Analysis of Service Quality and Patient Satisfaction using SERVQUAL

Method in Particular Public Hospital

Johanes Ronaldy Polla

, Respati Wulandari

, Ezra Aileen

and Thalia Dwiutami

BINUS University, Jakarta, Indonesia

Keywords:

Service quality, Patient satisfaction, Hospital and SERVQUAL method.

Abstract:

The purpose of this research is to measure the quality of services and patient satisfaction in the particular

public hospital and to ﬁnd out which service dimension is the main priority for improvement. This research

measures the gap between patient expectation and patient perspective based on questionnaires completed by

202 patients from various polyclinics. This research used SERVQUAL method based on ﬁve dimensions of

service quality such as tangible, reliability, responsiveness, assurance, and empathy. The result of this research

found that the gap value from all dimensions are negative, and the main priority dimension for improvement

are empathy and responsiveness dimension. The conclusion is the service quality in the hospital has not been

satisfactory yet and the hospital should improve the quality of service in all dimensions especially on empathy

and responsiveness dimensions.

1 INTRODUCTION

Service quality means the fulﬁllment of patient ex-

pectations, the ability of service providers to fulﬁll

the needs and expectations of patients will gener-

ate a positive performanceof the ability of service

providers. If the performance of service quality is

positive and provider’s performance met the patients’

expectations, the patients will be more conﬁdent in

the ability and competence of the provider or hospital

(Zarei et al., 2015). According to (Long, ), healing

and recovery are no longer the only measurements of

patient satisfaction. (Akhade et al., 2016) conducted

research in hospitals in several countries. Problems

of service quality found in general were about the ef-

fectiveness of care, availability of resources, ﬁnancial

accessibility, modernization of equipment, timeliness

of care delivery, performance accuracy, improvement

of interpersonal relationships, communication skills

of doctors, nurses, and other hospital personnel.

Hospitals in Indonesia are ranked at 774 in Asia

rankings and ranked 3858 in the world rankings. Hos-

pitals in Indonesia are still unable to compete with the

hospitals in Singapore that ranked at 45 and Malaysia

ranked at 171 in Asia (Punnakitikashem et al., 2012).

Hospitals in Indonesia are left behind compared to

ASEAN countries. Indonesian people choose to have

medical treatment in other countries. It means that the

quality of hospitals in Indonesia should be improved,

this is also a proof that the hospitals’ quality of ser-

vice in Indonesia is still low and there are still many

hospitals that have poor service.

Based on observation in Particular public hospi-

tal, the main problem in the hospitalsis service quality

that has been complained by the patients. According

to the Law of the Republic of Indonesia number 44

year 2009 about hospitals, hospitals’ permits can be

revoked if the hospitals no longer meet the require-

ments and standards, therefore this study aims to mea-

sure the services quality provided by the hospitals,

and researchers try to determine the service quality

and the level of patient satisfaction in Particular pub-

lic hospital based on data and ﬁnd the right solution

to solve the problem. This research also ﬁnd that the

hospitalsprovide registration service via SMS Gate-

way, where allow the patients to register without need

to come to the hospital and queue up, but patients are

still complaining because the SMS Gateaway service

registration is limited per day. The purpose of this re-

search is to measure the services quality that is given

to the patients and to explore the patients satisfaction

in the Particular public hospital. This research will

ﬁnd which service dimension of servqual is the top

priority for an improvement in the Particular public

hospital.

Polla, J., Wulandari, R., Aileen, E. and Dwiutami, T.

Analysis of Service Quality and Patient Satisfaction using Servqual Method in Particular Public Hospital.

DOI: 10.5220/0009867802350241

In Proceedings of the International Conference on Creative Economics, Tourism and Information Management (ICCETIM 2019) - Creativity and Innovation Developments for Global

Competitiveness and Sustainability, pages 235-241

ISBN: 978-989-758-451-0

235

2 LITERATURE REVIEW

Based on (Parasuraman et al., 1980) cited in (Rezaei

et al., 2016), the main way to improve the service

quality in health sector is to monitor and evaluate the

services provided by companies using tools and mod-

els for quality measurement. One of the best and most

used models to evaluate the service quality in health

care is the SERVQUAL model.SERVQUAL method

aims to understand how customers perceive service

quality. Instruments or questionnaires are used to

compare what service companies should offer, their

expectations, and their performances of actual service

performance (Punnakitikashem et al., 2012).

