DEVELOPING AN INPATIENT PERCEIVED HEALTHCARE SERVICE QUALITY SCALE (IP-HSQS)

Abstract

Quality is a high priority topic in healthcare services. After the debates on the implementation of SERVQUAL, the most widely used generic scale to determine service quality, in the healthcare industry, recent studies on service quality focus on the development of industry and culture-specific scales. The initial aim of this study is to develop a model for the conceptualization of healthcare service quality, and then develop a valid and reliable scale that can be used in the measurement of the perceived healthcare service quality of inpatients in Turkish public hospitals through exploratory and confirmatory factor analyses. The study also recommends a method to be used in the model for the prioritization of dimensions. The devised scale was implemented on 268 patients in a public hospital in Eskisehir, Turkey. The output shows that the inpatients rank quality dimensions based on their priorities as staff quality, physical quality and process quality respectively. A 51-item scale has been recommended, as a result of statistical analyses

Keywords

• Service Quality,Healthcare Industry,Scale Development,Healthcare Service Quality,Service Quality Perceptions of Inpatient

YATAN HASTALARIN SAĞLIK HİZMET KALİTESİNE İLİŞKİN ALGISINI ÖLÇMEK İÇİN BİR ÖLÇEK GELİŞTİRME ÇALIŞMASI

Abstract

Kalite sağlık hizmetlerinde yüksek derecede öncelikli bir konudur. Hizmet kalitesi ölçümünde en çok kullanılan jenerik bir ölçek olan SERVQUAL’in uygulanması üzerine yapılan tartışmalar neticesinde, son çalışmalar endüstri ve kültüre özgü ölçekler geliştirilmesi yönündedir. Bu çalışmanın ilk amacı sağlık hizmet kalitesinin kavramsallaştırılması için bir model önermek, sonrasında da açıklayıcı ve doğrulayıcı faktör analizleri aracılığıyla Türkiye’de kamu hastanelerinde yatan hastaların sağlık hizmet kalitesine ilişkin algılarını ölçmede kullanılabilecek geçerli ve güvenilir bir ölçek geliştirmektir. Çalışma ayrıca modelde yer alan boyutların önceliklendirilmesi için de bir yöntem önermektedir. Önerilen ölçek Türkiye’de Eskişehir ilinde yer alan bir kamu hastanesinde yatan 268 hastaya uygulanmıştır. Çıktılar, yatan hastaların kalite boyutlarını öncelik sıralamasının personel kalitesi, fiziksel kalite ve süreç kalitesi şeklinde olduğunu göstermektedir. İstatistiksel analiz sonuçlarından hareketle 51 maddeden oluşan bir ölçek önerilmiştir.

Keywords

• Hizmet Kalitesi,Sağlık Endüstrisi,Ölçek Geliştirme,Sağlık Hizmet Kalitesi,Yatan Hastaların Hizmet Kalitesi Algıları

References

1. Aagja, J. P. & Garg, R. (2010). Measuring perceived service quality for public hospitals (PubHosQual) in the Indian context. International Journal of Pharmaceutical and Healthcare Marketing, 4(1), 60-83.
2. Agarwal, A. & Singh, A. R. P. (2016). Service quality and patient satisfaction: An exploratory study of pathology laboratories in Jaipur. Hospital Topic, 94(2), 23-32.
3. Akhade G.N., Jaju, S.B. & Lakhe R. R. (2013). A review on healthcare service quality dimensions. Sixth International Conference on Emerging Trends in Engineering and Technology.
4. Ayhan, E. (2009). Sağlık işletmelerinde uygulanmak üzere iç aralık analizi modeli oluşturulması. (Unpublished MSc thesis). Istanbul Technical University, Social Sciences Institute, İstanbul.
5. Bakan, İ., Büyükbeşe, T. & Erşahan, B. (2014). The impact of total quality service (TQS) on healthcare and patient satisfaction: An empirical study of Turkish private and public hospitals. The International Journal of Health Planning and Management, 29(3), 292-315.
6. Barzi, A. (2009). Quality in healthcare organizations: Its meaning and measurement, (Unpublished Doctor of Philosophy Thesis). University of Texas, Texas School of Public Health, Texas.
7. Brady, M. K. & Cronin, J. J. (2001). Customer orientation: Effects on customer service perceptions and outcome behaviors. Journal of Service Research, 3, 241-251.
8. Büyüközkan, G., Çiftçi, G. & Güleryüz, S. (2011). Strategic analysis of healthcare service quality using fuzzy AHP methodology. Expert Systems with Applications, 38, 9407–9424.

