St.

Andrew’s College
Of Arts, Science and Commerce
St.Domnic Road, Bandra (W)
Mumbai 400050

Certificate

This is to certify that the above mentioned students have done

the project on 18 September 2009 as a part of Service sector
management Subject.

This study has been carried out by the students under my

guidance and supervision during the period of 2009-10. The
project work is original and authentic to best of knowledge.

Place: Mumbai

Date:

Signature of the guide

 TABLE OF CONTENTS Page No.

1. Introduction to Service Sector

2. Concept of Service Marketing

3. Hospitals in India

4. History of Hospitals

5. PEST Analysis

6. Unique Characteristics of Hospitals

7. Classification of Hospitals

8. 7 P’s of Hospital Sector

9. Market sementation

10.Quality Dimension

11.Conclusion

INTRODUCTION- SERVICE SECTOR

The service sector has been growing significantly for more than
fifty years to the extent that in the developed world, more people
earn their living from producing services than making
manufactured goods. In fact around three quarters of the
population in the United States and the European Union are
employed in service industries. Services therefore have a major
impact on national economies. The subject of Services Marketing
has grown in response to this. Latterly however, manufacturing
and technology industries have also recognised the need to
provide services not only as a means of adding value to the
physical products which they market but also as the basis for a
different orientation to the management of their businesses. This
module will address the key issues, concepts and models which
form the core of Services Marketing theory, focusing, as far as
possible, on the service industries of relevance to students taking
the module.

What is a Service?

Services include all economic activities whose output is not a

physical product or construction, is generally consumed at the
time it is produced and provides added value in forms (such as
convenience, timeliness, comfort or health). That is essentially
intangible concerns of its first purchaser.
Concept of ‘Service Marketing’
The perception of service marketing focuses on selling the
services in the best interest of users/ customers. Marketing a
service is meant marketing something intangible. It is marketing
a promise. In the marketing of services, we go through a number
of problems directly or indirectly influencing the business index.
The problems like market segmentation, marketing information
system, behavioral management are studied minutely which
simplify the task of formulating a sound mix for marketing, such
as Product mix, Promotion mix, Price mix and the Place mix. It is
important to mention that we find “People” an important mix of
marketing services. If we market the services in a right direction,
the available opportunities can be capitalized on optimally and
also it contributes substantially to the process of development. In
view of the above, we observe the following key points regarding
the concept or perception of services marketing:
• It is a managerial process of managing the services.
• It is an organized effort for providing a sound foundation for
the development of an organization.
• It is a social process helping an organization to understand
the emerging social problem and to take part in the social
Service Management is:
transformation process to justify its existence in the society.
1) To understand the utility the customers receive by consuming or using the service
offering of the organization
2) To understand how the organization (personnel, technology, physical resources,
systems and customers) will be able to produce and deliver this utility
3) To understand how the organization should be developed and managed so that the
intended quality can be achieved
4) To make the organization function so that this quality can be delivered on a
continuous basis.
 THE HOSPITAL INDUSTRY

Today the hospital is a place for diagnosis and treatment of

human ailments and restoration of health and well being. The
basic function of a hospital is to give proper treatment to the
injured and sick without having any social, economic and racial
discrimination.

Some of the other important functions and services of modern

hospitals are training of the doctors and nurses, support to
medical research and assistance to all activities carried out by
public health and voluntary agencies to prevent diseases. It is
also a center for training of health workers and bio-social
research. Today it also acts as an institution that provides
accommodation to patients for medical nursing and care. Medical
services are primarily provided by the central and state
governments.

Hospitals are not for profit making, they are social institutions
that make the required medical services available to society. With
time the classes and quality of hospitals have changed a lot .
Most hospitals today are trying to provide all ultra facilities and
are in the process of making state of the art hospitals. Hospitals
provide the infrastructure facility to healthcare

The last two decades have seen the mushrooming of corporate

and privately run hospitals. Most large trust and corporate
hospitals have invested in modern equipment and focus on super-
specialties.

The private sector accounts for 70% of primary medical care and
40% of all hospital care in India. They employ 80% of the
country’s medical personnel.

The corporate hospital sector is most evolved in the south while

charitable/trust hospitals proliferate in the west. However, the
north and east are also showing a growing trend in private
hospital expansion. Key therapeutic areas are cardiology,
nephrology, oncology, orthopedics, geriatrics, maternity and
trauma/critical care.

