TO ANALYSE LEVEL OF PERCEPTION TOWARDS HOSPITAL VARIOUS SERVICES OFFERED BY MULTI - SPECIALITY HOSPITALS IN COIMBATORE CITY Dr.S.Karthikeyan, Assistant Professor, Department of Commerce (CA), Government Arts College, Udumalpet, Tirupur Dt. - 642 126 ABSTRACT In India healthcare is delivered through both the public sector and private sector. The public healthcare system consists of healthcare facilities offered by central and state government which provide services at free of cost or at a subsidized rates to people living below the poverty line (BPL) both in rural and urban areas. The changing pattern of hospital will result in dominance of consumers as against providers. The successful hospital is one, which provides good care services. Objectives of the study, To measure the factors influencing level of perception towards hospital various services offered by select Private Multi Speciality hospitals in Coimbatore City. Methodology of the study:they are PSG Hospital, Kovai Medical Center and Hospital (KMCH), KG Hospital,G. Kuppuswamy Naidu Memorial Hospital (GKNM), and Sri Ramakrishna Hospital. The above mentioned five hospitals have total bed capacity is 3540. At the time of data collection, the researcher applied convenient sampling technique. Both primary and secondary data sources are applied for the effective conduct of this study. Important findings of the study, Easy of get appointments with the doctors by telephone, Time taken to get an appointment with the doctors and consult the doctors, Correctly diagnose the diseases by the doctor, Explanations about the diseases by the Doctor, Doctor s behavior, Acceptance of test reports taken outside or by other doctors, Time to take the test and prepare the report, Doctors explain adequately about the test reports. Suggested this study, Although patient satisfaction is proved to be an important measure of quality of care, it cannot be used as the only measure. It found that older patients assessments are not a sufficient basis for assessing the technical quality of their primary care. Conclude this study, Today, India hostess world class hospitals with multi-disciplinary super speciality medical center of international standards. Most of these private hospitals are well equipped with the most advanced diagnostic and treatment facilities. These hospitals offer a total health care, i.e., both preventive and curative. Key words: Factor analysis, customer satisfaction, multi- speciality hospitals, etc., INTRODUCTION In India healthcare is delivered through both the public sector and private sector. The public healthcare system consists of healthcare facilities offered by central and state government which provide services at free of cost or at a subsidized rates to people living below the poverty line (BPL) both in rural and urban areas. With the liberalization of Indian economy in 1991, the health care industry is heading towards growth phase. The introduction of product patents concept by the private hospitals has encouraged private and corporate hospitals to launch specialised life-saving medical services and drugs 1. Thus, in recent past the private sector has emerged a vibrant force in India's healthcare industry, lending its services to both national and international patients. This sector s share in healthcare delivery has increased from 66 per cent in 2005 to 81 per cent in 2017. Its share in hospitals and hospital beds is also increased respectively from 40 per cent to 74 per cent during this study 2. Today, India hostess world class hospitals with multidisciplinary super speciality medical center of international standards. Most of these private hospitals are well equipped with the most advanced diagnostic and treatment facilities. These hospitals offer a total health care, i.e., both preventive and curative. 1 http://answeringlaw.com/php/displaycontent.php?linkid=1306 2 Ibid, RNCOS Report (2012-13) 78
With the growth of private and corporate hospitals in India, hospital marketing is becoming increasingly competitive across India. The hospital services are gradual shifting from the selling to marketing vis-a-vis the customer orientation 3. Hospital marketing is a specialised field that deals with connecting patients, physicians, and hospitals. Nowadays, hospital marketing is considered necessary than ever before, to ensure long-term viability and to obtain the range of high quality among the individuals healthcare. The private hospitals operating across India have to realize the fact that the patients nowadays are more aware and more quality conscious than before. So, it stands to reason that a high level of quality, which provides patient satisfaction, is more important for a hospital. Consumer satisfaction is important to the hospital because it is generally assumed to be a significant determinant of repeated visit, to retain the positive word-of-mouth promotion of hospital services, and patients loyalty. STATEMENT OF THE PROBLEM Health care industry in India is an emerging industry, as health is the utmost importance