Development and Validation of Survey Instrument for Measurement of Hospital Functional Service Quality

Iram Fatima; Muhammad Shafiq; Ayesha Humayun

doi:10.53685/jshmdc.v5i1.188

Authors

Iram Fatima Institute of Quality and Technology Management, University of the Punjab, Lahore, Pakistan
Muhammad Shafiq Faculty of Quality and Industrial Systems Engineering, University of the Punjab, Lahore, Pakistan
Ayesha Humayun Department of Public Health and Community Medicine, Sheikh Zayed Postgraduate Medical Institute, Lahore, Pakistan

DOI:

https://doi.org/10.53685/jshmdc.v5i1.188

Keywords:

Service Quality, Func.Qual, Hospital, Survey Instrument

Abstract

Background: Emergency, diagnostics, and surgical services are critical areas of hospitals both in terms of technicalities and resource creation. The literature review reflects that there is a need to develop a survey instrument-based measurement model that can identify areas of functional service quality within hospital facilities based on patients’ perspectives as hospital quality improvement initiatives.

Objective: To design and validate an instrument that helps to evaluate the functional service quality of hospitals using structural equation modeling.

Methods: It was a mixed-method research having a cross-sectional study design. A total of 817 responses were purposively collected from consumers of surgical, emergency, and diagnostic departments of tertiary care hospitals. Simple descriptive, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed to identify the factors to formulate the instrument using SPSS Amos 20.0

Results: The study validated seven constructs for the development of Func.Qual (Survey instrument named to measure hospital functional service quality). Amongst these constructs’ assurance, responsiveness communication, and reliability are critical contributing factors reported earlier. Whereas promptness, food and aesthetics are new constructs extracted in local settings. The values of goodness of model fit indices found statistically valid with Comparative Fit Index (CFI=0.96), Root Mean Square Error of Approximation (RMSEA=0.055) and Standardized Root Mean Square Residual (SRMR=0.05).

Conclusion: Func.Qual is a powerful survey instrument to measure hospital functional service quality. The current study is an effort to enrich the literature associated with the body of knowledge for hospital functional service quality.

References

Ali J, Jusoh A, Idris N, Nor KM. Healthcare service quality and patient satisfaction: a conceptual framework. Int. J. Qual. Reliab. Manag. 2024; 41(2): 608-627. doi:10.1108/IJQRM-04-2022-0136 DOI: https://doi.org/10.1108/IJQRM-04-2022-0136

Taufik M, Abdat M, Saputra I, Usman S, Maulana T. Analysis of the Influence of Service Quality on the Brand Image of Sakinah General Hospital Lhokseumawe, Indonesi. Int. res. j. pharm. med. sci. 2024 7 (1): 72-75.

Gronroos C. A service quality model and its marketing implications. EJM. 1984; 18(4): 36-44. DOI: https://doi.org/10.1108/EUM0000000004784

Shabbir A, Malik SA, Malik SA. Measuring patients’ healthcare service quality perceptions, satisfaction, and loyalty in public and private sector hospitals in Pakistan. Int. J. Qual. Reliab. Manag. 2016; 33(5):538-557 doi:10.1108/IJQ RM-06-2014-0074 DOI: https://doi.org/10.1108/IJQRM-06-2014-0074

Ibrahim MS. Validating service quality (SERVQUAL) in healthcare: Measuring patient satisfaction using their perceptions in Jordan. J. Inf. Knowl. Manag. 2020; 19(01): 2040021. doi:10.1142/S0219649220400213 DOI: https://doi.org/10.1142/S0219649220400213

Ramli AH. Patient satisfaction, hospital image and patient loyalty in West Sulawesi Province. Business and entrepreneurial review. 2017; 17(1): 1-4. DOI: https://doi.org/10.25105/ber.v16i2.5088

Shafiq M, Naeem MA, Munawar Z, Fatima I. Service Quality Assessment of Hospitals in Asian Context: An Empirical Evidence From Pakistan. Inquiry. 2017; 54: 46958017714664.doi:10.1177/0046958017714664. DOI: https://doi.org/10.1177/0046958017714664

