revenues. It is also providing substantial opportunities in

terms of employment. Healthcare industry comprises mainly of the hospitals,

medical investigations, medical insurance, medical tourism and the related

equipment. The manpower comprises of doctors, nursing staff, technicians and

support staff. The total industry size is expected to touch USD160 billion by end of

2017 & USD280 billion by 2020. In India the categorization of medical services

can be done in two categories; Public and Private.

Growth drivers of this industry are

Increasing health awareness and disposal incomes.

Increasing penetration of health insurance.

Increasing ageing population in India.


730

Exponential growth in medical tourism.

The public health care system is not capable of taking care of entire population

of the country. This aspect has given a fillip to the development of private hospitals

in India. It has become the dominant sector of the two and almost 80 % of the total

spending comes from this sector. Some of the major players in India are Apollo

Hospitals and Escorts Group, Fortis healthcare, Max healthcare, Wockhardt and

Manipal Health Systems.

4. Healthcare in Delhi NCR

The Delhi government has a separate ministry known as Ministry of Health and

Family Welfare responsible for health care of citizens under its jurisdiction.

Hospitals form part as an integral unit in administering health care services. The

Delhi government has about 38 government hospitals under it

(.http://www.delhi.gov.in/wps/wcm/connect/doit_health/Health/Home/Hospitals/).

Besides these, hospitals under the Central government like the All India Institute of

Medical Sciences (AIIMS), Safdarjung Hospital, Deen Dayal Upadhyay Hospital ,

New Delhi , Ram Manohar Lohia Hospital, New Delhi , are some of the important

and well known hospitals in Delhi NCR.

There are a large number of private hospitals in Delhi NCR .The private

hospitals in Delhi are either of multi-specialty types – Apollo Hospitals, Vedanta

Hospitals, Max Health care Hospitals, Fortis Hospitals or they are of super

specialization types – Centre for Sight Hospitals for eye , RG stone Clinic for

Urology and related medical ailments.

Some of these private hospitals in Delhi NCR are world class; besides catering

to local patients attract a number of patients from neighboring countries like


731

Pakistan, Afghanistan, Nepal, and the Middle East countries. Besides patients also

come form Europe and North America.

The healthcare services in Delhi NCR are therefore a mix of both public and

private hospitals which caters for the populations residing in Delhi and neighboring

cities like Gurgaon, Noida, Faridabad, Noida and Ghaziabad which constitute the

Delhi NCR region.

5. Service Quality.

Quality is an important part of our lives in each and every aspect. People and

consumer keep looking for the quality of services and products that they consume.

Due to these changing demands, quality has become an extremely important factor

to be considered by the product and services provider both in terms of production

and delivery. Quality is what provides the competitive advantage to the service

provider. Paying attention to quality by improving it, results in reducing waste,

rework, delays, lower costs, higher market share, and brand image which

ultimately leads to productivity and profits. That is why, it is very important to

define, measure and improve quality of healthcare services.

Definitions of Quality, due its nature and intangible characteristics; vary

depending on whose perspective is taken and within which context it is considered.

No single universally accepted definition exists. Quality, therefore, has been

defined in most simplest of terms as „ the degree of excellence of something‟.

Researchers have conceptualized service quality in two different ways. The first

is the Nordic perspective proposed by Gronoos, 1982, 1984. The service quality

dimensions are defined in terms of functional and technical quality. These

dimensions were found to be generically applicable to all services. While the


732

technical aspect deals with „what‟ is provided by the service and the functional

aspect deals with „how‟ the service is provided.

The second perspective is the American perspective. This perspective brings

out the abstractness and the elusive nature of this construct on account of three

unique factors which are intangibility, heterogeneity and inseparability of

production and consumption of the nature of the service (Parsuraman, Zeithaml

and Berry 1985). Parsuraman et, al., 1985, differentiates perceived quality and

objective quality. The former being a customer‟s judgement about an entity‟s

overall excellence and the latter being a form of the attitude.

It is generally agreed that service quality is a higher order construct and is

multidimensional in nature (Grönroos, 1984; Parasuraman, Zeithaml, & Berry,

1995).