Hospitals are not for profit making, they are social institution to
make available to society the required Medicare services.
However this may not be true for private hospitals. Today
hospitals are a place of diagnosis and treatment of human ills, for
the training research, promoting health care activities and to
some extent a center helping biosocial research. WHO states that
hospitals are socio-medical organization whose functions are:
Curative, preventive, patient services and training of health
workers in biosocial research.

With time the classes and quality of hospitals have changed a lot
today. Most hospitals today are trying to provide all ultra facilities
and are in the process of making state of the art hospitals.
Hospitals provide the infrastructure facility to healthcare.

Hospitals in India

By the late 1980s, there were approximately 128 medical

colleges--roughly three times more than in 1950. Data for 1987
shows that there were 320,000 registered medical practitioners
and 219,300 registered nurses. Various studies have shown that
in both urban and rural areas people preferred to pay and seek
the more sophisticated services provided by private physicians
rather than use free treatment at public health centres.

The fast pace of development of the private medical sector and

the burgeoning middle class in the 1990s have led to the
emergence of the new concept in India of establishing hospitals
and health care facilities on a for-profit basis.
Current Scenario

India, the growing economic power in Asia is witnessing frenetic

growth of its health care sector. India’s much-noted economic
growth is rapidly improving living standards and the healthcare
industry will be a major beneficiary of the overall increase in
incomes. Recent major regulatory reforms have improved the
growth prospects for health insurance and, as a result, a large
section of middle income families will be able to afford healthcare
services leading to high demand.

The report of the National Commission on Macroeconomics and

Health had estimated the size of private healthcare sector in India
to be worth Rs 69,000 crore and projected that size to double to
Rs 156,000 crore by 2012,besides an additional Rs 39,000 crore if
health insurance picks up. With the current pace, the corporate
segment in the private medical service sector is likely to absorb a
good share of this business.

Large domestic market is well complemented by inflow of

overseas Medical tourists. The number of Medical tourists has
increased ten-fold from 10,000 in 2000-01 to about 100,000 in
2004-05.
HISTORY OF HOSPITALS

Etymology
During the Middle Ages the hospital could serve other functions,
such as almshouse for the poor, or hostel for pilgrims. The
name comes from German “hospes” (host), which is also the
root for the English words hotel, hostel, and hospitality.

Early history
In ancient cultures, religion and medicine were linked. The
earliest known institutions aiming to provide cure were
Egyptian temples. Greek temples dedicated to the healer-
god Asclepius might admit the sick, who would wait for
guidance from the god in a dream. The Romans adopted his
worship.

The Sinhalese (Sri Lankans) are perhaps responsible for

introducing the concept of dedicated hospitals to the world.

Institutions created specifically to care for the ill also appeared

early in India. King Asoka founded 18 hospitals in 230 BC.
There were physicians and nursing staff, and the expense
was borne by the royal treasury. State-supported hospitals
later appeared in China during the first millennium A.D.
Statistics
Number of Hospitals:
States Government Private Total
Punjab 174 39 217
Haryana 58 20 78
Maharashtra 445 2583 3115
Gujarat 263 2031 2370
Rajasthan 218 0 218
H.P 46 6 57
Karnataka 209 56 293
W. Bengal 242 129 392
Kerala 141 1899 2040
Assam 141 80 268
A.P 141 1722 1863
U.P 534 139 652
Tamilnadu 282 119 408
M.P 363 0 363
Bihar 237 90 328
Orissa 250 29 284

PEST ANALYSIS

In India even after 60 years of independence we all have to

accept that the government has failed to provide the basic health
care facilities in many areas. Health care sector is one of the most
neglected which is only meant for slogans by most of our
politicians. Following are the list of factors that affect the health
care sector:

POLITICAL FACTORS

 There are non- merit quotas in medical institutions which is

adversely affecting the quality & perhaps, the availability of
trained and skilled medical professionals. It is said that
because of these reservations the quality of the future Indian
doctors will be very poor.
 It is mandatory for the hospitals to keep 20% of the beds
free for those from the lower classes who cannot afford
costly treatments.
 Providing subsidized land and equipment to Hospitals will
help them cater to their poorer patients better.
 Reduction in Import duties will help Hospitals acquire new,
modern and more sophisticated medical equipment and
technologies.