9. Chakravarty, C.A. (2011). Evaluation of service quality of hospital outpatient department services. MJAFI, 67(3), 221-224.
10. Chahal, H. & Kumari, N. (2010). Development of multidimensional scale for healthcare service quality (HCSQ) in Indian context. Journal of Indian Business Research, 2(4), 230-255.
11. Cronin, J. J. & Taylor, S.A. (1992). Measuring service quality: A reexamination and extension. Journal of Marketing, 56(3), 55-68.
12. Dagger, T. S., Sweeney, J. C. & Johnson L.W. (2007). A hierarchical model of health service quality scale development and investigation of an integrated model. Journal of Service Research, 10(2), 123-142.
13. DeVellis, R. F. (2003). Scale Development Theory and Applications, Second Edition, Cume 26: Applied Social Research Methods Series.
14. Duggirala, M., Rajendran, C. & Anantharaman, R.N. (2008). Patient-perceived dimensions of total quality service in healthcare. India Benchmarking: An International Journal, 15(5), 560-583.
15. Eldem, E. (2009). Hizmet sektöründe SERVQUAL analizini kullanarak hizmet kalitesinin ölçülmesi ve bir sağlık kuruluşunda uygulama denemesi. (Unpublished MSc Thesis). Eskisehir Osmangazi University, Natural and Applied Sciences Institute, Eskisehir.
16. Ergin, B. M. (2010). Üniversite spor merkezlerindeki algılanan hizmet kalitesinin Yapısal Eşitlik Modeli (YEM) ile incelenmesi, Unpublished doctoral dissertation, Gazi University, Ankara.
17. Gaskin, J. Youtube SEM Series, Gaskination’s StatWiki. http://statwiki.kolobkreations.com. (Accessed 27 June 2016).
18. Gronroos, C. (2001). The perceived service quality concept – A mistake. Managing Service Quality, 11(3), 150-152.
19. Gronroos, C. (2007). Service Management and Marketing, Third Edition, England: John Wiley&Sons.
20. Gülmez, M. (2005). Sağlık hizmetlerinde memnuniyet ölçümü ve Cumhuriyet Üniversitesi Araştırma Hastanesi’nde ayakta tedavi gören hastalara yönelik bir uygulama. C.Ü. Iktisadi ve Idari Bilimler Dergisi, 6(2), 147-169.
21. Hair, J. F., Wolfinbarger, M., Ortinau, D. J. & Bush, R. P. (2008). Essentials of Marketing Research. Mc Graw Hill.
22. İkiz, H. E. (2010). Hizmet kalitesi modellerinin karşılaştırılması üzerine bir arastirma. (Unpublished Doctor of Philosophy Thesis). Dokuz Eylül University, Social Sciences Institute, Izmir.
23. Karatepe, O. M. Avcı, T. (2002). Measuring service quality in the hotel industry: Evidences from Northern Cyprus. Anatolia- An International Journal of Tourism and Hospitality Research, 13(1), 19-32.
24. Kashif, M., Ramayah, T. & Sarifuddin, S. (2016). PAKSERV - measuring higher education service quality in a collectivist cultural context. Total Quality Management & Business Excellence, 27(3-4), 265-278.
25. Kayral, H. (2012). Sağlık işletmelerinde algılanan hizmet kalitesi ve Ankara’da hastane türlerine göre bir araştırma. (Unpublished Doctor of Philosophy Thesis). Gazi Üniversitesi University, Social Sciences Institute, Ankara.
26. Kumaraswamy, S. (2012). Service quality in health care centres: An empirical study. International Journal of Business and Social Science, 3(16), 141-150.
27. Ladhari, R. (2008). Alternative measures of service quality: A review. Managing Service Quality, 18(1), 65-86.
28. Lam, E. T. C. (2000). Service quality assessment scale (SQAS): An instrument for evaluating service quality of health-fitness clubs. Unpublished doctoral dissertation, University of Houston, Texas.
29. Lee, D. H. (2017). HEALTHQUAL: A multi-item scale for assessing healthcare service quality. Service Business, 11(3), 491-596.
30. Lee, H., Delene, L.M., Bunda, M. A. & Kim, C. (2000). Methods of measuring health-care service. Quality Journal of Business Research, 48, 233–246.
31. Lee, H., Vlaev, I., King, D., Mayer, E., Darzi, A. & Dolan, P. (2013). Subjective wellbeing and the measurement of quality in healthcare. Social Science & Medicine, 99, 27-34.
32. Leebov, W. & Scott, G. (1994) Service quality improvement- The customer satisfaction strategy for healthcare. USA: AHA Books.
33. Lupo, T. (2013). A fuzzy SERVQUAL based method for reliable measurements of education quality in Italian higher education area. Expert Systems with Applications, 40, 7096–7110.
34. Mazur, M. (2013). Quality in health care: Possibilities and limitations of quantitative research instruments among health care users. Quality Quantity, 47, 1703-1716.
35. Miranda, F. J., Chamorro, A., Murillo, L. R. & Vega, J. (2010). Assessing Primary Healthcare Services Quality in Spain: Managers vs. Patients’ Perceptions. The Service Industries Journal, 30(13), 2137–2149.
