CHAPTER 5 AN ANALYSIS OF SERVICE QUALITY IN HOSPITALS

Transcription

1 CHAPTER 5 AN ANALYSIS OF SERVICE QUALITY IN HOSPITALS Fifth chapter forms the crux of the study. It presents analysis of data and findings by using SERVQUAL scale, statistical tests and graphs, for the data that have been collected from the patients of 10 select hospitals through quantitative survey by conducting in-depth interviews to get a comprehensive idea about every service quality dimension of SERVQUAL. The collected data is being analyzed according to the directions mentioned in the SERVQUAL model, frame of references and literature review. As part of the analysis comparisons were made between select Government, Private and Missionary owned hospitals based on their bed strengths i.e. 500 and above bedded hospitals (Medical college hospitals), 100 and above bedded, 50 to 100 bedded and 30 to 50 bedded hospitals. Further, analyzed results were tested with formulated hypothesis to draw conclusions on service quality offered by the select hospitals. 19

2 5.1. INTRODUCTION: This chapter presents the results of the questionnaire, the patterns of the results and analyses of their relevance to the research questions and aims in two parts. In the first part, the results are analysed to identify the demographics to get a broader idea of the sample. In the second part collected service quality details of select hospitals are analysed to determine service gaps between patients perceptions and expectations by using SERVQUAL scale proposed by Parasuraman, Berry et al and statistical tools using SPSS 1 Chi-square (X2) and Analysis of Variance (ANOVA). SERVQUAL: SERVQUAL is a scale for measuring service quality. The model is based on the premise that the best way to measure service quality is to base it on the patient s experience of quality. In SERVQUAL, quality is defined by the gap between what a customer expects and what the customer perceives. SERVQUAL breaks service quality down to five basic dimensions - Reliability, Assurance, Tangibles, Empathy and Responsiveness often referred to as RATER. According to Parasuraman et al. (1988)2 Service quality = Perception Expectation. The higher the positive score, the better the service quality. The main benefit of the SERVQUAL scale is the capability to identify the service quality shortfalls. Chi-square: Chi square is a statistical test that examines variation. It compares variation between two different populations and makes a determination of whether the variation is 1 Parasuraman, A., Zeithaml, V. A., and Berry, L. L (1985), A Conceptual Model of Service Quality and Its Implications for Future Research, Journal of Marketing, 9 (Fall) Parasuraman, Zeithaml A. Valarja and Berry Leonard (1988). SERVQUAL. A Multiple Item Scale for Measuring Consumer Perceptions of Service Quality, Journal of Retailing, 6(1),

3 the same. Chi square helps determine the statistical significance of a relationship between an Attribute X and an Attribute Y in Y = f(x1, X2... Xn). The approach used is to assume the variables (X Data and Y Data) independent and set up the hypotheses as follows: *Ho: Data are Independent (Not Related) *Ha: Data are Dependent (Related) The output of the test is a "p-value", indicates the likelihood of seeing a relationship. A high p-value means there is no relationship between the X data and Y data. A low p value (<.10) indicates that there is a relationship. A low p value cannot be purely by random chance. If the p-value is less than 0.10, then the null hypothesis Ho should be rejected and Ha should be accepted. Chi-square X2 is a statistical test commonly used to compare observed data with data we would expect to obtain according to a specific hypothesis. That is, chi-square is the sum of the squared difference between observed (O) and the expected (E) data, divided by the expected data in all possible categories i.e. X2 = (O E)2 / E. As with any statistical test, Chi Square comes with its set of "could be" and "might be" statements. ANOVA: ANOVA is a statistical method for making simultaneous comparisons between two or more means, a statistical method that yields values that can be tested to determine whether a significant relation exists between variables. 151

4 5. 2. DEMOGRAPHIC CHARACTERISTICS ANALYSIS: This analysis has been carried-out to have a general idea about the respondents Age groups, Gender, Income levels and Education levels Respondents according to their Age group: Details relating to age groups of sample respondents are furnished in the following table: Hospital type Government Hospitals Private Hospitals Missionary Hospital Table 5.1 Respondents according to their Age Group <= AND YEARS YEARS YEARS YEARS ABOVE Count % Count % Count % Count % SOURCE: Field data Table 5.1 indicates respondents according to their rage group. Respondents from Government hospital are 160 in which maximum respondents % are from <= 30 years age group followed by.625% from 31-0 years, % from 1-50 years, 17.5% from years and % from more than 61 years age group. Out of 0 respondents from Private hospitals, maximum respondents are from the age group 1-50 years with 22.5% followed by years with 22%, 31-0 years and 61 and above with.5% and age group <=30 years with 1.5%. 152

5 The sample of 0 respondents from Missionary hospital, maximum are from age group <=30 years with 55%, followed by age groups 61 and above, 1-50, 31-0 and with 15%, 12.5%, 10% and 7.5% respectively. Graph 5.1 Respondents according to their Age Group AGE GROUPS s <=30 YEARS Pearson ChiSquare s 31-0 YEARS Missionary Hospitals 1-50 YEARS YEARS 61 AND ABOVE Chi-Square Test Value Df Asymp. Sig. (2-sided) E-07 Chi-square test is carried out to determine whether there is any significant difference between the age groups of respondents with respect to Government, Private, and Missionary hospitals. Calculated Chi-square value 5.8 is greater than Chi-square critical value Thus, there is a significant difference between the age groups of respondents at 95% confidence level. 153

6 5.2.2 Respondents according to Gender: Table 5.2 Respondents according to Gender Hospital type FEMALE MALE Government hospitals Count % Private hospitals Count % Missionary hospital Count % Count % SOURCE: Field data. Table 5.2 shows that there are 82(51.25%), 77(38.5%) and 23(57.5%) female respondents representing Government, Private and Missionary Hospitals respectively and the corresponding male respondents are 78(8.75%), 123(61.5%) and 17(2.5%) respectively. This shows that female respondents are slightly over-represented in the Government and Missionary hospitals sample, where as in private hospitals male respondents are over-represented than female respondents. Graph 5.2 Respondents according to Gender GENDER s s Female Missionary Hospitals Male 15

7 Chi-Square Tests Value Df Asymp. Sig. (2-sided) Pearson ChiSquare To test whether there is any significant difference between respondents genders with respect to Government, Private, and Missionary hospitals, the Chi-square test is conducted. Calculated Chi-square value 8.08 is greater than Chi-square critical value Thus, there is a significant difference between respondents gender at 95% confidence level Respondents according to their family Income levels: The details pertaining to the annual income of the sample respondent families are furnished in the Table 5.3. Table 5.3 Respondents according to their family Income levels Hospital type Government hospitals Private hospitals Missionary hospital BELOW RS /- RS /TO 1000/- RS.1000/TO /- RS TO 000/- RS.000 TO & ABOVE Count % Count % Count % Count % SOURCE: Field data. Table 5.3 represents according to their family Income levels. It has been observed that most of the patients who belongs to Income groups Below Rs /- and Rs /- to 155

8 1000/- are availing medical facilities of Government and Missionary hospitals i.e. 2.5% and 8.75% respectively. The researcher also observed that few percentage of people (10%) of below Rs /- Income level are utilizing Medical facilities of Private hospitals. The above table shows that most of the respondents are belong to Rs.60000/- to Rs.1000/- income group. In Government hospitals 2.5% respondents belong to below Rs.60000/- income group, 8.75% respondents Rs.60000/- to Rs.1000/- and remaining 8.75% belongs to remaining income groups (i.e. Rs.1000/- to /-, Rs /- to 000/- and Rs.000 and above). In Missionary hospitals 0% respondents are from below Rs.60000/- income group, remaining 17.5% respondents to income group Rs.1000/- to /- and Rs /to 000/-. In private hospitals 27.5% are from income group Rs.1000/- to /-, 16% from Rs /- to Rs.000/-, 10% from income group below Rs.6000/- and above, and only 7.5% of respondents belong to income group below Rs.00/- and above. 156

9 Graph 5.3 Respondents according to their family Income levels INCOME LEVELS s BELOW RS /- Pearson ChiSquare s RS /- TO 1000/- Missionary Hospitals RS. 1000/- TO / TO 000/- 000 TO & ABOVE Chi-Square Tests Value Df Asymp. Sig. (2-sided) E-18 In order to test whether there is any significant difference in the income levels of respondents with respect to Government, Private and Missionary hospitals, the Chisquare test is carried-out. Calculated Chi-square value is greater than Chi-square critical value Thus, there is a significant difference between the income levels of respondents at 95% confidence level Respondents according to their levels of Education: Table 5. shows that nearly 1/3 (33.75%) of the respondents are illiterates and 2/3 are literates i.e % educated up to high school level, 12% graduates and 1.75% post 157

10 graduates. This reveals that total literate percentage of respondents are 66.25% of select sample Government, Private and Missionary hospitals. Table 5. Respondents according to their levels of Education Hospital type Government hospitals Private hospitals Missionary hospital ILLITERATE UPTO SSC GRADUATION POST GRADUATION OTHERS Count % Count % Count % Count % SOURCE: Field data. Graph 5. Respondents according to their levels of Education EDUCATION LEVELS s ILLITERATE Pearson ChiSquare s UPTO SSC GRADUATION Missionary Hospitals POST GRADUATION OTHERS Chi-Square Tests Value df Asymp. Sig. (2-sided) E

11 Chi-square test is carried-out to test whether there is any significant difference in the education levels of respondents with respect to Government, Private and Missionary hospitals. Calculated Chi-square value is greater than Chi-square critical value Thus, there is a significant difference between the education levels of respondents at 95% confidence level. 5.3 COMPARISON BETWEEN SELECT HOSPITALS ANALYSIS PROCESS: The following process has been followed to analyze patients service quality by SERVQUAL scale and statistical tools between Government, Private and Missionary hospitals. Comparison between Hospitals having bed strength 500 and above: Comparison between Government and Private owned hospitals having bed strength 500 and above i.e. NTR Health University General Hospital (UGH), Vijayawada and Pinnemaneni Siddhartha Medical College Hospital (Private Medical College Hospital), Chinaoutapalli has been made. Missionary Medical College Hospital has not been considered here due to unavailability hence researcher conducted between Government and Private Medical College Hospitals as per the sample to know hospitals service quality by SERVQUAL scale and patients satisfactory levels. 159