Definition as proposed by Hung, Huang & Chen 2003, „the degree to which an

event or experience meets an individual‟s needs or expectations‟, is consistent with

that of Parasuraman, Zeithaml & Berry, 1988.

As per Morrison-Coulthard , 2004, the key performance metrics in many a service

organizations are perception of quality by a customer and their satisfaction.

The service quality model as conceptualized by Parasuraman, Zeithaml, & Berry

, 1985, concurred on the fact that service quality is a comparison between the

expectation and performance of the service. There are a number of gaps which

have been identified and these are highlighted in subsequent paragraphs.


733

The Service Quality model has a total of five gaps

Gap1. This gap is about the fact that management is not always correct in

understanding the exact nature of requirement of the customer wants.

Gap 2. This gap is on account of inability on part of management to ensure

provision of standards to customers having understood their needs.

Gap 3. This gap is on account of inability of the service personnel to provide the

service as per laid down quality standards because of poor training, lack of

education etc.


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Gap 4. This gap is on account of the customer‟s expectations getting affected by

external communication i.e., advertisements word of mouth etc.

Gap 5. Perceived service quality is defined in the model as the difference between

customer expectations and perceptions. This gap is termed as gap 5, which depends

on the size and direction of the four gaps associated with the delivery of service

quality on the marketer‟s side.

This paper offers insights in to consumers‟ perception on service quality.

6. SERVQUAL Model

Parasuraman, Zeithaml and Berry, 1988, developed a SERVQUAL model which

could be used across a number of services for evaluating the service quality. The

SERVQUAL is a concise multiple item scale with good reliability and validity that

can be used to better understand the service expectations and perceptions of

consumers and, as a result, improve service. Parasuraman et al., suggest five-

dimension framework of service quality that encompasses tangibles, reliability,

responsiveness, assurance and empathy to analyze service quality with a total of 22

items as part of these dimensions. This resulted from an initial 10 dimensions

having 97 items. This 97 item instrument was refined with a single aim of

developing a concise instrument which would be reliable and meaningful in

assessing in a variety of service applications. This is a tool that finds applicability

across wide range of services. It is basic framework through the expectation –

perception format that encompasses the five service dimensions.

The five dimension having 22 items is often referred to as RATER Model.

The RATER refers to service quality dimensions such as Reliability, Assurance,

Tangibility, Empathy and Responsiveness. The concise definitions as suggested by

this paper are Tangible: Physical facilities, equipment, and appearance of


735

personnel. Reliability: Ability to perform the promised service dependably and

accurately. Responsiveness: Willingness to help customers and provide prompt

service. Assurance: Knowledge and courtesy of employees and their ability to

inspire trust and confidence. Empathy: Caring, individualized attention the firm

provides its customers.

Further amplifying the meaning of these dimensions.

Reliability refers to a providers‟ ability to perform the promised service

dependably and accurately. Perceptions of reliability are also lessened with doctors

who do not provide correct treatment at the first time (accusation that doctors

recommend unnecessary medical tests, irregular supervision of patients by care

providers and specialists are unavailable). Patients expect hospital staff to respond

promptly when needed. It is the willingness and promptness of responding to the

patients. They also expect the experts and required equipment to be available,

functional and able to provide quick diagnoses of diseases.

Assurance is the knowledge, skill and courtesy of the service provider that

inspire trust and confidence in consumers‟ mind. In the health care setting,

assurance is reflected by competencies of diagnosis, skills to interpret laboratory

report, provide appropriate explanations to queries. Well-trained nurses and other

support staffs also play vital roles in providing support to patients‟ feelings of

assurance and safety.

Tangibility is the attribute of being easily detectable with the senses. Appearance

(tangibility) of the physical facilities, equipment, personnel and written materials

affects patients‟ satisfaction. A systematized, ordered and clean appearance of

hospital premises, restrooms, equipment, wards, beds and the whole construction


736

or infrastructure can influence patients‟ impressions about the hospital. Tangibles

are the physicals representations of intangible service that create the image in

customer‟s mind.

Empathy represents the sympathy of service provider. Health care providers‟

should have sympathy and understanding of customers‟ wants and expectations.

This is the factor to provide individualized care and attention to customers.

Generally, a good customer/employee relationship can be established when the

employee understands the personal needs and values of the customer.