The level of expectation and performance of ser-

vice quality is measured by ﬁve dimensions based on

(Manulik et al., 2016):

1. Tangibility (appearance of physical facilities,

equipments, and personnel)

2. Reliability (ability to perform promised services

accurately and appropriately)

3. Responsiveness (willingness to provide fast ser-

vice and ability to help customers)

4. Assurance (knowledge and propriety of employ-

ees, ability to build conﬁdence and trust)

5. Empathy (concern, individual attention given to

the company’s customers)

3 RESEARCH METHODOLOGY

The method used in this research is quantitative meth-

ods. Quantitative research is done bycollecting nu-

merical data, observing and measuring phenomena

that can be analyzed statistically, repeated and repli-

cated by the same researchers or other researchers

under imilar onditions (Hancock., 2002; Hamilton.,

2003) cited in (Everest, 2014).

The type of data used in this research is the pri-

mary data. Primary data refers to information ob-

tained directly by researchers on interest variables

for speciﬁc research purposes (Sekaran and Bougie.,

2013: p113). This research was conducted using con-

venience sampling technique.Convenience is collect-

ing information from a group of people who are will-

ing to give it (Sekaran and Bougie, 2016). There are

202 inpatients and outpatients from several polyclin-

ics in the hospital.

3.1 Data Collection

This study was conducted for a month by collecting

the information based on literature review related to

the research that taken from books, journals, previ-

ous research and others. Primary data collecting was

obtained through questionnaires distribution and by

short interview given to 202 patients in Particular par-

ticular public hospital from 23 polyclinics distributed

randomly from 23 polyclinics in the hospital, this is

limited due to a non-visited polyclinic for the sake of

joint health. Data processing in this research began

by testing validity and reliability.

The questionnare is based on 22 questions, it has

three parts of statements where the ﬁrst one is mea-

suring the importance of service quality, the second is

measuring atient xpectations, and the third is measur-

ing patient performances of the actual service deliv-

ered. The 22 questions are divided into 5 dimensions.

Each dimension measures the service on a scale of 1

to 5.

1. Tangibility 4 attributes (appearance of physical fa-

cilities, equipments, personnel)

2. Reliability 5 attributes (ability to perform

promised services accurately and appropriately)

3. Responsiveness 4 attributes (willingness to pro-

vide fast service and ability to help customers)

4. Assurance 4 attributes (employee knowledge and

decency, their ability to build trust)

5. Empathy 5 attributes (concern, individual atten-

tion given to the company’s customers)

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The following formula is used to calculate servqual

gap:

SQ = comparisono f expectation(E)

withper f ormancelevel(P)

SQ = P − E (1)

Figure 1: Operational Variables.

4 RESULTS AND DISCUSSION

Based on the data processing, found the result of re-

spondents by gender, as follows:

Figure 2: Respondents by gender.

Based on the data processing, found the results of

respondents by age, as follows:

Figure 3: Respondents by age.

Based on the data processing, found the results of

respondents by last education, as follows:

Figure 4: Respondents by last education.

Based on the data processing, found the results of

respondents by income, as follows:

Figure 5: Respondents by income.

Analysis of Service Quality and Patient Satisfaction using Servqual Method in Particular Public Hospital

237

Based on the data processing, found the results of

respondents by polyclinic, as follows:

Figure 6: Respondents by polyclinic.

Questionnaires were distributed to 23 polyclinics

in the hospital. The number of respondents obtained

is 202, which from 202 respondents have different

proﬁles. The result of respondent proﬁle data shows

that most patients of Particular public hospital are fe-

male with productive age that is 21 to 30 years old

with high school diploma or equal to working as a

housewife with income below 3 million.

Figure 7 are obtained from calculating the value of

servqual gap from patient Performance minus patient

Expectation.

Figure 7: Average servqual gap value.

The biggest gap found in P10 with the value of

-1.07 i.e. hospital employees have not been able to

provide services on time and P19 with a value of -1.06

i.e. the hospital does not have an organized schedule

because based on open questions, most of the patients

are complainingabout the queue and the service time-

liness.

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Overall the quality service from Particular public

hospital has not fulﬁll patients’ expectation because

patients’ expectation is higher than patient’ perfor-

mance.

Figure 8: Cartesian diagram

There are 4 quadrants in Cartesian diagram.

Quadrant I is the priority area that must be improved

because it has a very important value, but the service

has not met patient’s expectations. The attributes in-

cluded in quadrant II are P1 (the hospital has com-

plete medical equipment), P2 (the hospital has good

facilities), P10 (hospital employees provide services

on time), P16 (the hospital has friendly employees),

P19 (the hospital has an organized schedule).