12 Figure 5.1 Comparison between hospitals having bed strength 500 and above NTR Health University Private Medical General Hospital College Hospital Out-patients Out-patients In-patients Comparison between Both O/P & I/P In-patients Both O/P & I/P patients satisfactory levels. Comparison between Comparison between Hospitals having bed strength 100 and above: Comparison between Government and Private owned hospitals having bed strength 100 Comparison between and above i.e. Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada has been carried out. Here only one Missionary hospital exists i.e., St. Anns Hospital, Vijayawada but the hospital authorities refused permission to conduct the present study. Hence the study is conducted between government and private hospitals as per the sample to know hospitals service quality using SERVQUAL scale and patients satisfactory levels. 160

13 Figure 5.2 Comparison between hospitals having bed strength 100 and above Comparison between hospitals having bed strength 50 to 100: Comparison between Government, Private and Missionary owned hospitals having bed strength 50 and above i.e., Government Area Hospital-Nuzvid, Prashanth HospitalVijayawada, Dr. M.J. Naidu Hospital-Vijayawada and Gifford Memorial Hospital, Nuzvid is made for the present study to know hospitals service quality by SERVQUAL scale and patients satisfactory levels. Figure 5.3 Comparison between hospitals having bed strength 50 to

14 Comparison between hospitals having bed strength 30 to 50: Comparison between Government and Private owned hospitals having bed strength 30 to 50 i.e., Government Community Health Centre, Jaggaiahpet and Latha Super Speciality Hospital, Vijayawada has been carried-out. In this category one Missionary hospital exists i.e. St. Anns Hospital, Avanigadda, but the management of this hospital has not given permission to carry-out present study and hence excluded and conducted study between government and private hospitals to know hospitals service quality by emphasizing SERVQUAL scale and patients satisfactory levels. Figure 5. Comparison between hospitals having bed strength 30 to 50 Comparison between hospitals irrespective of bed strength (all together): Over all comparison has been carried-out between Government, Private and Missionary owned hospitals irrespective of bed strength i.e., all Government hospitals considered as one, all Private hospitals considered as one and Missionary hospitals considered as one to know over all hospitals service quality by emphasizing SERVQUAL scale and patients satisfactory levels. 162

15 Figure 5.5 Comparison between all select Government, Private and Missionary hospitals irrespective of bed strength Select Government Hospitals Out-patients In-patients Select Private Select Missionary Hospitals Out-patients Hospitals Out-patients In-patients In-patients Comparison Both O/P & I/P Both O/P & I/P Both O/P & I/P Comparison. FINDINGS OF SERVICE QUALITY IN SELECT HOSPITALS: Below mentioned SERVQUAL scale attributes of service quality are analysed to find out service quality of selective hospitals of Krishna District of Andhra Pradesh. Comparative analysis has been carried out between Government, Private and Trust owned (Missionary) hospitals based on bed strength using SERVQUAL scale and Analysis of Comparison Variance (ANOVA). Attribute No. Table Service quality attributes Attribute 1. The hospital has modern looking equipment. 2. The physical facilities in the hospital are visually appearing. 3. Personnel in the hospital are neat in appearance. 163

16 . Materials associated with the services (such as pamphlets, statements, boards) are visually appearing. 5. When the hospital promises to do something by a certain time it does so. 6. When you have a problem, the hospital shows a sincere interest in solving it. 7. The hospital gets things right the first time. 8. The hospital provides its services at the time it promises to do so. 9. The hospital insists on error-free records. 10. The personnel in the hospital tell you exactly when services will be performed. 11. Personnel in the hospital give you prompt service. 12. Personnel in the hospital are always willing to help you. 13. Personnel in the hospital are never be too busy to respond to your requests. 1. The behavior of personnel in the hospital instills confidence in you. 15. You feel safe in your dealings with the hospital. 16. Personnel in the hospital are consistently courteous with you. 17. Personnel in the hospital have the knowledge to answer your questions. 18. The hospital gives you individual attention. 19. The hospital operating hours convenient to all its patients.. The hospital has employees who give you personal attention. 21. The hospital considers your interests best at heart. 22. The personnel of the hospital understand your specific needs. 16

17 COMPARISON BETWEEN HOSPITALS HAVING BED STRENGTH 500 AND ABOVE : NTR University General Hospital, Vijayawada. : Pinnemaneni Siddhartha Medical College Hospital, Chinaoutapalli. 165

18 5..1. Analysis of Service Quality in hospitals having bed strength 500 and above Out-patients perception towards Service Quality: Table 5.6 Gaps between perceptions and expectations towards Service Quality opined by Out-patients of Government and Private hospitals having bed strength 500 and above GOVERNMENT HOSPITAL PRIVATE HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangable SVQ Avg Reliability SVQ 0.35 Avg Responsiveness SVQ 0.5 Avg Tangable SVQ 0.3 Avg Reliability SVQ 0.13 Avg Responsiveness SVQ 0.15 Avg Assurance SVQ 0.35 Avg Assurance SVQ Avg Empathy SVQ AVERAGE UNWEIGHTED SERVQUAL SCORE 0.35 Avg Empathy SVQ AVERAGE UNWEIGHTED SERVQUAL SCORE Score from Table Avg weight from Table Weighted Score Score from Table Avg weight from Table Weighted Score

19 AVERAGE WEIGHTED SERVQUAL SCRORE AVERAGE WEIGHTED SERVQUAL SCRORE Table 5.6 summarizes the gaps between the Perceptions and Expectations of 22 service quality attributes in case of Government and Private Medical College hospitals out-patients. The table indicates that all 22 service quality attributes of NTR Health University General Hospital are positive which shows that all 22 service attributes met and exceeded out-patients expectation levels. 5 service attributes (i.e. attribute no., 5, 8, 12 and 13) out of 22 attributes of Private Medical College hospital are negative. In other words, out-patients expectations levels are higher than perceptions levels in case of these 5 attributes. The above table reveals the Average Unweighted and Weighted SERVQUAL scores of 22 attributes opined by sample respondents. The Average Unweighted and Weighted SERVQUAL scores of NTR Health University General hospital are more than those of Private Medical College hospital. This shows that out-patients service quality of NTR Health University General Hospital are good enough when compared to those of Private Medical College Hospital. Analysis of Variance (ANOVA) is employed to understand whether the differences are significant or not with respect to the service quality in the mean variance among the responses given by out-patients of NTR Health University General Hospital and Private Medical College Hospital and the results are set below. 167

20 Table 5.7 ANOVA between Out-patients perception towards Service Quality Hospitals having bed strength 500 and above ANOVA TEST TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL N Mean Std. Deviation F Sig The above ANOVA details are also shown in the following graph. 168

21 Graph 5.5 Out-patients perception towards Service Quality Hospital having bed strength 500 and above O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI TANGIBLES O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI RELIABILITY O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI O/P GOVT MED COL, VJA RESPONSIVENESS Std. Deviation O/P PVT MED COL, CPAALI ASSURANCE O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI EMPATHY O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI OVERALL Mean F Table value (1, 38, 0.05) =.08. The above ANOVA Table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This shows that there is no significant difference in service quality in the mean variance among the responses given by out-patients of NTR Health University General Hospital & Private Medical College Hospital, because the overall ANOVA value of out-patients is

22 Table 5.8 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 500 and above SATISFACTORY LEVELS Tangibles Reliability Responsiveness Assurance Government Hospital The above details are also shown in the following graph. Empathy Overall Graph 5.6 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 500 and above O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI TANGIBLES O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI RELIABILITY O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI RESPONSIVENESS O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI ASSURANCE O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI EMPATHY O/P GOVT MED COL, VJA O/P PVT MED COL, CPAALI OVERALL % Of Patient Satisfaction The above table and graph represent satisfactory levels of service quality of out-patients services of NTR Health University General Hospital, Vijayawada and Private Medical College Hospital, Chinaoutapalli. Patients of NTR Health University General Hospital 170

23 are more satisfied with 65.27% to 22 attributes of service quality against 62.95% in case of Private Medical College Hospital. On observation the researcher found that NTR Health University General Hospital is creating more awareness among public by displaying placards and conducting specialized medical camps with the help of private hospitals being suggested by Government. It is also found that the NTR Health University General Hospital is offering all specialized medical services including cardiology, neurology, urology, nephrology, pulmonology, gastroenterology in OPD services supported by all diagnostic services having skilled and experienced medical and paramedical staff. On the other side, Private Medical College hospital management is not showing much interest on public awareness towards health and diseases at least by displaying statements, boards, disturbing pamphlets as it wants their premises neat, clean and good looking. OPD services are offered only in mornings and evenings, as all the time specialized doctors are not available except OPD timings, due to the reason hospital does not stand on promises to do something by certain time and in the absence of doctors concerned staff feel free and show full of activity to patients. 171

24 5..2. Analysis of Service Quality in hospitals having bed strength 500 and above In-patients perception towards Service Quality: Table 5.9 Gaps between perceptions and expectations towards Service Quality opined by In-patients of Government and Private hospitals having bed strength 500 and above GOVERNMENT HOSPITAL PRIVATE HOSPITAL PERCEPTION Q.NO. EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangable SVQ Avg Tangable SVQ Avg Reliability SVQ 0.32 Avg Reliability SVQ Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ 0.65 Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE 0.38 Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE

25 Score from Table 1 Avg weight from Table 2 Weighted Score Score from Table 1 Avg weight from Table 2 Weighted Score AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE According to SERVQUAL, the higher the positive score, the better is the service quality. Table 5.9 sums-up the main points, that the gaps found between the Perceptions and Expectations of the 22 service quality attributes of SERVQUAL of in-patients of Government and Private Medical College Hospitals. Table 5.9 indicates that service quality attributes (i.e. 1, 8, 12 and 13) out of 22 service quality attributes are under expectation and remaining 18 service quality attributes met and exceeded in-patients expectation levels of NTR Health University General Hospital. 10 out of 22 service quality attributes (i.e. attribute no., 5, 7, 8, 11, 12, 13, 18, 21 and 22) of Private medical college hospital are negative. This shows patients perception levels are more than expectation levels in these service quality attributes and remaining attributes met and exceeded expectation levels. Table reveals the Average Unweighted and Weighted SERVQUAL scores of 22 attributes opined by sample respondents. The Average Unweighted and Weighted SERVQUAL scores of NTR Health University General Hospital are more than those of Private Medical College hospital. This makes known that in-patients service quality of NTR Health University General Hospital are good enough than Private Medical College Hospital. 173