The tool is also usable along each of the five service dimensions by averaging

the difference scores on items making up the dimension. It is also able to give an

idea on overall measure of service quality in form of an average score across all

five dimensions. It also is able to determine the relative importance of the five

dimensions in influencing customer‟s overall quality perceptions .

The SERVQUAL model has also its demerits and concerns (Asubonteng,

McCleary, & Swan, 1996; Buttle ,1996 ; )

7. Patient’s Satisfaction

Satisfaction is basically when the expectations of a person are met and the needs

that were arising in a human are also fulfilled. In a hospital if the patients‟

expectations about the treatment are fulfilled he is satisfied but if they are not then

he is dissatisfied. Everyone‟s main objective today is to satisfy its own customer to

sustain and to grow. Patients that are highly satisfied create a very personal

connect with the healthcare providers. Satisfaction is a complex area to understand

because it is personal area of thought and emotions.


737

Also the patients‟ judge the significant indicators of the quality of care,

accuracy of diagnoses and the effectiveness of treatment. So satisfaction could

broadly means the ability to identify what a person wants and then giving it to that

person.

Patients or the customer satisfaction has been defined as „the customer‟s overall

feeling of contentment with a customer interaction‟ (Harris, 2010).

In many countries today, the healthcare management sector, places a lot of

emphasis on patient satisfaction. Evidence can be found from the frequency of

observed recent academic publications related to satisfaction. Furthermore, surveys

about patient satisfaction have used some data as dependent variables to evaluate

SERVQUAL on the assumption that patient satisfaction depends on the structure,

process and outcome of care available at the time of delivery.

Many different scales are used to measure patient‟s satisfaction. All these scales

differentiate by using different dimensions. Zyzanski , Hulka and Cassel ,1974,

used dimensions such as professional competence , personal qualities and cost /

convenience. Baker,1990, focused on three dimensions ; professional care, depth

of relationship and perceived time. Reidenbach , Sandifer – Smallwood (1990)

made use of seven dimensions for evaluating customer‟s satisfaction . These were

patient confidence, business competence, treatment quality, support services,

physical appearance, waiting time and empathy. Some studies use qualitative

methods to analyze hospitals. Examples of this are Structural Equation Modelling

used by Marley, K. A., Collier, D.A., and Goldstein, S.M., 2004; and by Doughlas


738

& Fredendall, 2004. Strong Advocates of SERVQUAL model are Asubonteng,

McCleary, and Swan, 1996.

Service Quality also contributes towards the aspect of customer satisfaction as

indicated in these papers. (Bolton & Drew, 1991; Carman, J., 1990.; Mosahab, R.,

Mahamad, O., & Ramayah, T., 2010. ).

Churchill & Suprenant, 1982, have concluded that service quality is one of the

most important contributors towards customer satisfaction . This is ably supported

by Kettinger & Lee, 1994.

8. Objectives of the Research paper

Objective

The main objective of this research paper is to analyze the Service Quality in

Private Hospitals in Delhi NCR using the SERVQUAL instrument.

Methodology

Research Methodology can be defined as s scientific way to analyze a research

problem and draw meaningful conclusions. The information has been got by

administering a questionnaire to those people who have availed of the private

hospitals services as a patient. In case of patients who were unable to fill the

questionnaire on account of any constraint say unable to understand on account of

age, language etc.; help of personnel accompanying the patient was taken. A total

of 300 questionnaires were distributed and a total of 228 patients responded.


739

Sampling and Data Collection Method.

The questionnaire was distributed to only those people who have availed the

services of private hospitals in Delhi NCR. A self-administered questionnaire was

used for this. The questionnaire was divided into two parts. The first part consisted

of 23 questions for the expectations of the patients from the hospital they are likely

to use the services. These 23 questions were divided under 5 dimensions with 6

items part of Tangible dimension, 4 items part of Reliability dimension, 5 items

part of Responsive dimension, 4 items part of Assurance dimension and 4 items

part of Empathy dimension. The second part consisted of similar questions

differently worded for the perceptions of the patients based on the experience after

availing the services in the hospitals. Each question was assessed on a 5 point

Likert scale.

Questionnaire Statements for Patient‟s

S.

No.