for all human beings. Thus, private hospitals are keen in competing with one another i.e., either large or small in attracting the attention of their consumers (patients) in every aspects. The changing pattern of hospital will result in dominance of consumers as against providers. The successful hospital is one, which provides good care services. Caring is not only curing and managing the patients disease, it is about caring patients through different functional areas such as nursing, food, and nutrition, patients safety, pharmacy etc. the hospitals are much like other organizations, but, it has some special features like individual cares, emergency services and it cannot make any mistakes because it may cause life threatening conditions. Thus, it can be said that satisfying patients and their attendants is highly significant in hospitals 4. The above presented conceptual discussion provoked the researcher for the conduct of this study. The present study aims to draw an introspective analysis on the inpatients satisfaction towards healthcare services offered by Private Multi- Speciality hospitals in Coimbatore City. OBJECTIVES OF THE STUDY To measure the factors influencing level of perception towards hospital various services offered by select private hospitals in Coimbatore City RESEARCH METHODOLOGY The study is both explorative and descriptive in nature. The study is concentrated on Private Multi - Speciality hospitals currently functioning in Coimbatore City. The List of large scale private multi specialty hospitals with more than 300 bedding capacity was selected for the study. In Coimbatore City the five hospitals having more than 300 bedding capacity were chosen for the survey and for data collection. They are PSG Hospital, Kovai Medical Center and Hospital (KMCH), KG Hospital,G. Kuppuswamy Naidu Memorial Hospital (GKNM), and Sri Ramakrishna Hospital. The above mentioned five hospitals have total bed capacity is 3540.Ten percent of the actual population was chosen based on their proportionate distribution of populations i.e. 354 inpatients were considered as the research population. At the time of data collection, the researcher applied convenient sampling technique. Both primary and secondary data sources are applied for the effective conduct of this study. TABLE: 1 KMO AND BARTLETT'S TEST LEVEL OF PERCEPTION ABOUT HOSPITAL VARIOUS SERVICES OFFERED FROM ONE CATEGORY TO OTHER Kaiser-Meyer-Olkin Measure of Sampling Adequacy.795 Bartlett's Test of Sphericity Approx. Chi-Square 7763.492 DF 45 Sig.000 Level of Significance: 5 per cent In the present study, Kaiser-Meyer-Oklin (KMO) Measure of Sampling Adequacy (MSA) and Bartlett s test of Sphericity were applied to verify the adequacy or appropriateness of data for factor analysis. In this study, the value of KMO for overall matrix was found to be excellent (0.795) and Bartlett s test of Sphericity was highly significant (p<0.05). Bartlett s Sphericity test was effective, as the chi-square value draws significance at five per cent level. The results thus indicated that the sample taken was appropriate to proceed with a factor analysis procedure. 3 Sreenivas. T, Srinivasarao.B and SrinivasaRao.U (2013), An Analysis on Marketing Mix in Hospitals, International Journal of Advanced Research in Management and Social Sciences, Volume No. 2, Issue No. 4, ISSN: 2278-6236, PP: 187-, April 4 NanditaLaishram androbitasorokhaibam (2012), Appraisal of Patient Satisfaction in Shija Hospital and Research Institute, Manipur, North-East India,International Journal of Scientific and Research Publications, Volume.No.2, Issue.No.11, ISSN 2250-3153, PP;1-4,November 79
TABLE: 2 COMMUNALITIES LEVEL OF PERCEPTION ABOUT HOSPITAL VARIOUS SERVICES OFFERED FROM ONE CATEGORY TO OTHER Variables Initial Extraction Registration Procedures Easy of get appointments with the doctors by telephone 1.000.989 Time taken to get an appointment with the doctors and consult the doctors 1.000.991 Conveniences of meeting the doctors concerned 1.000.993 Doctors Behaviour& Reliability in Service Correctly diagnose the diseases by the doctor 1.000.993 Explanations about the diseases by the Doctor 1.000.990 Doctor s behaviour 1.000.991 Diagnosing Procedures Acceptance of test reports taken outside or by other doctors 1.000.991 Time to take the test and prepare the report 1.000.989 Doctors explain adequately about the test reports 1.000.988 Doctors do not advice to take unnecessary tests 1.000.995 Doctors do not advice to take unnecessary surgery 1.000.993 Medicines availability within premises 1.000.993 Inpatient Services Compelling the patients to buy the medicines at that hospital itself 1.000.991 Compelling the patients to prolonged their stay for treatment at the hospital 1.000.992 Provision of uninterrupted hot and cold water in your room 1.000.991 Provision of uninterrupted power supply in the room 1.000.991 Variables Initial Extraction Cooperation of the Nurses and Other Staff Maintenance of the room and the bed (including the blankets and the pillows 1.000.989 Daily removal of the dusts and wastage in the room 1.000.993 Nurses administer the medicines to the patients on time 1.000.987 Sufficient Visiting Hours 1.000.989 Hospital & Other Services Function of emergency ward 1.000.995 Function of ICU ward 1.000.988 Other Services (Lift, Canteen, Parking Facilities & Medical Shops, ATM etc) 1.000.994 Cost of Services Health Services & Medical Cost 1.000.993 Other Services Other Services Time convinces & Discharges 1.000.999 In order to provide a more parsimonious interpretation of the results, 25 item scales was then Factor analyzed using the Principal Component method with Varimax rotation. 80
