The Mediating Effect of Patient Satisfaction in the Patients' Perceptions of Healthcare Quality - Patient Trust Relationship

The main purpose of this study is to investigate the relationship between patient perception of healthcare quality, patient satisfaction, and patient trust and the mediating effect of patient satisfaction. Study aim also to test the significance of socio-demographic variables in determining healthcare quality, patient satisfaction, and patient trust. Patient perception of healthcare quality was measured using modified SERVQUAL model and results indicate that it appears to be a consistent and reliable scale. Finding indicate that, while patient perception of healthcare quality has a strong and positive impact on the patient satisfaction and patient trust , patient satisfaction has also significant impact on patient trust. Moreover, patient satisfaction appears to play an important mediating role in increasing the strength of the association between healthcare quality and patient trust in healthcare service provider. Results confirm the varying importance of some socio-demographic variables on patient perception of healthcare quality, patient satisfaction, and patient trust. It has also been found that private hospitals have higher overall healthcare quality than public hospitals. Study indicate that patient of private hospitals are more satisfied and feel more trust in healthcare service provider than public hospitals.

[1]  O. Souelem Mental patients' attitudes toward mental hospitals. , 1955, Journal of clinical psychology.

[2]  J. Hillson,et al.  Attitudes toward mental hospitals. , 1956, Journal of clinical psychology.

[3]  A. Parasuraman,et al.  A Conceptual Model of Service Quality and Its Implications for Future Research , 1985 .

[4]  A. Donabedian,et al.  The quality of care. How can it be assessed? , 1988, JAMA.

[5]  B. McNeil,et al.  Patient satisfaction as an indicator of quality care. , 1988, Inquiry : a journal of medical care organization, provision and financing.

[6]  A. Parasuraman,et al.  SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. , 1988 .

[7]  A. Woodside,et al.  Linking service quality, customer satisfaction, and behavioral intention. , 1989, Journal of health care marketing.

[8]  Stephen W. Brown,et al.  A Gap Analysis of Professional Service Quality , 1989 .

[9]  B. Weiss,et al.  Patient Satisfaction Survey Instrument for Use in Health Maintenance Organizations , 1990, Medical care.

[10]  J. Carman Consumer perceptions of service quality: an assessment of the SERVQUAL dimensions , 1990 .

[11]  H. Vuori,et al.  Patient satisfaction--does it matter? , 1991, Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care.

[12]  Uolevi Lehtinen,et al.  Two Approaches to Service Quality Dimensions , 1991 .

[13]  R M Shewchuk,et al.  A model of service quality perceptions and health care consumer behavior. , 2008, Journal of hospital marketing.

[14]  M P Malone,et al.  Satisfied patients can spell financial well-being. , 1991, Healthcare financial management : journal of the Healthcare Financial Management Association.

[15]  A. Parasuraman,et al.  Refinement and reassessment of the SERVQUAL scale. , 1991 .

[16]  W. Mangold,et al.  Adapting the SERVQUAL scale to hospital services: an empirical investigation. , 1992, Health services research.

[17]  B. Lin,et al.  A Framework for Measuring Quality in Health Care , 1992 .

[18]  Steven A. Taylor,et al.  Measuring Service Quality: A Reexamination and Extension , 1992 .

[19]  R. Teas,et al.  Consumer Expectations and the Measurement of Perceived Service Quality , 1993 .

[20]  Gilbert A. Churchill,et al.  Improving the measurement of service quality , 1993 .

[21]  Walbridge Sw,et al.  Measuring physician attitudes of service quality. , 1993 .

[22]  M Peyrot,et al.  Consumer satisfaction and perceived quality of outpatient health services. , 1993, Journal of health care marketing.

[23]  A. Parasuraman,et al.  More on improving service quality measurement , 1993 .

[24]  R. Teas,et al.  Expectations, Performance Evaluation, and Consumers’ Perceptions of Quality , 1993 .

[25]  L. Delene,et al.  Measuring physician attitudes of service quality. , 1993, Journal of health care marketing.