Statement for Patient‟s Expectation

of Service Quality

Statement of Patient‟s Perception

of service Quality

Tangible Dimension Tangible Dimension

1 Hospitals to be equipped with best

and latest modern equipment

Hospital has the best and latest

modern equipment

2 Hospitals to have good aesthetics

and customer friendly environment

Hospital has good aesthetics and

customer friendly environment

3 Hospitals to have smartly dressed

staff at all such places where

patients contact them

Hospital has smartly dressed staff

at all such places where patients

contact them

4 Hospitals to give maximum Hospital gives maximum priority


740

priority to cleanliness and tidiness to cleanliness and tidiness

5 Hospitals to have adequate number

of medical facilities like MRI , CT

scan, OT‟s etc

Hospitals has adequate number of

medical facilities like MRI , CT

scan, OT‟s etc

6 Hospital is to be located at a

convenient place

Hospital is located at a

convenient place

Reliability Dimension Reliability Dimension

7 Hospital staff is concerned about

your wellbeing and not only do lip

service.

Hospital staff is concerned about

your wellbeing and not only does

lip service.

8 Hospital services are to be rendered

within the acceptable time limits

Hospital services are rendered

within the acceptable time limits

9 Documentation and record keeping

is integral to good practices by the

hospital

Good Documentation and record

keeping is practiced by the

hospital

10 Information about any aspect of the

hospital e.g., treatment, facility,

financial is to be made available

and in clear terms

Information about any aspect of

the hospital e.g., treatment,

facility, financial is made

available in clear terms

Responsive Dimension Responsive Dimension

11 Doctors are more than willing to

help the patients in the hospital

Doctors are more than willing to

help the patients in the hospital

12 Responsiveness to patient‟s needs

is an important trait of employees

of the hospital

Employees are responsiveness to

patient‟s needs

13 The staff of the hospital is The staff of the hospital is


741

knowledgeable in aspects related to

patient‟s queries

knowledgeable to answer

patient‟s queries

14 Hospital operating hours are

convenient to patients

Hospital operating hours are

convenient to patients

15 The hospital on its own will

provide accurate and reliable

information of the patient

whenever asked for

The hospital provides accurate

and reliable information of the

patient

Assurance Dimension Assurance Dimension

16 Interacting with hospitals staff

builds confidence in patients

Hospitals staff instills confidence

in patients

17 The employees and staff of the

hospital are polite and courteous

The employees and staff of the

hospital are consistently polite

and courteous with you

18 Patients feel safe and secure at the

hospital

Patients feel safe and secure at the

hospital

19 The doctors and nurses give

individual attention to patients

The patient gets individual

attention from the doctors and

nurses

Empathy Dimension Empathy Dimension

20 Every specific and individual need

is understood by the hospital staff

The hospital staff understand‟ s

every specific and individual

needs of the patients

21 All possible medical services are

available within the hospital

All possible medical services are

available within the hospital

22 Visiting hours are convenient for Visiting hours are convenient for


742

the visitors the visitors

23 The front line staff of the hospitals

are courteous

The attitude of the front line staff

of the hospital is courteous

Demographic Analysis

Table No 1

S .

No.

Demographic

Aspect

Numbers Percentage

1 Gender Male 126 55.3%

Female 102 44.7%

2 Age Below 25 yrs 24 10.5%

25-50 yrs 78 34.3%

50-75 yrs 88 38.5%

Above 75 yrs 38 16.7%

3 Educational

qualifications

Primary level 34 14.9%

Senior

Secondary level

45 19.7%

Graduation 87 38.2%


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Post-Graduation

and above

62 27.2%

4 Marital status Married 211 92.5%

Unmarried 17 7.5%

5 Occupation Unemployed/

dependent

16 7.1%

Business 67 29.3%

Agriculture 23 10.1%

Private Service 77 33.8%

Government

Service

45 19.7%

6 Income Levels

of family

(monthly)

Rs 10,000 and

below

15 6.6%

Rs 10,001-Rs

25,000

46 20.2%

Rs 25,001- Rs

50,000

43 18.8%

Rs 50,001 and

above

124 54.4%


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Findings and Analysis

The questionnaire was self-administered and received back. From a total of 300

questionnaires given to the patients, 228 responded. Out of these 126 (55.3%) were

males and 102 (44.7%) were females. As far the age demographics, 24 (10.5%)

patients were below 25 years of age, 78 ( 34.3%) were between 25 and 50 years ,88

(38.5 %) were between 50 and 75 years of age and 38 (16.7%) were above 75

years of age. Regarding the educational qualifications of the patients 34 (14.9%)

studied till the primary level, 45 (19.7%) patients studied till the Secondary level,

87 (38.2 %) were graduates and 62 (27.2%) were post graduates and above.