ECONOMIC FACTORS

 Because of the increase in the per capita income amongst

the higher and middle classes of the society there has been
 an increase in the spending from these classes in the health
care sector.
 Service Tax on Hospital services @ 12.24% has increased
the costs of services provided by the Hospitals. In addition,
the cost of input services (electricity, cleaning, maintenance,
laboratory, laundry, patient care, transportation, ancillary
services etc.) has increased due to imposition of service tax
and a hike in Tax rate from 10% to 12%.
 Cost advantage in healthcare that India offers coupled with
technologically advanced medical treatment system has
helped in the growth of medical tourism.
 The cost of making and maintaining a hospital is extremely
high.
 Introduction of Private Medical insurers has increased the
reach of medical insurance amongst the Indian public. This is
helping the hospitals service more patients.
 Third Party Administrators (TPA’s) has increased the claims
settlement rate at increased cost of medical insurance.

SOCIAL FACTORS

 Certain percentages of beds have to be kept for poor people.

For example in Bombay 20% of the beds have to be kept
reserved for poor people whether it is a private or a public
 hospital.
 Look after the needs of local poor people.
 Open counseling and relief centres.
 Safe disposal of hospital wastes like used injection needles,
waste blood etc & taking care of the environment is to be
given high priority.
 Campaigns and free medical checkups have to be conducted
whenever necessary.
 In brief the social aspect of the hospital industry is to see
that latest treatment and medicines are available to people
at large at concessional rates or free of cost and that its
activities are not only restricted to rich people.

TECHNOLOGICAL FACTORS

 A large number of technically qualified professionals have

made it possible to expand the medical services.
 Computerization and telecommunication services have made
remote area treatment a reality.
 Use of new age equipments is making the delivery of
medical treatment better.
  Stem cell research has opened up a whole new arena of
Hospital services, wherein, a new body part can be grown to
replace a dead or a diseased organ within the body of the
patient.
 Robotics micro-surgery: - a greater degree of robotics
technology in operating room to provide precise and less
traumatic as well as less destructive surgery.
 Laser technology
 Employment of information technology tools for networking
of examination rooms, treatment rooms, operating rooms
and diagnostic reporting rooms.
 Deployment of information technology tools for generation of
specific disease related databases, classified by a number of
variables.

UNIQUE CHARACTERISTICS OF SERVICES With

Respect To Hospitals
 There are four commonly cited characteristics of services
that make them different to market from goods: Intangibility,
Inseparability, Variability and Perishability.

INTANGIBILITY:
Intangible means that which cannot be seen or touched.
Intangible services are difficult to sell because they cannot be
produced and displayed ahead of time. They are therefore harder
to communicate to prospective customers.

Example – A services of a surgeon cannot be seen, it can only

be felt and the difference in the patient can be noticed when he
recovers, hence the doctor charges a premium for the services
offered by him.

INSEPARABILITY:

This characteristic is interpreted differently by different

service marketing marketers, but all interpretations point out that
special operation problems exist for the firm's managers. One
interpretation of this term is the inseparability of customers from
the service delivery process. In particular, many services require
the participation of the customer in the production process.

In case of the hospital industry, patient has to present for

experiencing the services being offered. Only then can he be
treated. In case if he is not present in person he would have to
communicate with the doctor to get some feedback, the doctors
can work only when there are patients, A Hospital Industry will not
work if there are only patients and no doctors.

VARIABILITY :

The fact that service quality is difficult to control compounds the

marketer's task. Intangibility alone would not be such a problem
in customers could be sure that the services they were to receive
would be just like the successful experiences their neighbors were
so pleased with. But in fact, customers know that services can
vary greatly. Even the same service provider has good days and
bad days or may be less focused at different times of day.
Services are performances, often involving the cooperation and
skill of several individuals, and are therefore unlikely to be same
every time. This potential variability of service quality raises the
risk faced by the consumer.