26 Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the mean variance among the responses given by in-patients of NTR Health University General Hospital and Private Medical College Hospital and the results are set below. Table 5.10 ANOVA between In-patients perception towards Service Quality Hospitals having bed strength 500 and above ANOVA TEST TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL N Mean The above ANOVA results are also shown in the following graph. Std. Deviation F Sig

27 Graph 5.7 In- patients perception towards Service Quality Hospitals having bed strength 500 and above I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI TANGIBLES I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI RELIABILITY I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI I/P GOVT MED COL, VJA RESPONSIVENESS Std. Deviation I/P PVT MED COL, CPAALI ASSURANCE I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI EMPATHY I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI OVERALL Mean F Table value (1, 38, 0.05) =.08. The above ANOVA Table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This shows that there is no significant difference in service quality in the mean variance among the responses given by in-patients of NTR Health University General Hospital & Private Medical College Hospital because the overall ANOVA value of in-patients is

28 Table 5.11 In-patients satisfactory levels towards Service Quality Hospitals having bed strength 500 and above SATISFACTORY LEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall The above details are also shown in the following graph. Graph 5.8 In-patients satisfactory levels towards Service Quality Hospitals having bed strength 500 and above I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI TANGIBLES I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI RELIABILITY I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI RESPONSIVENESS I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI ASSURANCE I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI EMPATHY I/P GOVT MED COL, VJA I/P PVT MED COL, CPAALI OVERALL % Of Patient Satisfaction The above table and graph represent satisfactory levels of service quality of in-patients services of NTR Health University General Hospital, Vijayawada and Private Medical College Hospital, Chinaoutapalli. Patients of NTR Health University General Hospital 176

29 are more satisfied with 65.27% to 22 attributes of service quality than those of Private Medical College Hospital with 61.97%. The researcher observed that NTR Health University General Hospital lacks of specialized equipments, instruments and specialized operation theaters to perform specialized medical & surgical procedures for in-patients suffering from super speciality syndromes. Most of the consultants are available in the day time due to which the hospital does not stand on its promises to do something by a certain time and in such a case the concerned paramedical staff pretends as full of activity to patients. Even this almost holds good in case of the Private Medical College hospital under study. Also the Private Medical College hospital management is not showing much interest on public awareness towards health and diseases. Further, in the case of Private Medical College hospital Individual attention limited to nursing staff only not by the doctors because more number of patients are coming for treatment and every patient has to be seen by available few doctors. Because of the above all service quality attributes are not possible to be maintained by the Private Medical College hospital Analysis of Service Quality in hospitals having bed strength 500 and above Out & In-patients (all together) perception towards Service Quality: Table 5.12 Gaps between perceptions and expectations towards Service Quality opined by Out & Inpatients of Government and Private hospitals having bed strength 500 and above GOVERNMENT HOSPITAL PRIVATE HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE

30 TABLE 1 TABLE 1 Avg Tangable SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ 0.5 Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table 1 Avg weight from Table Weighted Score Avg Tangable SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table Avg weight from Table 2 Weighted Score AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.12 provides information about the gaps found between Perceptions and Expectations of 22 service quality attributes of SERVQUAL of both In & Out-patients 178

31 of Government and Private Medical College Hospitals. It indicates that 1 service quality attribute i.e. 13 out of 22 service quality attributes is under expectation and remaining 21 service quality attributes met and exceeded both In & Out-patients expectation levels of NTR Health University General Hospital, Vijayawada. 6 out of 22 service quality attributes (i.e. attribute no., 5, 8, 12, 13 and 18) are negative in case of Private medical college hospital. This shows expectation levels of patients of Private Medical College hospital are more than perception levels in these attributes. The above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of NTR Health University General Hospital are more than Average Unweighted and Weighted SERVQUAL scores of Private Medical College hospital. This shows medical services quality towards patients of NTR Health University General Hospital are good enough than those Private Medical College Hospital. Hypothesis testing: 1. H0. Overall mean perception score is lower than overall mean expectation score of s. From the above results and discussion it is evident that overall mean perception score (.3) is higher than overall mean expectation score () of NTR Health University General Hospital, Vijayawada. Hence formulated Hypothesis 1 viz., Overall mean perception score is lower than overall mean expectation score of s is rejected. 179

32 2. H0. Overall mean perception score is higher than overall mean expectation score of s. Further overall mean perception score (.2) is higher than overall mean expectation score () of Private Medical College Hospital i.e. Pinnemaneni Siddhartha Medical College Hospital, Chinaoutapalli. Hence formulated Hypothesis 2 viz., Overall mean perception score is higher than overall mean expectation score of s is significant. Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses given by overall patients (both I/P & O/P) of NTR Health University General Hospital and Private Medical College Hospital and the results are set below. Table 5.13 ANOVA between Out & In-patients perception towards Service Quality Hospitals having bed strength 500 and above ANOVA TEST TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL N Mean Std. Deviation F Sig

33 The ANOVA test results are also shown in the following graph. Graph 5.9 Out & In-Patients perception towards service quality Hospitals having bed strength 500 and above GOVT MED COL, VJA PVT MED COL, CPAALI GOVT MED COL, VJA PVT MED COL, CPAALI GOVT MED COL, VJA PVT MED COL, CPAALI GOVT MED COL, VJA PVT MED COL, CPAALI GOVT MED COL, VJA PVT MED COL, CPAALI 0.00 TANGIBLES RELIABILITY RESPONSIVENESS Std. Deviation ASSURANCE EMPATHY GOVT MED COL, VJA PVT MED COL, CPAALI OVERALL Mean F Table value (1, 78, 0.05) = Table 5.13 discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This shows that there is no significant difference in service quality in the mean variance among the responses given by patients (both out & in-patients) of NTR Health University General Hospital & Private Medical College Hospital, because the overall ANOVA value of both in & out-patients is

34 Table 5.1 Out & In-Patients satisfactory levels towards Service Quality Hospitals having bed strength 500 and above SATISFACTORY LEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall The above details are also shown in the following graph. Graph 5.10 Out & In-Patients satisfactory levels towards Service Quality Hospitals having bed strength 500 and above GOVT MED COL, VJA PVT MED COL, CPAALI TANGIBLES GOVT MED COL, VJA PVT MED COL, CPAALI RELIABILITY GOVT MED COL, VJA PVT MED COL, CPAALI RESPONSIVENESS GOVT MED COL, VJA PVT MED COL, CPAALI ASSURANCE GOVT MED COL, VJA PVT MED COL, CPAALI EMPATHY GOVT MED COL, VJA PVT MED COL, CPAALI OVERALL % Of Patient Satisfaction The above table and graph represent satisfactory levels of service quality of overall patients (O/P & I/P) of NTR Health University General Hospital, Vijayawada and Private Medical College Hospital, Chinaoutapalli. Patients of NTR Health University General 182

35 Hospital are more satisfied with 65.27% to 22 service quality attributes of SERVQUAL than Private Medical College Hospital with 62.3%. On observation researcher found that in NTR Health University General Hospital most of the consultants are available in the day time only to give treatment to OPD patients due to the result specialized procedures and diagnostic tests are conducting during day time. Because of this reason the staff pretends full of activity not even to respond patients requests in the day time. In absence of administrative staff and concerned doctors during night times, nursing and other staff feel free and do not show much interest to perform regular duties. In Private Medical College hospital, the management is not showing interest towards health and diseases among public, OPD services are offered in morning and evening times only and the specialist doctors are not available except OPD timings, due to which the hospital is failing to fulfill its promises and to do things by time. Available few consultants have to take care of both out-patients and in-patients due to the reason individual attention is limited to nursing staff only not by the doctors. 183

36 COMPARISON BETWEEN HOSPITALS HAVING BED STRENGTH 100 AND ABOVE : District Hospital, Machilipatnam. : Dr. Ramesh Cardiac and Multispeciality Hospital, Vijayawada. 18

37 5... Analysis of Service Quality in hospitals having bed strength 100 and above Out-patients perception towards Service Quality: Table 5.15 Gaps between perceptions and expectations towards Service Quality opined by Outpatients of Government and s having bed strength 100 and above GOVERNMENT HOSPITAL PRIVATE HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangable SVQ Avg Tangable SVQ Avg Reliability SVQ 0.0 Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ 0. Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table Avg weight from Table Weighted Score Avg Responsiveness SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table Avg weight from Table 2 33 Weighted Score

38 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.15 gives information about the gaps found between the Perceptions and Expectations of 22 service quality attributes of SERVQUAL of Out-patients of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. Table indicates that attributes (i.e. 5, 18, 19 and ) out of 22 service quality attributes of Government District Hospital, Machilipatnam are under expectation and remaining 18 service quality attributes met and exceeded outpatients expectation levels. Other side 3 attributes (i.e. 5, 10 & 11) are negative out of 22 service quality attribute scores of Ramesh Cardiac and Multispecialty Hospital, Vijayawada i.e. expectation levels are more than perception levels in these attributes. The above table reveals the Average Unweighted and Weighted SERVQUAL scores of 22 attributes opined by sample respondents. Average Unweighted and Weighted SERVQUAL scores of Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada are more than those of Government District Hospital, Machilipatnam. This shows that outpatients service quality of Dr. Ramesh Cardiac & Multispecialty Hospital are good enough than Government District Hospital. Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the mean variance among the responses given by out-patients of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada and the results are set below. 186

39 Table 5.16 ANOVA between Out-patients perception towards Service Quality Hospitals having bed strength 100 and above ANOVA TEST TANGIBLES RELIABILITY Mean RESPONSIVENESS ASSURANCE EMPATHY OVERALL Std. Deviation N The above details are also shown in the following graph. F Sig

40 Graph 5.11 Out-patients perception towards Service Quality Hospital having bed strength 100 and above TANGIBLES RELIABILITY RESPONSIVENESS Std. Deviation ASSURANCE EMPATHY O/P RAMESH HOSP, VJA O/P GOVT DIST HOSP, MTM O/P RAMESH HOSP, VJA O/P GOVT DIST HOSP, MTM O/P RAMESH HOSP, VJA O/P GOVT DIST HOSP, MTM O/P RAMESH HOSP, VJA O/P GOVT DIST HOSP, MTM O/P RAMESH HOSP, VJA O/P GOVT DIST HOSP, MTM O/P RAMESH HOSP, VJA O/P GOVT DIST HOSP, MTM 0.00 OVERALL Mean F Table value (1, 38, 0.05) =.08. The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This shows that there is no significant difference in service quality in the variance among the responses given by out-patients perception of Government District Hospital, Machilipatnam & Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada, because the overall ANOVA value of out-patients is