Regarding the marital status 211 (92.5%) were married and 17 (7.5%) unmarried.

As regards occupation of the patients, 16 (7.15%) were either unemployed or

dependents, 67 (29.3%) had their businesses, 23 (10.1%) were having profession in

agriculture related areas, 77(33.8%) were employed in private service, and 45

(19.7%) were government employees. Regarding the income level of the patients

15 (6.6%) had monthly family income less than Rs 10,000/-, 46 (20.2%) patients

had their income level between Rs 10,000/- and Rs 25,000/-, 43 (18.8%) has

income levels between Rs 25,000/- and Rs 50,000/- and 124 (54.5%) patients

earned over Rs 50,000/-.

Score on Expectation / Perception on Various Dimensions

S. No. Dimensions of

Service Quality

Service

Expectation

(SE)

Service

Perception

(SP)

Service gap

(SE-SP)

1 Tangible 4.27 4.29 0.02


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2 Reliability 4.15 4.25 0.10

3 Responsiveness 4.27 4.23 -0.04

4 Assurance 4.09 4.15 0.06

5 Empathy 4.12 4.09 -0.03

Average 4.18 4. 20

The widest positive gaps in the order of decreasing values are „Reliability‟

(0.10), „Assurance‟ (0.06), and „Tangible‟ (0.02). However in case of

„Responsiveness‟ and „Empathy‟, both have a negative gap of -0.04 and -0.03

respectively. These results bring out fact that patients are very optimistic as regards

dimensions of reliability, assurance and tangibility. In all these three cases the

service expectations exceed the service perceptions though in case of tangible the

difference in very minimal (0.02). As regards the dimension of responsiveness and

empathy is concerned the patient‟s expectations exceed their perception and get

much less than what they expect. The responsiveness dimension is related to

willingness of doctors to help, responsiveness to patient‟s needs, knowledge of

staff, convenience of operating hours for patients and providing of reliable and

accurate information to patient‟s whenever needed. The empathy dimension is

related to understanding of patient‟s needs by the hospital staff, availability of

medical services within the hospital, convenience of visiting hours by the visitors

and courtesy shown by front line staff. The negative service gap in case of these

two dimensions can negatively impact the customer satisfaction.


746

The management should pay additional attention to the dimensions of

responsiveness and empathy by analyzing the reasons for the gap between the

expectation and perception in order to further increase the customer satisfaction.

While the positive service gaps in other three dimensions are very assuring to the

management regarding their policies, procedures and steps taken in private

hospitals towards patient care including the fact that the average score of

perception (4.20) is greater than the expectation score (4.18); they should look into

those areas where further improvement can be undertaken to give a „wow‟ feeling

to its patients. The government policy regarding impetus to medical tourism has

been very encouraging in the recent past. The hospitals in Delhi NCR already

attract a sizeable number of patients from neighboring countries, countries of the

Middle East ,African countries and also from Europe and North America. It

therefore becomes all the more important for the hospitals to ensure that all factors

contributing towards higher levels of service quality are given the desired

importance.

Conclusion

The service industry worldwide has undergone a sea change in the last 20 years.

The healthcare industry would by 2020 be an US $8.7 trillion industry worldwide.

In India this industry would be worth US $ 280 billion by 2020. The main stay of

the industry are the private hospitals which have mushroomed all over India in the

past. The hospitals initially in the domain of the government control have now seen

entry of the big private players. Delhi NCR home to a vast population is catered for

by these hospitals. For gaining completive advantage it is therefore a must to

ensure that the patients who are the customers, are satisfied with services

rendered. SERVQUAL model is one of the tools to measure the gap between

expectations and perceptions to arrive at perceived service quality measure. The


747

private hospitals in Delhi NCR score well in three dimensions of service quality

namely reliability, assurance and tangibility. However in the dimension of

responsiveness and empathy the score is negative. The management should study

this aspect and take measures to overcome any shortcomings.