[26]  R M Shewchuk,et al.  The great gap. Physicians' perceptions of patient service quality expectations fall short of reality. , 1994, Journal of health care marketing.

[27]  A. Parasuraman,et al.  Alternative scales for measuring service quality: A comparative assessment based on psychometric and diagnostic criteria , 1994 .

[28]  Steven A. Taylor,et al.  Distinguishing service quality from patient satisfaction in developing health care marketing strategies. , 1994, Hospital & health services administration.

[29]  Stephen W. Brown,et al.  Consumer satisfaction and perceived quality: Complementary or divergent constructs? , 1994 .

[30]  J E Swan,et al.  What attributes determine quality and satisfaction with health care delivery? , 1994, Health care management review.

[31]  Imad B. Baalbaki,et al.  International Services Marketing: A Comparative Evaluation of the Dimensions of Service Quality between Developed and Developing Countries , 1994 .

[32]  S. A. Scardina,et al.  SERVQUAL: a tool for evaluating patient satisfaction with nursing care. , 1994, Journal of nursing care quality.

[33]  G. Hogg,et al.  Uninformed choice. , 1994, Journal of health care marketing.

[34]  Perceptions of responsiveness in service delivery. , 1995, Journal of hospital marketing.

[35]  K E Clow,et al.  Patient expectations of dental services. Image affects expectations, and expectations affect perceived service quality. , 1995, Journal of health care marketing.

[36]  B Lin,et al.  Methodological issues in patient satisfaction surveys. , 1995, International journal of health care quality assurance.

[37]  M. Fusilier,et al.  AIDS patients' perceptions of nursing care quality. , 1995, Journal of health care marketing.

[38]  G Chakraborty,et al.  Diagnosing perceived quality in the medical service channel. , 1995, Journal of health care marketing.

[39]  F. Buttle SERVQUAL: review, critique, research agenda , 1996 .

[40]  Simon S. K. Lam,et al.  SERVQUAL: A tool for measuring patients' opinions of hospital service quality in Hong Kong , 1997 .

[41]  D. Altman,et al.  Statistics notes: Cronbach's alpha , 1997 .

[42]  R. Rosenheck,et al.  Influence of patient and hospital factors on consumer satisfaction with inpatient mental health treatment. , 1997, Psychiatric services.

[43]  J. Dietz Satisfaction: A Behavioral Perspective on the Consumer , 1997 .

[44]  R. Kane,et al.  The relationship of patient satisfaction with care and clinical outcomes. , 1997, Medical care.

[45]  G. Zsidisin,et al.  The Identification and Measurement of Quality Dimensions in Health Care: Focus Group Interview Results , 1998, Health care management review.

[46]  S. Andaleeb,et al.  Determinants of customer satisfaction with hospitals: a managerial model. , 1998, International journal of health care quality assurance incorporating Leadership in health services.

[47]  Anna S. Mattila,et al.  The role of culture and purchase motivation in service encounter evaluations , 1999 .

[48]  N. Tang,et al.  An innovative framework for health care performance measurement , 1999 .

[49]  A. Dean,et al.  The applicability of SERVQUAL in different health care environments. , 1999, Health marketing quarterly.

[50]  J. Sitzia How valid and reliable are patient satisfaction data? An analysis of 195 studies. , 1999, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[51]  Ananthanarayanan Parasuraman Superior Customer Service and Marketing Excellence: Two Sides of the Same Success Coin , 2000 .

[52]  N. Tang,et al.  A study of patients' expectations and satisfaction in Singapore hospitals. , 2000, International journal of health care quality assurance incorporating Leadership in health services.

[53]  C. Grönroos Service Management and Marketing: A Customer Relationship Management Approach , 2000 .

[54]  Maxwell Drain Quality Improvement in Primary Care and the Importance of Patient Perceptions , 2001, The Journal of ambulatory care management.