41 Table 5.17 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 100 and above SATISFACTORY LEVELS Government Hospital Tangibles Reliability Responsiveness Assurance Empathy Overall The above details are also shown in the following graph. Graph 5.12 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 100 and above O/P GOVT O/P RAMESH O/P GOVT O/P RAMESH O/P GOVT O/P RAMESH O/P GOVT O/P RAMESH O/P GOVT O/P RAMESH O/P GOVT O/P RAMESH DIST HOSP, VJA DIST HOSP, VJA DIST HOSP, VJA DIST HOSP, VJA DIST HOSP, VJA DIST HOSP, VJA HOSP, MTM HOSP, MTM HOSP, MTM HOSP, MTM HOSP, MTM HOSP, MTM TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL % Of Patient Satisfaction The above table and graph represent satisfactory levels of service quality of out-patients services of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. Patients of Dr. Ramesh Cardiac and Multispecialty 189

42 Hospital are more satisfied with 69.09% to 22 service quality attributes of SERVQUAL against 61.82% in case of Government District Hospital. On observation researcher found that Government District Hospital is a first referral hospital for all Government Community Health Centres. Because of the reason more number of patients are coming throughout the district for treatment regularly and every patient has to be treated by available few doctors and paramedical staff. This is does not happen in all at a time due to a reason, as hospital does not stand on promises to do something by a certain time. Individual attention is limited to nursing staff only due to the same reason. Most of the consultant specialists are available in the day time only and most of the specialized procedures and diagnostic tests are carried-out in morning times. In case of emergency consultants and skilled technicians to perform specialized diagnostic tests and procedures are not available with-in the time. This leads to negative impression on government hospitals. On the other side private hospital i.e., Dr. Ramesh Cardiac and Multispecialty Hospital is creating health and disease awareness among public by conducting specialized camps, offering all specialized medical services including cardiology, neurology, nephrology and pulmonology, diabetology etc., in OPD services supporting all diagnostic services having skilled and experienced medical and paramedical staff round the clock. Out-patients are dissatisfied due to long waiting time at Out-patient department to meet concerned consultant even after taking prior appointment. Since hospital is renowned for cardiac ailments and cardiac emergencies, hospital staff also not sure when a particular consultant is available in OPD. Due to the reason hospital does not stand on promises to do something by a certain time. 190

43 ..5. Analysis of Service Quality in hospitals having bed strength 100 and above In-patients perception towards Service Quality: Table 5.18 Gaps between perceptions and expectations towards Service Quality opined by Inpatients of Government and Private hospitals having bed strength 100 and above GOVERNMENT HOSPITALS PRIVATE HOSPITAL PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE Q.NO. TABLE 1 TABLE 1 Avg Tangible SVQ Avg Reliability SVQ Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table 1 Avg weight from Table Weighted Score Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table 1 Avg weight from Table Weighted Score 191

44 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.18 provide information about the gaps found between the Perceptions and Expectations of the 22 service quality attributes of SERVQUAL of In-patients of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. Table indicates that 2 attributes (i.e. 13 and 22) out of 22 service quality attributes are under expectation and remaining service quality attributes met and exceeded In-patients expectation levels of Government District Hospital, Machilipatnam. 1 service quality attribute i.e., attribute no. is negative out of 22 service quality attributes of Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. This confirms remaining 21 service quality attributes met and exceeded expectation levels of service quality offered by Dr. Ramesh Cardiac and Multispecialty hospital. The above table reveals Average Unweighted and Weighted SERVQUAL scores of 22 attributes opined by sample respondents. The Average Unweighted and Weighted SERVQUAL scores of Dr. Ramesh Cardiac & Multispecialty Hospital, Vijayawada are more than those of Government District Hospital, Machilipatnam. This shows in-patients service quality of Dr. Ramesh Cardiac and Multispecialty Hospital are good enough than that of Government District Hospital. 192

45 ANOVA is applied to understand whether the differences are significant or not with respect to the service quality in the mean variance among the responses given by inpatients of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada and the results are set below. Table 5.19 ANOVA between In-patients perception towards Service Quality Hospital having bed strength 100 and above ANOVA TEST TANGIBLES RELIABILITY Mean RESPONSIVENESS ASSURANCE EMPATHY OVERALL Std. Deviation N The above details are also shown in the following graph. F Sig

46 Graph 5.13 In-patients perception towards Service Quality Hospital having bed strength 100 and above TANGIBLES RELIABILITY RESPONSIVENESS Std. Deviation ASSURANCE EMPATHY I/P RAMESH HOSP, VJA I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA I/P GOVT DIST HOSP, MTM 0.00 OVERALL Mean F Table value (1, 38, 0.05) =.08. The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This shows that there is no significant difference in service quality in the mean variance among the responses given by in-patients perception of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada, because the overall ANOVA value of in-patients is

47 Table 5. In-patients satisfactory levels towards Service Quality Hospital having bed strength 100 and above SATISFACTORY LEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall Government Hospital The above details are also shown in the following Graph. Graph 5.1 In-patients satisfactory levels towards Service Quality Hospitals having bed strength 100 and above I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA TANGIBLES I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA RELIABILITY I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA RESPONSIVENESS I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA ASSURANCE I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA EMPATHY I/P GOVT DIST HOSP, MTM I/P RAMESH HOSP, VJA OVERALL % Of Patient Satisfaction The above table and graph represents satisfactory levels of service quality of In-patients services of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. Patients of Dr. Ramesh Cardiac and Multispecialty 195

48 Hospital are more satisfied with 71.59% to 22 attributes of service quality against 63.05% in case of Government District Hospital. The researcher found that in Government District hospital, Machilipatnam all the doctors are available in OPD timings. Specialist doctors / department heads take daily rounds (visit in-patients in wards) before or after OPD timings. RMOs/DMOs only are available after OPD timings and during nights. In the absence of doctors paramedical staff pretends full of activity to patients. This creates negative impression on Government hospital In-patient services. All the service quality attributes are not possible in the government hospital for patients due to lack of medical, paramedical staff and sufficient resources. On the other side private hospital management wants to keep their hospital and premises neat and clean and doesn t show much interest on health and disease awareness among public by displaying placards. Remaining service quality attributes are positive meet and exceed patients expectation levels of Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. 196

49 ..6. Analysis of Service Quality in hospitals having bed strength 100 and above O/P & I/P patients (all together) perception towards Service Quality: Table 5.21 Gaps between perceptions and expectations towards Service Quality opined by Out and In-patients of Government and Private hospitals having bed strength 100 and above GOVERNMENT HOSPITAL PRIVATE HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangable SVQ Avg Tangable SVQ 0.7 Avg Reliability SVQ Avg Reliability SVQ 0.9 Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table Avg weight from Table Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Weighted Score Score from Table Avg weight from Table Weighted Score

50 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.21 present information that the gaps found between Perceptions and Expectations of 22 service quality attributes of SERVQUAL of both In & Out-patients of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. Table shows that 3 service quality attributes (i.e. 18, 19 and ) out of 22 service quality attributes are under expectation and remaining 19 service quality attributes met and exceeded both In & Out-patients expectation levels of Government District Hospital, Machilipatnam. 1 service quality attribute i.e. attribute no. is negative out of 22 service quality attributes of Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. Above table reveals Average Unweighted and Weighted SERVQUAL scores of 22 attributes opined by sample respondents. The Average Unweighted and Weighted SERVQUAL scores of Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada are more than Average Unweighted and Weighted SERVQUAL scores of Government District Hospital, Machilipatnam. This shows service quality of patients (both O/P & I/P) of Dr. Ramesh Cardiac and Multispecialty Hospital are good enough than Government District Hospital. 198

51 Hypothesis testing: 1. H0. Overall mean perception score is lower than overall mean expectation score of s. From the above results and discussion it is evident that overall mean perception score (.213) is higher than overall mean expectation score () of Government District Hospital, Machilipatnam. Hence formulated Hypothesis 1 viz., Overall mean perception score is lower than overall mean expectation score of s is rejected. 2. H0. Overall mean perception score is higher than overall mean expectation score of s. Further overall mean perception score (.790) is higher than overall mean expectation score () of i.e. Dr. Ramesh Cardiac and Multispeciality, Vijayawada. Hence formulated Hypothesis 2 viz., Overall mean perception score is higher than overall mean expectation score of s is significant. ANOVA is applied to understand whether the differences are significant or not with respect to the service quality in the mean variance among the responses given by patients (both I/P & O/P) of Government District Hospital, Machilipatnam and Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada and the results are set below. 199

52 Table 5.22 ANOVA between patients perception towards Service Quality Hospitals having bed strength 100 and above ANOVA TEST TANGIBLES RELIABILITY Mean RESPONSIVENESS ASSURANCE EMPATHY OVERALL Std. Deviation N The above details are also shown in the following graph. F Sig

53 Graph 5.15 Patients perception towards Service Quality Hospitals having bed strength 100 and above RAMESH HOSP, VJA RAMESH HOSP, VJA.36 GOVT DIST HOSP, MTM GOVT DIST HOSP, MTM RAMESH HOSP, VJA GOVT DIST HOSP, MTM RAMESH HOSP, VJA GOVT DIST HOSP, MTM GOVT DIST HOSP, MTM 5.77 RAMESH HOSP, VJA TANGIBLES RELIABILITY RESPONSIVENESS Mean ASSURANCE EMPATHY RAMESH HOSP, VJA GOVT DIST HOSP, MTM 0.00 OVERALL Std. Deviation F Table value (1, 78, 0.05) = The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by in-patients perception of Government District Hospital, Machilipatnam & Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada, because the overall ANOVA value of both out & in-patients is