Literature References

1. Asubonteng, McCleary, and Swan, 1996. SERVQUAL revisited: A critical

review of service quality. Journal of Services Marketing, 10(6); 62-81.

(Google Scholar).

2. Baker,R.,1990. Development of a questionnaire to assess patient‟s

satisfaction with consultations in general practice. British Journal of General

Practice, 40:487-490. (Pub med), (Web of Science), (Google Scholar).

3. Bolton, R. N., & Drew, J. H. (1991b). A multistage model of customers‟

assessments of service quality and value. Journal of Consumer Research,

17(4), 375-384.

4. Buttle, F. (1996). SERVQUAL: Review, critique, research agenda.

European Journal of Marketing, 30(1), 8-32.

5. Carman, J. (1990). Consumer perceptions of service quality: An assessment

of the SERVQUAL dimensions, Journal of Retailing, 66(1), 33-55.

6. Churchill, G.A., Jr., & Suprenant , c, 1982. An investigation into the

determinants of customer satisfaction. Journal of Marketing

Research,19(4),491-504.

7. Constitution of World Health Organization, 1948.


748

8. Doughlas,T.J. and Fredendall, L.D. 2004. Evaluating the Deming

management model of total quality in services. Decision Sciences, 35(3)

(Web of Science), (Google Scholar).

9. Gronroos , C , 1982, Strategic Management and Marketing in the service

sector, Helsingfors: Swedish School of Economics and Business

administration.

10.Grönroos, C. (1984). A service quality model and its marketing implications.

European Journal of Marketing, 18(4), 36–44. [Web of Science ®], [Google

Scholar]

11.Harris , E.K. (2010). Customer Service: P practical approach (5th ed.).

Boston, MA: Prentice Hall.

12.Health Survey & Development committee, 1946 (Bhore Committee)

13.Hung, Huang & Chen 2003. Service Qualirty Evaluation by service

performance matrix. Total Quality Management , 14(1),79-89.

14.Kettinger,W., & Lee,C, 1994. Perceived service quality and user satisfaction

with the information services function. Decision Sciences, 25(5),737-766.

15.Marley, K. A., Collier, D.A., and Goldstein, S.M., 2004.The role of clinical

and process quality in achieving patient satisfaction in hospitals. Decision

Sciences, 35(3): 349-369 (Web of Science) , (Google Scholar).

16.Morrison-Coulthard, L. J.,2004. Measuring service quality: A review and

critique of research using SERVQUAL. International Journal of Market

Research, 46(4), 479-497.


749

17.Mosahab, R., Mahamad, O., & Ramayah, T. (2010). Service quality,

customer satisfaction, and loyalty: A test of mediation. International

Business Research, (3/4), 72-80.

18.National Healthy Policy, Ministry of Health and Family Welfare,

Government of India, 1983.





21.Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1985). A conceptual

model of service quality and its implications for future research. Journal of

Marketing, 49(4), 41-50.

22.Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A

multiple-item scale for measuring customer perceptions of service quality.

Journal of Retailing, 64(1), 12-40.

23.Parasuraman, A., Berry, L. L., & Zeithaml, V. A. (1991). Refinement and

reassessment of the SERVQUAL scale. Journal of Retailing, 67(4), 420-450.

24.Reidenbach, R.E. and Sandifier-Smallwood,B.1990.. Exploring perceptions

of hospital operations by a modified SEVQUAL approach. Journal of Health

Care Marketing,10(4):47-55.(Pub Med),(Google Scholar).

25.V. Thiruveni , S.P. Nirmala Devi , M. Chandramouleeswaran,Saiva

Bhanu(2017), S-Derivation Pairs And Jordan S-Derivation Pairs On

Semiring, International Journal Of Pure And Applied Mathematics, 112 (5),

1-8


750

26.Zyzanski, S.J., Hulka, B.S. and Cassel, J.C. 1994. Scale for Measurement of

satisfaction with medical care: modifications in content, format and scoring,

Medical care, 12(7), Web of Science,(Google Scholar).


751

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