In the hospital industry, the services offered by one doctor

cannot be indentical to the services of another doctor as it may
vary due to several reasons such as experience, degree ,
knowledge etc. Also the services provided by one doctor to one
patient cannot be the same when he operates the same patient
again as all these things are even situational.
PERISHABILITY:

The fourth characteristic distinguishing services from goods is

their time dependence. Services cannot be inventoried, since they
are performed in real time. And time periods during which service
delivery capacity sits idle represent revenue-earning potential
that is lost forever. Periods of peak demand cannot be prepared
for in advance by producing and storing services, nor can they be
made up for after the fact. A service opportunity occurs at a point
in time, and when it is gone, it is gone forever. This can present
great difficulty in facilities planning
In the hospital industry, the injection used for one Patient cannot
be used for the other patient, there has to be a new set up for the
other patient, hence the other items used by one patient cannot
be inventoried by the others.
 CLASSIFICATION OF HOSPITALS

There are different types of hospitals established with the motto

of offering the medcare services and educational and training
facilities. In a natural way, we find distinction in their structure,
function and performance. The classification is found based on

different criteria as mentioned below.

Classification on the basis of objective

On the basis of the objective, there are three types of hospitals,
Teaching-cum-research for developing medicos and promoting
research to improve the quality of medical aid. General hospitals
are for treating general ailments and Special hospitals for
specialized services in one or a few selected areas.
This shows what is the main intention or motive of setting up the
hospital

On the basis of the OBJECTIVE there are three types:

 Classification of Hospitals on the basis of objective

Teaching cum research

This is for developing and promoting research to improve the

medical aid. These hospitals are affiliated with universities for
medical research and the training of medical personnel. Large
teaching/ research hospitals have a variety of goals. In addition to
treating patients, they are training sites for physicians and other
health professionals. Teaching institutions are almost always
affiliated with a medical school, which means patients have
access to highly skilled specialists who teach at the school and
are familiar with up-to-the-minute technology.
E.g. Pravara Medical Hospital & College, Pravara is a Teaching-
cum-research hospital.

General

The best-known type of hospital is the general hospital which is

set up to deal with many kinds of disease and injury, and typically
has an emergency ward to deal with immediate threats to health
and the capacity to dispatch emergency medical services. A
general hospital is typically the major health care facility in its
region, with large numbers of beds for intensive care and long-
term care; and specialized facilities for surgery, plastic surgery,
childbirth, bioassay laboratories, and so forth. General hospitals
minister to all types of illness.

Special

This is for treating specialized ailments or providing specialized

services in one or a few selected areas. Types of specialized
hospitals include trauma centers, children's hospitals, seniors'
hospitals, and hospitals for dealing with specific medical needs
such as psychiatric problems. Special hospitals are concerned
with only one disease or group of diseases.
VIMHANS is known for gamma-knife therapy and is a preferred
centre for brain and spinal surgery. Every year this hospital gets
60-70 patients, half of them from Mauritius with neurological
disorders requiring micro-brain surgery.

Classification on the basis of ownership

On the basis of ownership, there are four types of hospitals. This

shows who owns a hospital or in other words who are the owners
or have possession of the hospital. It can be divided in the
following ways:

On the basis of the OWNERSHIP, there are four types:

Classification of Hospitals on the basis of ownership

Government

This is owned managed and controlled by government.

Government hospitals are operated and maintained wholly by the
national, provincial, city or municipal government, or other
political unit; or by any department, division, board or agency
thereof.
E.g. Nair Hospital and St. George are Government Hospitals.

Semi-Government
This is partially shared by the government. Semi-Government
hospitals are operated and maintained partially by the national,
provincial, city or municipal government, or other political unit; or
by any department, division, board or agency thereof.

Private

Private hospitals are privately owned, established and operated

with funds through donation, principal, investment, or other
means, by any individual, corporation, association, or
organization. They are profit-making institutions. Proprietary
hospitals are owned by corporations or, less often, by individuals
such as doctors who practice at the hospital. Hospital
corporations usually own a chain of institutions located in several
states, and they often own nursing homes or other types of health
care facilities as well.

Voluntary Agencies

These agencies are the ones that run hospitals. Hospitals run by
voluntary organizations. Many hospitals have hospital volunteer
programs where people (usually students and senior citizens) can
volunteer and provide various ancillary services. A voluntary
hospital is a nonprofit community facility operating under
religious or other voluntary auspices. Ultimate responsibility for
all that takes place at the hospital rests with its board of trustees,
generally selected from the community's business and
professional people, who serve without pay. To manage the
hospital the trustees appoint a paid administrator.