54 Table 5.23 Patients satisfactory levels (both O/P & IP) towards Service Quality Hospitals having bed strength 100 and above SATISFACTORY LEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall Government Hospital The above details are also shown in the following Graph. Graph 5.16 Patients satisfactory levels (both O/P & I/P) towards Service Quality Hospitals having bed strength 100 and above GOVT DIST HOSP, MTM RAMESH HOSP, VJA TANGIBLES GOVT DIST HOSP, MTM RAMESH HOSP, VJA RELIABILITY GOVT DIST HOSP, MTM RAMESH HOSP, VJA RESPONSIVENESS GOVT DIST HOSP, MTM RAMESH HOSP, VJA ASSURANCE GOVT DIST HOSP, MTM RAMESH HOSP, VJA EMPATHY GOVT DIST HOSP, MTM RAMESH HOSP, VJA OVERALL % Of Patient Satisfaction The above table and graph represent satisfactory levels of patients (both OP & IP) of Government District Hospital, Machilipatnam & Dr. Ramesh Cardiac and Multispecialty Hospital, Vijayawada. Patients of Dr. Ramesh Cardiac and Multispecialty Hospital were 2

55 more satisfied with 70.3% to 22 service quality attributes of SERVQUAL than Government District Hospital with 62.3%. On study researcher found that more number of patients is coming for treatment all over the district regularly to Government District hospital. Available few consultants and doctors take care of both out-patients and In-patients. Individual attention is not possible due to limited medical and paramedical staff and this is not happen all at a time. A trained nurse is available round-the-clock in wards to give medical aid to the in-patients and at OPDs for out-patients. Hence individual attention limited to nursing staff only. All specialized procedures and diagnostic tests are carried-out in the day time due to availability of consultants, specialist doctors and technicians. Consultants, technicians, specialized diagnostic tests and procedures are not available within the time during nights this leads negative impression on government hospital services. Where in private hospital (i.e. Dr. Ramesh Cardiac and Multispecialty Hospital) all service quality attributes are positive except one. Unlike government hospitals, private hospitals want to keep their hospitals buildings, premises clean, neat and well furnished not with placards and statements on walls to bring health and disease awareness among public which disturbs building elevation, spoils hospital wall paintings some times looks odd. Due to the reason private hospital management does not show much interest on health and disease awareness by displaying materials associated with the services and diseases. 3

56 COMPARISON BETWEEN HOSPITALS HAVING BED STRENGTH 50 TO 100 : Area Hospital, Nuzvid Missionary Hospital: Gifford Memorial Hospital, Nuzvid : Prashanth Hospital, Vijayawada M.J. Naidu Hospital, Vijayawada

57 5..7. Analysis of Service Quality in hospitals having bed strength 50 to 100 Outpatients perception towards Service Quality: Table 5.2 Gaps between perceptions and expectations towards Service Quality opined by Outpatients of Government, Missionary and s having bed strength 50 to 100 GOVERNMENT HOSPITAL MISSIONARY HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangible SVQ Avg Reliability SVQ 0.33 Avg Tangible SVQ Avg Reliability SVQ 0.95 Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Avg weight Score from from Table Table Weighted Score Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Avg weight Score from from Table Table Weighted Score

58 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE PRIVATE (PRASHANTH) HOSPITAL PERCEPTION EXPECTATION PRIVATE (M.J. NAIDU) HOSPITAL SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE Q.NO. TABLE 1 Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE TABLE Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE

59 Score from Table 1 Avg weight from Table 2 Weighted Score Avg weight from Table 2 Weighted Score AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Score from Table Table 5.2 shows that the gaps found between Perceptions and Expectations of 22 service quality attributes of SERVQUAL of out-patients of Government Area HospitalNuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. Table indicates that 3 service quality attributes (i.e. 8, 12 and 13) out of 22 service quality attributes are under expectation and remaining 19 service quality attributes met and exceeded out-patients expectation levels of Government Area Hospital-Nuzvid. In Missionary hospital i.e., Gifford Memorial Hospital, Nuzvid and Prashanth Hospital, Vijayawada all 22 service quality attribute scores are positive which confirm patients perceptions levels are met or exceeded in service quality provided by these hospitals. 1 service quality attribute i.e. attribute no. is negative out of 22 service quality attributes of M.J. Naidu Hospital, Vijayawada. This means patients perception levels are equal or more than expectation levels in remaining 21 service qualities attributes. The above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of Gifford Memorial HospitalNuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada are nearly same and more than the scores of Government Area Hospital, Nuzvid. This make known 7

60 that out-patients service quality of Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada are good enough than that of Government Area Hospital, Nuzvid. A detailed analysis with the help of Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses given by out-patients of Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital, Vijayawada and the results are set below. Table 5.25 ANOVA between Out-patients perception towards Service Quality Hospitals having bed strength 50 to 100 ANOVA TEST TANGIBLES RELIABILITY Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital Mean Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital RESPONSIVENESS Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital ASSURANCE Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital EMPATHY Std. Deviation N F Sig

61 Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital OVERALL The above details are also shown in the following Graph Graph 5.17 Out-patients towards Service Quality Hospital having bed strength 50 to O/P AREA HOSP, NUZ O/P GIFF MISS, NUZ TANGIBLES RELIABILITY RESPONSIVENESS Std. Deviation ASSURANCE EMPATHY O/P M.J.NAIDU, VJA O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P M.J.NAIDU, VJA O/P AREA HOSP, NUZ O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P M.J.NAIDU, VJA O/P AREA HOSP, NUZ O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P AREA HOSP, NUZ O/P M.J.NAIDU, VJA O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P M.J.NAIDU, VJA O/P PRASANTH, VJA O/P M.J.NAIDU, VJA O/P AREA HOSP, NUZ O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P AREA HOSP, NUZ 0.00 OVERALL Mean F Table value (1, 78, 0.05) = The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by out-patients perception of Government Area Hospital9

62 Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital-Vijayawada, because the overall ANOVA value of out-patients is Table 5.26 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 50 to 100 SATISFACTORY LEVELS Tangibles Reliability Responsiveness Government Hospital Missionary Hospital (Prashanth) (M.J. Naidu) The above details are also shown in the following Graph. Assurance Empathy Overall Graph 5.18 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 50 to TANGIBLES RELIABILITY ASSURANCE EMPATHY O/P M.J.NAIDU, VJA O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P M.J.NAIDU, VJA O/P AREA HOSP, NUZ O/P PRASANTH, VJA O/P GIFF MISS, NUZ O/P M.J.NAIDU, VJA O/P AREA HOSP, NUZ O/P PRASANTH, VJA O/P GIFF MISS, NUZ O/P M.J.NAIDU, VJA RESPONSIVENESS O/P AREA HOSP, NUZ O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P M.J.NAIDU, VJA O/P AREA HOSP, NUZ O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P M.J.NAIDU, VJA O/P AREA HOSP, NUZ O/P GIFF MISS, NUZ O/P PRASANTH, VJA O/P AREA HOSP, NUZ 0.00 OVERALL % Of Patient Satisfaction 210

63 The above table and graph represents satisfactory levels of out-patients of Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth HospitalVijayawada and M.J.Naidu Hospital, Vijayawada. Patients of private hospitals (Prashanth Hospital-Vijayawada with 69.68% and M.J.Naidu Hospital, Vijayawada with 72.55%) and missionary hospital (Gifford Memorial Hospital-Nuzvid with 72.27%) are more satisfied than patients of Government area hospital, Nuzvid with 63.6%. On study the researcher found that in Government Area Hospital-Nuzvid all the day time OPD services are not available except in morning and evenings. Most of the doctors are available in OPD timings to treat out-patients. All the out-patients have to be treated by available few medical and paramedical staff this is does not happen all at a time i.e., OPD waiting time, waiting time for diagnostic reports. Due to the reason hospital does not stand on promises to do something by a certain time. Secure minds feels free, government employees have job security due to the reason few hospital staff pretends as busy to respond patient s requests. In missionary hospital i.e. Gifford Memorial Hospital, Nuzvid and Prashanth Hospital, Vijayawada all 22 service quality attribute scores are positive which confirm these hospital is creating more awareness among public by displaying placards, conducting specialized health camps, offering medical services as they have specified including necessary diagnostic services and have skilled, experienced medical and paramedical staff. In another private hospital named M.J. Naidu Hospital, Vijayawada management does not show much interest on displaying placards to bring awareness among public to keep their hospital clean and neat except this management has been taking steps to fulfill patients desires more than what they expected. 211

64 ..8. Analysis of Service Quality in hospitals having bed strength 50 to 100 Inpatients perception towards Service Quality: Table 5.27 Gaps between perceptions and expectations towards Service Quality opined by Inpatients of Government, Missionary and Private hospitals having bed strength 50 to 100 GOVERNMENT HOSPITAL MISSIONARY HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ 0.5 Avg Assurance SVQ 0.75 Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE 0.1 Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE 0.38 Score from Table 1 Avg weight from Table Weighted Score Score from Table 1 Avg weight from Table Weighted Score 212

65 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE PRIVATE (PRASHANTH) HOSPITAL PRIVATE (M.J. NAIDU) HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 Avg Tangible SVQ Avg Reliability SVQ TABLE Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ Avg Empathy SVQ 0.85 Avg Empathy SVQ

66 AVG UNWEIGHTED SVQ SCORE Score from Table Avg weight from Table 2 AVG UNWEIGHTED SVQ SCORE Weighted Score Score from Table Avg weight from Table 2 Weighted Score AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.27 indicates that the gaps found between the Perceptions and Expectations of the 22 service quality attributes of SERVQUAL of In-patients of Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. Table shows that all 22 service quality attributes of SERVQUAL are positive of all three category select hospitals i.e. Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. 22 service quality attributes met and exceeded Inpatients expectation levels which indicates in-patients of these hospitals are happy with the service quality offer by the select hospitals in three categories. Their perception levels are equal or more than expectation levels in all 22 service quality attributes. Above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of private hospitals i.e. M.J. Naidu Hospital-Vijayawada and Prashanth Hospital-Vijayawada are more than the scores of missionary hospital i.e. Gifford Memorial Hospital-Nuzvid and Government Area Hospital, Nuzvid. This shows in-patients medical services service quality of M.J. Naidu 21

67 Hospital-Vijayawada and Prashanth Hospital-Vijayawada are good enough than Gifford Memorial Hospital-Nuzvid and Government Area Hospital, Nuzvid. Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses given by in-patients of Government Area Hospital-Nuzvid, Gifford Memorial HospitalNuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital, Vijayawada and the results are set below. Table 5.28 ANOVA between In-patients perception towards Service Quality Hospitals having bed strength 50 to 100 ANOVA TEST TANGIBLES Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital RELIABILITY Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital RESPONSIVENESS Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital ASSURANCE Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital EMPATHY Missionary Hospital Private (Prashanth) Hospital, Std. Deviation N Mean F Sig