Amankwah O, Choong WW, Boakye-Agyeman NA. Patients satisfaction of core health-care business: the mediating effect of the quality of health-care infrastructure and equipment. J. Facil. Manag. 2024; 22(3): 365-381. doi:10.1108/JFM-12-2021-0154 DOI: https://doi.org/10.1108/JFM-12-2021-0154

Fatima I, Humayun A, Iqbal U, Shafiq M. Dimensions of service quality in healthcare: a systematic review of the literature. Int J Qual Health Care.2019; 31(1):11-29.doi:10.1093/intqhc/mzy1 25. DOI: https://doi.org/10.1093/intqhc/mzy125

Morgan DL. Focus groups as qualitative research. Sage publications; 1996. DOI: https://doi.org/10.4135/9781412984287

Lamm KW, Lamm AJ, Edgar D. Scale development and validation: Methodology and recommendations. J. int. agric. ext. educ. 2020; 27(2):24-35. doi:10.5191/jiaee.2020.27224 DOI: https://doi.org/10.5191/jiaee.2020.27224

Busby M, Matthews R, Burke FJ, Mullins A, Schumaker K. Long-term validity and reliability of a patient survey instrument designed for general dental practice. Br Dent J. 2015; 219(7): 337-341; discussion 342. doi: 10.1038/sj.bdj.2 015.749. DOI: https://doi.org/10.1038/sj.bdj.2015.749

Castle NG, Brown J, Hepner KA, Hays RD. Review of the literature on survey instruments used to collect data on hospital patients' perceptions of care. Health Serv Res. 2005; 40 (6 Pt2): 1996-2017. doi:10.1111/j.1475-6773. 2005.00475.x. DOI: https://doi.org/10.1111/j.1475-6773.2005.00475.x

Endeshaw B. Healthcare service quality-measurement models: a review. J. Health Res. 2021; 35(2): 106-117. DOI: https://doi.org/10.1108/JHR-07-2019-0152

Ibrahim MS, Ahmed MS. SERVQUAL reliability and validity a pilot study to evaluate patients’ satisfaction in the Jordanian hospitals. Int. Manag. Rev. 2019; 15(1):56-67.

Andaleeb SS. Service quality in public and private hospitals in urban Bangladesh: A comparative study. Health Policy. 2000; 53(1):25-37. doi:10.1016/s0168-8510(00)00077-4. DOI: https://doi.org/10.1016/S0168-8510(00)00077-4

Zarei E, Daneshkohan A, Pouragha B, Marzban S, Arab M. An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran. Glob. J. Health Sci. 2015; 7(1):1. doi: 10.5539/gjhs.v7n1p1 DOI: https://doi.org/10.5539/gjhs.v7n1p1

Dagger TS, Sweeney JC, Johnson LW. A hierarchical model of health service quality: scale development and investigation of an integrated model. J. Serv. Res. 2007; 10(2):123-142. doi:10.1177/1094670507309594 DOI: https://doi.org/10.1177/1094670507309594

Kilbourne WE, Duffy JA, Duffy M, Giarchi G. The applicability of SERVQUAL in cross‐national measurements of health‐care quality. J. Serv. Mark. 2004; 18(7): 524-533. doi:10.1108/08876040410561857. DOI: https://doi.org/10.1108/08876040410561857

Andaleeb SS. Public and private hospitals in Bangladesh: service quality and predictors of hospital choice. Health Policy Plan. 2000; 15(1): 95-102. doi: 10.1093/heapol/15.1.95 DOI: https://doi.org/10.1093/heapol/15.1.95

Andaleeb SS. Service quality perceptions and patient satisfaction: a study of hospitals in a developing country. Soc. Sci. Med. 2001; 52(9): 1359-1370. doi: 10.1016/s0277-9536(00)00235-5. DOI: https://doi.org/10.1016/S0277-9536(00)00235-5

Altuntas S, Dereli T, Yilmaz MK. Multi-criteria decision-making methods based weighted SERVQUAL scales to measure perceived service quality in hospitals: A case study from Turkey. Total Qual. Manag. Bus. Excell. 2012; 23(11-12):1379-1395.doi:10.1080/14783363.2012.661136 DOI: https://doi.org/10.1080/14783363.2012.661136

Akter MS, Upal M, Hani U. Service quality perception and satisfaction: a study over sub-urban public hospitals in Bangladesh. J. Serv. Res. 2008:125.