[55]  P. Auquier,et al.  Development of a French inpatient satisfaction questionnaire. , 2001, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[56]  A. Zaslavsky,et al.  Adjusting for Patient Characteristics When Analyzing Reports From Patients About Hospital Care , 2001, Medical care.

[57]  Raymond Liu,et al.  Recognizing cross‐cultural differences in consumer complaint behavior and intentions: an empirical examination , 2001 .

[58]  S. Andaleeb,et al.  Service quality perceptions and patient satisfaction: a study of hospitals in a developing country. , 2001, Social science & medicine.

[59]  K Kroenke,et al.  Predictors of patient satisfaction. , 2001, Social science & medicine.

[60]  J. Arnetz,et al.  Quality of paediatric care: application and validation of an instrument for measuring parent satisfaction with hospital care. , 2001, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[61]  J. J. Cronin,et al.  Some New Thoughts on Conceptualizing Perceived Service Quality: A Hierarchical Approach , 2001 .

[62]  M. Rahmqvist,et al.  Patient satisfaction in relation to age, health status and other background factors: a model for comparisons of care units. , 2001, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[63]  Norizan M. Kassim,et al.  Service quality: gaps in the Malaysian telemarketing industry , 2002 .

[64]  J. L. Tucker The moderators of patient satisfaction. , 2002, Journal of management in medicine.

[65]  P. Laippala,et al.  Measurement of outpatients' views of service quality in a Finnish university hospital. , 2002, Journal of advanced nursing.

[66]  S. Hampson,et al.  The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. , 2002, Health technology assessment.

[67]  J. Gurwitz,et al.  A demonstration of the impact of response bias on the results of patient satisfaction surveys. , 2002, Health services research.

[68]  F. Guillemin,et al.  Factors determining inpatient satisfaction with care. , 2002, Social science & medicine.

[69]  A. Caruana Service loyalty: The effects of service quality and the mediating role of customer satisfaction , 2002 .

[70]  William C. Johnson,et al.  Service quality in the Thai telecommunication industry: a tool for achieving a sustainable competitive advantage , 2002 .

[71]  S. Margolis,et al.  Patient satisfaction with primary health care services in the United Arab Emirates. , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[72]  T. Powers,et al.  The satisfaction score. , 2003, Marketing health services.

[73]  J. Seager,et al.  Interpersonal and organizational dimensions of patient satisfaction: the moderating effects of health status. , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[74]  Rodolfo Vázquez,et al.  The Role of Market Orientation In Business Dyadic Relationships: Testing an Integrator Model , 2003 .

[75]  Michael Duffy,et al.  The applicability of SERVQUAL in cross‐national measurements of health‐care quality , 2004 .

[76]  Ding Hooi Ting,et al.  Service quality and satisfaction perceptions: curvilinear and interaction effect , 2004 .

[77]  Kevin Au,et al.  Attributions on dissatisfying service encounters , 2004 .

[78]  Michel Laroche,et al.  Service Quality Perceptions and Customer Satisfaction: Evaluating the Role of Culture , 2004 .

[79]  Woo-Hyun Cho,et al.  The relationships among quality, value, satisfaction and behavioral intention in health care provider choice: A South Korean study , 2004 .

[80]  J. James,et al.  Service quality dimensions: an examination of Grönroos’s service quality model , 2004 .

[81]  Naresh K. Malhotra,et al.  Dimensions of service quality in developed and developing economies: multi‐country cross‐cultural comparisons , 2005 .

[82]  Mary Anne Raymond,et al.  A comparison of service quality dimensions conveyed in advertisements for service providers in the USA and Korea , 2005 .

[83]  Naceur Jabnoun,et al.  A customized measure of service quality in the UAE , 2005 .

[84]  Anupama D. Ramachandran,et al.  Standards and Customer Satisfaction in the Healthcare Industry , 2005 .

[85]  Fatma Pakdil,et al.  Patient satisfaction in a preoperative assessment clinic: an analysis using SERVQUAL dimensions , 2005 .