68 Private (M.J. Naidu) Hospital Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital OVERALL The above details are also shown in the following Graph Graph 5.19 In-patients perception towards Service Quality Hospitals having bed strength 50 to TANGIBLES RELIABILITY RESPONSIVENESS Std. Deviation ASSURANCE EMPATHY I/P M.J.NAIDU, VJA I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P PRASANTH, VJA I/P GIFF MISS, NUZ I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P AREA HOSP, NUZ 0.00 OVERALL Mean F Table value (1, 78, 0.05) = The ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no sigficant difference in service quality in the mean variance among the responses given by in-patients perception of Government Area Hospital-Nuzvid, 216

69 Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital-Vijayawada, because the overall ANOVA value of in-patients is Table 5.29 In-patients satisfactory levels towards Service Quality Hospitals having bed strength 50 to 100 SATISFACTORY LEVELS Government Hospital Tangibles Reliability Responsiveness Assurance Empathy Overall Missionary Hospital Private (Prashanth) Hospital Private (M.J. Naidu) Hospital The above details are also shown in the following Graph. Graph 5. In-patients satisfactory levels towards Service Quality Hospitals having bed strength 50 to TANGIBLES RELIABILITY ASSURANCE EMPATHY I/P M.J.NAIDU, VJA I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P PRASANTH, VJA I/P GIFF MISS, NUZ I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P PRASANTH, VJA I/P GIFF MISS, NUZ I/P M.J.NAIDU, VJA RESPONSIVENESS I/P AREA HOSP, NUZ I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P M.J.NAIDU, VJA I/P AREA HOSP, NUZ I/P GIFF MISS, NUZ I/P PRASANTH, VJA I/P AREA HOSP, NUZ OVERALL % Of Patient Satisfaction 217

70 The above table and graph represents in-patients satisfactory levels of Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital, Vijayawada. Patients of private hospitals (Prashanth HospitalVijayawada with 72.59% and M.J.Naidu Hospital, Vijayawada with 73.77%) are more satisfied than patients of missionary hospital (Gifford Memorial Hospital-Nuzvid with 67.86%) and Government area hospital, Nuzvid with 65.82%. On observation the researcher found that patients are positive with service quality offer by the select hospitals in three categories i.e. Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu HospitalVijayawada, which indicates these hospitals are creating more awareness among public by displaying placards, conducting medical camps, offering all specified medical services supporting with all diagnostic services and have skilled and experienced medical and paramedical staff. This is positive effect patients show interest to get treatment in these hospitals for their health needs. 218

71 ..9. Analysis of Service Quality in hospitals having bed strength 50 to 100 Out & In-patients (all together) perception towards Service Quality: Table 5.30 Gaps between perceptions and expectations towards Service Quality opined by Out & Inpatients of Government, Missionary and s having bed strength 50 to 100 Missionary Hospital Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangible SVQ Avg Reliability SVQ Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table 1 Avg weight from Table Weighted Score Score from Table 1 Avg weight from Table Weighted Score 219

72 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Private (Prashanth) Hospital Private (M.J NAIDU) Hospital Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION TABLE 1 Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE SERVQUAL SCORE TABLE Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE

73 Score from Table 1 Avg weight from Table 2 Weighted Score Score from Table 1 Avg weight from Table 2 Weighted Score AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.30 indicates that the gaps found between the Perceptions and Expectations of the 22 service quality attributes of SERVQUAL of overall Out and In-patients of Government Area Hospital- Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. Table shows that all 22 service quality attributes of SERVQUAL are positive of three category hospitals i.e. Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. This means all 22 service quality attributes met and exceeded patients expectation levels of all three categories of hospitals. This indicated both Out & In-patients are satisfied with the service quality offer by the above select category hospitals. Above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of private hospitals i.e. M.J. Naidu Hospital-Vijayawada and Prashanth Hospital-Vijayawada are more than the scores of missionary hospital i.e. Gifford Memorial Hospital-Nuzvid and Government Area Hospital, Nuzvid. This shows patients medical services service quality of M.J. Naidu Hospital-Vijayawada and Prashanth Hospital-Vijayawada are good enough than missionary hospital i.e. Gifford Memorial Hospital-Nuzvid and Government Area Hospital, Nuzvid. 221

74 Hypothesis testing: 1. H0. Overall mean perception score is lower than overall mean expectation score of s. From the above results and discussion it is evident that overall mean perception score (.381) is higher than overall mean expectation score () of Government Area Hospital, Nuzvid. Hence formulated Hypothesis 1 viz., Overall mean perception score is lower than overall mean expectation score of s is rejected. 2. H0. Overall mean perception score is higher than overall mean expectation score of s. Further overall mean perception score (.977) is higher than overall mean expectation score () of s i.e. Prashanth Hospital, Vijayawada and M.J. Naidu Hospital, Vijayawada. Hence formulated Hypothesis 2 viz., Overall mean perception score is higher than overall mean expectation score of s is significant. 3. H0. Over all mean Perception score is lower than overall mean expectation score of Missionary Hospitals. Based on the above table it is evident that overall mean perception score (.76) is higher than overall mean expectation score () of Missionary Hospital i.e. Gifford Memorial Hospital, Nuzvid. Hence formulated Hypothesis 3 viz., Overall mean perception score is lower than overall mean expectation score of Missionary Hospitals is rejected. Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses given by patients (both I/P & O/P) of Government Area Hospital-Nuzvid, Gifford 222

75 Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu HospitalVijayawada and the results are set below. Table 5.31 ANOVA between patients perception towards service quality Hospital having bed strength 50 to 100 ANOVA TEST TANGIBLES Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital RELIABILITY Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital RESPONSIVENESS Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital ASSURANCE Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital EMPATHY Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital Std. Deviation N Mean F Sig

76 Missionary Hospital Private (Prashanth) Hospital, Private (M.J. Naidu) Hospital OVERALL The above details are also shown in the following Graph Graph 5.21 Patients perception towards Service Quality Hospital having bed strength 50 to M.J.NAIDU HOSP, VJA 0.00 GIFF MISS HOSP, NUZ AREA HOSP, NUZ AREA HOSP, NUZ 3.61 GIFF MISS HOSP, NUZ AREA HOSP, NUZ.00 TANGIBLES RELIABILITY RESPONSIVENESS Std. Deviation ASSURANCE Mean EMPATHY PRASANTH HOSP, VJA AREA HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA GIFF MISS HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA GIFF MISS HOSP, NUZ AREA HOSP, NUZ M.J.NAIDU HOSP, VJA GIFF MISS HOSP, NUZ PRASANTH HOSP, VJA M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA AREA HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA GIFF MISS HOSP, NUZ 0.00 OVERALL F Table value (1, 158, 0.05) = The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by patients (both O/P & I/P) perception of Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada 22

77 and M.J.Naidu Hospital-Vijayawada, because the overall ANOVA value of both out & in-patients is Table 5.32 Patients satisfactory levels (both O/P & I/P) towards Service Quality Hospitals having bed strength 50 to 100 SATISFACTORY LEVELS Tangibles Reliability Responsiveness Government Hospital Missionary Hospital Private (Prashanth) Hospital, Private (M.J Naidu) Hospital The above details are also shown in the following graph. Assurance Empathy Overall Graph 5.22 Patients satisfactory levels (both O/P and I/P) towards Service Quality Hospitals having bed strength 50 to TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA AREA HOSP, NUZ GIFF MISS HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA AREA HOSP, NUZ GIFF MISS HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA AREA HOSP, NUZ GIFF MISS HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA AREA HOSP, NUZ GIFF MISS HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA AREA HOSP, NUZ GIFF MISS HOSP, NUZ M.J.NAIDU HOSP, VJA PRASANTH HOSP, VJA AREA HOSP, NUZ GIFF MISS HOSP, NUZ 0.00 OVERALL % Of Patient Satisfaction 225

78 The above table and graph represents satisfactory levels of patients (both O/P & I/P) of Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J.Naidu Hospital-Vijayawada. Patients of private hospitals (Prashanth Hospital, Vijayawada with 71.1% and M.J.Naidu Hospital, Vijayawada with 73.16%) and missionary hospital (Gifford Memorial Hospital, Nuzvid with 70.07%) are more satisfied than patients of Government area hospital, Nuzvid with 6.73%. Researcher found that all 22 service quality attributes of SERVQUAL are positive of three category hospitals i.e. Government Area Hospital-Nuzvid, Gifford Memorial Hospital-Nuzvid, Prashanth Hospital-Vijayawada and M.J. Naidu Hospital-Vijayawada. This found patients are happy with the medical services offering by three category hospitals in all service quality attributes of SERVQUAL. 226

79 COMPARISON BETWEEN HOSPITALS HAVING BED STRENGTH 30 TO 50 : Community Health Centre, Jaggaiahpet. : Latha Superspeciality Hospital, Vijayawada. 227

80 Analysis of Service Quality in hospitals having bed strength 30 to 50 Outpatients perception towards Service Quality: Table 5.33 Gaps between perceptions and expectations towards Service Quality opined by Outpatients of Government and s having bed strength 30 to 50 GOVERNMENT HOSPITAL PRIVATE HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 TABLE 1 Avg Tangible SVQ 0.5 Avg Tangible SVQ Avg Reliability SVQ 0.19 Avg Reliability SVQ Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table 1 Avg weight from Table Weighted Score Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table 1 Avg weight from Table Weighted Score 228

81 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.33 gives information that the gaps found between Perceptions and Expectations of 22 service quality attributes of SERVQUAL of Out-patients of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada. It indicates that 6 service quality attributes (i.e. 5, 6, 12, 13, and 21) out of 22 service quality attributes are under expectation remaining 16 service quality attributes met and exceeded out-patients expectation levels of Government Community Health Centre, Jaggaiahpet. Table shows that all 22 service quality attribute scores of Latha Superspeciality Hospital, Vijayawada are positive i.e. all 22 service quality attributes met and exceeded out-patients expectation levels. This means patients are satisfied with the service quality offer by the hospital. Above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of Latha Superspeciality Hospital, Vijayawada are more than scores of Government Community Health Centre, Jaggaiahpet. This make known that out-patients medical services service quality of Latha Superspeciality Hospital, Vijayawada are good enough than Government Community Health Centre, Jaggaiahpet. Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses 229