Classification on the basis of path

On the basis of path of treatment, we find allopath, the system

which is promoted under the English system. This shows the path
or trail of treatment. Ayurved is based on Indian system where
herbals are used for preparing the medicine. Like this we find
Unani and others

On the basis of PATH OF TREATMENT, there are:

 Classification of Hospitals on the basis of Path of Treatment

Allopath

This term is generally used to describe the conventional approach

to medicine or "Western" medicine. It is the system that is
promoted under the English system. It is the method of treating
disease by the use of agents that produce effects different from
those of the disease treated. It’s the system of medical practice
which treats disease by the use of remedies which produce
effects different from those produced by the disease under
treatment. A system, which treats a disease with drugs having
opposite effects to existing symptoms, each successive discovery
and development in Allopathy, is the result of extensive research.
Each new remedy has helped alleviate pain and suffering and
increased the life span of people.

Ayurveda

It is based on the Indian system where herbal are used for

preparing medicines. It is India's traditional, natural system of
medicine that has been practiced for more than 5,000 years.
Ayurveda provides an integrated approach to preventing and
treating illness through lifestyle interventions and natural
therapies. Published studies have documented reductions in
cardiovascular disease risk factors, including blood pressure,
cholesterol, and reaction to stress, in individuals who practice
Ayurvedic methods.

Homeopath

A system of therapy based on the concept that disease can be

treated with drugs (in minute doses) thought capable of
producing the same symptoms in healthy people as the disease
itself. According to homeopathy, symptoms are the body's way of
fighting disease. It is a system of alternative medicine that strives
to treat "like with like". Homeopathy rests on the premise of
treating sick persons with therapeutic agents [drugs, remedies]
that are deemed to produce similar symptoms in a healthy
individual.

Unani

It is a comprehensive system encompassing virtually all of the

known healing systems of the world. As an alternative medicine,
Unani has found favor in Asia especially India. In India, Unani
practitioners can practice as qualified doctors, as the Indian
government approves their practice. Unani medicine is very close
to Ayurveda.
Others

Many hospitals are maintained solely for the treatment of military

personnel and veterans. Some hospitals are placed on special
high priority segments of the public works or utilities
infrastructure to ensure continuity of care during a state of
emergency.

Classification on the basis of size

On the basis of size, we find variation in the size of hospitals.

On the basis of the SIZE, there are:

 Classification of Hospitals on the basis of size

Teaching

These hospitals have 500 beds and differ according to the tune of
students.

District

They have 200 beds which can be raised to 300 beds according to
the changing requirements.

Taluka

These generally have 50 beds that can be raised to 100

depending on the needs.

Primary Health Centers

They consist of beds from the range of 6-10.

 SEVEN P’S

PRODUCT

A product is a set of attributes assembled in an identifiable form.

The product is the central component of any marketing mix. The
product component of the marketing mix deals with a variety of
issues relating to development, presentation and management of
the product which is to be offered to the market palce. It covers
issues such as service package, core services and peripherals,
managing service offering and developing service offering.

Hospitals today offer the following services:

1. Emergency services
2. Ambulance services
3. Diagnostic services
4. Pharmacy services
5. Casualty services

Emergency Services: Emergency services and care at most

hospitals is unique and advanced. The hospitals have state of the
art ambulances. The CCU’s on wheels under supervision by
medical and para-medical staff. There is hi tech
telecommunication available to a patient in an emergency at any
given time.

Ambulance Services: Hi Tech ambulances linked by state of

the art telecommunications are fully equipped with doctors that
are available to render medical attention and assistance in case
of emergencies at the patient’s doorstep.

Diagnostic Services: Modern hospitals are muti-speciality

and muti-disciplinary, that can handle any kind of ailment, they
offer a wide range of facilities for e.g : orthopaedics, Oncology,
Neurology, plastic surgery etc.

Pharmacy Services: Most hospitals also have a pharmacy

which is open 24 hrs. It caters to the needs not only of the
inpatients and out patients, but also patients from the other
hospitals who require emergency drugs.

Casualty services: Includes a 24 hrs casualty department,

which attends to the accident or emergency cases.

Apart from the above services, hospital also offer “Health

diagnosis programme” which is a comprehensive, complete,
periodic health check up provided for busy executives,
professional businessmen.
The health diagnosis programme consists of the following:
1. Master health check up.
2. Executive health check up.
3. Diabetic’s health check up.