TABLE: 3 ROTATED COMPONENT MATRIX LEVEL OF PERCEPTION ABOUT HOSPITAL VARIOUS SERVICES OFFERED FROM ONE CATEGORY TO OTHER Variables Level of Perception Excellent Good Fair Poor Very Poor Registration Procedures et appointments with the doctors by telephone.622.606 - - - X 2 - Time taken to get an appointment with the doctors and consult the doctors.657.554 - - - X 3 - Conveniences of meeting the doctors concerned - -.726 - - Doctors Behaviour& Reliability in Service X 4 - Correctly diagnose the diseases by the doctor.586.695 - - - X 5 - Explanations about the diseases by the Doctor.616 - - - X 6 - Doctor s behaviour.789 - - - - Diagnosing Procedures X 7 - Acceptance of test reports taken outside or by other doctors.651. - - - X 8 - Time to take the test and prepare the report.721 - - - X 9 - Doctors explain adequately about the test reports.778 - - - - X 10 - Doctors do not advice to take unnecessary tests.802 - - - - X 11 - Doctors do not advice to take unnecessary surgery.699 - -. - X 12 - Medicines availability within premises -.726 - - - mpelling the patients to buy the medicines at that hospital itself.598.657 - - - X 14 - Compelling the patients to prolonged their stay for treatment at the hospital.705.506 - - - X 15 - Provision of uninterrupted hot and cold water in your room.606.640 - - - X 16 - Provision of uninterrupted power supply in the room.583.710 - - - Cooperation of the Nurses and Other Staff X 17 - Maintenance of the room and the bed (including the blankets and the pillows.726 - - - X 18 - Daily removal of the dusts and wastage in the room.586.695 - - - X 19 - Nurses administer the medicines to the patients on time.575.720 - - - X 20 - Sufficient Visiting Hours.580 - -.718 Hospital & Other Services X 21 - Function of emergency ward.802 - - - - X 22 - Function of ICU ward.798 - - - - X 23 - Other Services (Lift, Canteen, Parking Facilities & Medical Shops, ATM etc)unnecessary surgery - -.796 - - Cost of Services X 24 - Health Services & Medical Cost.691.517 - - - Other Services X 25 -Other Services Time convinces & Discharges -.530.705 - - Eigen value 23.818.508.222.153.087 % of Variance 95.272 2.034.889.611.348 Cumulative 95.272 97.306 98.195 98.806 99.154 Level of Significance: 5 per cent Five factors extracted together accounted for 99.154 percent of the total variance (information contained in the original 25 variables). This is pretty good, because the researcher was able to economize on the number of variables (from 25 researcher have reduced them to five underlying factors), while the data lost only about 99 percent of the information content (1 percent is retained by the five factors extracted out of the 25 original variables). Five factors were identified as being maximum percentage variance accounted. The variable X 1, X 2, X 4, X 5, X 6, X 7, X 8, X 9, X 10, X 11, X 13, X 14, X 15, X 16, X 17, X 18, X 19, X 20, X 21, X 22 and X 24 was grouped as factor I and it accounted for 95.272 per cent of the total variance. The variables X 1, X 2, X 4, X 7, X 8, X 12, X 13, X 14, X 15, X 16, X 18, X 19, X 24 and X 25 constituted the factor II and it accounted for 2.034 per cent of the total variance. The variable X 9,X 23 and X 25 constituted the factor III and it accounted for 0.889 per cent of the total 81
variance. The variable X 5 andx 11 constituted the factor IV and it accounted for 0.611 per cent of the total variance. The variable X 20 constituted the factor V and it accounted for 0.348 per cent of the total variance. TABLE: 4 FACTOR ANALYSIS AND RELIABILITY TEST LEVEL OF PERCEPTION ABOUT HOSPITAL VARIOUS SERVICES OFFERED FROM ONE CATEGORY TO OTHER Factors F 1 F 2 F 3 F 4 Factor Interpretation Excellent Good Fair Poor Variables included in the factors Easy of get appointments with the doctors by telephone, Time taken to get an appointment with the doctors and consult the doctors, Correctly diagnose the diseases by the doctor, Explanations about the diseases by the Doctor, Doctor s behavior, Acceptance of test reports taken outside or by other doctors, Time to take the test and prepare the report, Doctors explain adequately about the test reports, Doctors do not advice to take unnecessary tests, Doctors do not advice to take unnecessary surgery, Compelling the patients to buy the medicines at that hospital itself, Compelling the patients to prolonged their stay for treatment at the hospital, Provision of uninterrupted