82 given by out-patients of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada and the results are set below. Table 5.3 ANOVA between out-patients perceptions towards Service Quality Hospitals having bed strength 30 to 50 ANOVA TEST TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL N Mean Std. Deviation F Sig The above details are also shown in the following graph. 230

83 Graph 5.23 Out-patients perception towards Service Quality Hospitals having bed strength 30 to O/P CHC, JPT O/P LATHA, VJA TANGIBLES O/P CHC, JPT O/P LATHA, VJA RELIABILITY O/P CHC, JPT O/P LATHA, VJA O/P CHC, JPT RESPONSIVENESS Std. Deviation O/P LATHA, VJA ASSURANCE O/P CHC, JPT O/P LATHA, VJA EMPATHY O/P CHC, JPT O/P LATHA, VJA OVERALL Mean F Table value (1, 38, 0.05) =.08. The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by out-patients perception of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada, because the overall ANOVA value of out-patients is

84 Table 5.35 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 30 to 50 SATISFACTORY LEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall Government Hospital The above details are also shown in the following Graph. Graph 5.2 Out-patients satisfactory levels towards Service Quality Hospitals having bed strength 30 to O/P CHC, JPT O/P LATHA, VJA TANGIBLES O/P CHC, JPT O/P LATHA, VJA RELIABILITY O/P CHC, JPT O/P LATHA, VJA RESPONSIVENESS O/P CHC, JPT O/P LATHA, VJA ASSURANCE O/P CHC, JPT O/P LATHA, VJA EMPATHY O/P CHC, JPT O/P LATHA, VJA OVERALL % Of Patient Satisfaction The above table and graph represents satisfactory levels of out-patients of Government Community Health Centre, Jaggaiahpet & Latha Speciality Hospital, Vijayawada. Patients of Latha Superspeciality Hospital, Vijayawada are more satisfied with 69.18% to 232

85 22 service quality attributes of SERVQUAL than Government Community Health Centre, Jaggaiahpet with 62.6%. On observation the researcher found that the gaps found between Perceptions and Expectations of Out-patients of Government Community Health Centre (CHC), Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada. Like all Government hospitals, Government Community health centre, Jaggaiahpet also offering OPD services during morning and evening times. All the hospital doctors are available during OPD timings except scheduled night duty RMO/DMOs to treat OPD patients. CHCs are referral hospitals for PHCs with specialized services. Because of the reason more number of patients is coming for treatment every day and every patient has to be treated by available few medical and paramedical staff. It is not possible to treat all OPD patients at a time this leads OPD waiting time and waiting time for diagnostic test reports. In case of emergencies in after noon and nights specialized doctors and specialized procedures are not available in time leads negative impression on government hospital services. In the absence of doctors concerned staff pretends busy to patients. Individual attention limited to nursing staff only not by doctors due to the above reason. On the other side all service quality attribute scores of Latha Superspeciality Hospital are positive. This reveals hospital has modern looking equipment, sufficient physical facilities in hospital, creating awareness among public towards health and diseases by displaying placards and conducting medical camps, OPD services supporting with diagnostic services and have skilled and experienced medical and paramedical staff round the clock. 233

86 ..11. Analysis of Service Quality in hospitals having bed strength 30 to 50 Inpatients perception towards Service Quality: Table 5.36 Gaps between perceptions and expectations towards Service Quality opined by Inpatients of Government and Private hospitals having bed strength 30 to 50 GOVERNMENT HOSPITAL PRIVATE HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE TABLE 1 Avg Tangible SVQ Avg Reliability SVQ TABLE Avg Tangible SVQ Avg Reliability SVQ Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ 1.35 Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE 0.92 Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table 1 Avg weight from Table Weighted Score Score from Table 1 Avg weight from Table Weighted Score 23

87 AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.36 provide information that the gaps found between Perceptions and Expectations of the 22 service quality attributes of SERVQUAL of In-patients of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada. Table indicates that all 22 service quality attribute scores of Government community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada are positive i.e. all the 22 service quality attributes met and exceeded In-patients expectation levels which indicates both government and private hospitals are actively participating in offering service quality to its patients round the clock. The above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of Latha Superspeciality Hospital, Vijayawada are more than the scores of Government community Health Centre, Jaggaiahpet. This shows in-patients medical services service quality of Latha Superspeciality Hospital, Vijayawada are good enough than Government community Health Centre, Jaggaiahpet. Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses given by in-patients of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada and the results are set below. 235

88 Table 5.37 ANOVA between In-patients perceptions towards service quality Hospitals having bed strength 30 to 50 ANOVA TEST TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL N Mean 1.00 Std. Deviation F Sig The above details are also shown in the following Graph. 236

89 Graph 5.25 In-patients perception towards Service Quality Hospitals having bed strength 30 to I/P CHC, JPT I/P LATHA, VJA TANGIBLES I/P CHC, JPT I/P LATHA, VJA RELIABILITY I/P CHC, JPT I/P LATHA, VJA RESPONSIVENESS Mean I/P CHC, JPT I/P LATHA, VJA ASSURANCE I/P CHC, JPT I/P LATHA, VJA EMPATHY I/P CHC, JPT I/P LATHA, VJA OVERALL Std. Deviation F Table value (1, 38, 0.05) =.08. The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by in-patients perception of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada, because the overall ANOVA value of in-patients is

90 Table 5.38 In-patients satisfactory levels towards Service Quality Hospitals having bed strength 30 to 50 SATISFACTORY LEVELS Government Hospital Tangibles Reliability Responsiveness Assurance Empathy Overall The above details are also shown in the following Graph. Graph 5.26 In-patients satisfactory levels towards Service Quality Hospitals having bed strength 30 to I/P CHC, JPT I/P LATHA, VJA TANGIBLES I/P CHC, JPT I/P LATHA, VJA RELIABILITY I/P CHC, JPT I/P LATHA, VJA RESPONSIVENESS I/P CHC, JPT I/P LATHA, VJA ASSURANCE I/P CHC, JPT I/P LATHA, VJA EMPATHY I/P CHC, JPT I/P LATHA, VJA OVERALL % Of Patient Satisfaction The above table and graph represents satisfactory levels of in-patients of Government Community Health Centre, Jaggaiahpet & Latha Speciality Hospital, Vijayawada. Patients of Latha Superspeciality Hospital, Vijayawada are more satisfied with 73.73% to 238

91 22 service quality attributes of SERVQUAL than Government Community Health Centre, Jaggaiahpet with 65.68%. On observation researcher found that no gaps found between Perceptions and Expectations of service quality attributes of SERVQUAL of In-patients of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada. All service quality attribute scores of Government community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada are positive. Patients are satisfied with the services offered by both Government and Private hospitals as result of sufficient equipments and physical facilities, creating health awareness among public, offering medical services as stated by them supporting with all diagnostic services, have skilled and experienced medical and paramedical staff Analysis of Service Quality in hospitals having bed strength 30 to 50 Out & In-patients (all together) perception towards Service Quality: Table 5.39 Gaps between perceptions and expectations towards Service Quality opined by Out & Inpatients of Government and Private hospitals having bed strength 30 to 50 GOVERNMENT HOSPITAL PRIVATE HOSPITAL Q.NO. PERCEPTION EXPECTATION SERVQUAL SCORE PERCEPTION EXPECTATION SERVQUAL SCORE

92 TABLE 1 TABLE 1 Avg Tangible SVQ Avg Reliability SVQ Avg Tangible SVQ 0.7 Avg Reliability SVQ Avg Responsiveness SVQ Avg Responsiveness SVQ Avg Assurance SVQ Avg Assurance SVQ Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Score from Table Avg weight from Table 2 Avg Empathy SVQ AVG UNWEIGHTED SVQ SCORE Weighted Score Score from Table Avg weight from Table 2 Weighted Score AVG WEIGHTED SER SCRORE AVG WEIGHTED SER SCRORE Table 5.39 provides information that the gaps found between Perceptions and Expectations of 22 service quality attributes of SERVQUAL of both In & Out-patients of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada. It shows that 1 service quality attributes i.e. 6 out of 22 service quality attributes is under expectation and remaining 21 service quality attributes met and exceeded both In & Out-patients expectation levels of Government Community Health

93 Centre, Jaggaiahpet. All 22 service quality attributes of Latha Superspeciality Hospital are positive i.e., all service quality attributes met and exceeded patients expectations. Above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of Latha Superspeciality Hospital, Vijayawada are more than the scores of Government Community Health Centre, Jaggaiahpet. This shows patients service quality of Latha Superspeciality Hospital, Vijayawada are good enough than Government Community Health Centre, Jaggaiahpet. Hypothesis testing: 1. H0. Overall mean perception score is lower than overall mean expectation score of s. From the above results and discussion it is evident that overall mean perception score (.31) is higher than overall mean expectation score () of Government Community Health Centre, Nuzvid. Hence formulated Hypothesis 1 viz., Overall mean perception score is lower than overall mean expectation score of s is rejected. 2. H0. Overall mean perception score is higher than overall mean expectation score of s. Further overall mean perception score (.907) is higher than overall mean expectation score () of s i.e. Latha Superspeciality Hospital, Vijayawada. Hence formulated Hypothesis 2 viz., Overall mean perception score is higher than overall mean expectation score of s is significant. Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses 21

94 given by patients (both O/P & I/P) of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada and the results are set below. Table 5.0 ANOVA between patients perceptions towards Service Quality Hospitals having bed strength 30 to 50 ANOVA TEST TANGIBLES RELIABILITY RESPONSIVENESS ASSURANCE EMPATHY OVERALL N Mean Std. Deviation F Sig The above details are also shown in the following graph. 22

95 Graph 5.27 Patients perception towards Service Quality Hospitals having bed strength 30 to GOVT LATHA GOVT LATHA GOVT LATHA GOVT LATHA GOVT LATHA GOVT LATHA CHC, JPET HOSP, VJA CHC, JPET HOSP, VJA CHC, JPET HOSP, VJA CHC, JPET HOSP, VJA CHC, JPET HOSP, VJA CHC, JPET HOSP, VJA TANGIBLES RELIABILITY RESPONSIVENESS Std. Deviation ASSURANCE EMPATHY OVERALL Mean F Table value (1, 78, 0.05) = The ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by patients (both O/P & I/P) perception of Government Community Health Centre, Jaggaiahpet and Latha Superspeciality Hospital, Vijayawada, because the overall ANOVA value of both out & in-patients is