36. Miranda, F. J., Chamorro, A., Murillo, L. R. & Vega, J. (2012). Primary health care services quality in Spain-A formative measurement approach using PLS path modeling. International Journal of Quality and Service Sciences, 4(4), 387-398.
37. Mosadeghrad, A. M. (2013). Healthcare service quality: Towards a broad definition. International Journal of Health Care Quality Assurance, 26(3), 203-219.
38. Murti, A. Deshpande, A. & Srivastava, N. (2013). Patient satisfaction and consumer behavioral intentions: An outcome of service quality in health care services. Journal of Health Management, 15(4), 549–577.
39. Ozic, S. (2007). Measurement of quality in health-care sector: Application of SERVQUAL method in Celal Bayar University Hospital. (Unpublished MSc Thesis) Dokuz Eylül University, İzmir.
40. Özdamar, K. (2004) Paket programlar ile istatistiksel veri analizi-çok değişkenli istatistiksel analizler. 5. Basım. Eskisehir: Kaan Kitabevi.
41. Özkara, B. Y. (2015). Tüketicilerin çevrimiçi bilgi aramaları bağlamında akış deneyiminin bilgiden tatmin üzerindeki etkisinin araştırılması. (Unpublished PhD Thesis). Eskisehir Osmangazi University, Social Sciences Institute, Eskisehir.
42. Pai, Y.P. & Chary, S.T. (2013). Dimensions of hospital service quality: A critical review perspective of patients from global studies. International Journal of Health Care Quality Assurance, 26(4), 308-340.
43. Parasuraman, A., Zeithaml, V.A. & Berry, L. L. (1988). SERVQUAL: A multiple- item scale for measuring consumer perceptions. Journal of Retailing, 64(1), 12-40.
44. Polsa, P., Fuxiang, W., Saaksjarvi, M. & Shuyuan, P. (2013). Cultural values and health service quality in China, International Journal of Health Care Quality Assurance, 26(1), 55-73.
45. Pollack, B. L. & Alexandrov A. (2013). Nomological validity of the Net Promoter Index Question. Journal of Services Marketing, 27(2), 118–129.
46. Ramsaran-Fowdar, R.R. (2004). Identifying health care quality attributes. Journal of Health and Human Services Administration, 27(3/4), 428.
47. Raposo, M., Lino, E. H. Maria, A. E. & Duarte P. A. (2009). Dimensions of service quality and satisfaction in healthcare: A patient’s satisfaction index. Service Business, 3, 85–100.
48. Rashid, W. E. W. & Jusoff H. K. (2009). Service quality in health care setting. International Journal of Health Care Quality Assurance, 22(5), 471-482.
49. Sağlık Bakanlığı Tedavi Hizmetleri Genel Müdürlüğü Performans Yönetimi ve Kalite Geliştirme Daire Başkanlığı (2011). Hastane Hizmet Kalite Standartları, Ankara: Pozitif Matbaa.
50. Senic, V. & Marinkovic´ V. (2013) Patient care, satisfaction and service quality in health care. International Journal of Consumer Studies, 37, 312–319.
51. Shabbir, A., & Malik S. A. (2016). Measuring patients’ healthcare service quality perceptions, satisfaction, and loyalty in public and private sector hospitals in Pakistan. International Journal of Quality & Reliability Management, 33(5), 538-557.
52. Sony, A. (2016). www.pietutors.com. (Accessed: 21 October 2016).
53. Tabachnick, B. G. & Fidell, L. S. (2011). Using multivariate statistics. 6th edition. U.S.A: Pearson.
54. Taşkıran Mohammad, G. (2007). Sağlık hizmetlerinde kalite yönetimi, SERVQUAL analiz ile değerlendirilmesi ve Ankara Ulus Devlet Hastanesi’nde uygulama. (Unpublished MSc Thesis). Gazi University, Social Sciences Institute, Ankara.
55. Teng, C., Ing, C., Chang, H. & Chung K. (2007). Development of service quality scale for surgical hospitalization. J Formos Med Assoc, 106(6), 475-484.
56. Tokay, M. (2000). Sağlık hizmetlerinin pazarlanmasında kalite ve hasta tatmini- Eskisehir Devlet Hastanesinde bir uygulama. (Unpublished MSc Thesis). Anadolu University, Social Sciences Institute, Eskisehir.
57. Turan, A. & Bozaykut-Buk, T. (2016). Analyzing perceived healthcare service quality on patient related outcomes. International Journal of Quality and Service Sciences, 8(4), 478-497.
58. Vavra, T.G. (1999). Müşteri tatmini ölçümlerini geliştirmenizin yolları. Kalder Yayınları No: 28: İstanbul.
59. Yağcı, M. & Duman, T. (2006). Hizmet kalitesi - müşteri memnuniyeti ilişkisinin hastane türlerine göre karşılaştırılması: Devlet, özel ve üniversite hastaneleri uygulaması. Doğuş Üniversitesi Dergisi, 7(2), 218-223.
60. Yalçın İncik, E., Çakır, Ö. ve Özdemir Alıcı, D. (2015). A study of scale development on primary school students’ attitudes towards project based learning. Elementary Education Online, 14(3), 1096-1105.
61. Yasa, E. (2012). Sağlık sektöründe hizmet kalitesi, müşteri memnuniyeti ve bağlılık ilişkisi: Devlet, özel ve üniversite hastaneleri karşılaştırması. (Unpublished PhD Thesis). Cukurova University, Social Sciences Institute, Adana.