Figure 9: Cartesian diagram Tangible dimension

The main priorities for improvement for the hospi-

tal are facilities and medical equipment in the hospi-

tal, because according to the short interview with the

patient, the medical equipments owned by the hospi-

tal are less complete and it also has inadequate hos-

pital facilities. The hospital is not able to do some of

emergency measures and major surgery.

Inpatient wards in hospitals are also inadequate

because hospital’s building has reached the maximum

capacity.

Figure 10: Cartesian diagram

Based on the calculation of servqual gap from the

average value of performance and the average value

of expectation on Reliability dimension, There is no

attributes included in quadrant I because according to

the patients’ performance, the attribute of Reliability

dimension is good enough.

Figure 11: Cartesian diagram Responsiveness dimension

Based on the calculation of servqual gap from the

average value of performance and the average value of

expectation on Responsiveness dimension, attributes

included in quadrant I is P10 (Hospital employees

provide services on time).

Analysis of Service Quality and Patient Satisfaction using Servqual Method in Particular Public Hospital

239

The attributes included in quadrant II is P11 (Hos-

pital employees are always ready to serve patients).

Figure 12: Cartesian diagram Assurance dimension

Based on the calculation of servqual gap from the

average value of performance and the average value

of expectation on Assurance dimension, the attribute

included in quadrant I is P16 (the hospital has friendly

employees). The attributes included in quadrant II is

P15 (the hospital employee makes the patient feel se-

cure). In the Assurance dimension, the main prior-

ity for improvement for the hospital is the hospitality

from hospital employees, because some patients feel

the nurse did not give appropriate hospitality. Based

on a short interview, sick patients want to get good

service from the nurses and doctors. But hospital’s

employees can make patients feel safe while in the

hospital because patients believe that they have been

treated by professionals.

5 CONCLUSIONS AND

RECOMMENDATION

The purpose of this research is to measure the ser-

vices quality that’s given to the patient and to explore

the patient satisfaction in the Particular public hos-

pital. This researchﬁnd which service dimension of

servqual is the top priority for an improvement in the

Particular public hospital, where the Servqual method

is used to know the gap value between patients per-

formance and patients expectation.

The result of this research from calculating the gap

in 22 attributes using Servqual method is negative.

The largest gap value was found in P10 with a value

of -1.07 i.e. hospital employees have not been able

to provide services on time and P19 with a value of

-1.06 i.e. hospital does not have an organized sched-

ule. The smallest gap value is found in P3 with val-

ues of - 0.47 i.e. Hospital employees are well dressed

and P17 with a value of -0.56 i.e. all hospital em-

ployees have a medical knowledge to answer patients’

questions. And also the service attributes, which ac-

cording to the patients, has the most important value,

so that the hospital should think and improve the ser-

vice are, P21 with values of 4.91 and P22 with values

of 4.92, where P21 is about the hospital already pro-

vides the best service to patientsand P22 is about the

hospital employees understand the needs of the pa-

tient because the patients expect the hospital to pro-

vide services in accordance with the required by the

patientand patients expect to get good service and feel

satisfy. In the level of service quality provided by the

hospital is found that the attributes of the ﬁve dimen-

sions have a negative gap value.

6 IMPLICATIONS

Based on the analysis results of this study, patients

expect the hospital can improve the service quality

by improving the timeliness of service. Manage the

doctors’ schedule by arranging the operation sched-

ule. When operation and visit schedule are managed,

patient will not wait too long for a visit. Manage the

queues in registration by increasing the registration

counters. Minimize the number of queues by adding

the registration quota via SMS Gateway or the hos-

pital can also create a special website to register, to

get the queue number and will also be determined at

what time the patient will be checked, so that patients

do not have to queue for too long and it will reduce

the number of queues in the hospital, and improve the

pharmacy queues by adding more of pharmacy staff.

The hospital is also expected to give individual care

and attention to the patient, hopefully patients would

feel more comfortable in the hospital.

7 LIMITATION

This research is limited to the service quality in partic-

ular public hospital with 202 respondents. Suggestion

for future research is to analyze and compare service

quality in more than one hospital, especially in pri-

vate hospitals. Find more respondents with various

backgrounds. Most respondents in this study chose

the hospital because this hospital because it is free of

charge and they get recomendation letter from their

nearest health care.

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