96 Table 5.1 Patients satisfactory levels (both O/P & I/P) towards Service Quality Hospitals having bed strength 30 to 50 SATISFACTORY LEVELS Tangibles Reliability Responsiveness Assurance Empathy Overall The above details are also shown in the following graph Government Hospital Table 5.28 Patients satisfactory levels (both O/P & I/P) towards Service Quality Hospitals having bed strength 30 to GOVT CHC, JPET LATHA HOSP, VJA TANGIBLES GOVT CHC, JPET LATHA HOSP, VJA RELIABILITY GOVT CHC, JPET LATHA HOSP, VJA RESPONSIVENESS GOVT CHC, JPET LATHA HOSP, VJA ASSURANCE GOVT CHC, JPET LATHA HOSP, VJA EMPATHY GOVT CHC, JPET LATHA HOSP, VJA OVERALL % Of Patient Satisfaction The above table and graph represents satisfactory levels of patients (both O/P & I/P) of Government Community Health Centre, Jaggaiahpet & Latha Speciality Hospital, Vijayawada. Patients of Latha Speciality Hospital, Vijayawada are more satisfied with 2

97 71.5% to 22 service quality attributes of SERVQUAL than Government Community Health Centre, Jaggaiahpet with 6.16%. On study researcher found that one service gap between perceptions and expectations of both In & Out-patients of Government Community Health Centre, Jaggaiahpet. Even it is a one service quality gap it creates negative impression on government hospital services. This is due to all the time doctors are not available except OPD timings. In absence of admin staff and doctors, nursing and paramedical staff pretends busy and not showing interest in solving the problems of patients. On the other side researcher found no service gaps between perceptions and expectations of patients of Latha Superspeciality Hospital, Vijayawada. Patients are happy with the services offer by the hospital in all manners. 25

98 COMPARISON BETWEEN HOSPITALS IRRESPECTIVE OF BED STRENGTH (ALL TOGETHER) GOVERNMENT HOSPITALS: NTR University General Hospital, Vijayawada Government District Hospital, Machilipatnam. Area Hospital, Nuzvid Community Health Centre (C.H.C), Jaggaiahpeta PRIVATE HOSPITALS: Pinnamaneni Siddhartha Medical College & Hospital, Chinaoutapalli. Dr. Ramesh Cardiac & Multispeciality Hospital, Vijayawada Prashanth Hospital, Vijayawada M.J. Naidu Hospital, Vijayawada Latha Super Speciality Hospital, Vijayawada MISSIONARY HOSPITAL: Gifford Memorial Hospital, Nuzvid 26

99 ..13. Analysis of Service Quality in hospitals all together irrespective of bed strength Out-patients perception towards Service Quality: Table 5.2 Gaps between perceptions and expectations towards Service Quality opined by Outpatients of Government, Private and Missionary Hospitals irrespective of bed strength Government Hospitals Private Hospitals SERVQUAL SCORE Q.NO. Missionary Hospital SERVQUAL SCORE SERVQUAL SCORE Unweighted Score Unweighted Score Tangibles Reliability Responsiveness Assurance Empathy Weighted Score Weighted Score 27

100 Tangibles Reliability Responsiveness Assurance Empathy Table 5.2 provides information that the gaps found between the Perceptions and Expectations of the 22 service quality attributes of SERVQUAL of Out-patients of select Government, Private and Missionary owned hospitals. The above table indicates 2 service quality attributes (i.e. 13 and ) out of 22 service quality attributes are under expectation and remaining service quality attributes met and exceeded Out-patients expectation levels of select s. In Private hospital except one service quality attribute no. is under expectation and remaining 21 attributes met and exceeded Out-patients expectation levels. All 22 service quality attribute scores of missionary hospital are positive and this shows missionary hospital i.e. Gifford Memorial hospital courtesy is enough to offer all service quality attributes to its patients so as to meet their expectations. The above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of Missionary hospital are more than the scores of Private and Government hospitals. Private hospitals scores are more than Government hospitals scores. This makes known that out-patients medical services service quality of missionary hospital are good enough than private hospitals and private hospitals service quality is good enough than that of government hospitals. 28

101 Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses given by out-patients of Government, Private and Missionary hospitals and the results are set below. Table 5.3 ANOVA between Out-patients perception towards Service Quality Government, Private and Missionary Hospitals all together irrespective of bed strength Patient type OUTPATIENTS ANOVA TEST N Mean Std. Deviation GOVERNMENT HOSPITALS PRIVATE HOSPITALS MISSIONARY HOSPITAL The above details are also shown in the following graph. F Sig Graph 5.29 Out-patients perception towards Service Quality Government, Private and Missionary Hospitals all together irrespective of bed strength GOVERNMENT HOSPITALS PRIVATE HOSPITALS Mean MISSIONARY HOSPITAL Std. Deviation 29

102 F Table value (1, 178, 0.05) = The above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by out-patients perception of all Government, Private and Missionary Hospitals, because the overall ANOVA value of out-patients is Table 5. Out-patients satisfactory levels towards Service Quality - Government, Private and Missionary Hospitals all together irrespective of bed strength % OF SATISFACTION : OUT-PATIENTS GOVERNMENT HOSPITALS PRIVATE HOSPITALS MISSIONARY HOSPITAL The above details are also shown in the following Graph Graph 5.30 Out-patients satisfactory levels towards Service Quality - Government, Private and Missionary Hospitals all together irrespective of bed strength GOVERNMENT HOSPITAL PRIVATE HOSPITAL MISSIONARY HOSPITAL % of satisfaction 250

103 The above table and graph represents satisfactory levels of out-patients of Government, Private and Missionary Hospitals. Patients of Missionary hospital are satisfied with 72.27%, Private hospitals with 68.69% and Government hospitals with 63.3%. This shows patients of Missionary hospitals are more satisfied than patients of Private and Government hospitals. On average 66.91% of out-patients are satisfied with the service quality of all select Government, Private and Missionary hospitals. On study the researcher found gaps between the Perceptions and Expectations of Outpatients of select Government, Private hospitals and no gaps found in Missionary hospitals. In general in Government hospitals OPD services are offered during morning and evening times only, all the time specialized doctors are not available except OPD timings and also administrative department works in day time only. In absence of administrative staff and doctors, nursing and paramedical staff pretends busy to patients and not showing sincere interest in solving patient problems. Individual attention limited to nursing staff only not by the doctors. This is due to more number of patients are coming for treatment and every patient has to be treated by available few medical and paramedical staff. In Private hospitals all service quality attributes of SERVQUAL are positive except one service quality attribute i.e. attribute no.. This is for the reason that unlike government hospitals, private hospitals want to keep their hospital buildings and premises clean and neat with well furnished, fully equipped and round-the-clock services but not with materials associated with the services such as pamphlets, statements, boards which are visually appearing to bring health and disease awareness among public. Another side all service quality attribute scores of Missionary hospital are positive and 251

104 this shows missionary hospital i.e., Gifford Memorial hospital management taking care of the services offering by them are up to the mark and to reach expectations of the patients...1. Analysis of Service Quality in hospitals all together irrespective of bed strength In-patients perception towards Service Quality: Table 5.5 Gaps between perceptions and expectations towards Service Quality opined by In-patients of Government, Private and Missionary Hospitals irrespective of bed strength Government Missionary Hospitals s Hospital SERVQUAL SCORE Q.NO. SERVQUAL SCORE SERVQUAL SCORE Unweighted Score Unweighted Score Unweighted Score Tangibles Reliability Responsiveness Assurance

105 Empathy Weighted Score Weighted Score Weighted Score Tangibles Reliability Responsiveness Assurance Empathy Table 5.5 indicates that the gaps found between Perceptions and Expectations of 22 service quality attributes of SERVQUAL of In-patients of Government, Private and Missionary Hospitalss. It shows that all 22 service quality attributes of SERVQUAL are positive i.e. 22 service quality attributes met and exceeded In-patients expectation levels in select s and Missionary Hospital except s. 1 Service quality attribute of Private hospitals i.e. attribute no. is negative out of 22 service quality attributes remaining 21 attributes are met and exceeded in-patients expectation levels. This means Private hospitals management showing interest on modern equipment, medical services, and skilled medical and paramedical staff but not on materials associated with the services to bring awareness among public towards health and diseases. The above table reveals Average Unweighted and Weighted SERVQUAL scores. Average Unweighted and Weighted SERVQUAL scores of Private hospitals are more than the scores of Missionary hospital and Government Area Hospital. The table shows in-patients medical services service quality of private hospital are good enough than missionary and government hospitals. 253

106 Analysis of Variance (ANOVA) is applied to understand whether the differences are significant or not with respect to the service quality in the variance among the responses given by in-patients of Government, Private and Missionary Hospitals and the results are set below. Table 5.6 ANOVA between In-patients perceptions towards service quality Government, Private and Missionary Hospitals all together irrespective of bed strength Patient type IN-PATIENTS ANOVA TEST N Mean Std. Deviation GOVERNMENT HOSPITALS PRIVATE HOSPITALS MISSIONARY HOSPITAL The above details are also shown in the following graph. F Sig Graph 5.31 In-patients perception towards Service Quality Government, Private & Missionary Hospitals all together irrespective of bed strength GOVERNMENT HOSPITALS PRIVATE HOSPITALS Mean MISSIONARY HOSPITAL Std. Deviation 25

107 F Table value (1, 178, 0.05) = Above ANOVA table discloses P value is >0.05 i.e. level of significance is found to be not significant at 95 percent confidence level. This means that there is no significant difference in service quality in the mean variance among the responses given by in-patients perception of all Government, Private and Missionary Hospitals, because the overall ANOVA value of in-patients is Table 5.7 In-patients satisfactory levels towards Service Quality Government, Private & Missionary Hospitals all together irrespective of bed strength % OF SATISFACTION : IN-PATIENTS GOVERNMENT HOSPITALS PRIVATE HOSPITALS MISSIONARY HOSPITAL The above details are also shown in the following graph Graph 5.32 In-patients satisfactory levels towards Service Quality Government, Private & Missionary Hospitals all together irrespective of bed strength GOVERNMENT HOSPITAL PRIVATE HOSPITAL MISSIONARY HOSPITAL % of satisfaction 255