[86]  Huseyin Arasli,et al.  Customer service quality in the Greek Cypriot banking industry , 2005 .

[87]  Argyro Kanousi,et al.  An empirical investigation of the role of culture on service recovery expectations , 2005 .

[88]  M. Hall,et al.  The Importance of Trust for Ethics, Law, and Public Policy , 2005, Cambridge Quarterly of Healthcare Ethics.

[89]  Mosad Zineldin,et al.  The quality of health care and patient satisfaction: an exploratory investigation of the 5Qs model at some Egyptian and Jordanian medical clinics. , 2006, International journal of health care quality assurance incorporating Leadership in health services.

[90]  Boo Ho Voon,et al.  Linking a service‐driven market orientation to service quality , 2006 .

[91]  V. Entwistle,et al.  Trust in the context of patient safety problems. , 2006, Journal of health organization and management.

[92]  Antonio Escobar,et al.  Predictors of patient satisfaction with hospital health care , 2006, BMC Health Services Research.

[93]  G. Svensson New aspects of research into service encounters and service quality , 2006 .

[94]  U. Senarath,et al.  Factors determining client satisfaction with hospital‐based perinatal care in Sri Lanka , 2006, Tropical medicine & international health : TM & IH.

[95]  Charles R. Gowen,et al.  Exploring the efficacy of healthcare quality practices, employee commitment, and employee control , 2006 .

[96]  G. Rand,et al.  Cultural influences on service quality and customer satisfaction: evidence from Greek insurance , 2007 .

[97]  Joel Harmon,et al.  Links Among High‐Performance Work Environment, Service Quality, and Customer Satisfaction: An Extension to the Healthcare Sector , 2007, Journal of healthcare management / American College of Healthcare Executives.

[98]  K. Kueh,et al.  Culture and service quality expectations , 2007 .

[99]  G. Rosenthal,et al.  Are older patients more satisfied with hospital care than younger patients? , 2007, Journal of General Internal Medicine.

[100]  Rooma Roshnee Ramsaran-Fowdar,et al.  The relative importance of service dimensions in a healthcare setting. , 2008, International journal of health care quality assurance.

[101]  Christina Laspa,et al.  Patient Satisfaction Measurement for In-Hospital Services: A Pilot Study in Greece , 2008 .

[102]  Naresh K. Malhotra,et al.  Relationship Marketing, Customer Satisfaction and Loyalty: A Theoretical and Empirical Analysis From an Asian Perspective , 2008 .

[103]  Birgit Leisen Pollack,et al.  The nature of the service quality and satisfaction relationship , 2008 .

[104]  Maria Helena Vinagre,et al.  The influence of service quality and patients' emotions on satisfaction. , 2008, International journal of health care quality assurance.

[105]  M. Badri,et al.  Testing not-so-obvious models of healthcare quality. , 2008, International journal of health care quality assurance.

[106]  Riadh Ladhari A review of twenty years of SERVQUAL research , 2009 .

[107]  G. Zipp,et al.  The Relationship Between Patient Satisfaction and Inpatient Admissions Across Teaching and Nonteaching Hospitals , 2009, Journal of healthcare management / American College of Healthcare Executives.

[108]  M. Badri,et al.  Healthcare quality and moderators of patient satisfaction: testing for causality. , 2009, International journal of health care quality assurance.

[109]  John T. Mentzer,et al.  Creating commitment and loyalty behavior among retailers: what are the roles of service quality and satisfaction? , 2009 .

[110]  Devanathan Sudharshan,et al.  Segmentation and Resource Allocation The Relationships between Culture and Service Quality Perceptions: Basis for Cross-Cultural Market , 2009 .

[111]  Aditi Naidu,et al.  Factors affecting patient satisfaction and healthcare quality. , 2009, International journal of health care quality assurance.

[112]  L. Alrubaiee,et al.  Investigate the Impact of Relationship Marketing Orientation on Customer Loyalty: The Customer's Perspective , 2010 .