hot and cold water in your room, Provision of uninterrupted power supply in the room, Maintenance of the room and the bed (including the blankets and the pillows, Daily removal of the dusts and wastage in the room, Nurses administer the medicines to the patients on time, Sufficient Visiting Hours, Function of emergency ward, Function of ICU ward and Health Services & Medical Cost Easy of get appointments with the doctors by telephone, Time taken to get an appointment with the doctors and consult the doctors, Correctly diagnose the diseases by the doctor, Acceptance of test reports taken outside or by other doctors, Time to take the test and prepare the report, Medicines availability within, Compelling the patients to buy the medicines at that hospital itself, Compelling the patients to prolonged their stay for treatment at the hospital, Provision of uninterrupted hot and cold water in your room, Provision of uninterrupted power supply in the room, Daily removal of the dusts and wastage in the room, Nurses administer the medicines to the patients on time, Health Services & Medical Cost and Other Services Time convinces & Discharges Conveniences of meeting the doctors concerned, Other Services (Lift, Canteen, Parking Facilities & Medical Shops, ATM etc)unnecessary surgery and Other Services Time convinces & Discharges Explanations about the diseases by the Doctor and Doctors do not Cronbach s Alpha advice to take unnecessary surgery F 5 Very Poor Sufficient Visiting Hours 0.878 Source: Computed From Primary Data Factor analysis was used to find out the association between the levels of perception about hospital various services offered from one category to other. The Cronbach s reliability values (0.998, 0.996, 0.989, 0.954 and 0.878) indicate significant correlation in association between the levels of perception about hospital various services offered from one category to other. SUGGESTIONS OF TH E STUDY 1. The effect of patient characteristics on the different dimensions separately and specific recommendations for care are provided for particular patient groups. For both health status and education, the strongest effects were found on information and after care. Therefore, special attention has to go out for care after discharge for patients with a poor health status and higher educated patients, and more information should be given both during and after their discharge/visit. 2. Although patient satisfaction is proved to be an important measure of quality of care, it cannot be used as the only measure. It found that older patients assessments are not a sufficient basis for assessing the technical quality of their primary care. However it can give useful information for quality improvement next to other measures like patient experiences and records based measures. 0.998 0.996 0.989 0.954 82
3. Health service providers should look into these variables and use them to build strong relationships with their patients, for which competition has increased during recent years. This study helps doctors and health service providers to formulate strategies and tactics to effectively develop the loyalty of patients. It can help to secure loyal customers (patients) but also helps to generate and maintain long-term customers. 4. Trusting patients is the basis for creating committed customers as they should become loyal customers in the long term. Patients loyal to doctors can lead to the making of better diagnoses, reduction of patient desertion, development of efficient customer portfolios and minimization of searching costs for new- patients. Doctor can direct patients to trusted websites that contain reliable information. It may be more feasible for institutions such as hospitals, clinics and professional societies to recommend websites and to help patients assess them and for individual physicians to encourage doctor to use these institutional resources. CONCLUSION From the empirical data analysis it has been observed that the majority i.e., 75.80 per cent of the inpatients do not have problem in getting the appointment and consultation from the doctor. It has been found that the most of the inpatients have said that they are pleased with the courteous nature of doctors in particular multi speciality hospital and as the doctors in particular hospital do not prescribe unnecessary tests and surgeries. Whereas the respondents stated that particular medical center in Coimbatore lengthen their stay for treatment and the charges are too high for the stay. From the data discussion it has been observed that the majority of the inpatients exhibit high degree of satisfaction towards the reception services of particular hospital, pre-surgery care and the way they diagnose the disease. Further it has been inferred that the sample populations are found to be satisfied with the features such as pure drinking / hot water facilities, cooperation of nurses & other staff, ambulance services, housekeeping services and the mediclaim services provided in particular Private Multi - Speciality Hospital. 83