PRODUCT LEVELS

Core product:
The core product of the service is the service the customer is really getting or the
reason why the customer wants the service. In the hospitals the core service is the
cure that the customer is expecting. For example, a person who is suffering from
“appendicitis” expects relief from the pain and surgical removal of the appendix.
Every hospital provides a core service.

Basic service:
The basic product is what is necessary to satisfy the core benefit or need. In the
hospital sector, the basic product is the bed that is provided, the various qualified
doctors and the nurses that are there in the hospital to look after the patients. The
basic product in the hospitals sector also includes the advanced equipment required
for diagnosing, operating and curing the patient. This basic service also includes
the ward boys who are required for keeping clean and hygienic conditions that are
necessary for the patients.

Expected service or benefits:

The expected benefits refer to the standard of the services the customer expects.
These are the types of services that the hospitals have to provide, if such services
are not provided then the customer may not opt for the service.

Here the expected benefits are that the beds should be hygienic and the services
provided by the doctors and the nurses should be according to the industry norms.
The hospital premises should also be clean. The equipments should be in proper
working conditions and there should be a pleasing environment for the patients to
rest and get cured quickly.

Augmented benefits or additions:

These refer to the various additions to the services over and above the consumer
expectations. These benefits play an important role in attracting patients to the
hospital. In India most of the hospitals have tried to adapt the marketing strategies
of the western countries. Most of the hospitals provide private air-conditioned
rooms for their patients. A few private hospitals also provide maternity wards
wherein the babies and their mothers are taken care of. The children’s ward is a
special section in which hospitals provide special treatment and care for the
children. They are given toys and various other games to play with.

Some hospitals have nurses and doctors that provide exceptional services that
exceed the customer expectations. They provide the patients with pathology
services, a blood bank, there are also the radiology departments. They also have
pharmacies within the hospital building itself.
PRICE

Price is one of the prominent elements in the marketing mix. Price

charged must be acceptable to target customers and it should co
ordinate with other elements of the marketing mix.

According to Philip Kotler, one should try to “Sell Value, Not

Price”. Price is a major determinant of a buyer’s choice, as a
person must have the need, willingness and ability or financial
backing to buy the product. In hospital & health care sector
services involve the use of expensive and complex machinery,
which involve huge investments. Apart from that, the cost of
maintaining them and cost of running the hospital is in no terms
cheap.

Public sector pricing

In the public sector hospitals the subsidies received from the
government are significant sources of income. The public
hospitals provide free treatment to those who hail from the poor
sections of the society. These costs are incurred by the
government. The customers who are above the poverty line have
to pay nominal charges to the public hospitals for their treatment.
The rest of the amount is acquired from the respective
governments.

Private sector hospitals

The private sector hospitals have a distinctive pricing strategy.
They charge low or no price to the poor people. This depends on
the subsidy programs offered by the government. Some private
hospitals charge a very high price as compared to the cost of the
services provided. Most of the private hospitals have extremely
good quality services and this justifies their pricing strategies.
Now-a-days there are the facilities like medi-claim available that
help attract customers to the superior and expensive services.

Private Charity hospital

In private charity hospitals the pricing strategy adopted is
different from that of the public hospitals. What the private
charity hospitals do is that they provide free treatment to the
people from the poor strata of the society; they charge a minimal
rate or subsidized rate to the low and middle income groups who
can afford to pay and lastly they charge high fares to those
belonging to the upper-middle class and high class.

PLACE
This is an important element of the marketing mix which is known
as place mix, which focuses on the location of the service factory.
It refers to the contact point between the service provider and the
customer.

It is very important to form the place mix properly in case of

hospitals because of the very fact that the customer himself
comes to the service factory, also herein quiet a number of
factors and limitations come into play like the cost of the place
and the area required. Certain hospitals require a lot of space for
the building and all the facilities that are necessary for the
treatment of the patient; hence they may have to locate the
hospital at a place where there is lot of space available and at a
cheaper.

Some of the essential features which may be taken into

consideration are as easy and convenient accessibility, safety or
protection availability of the infrastructural facilities, attractive
and healthy surroundings.

The selection of place is very important in order to avoid the

inconveniences to the users in reaching to the hospital in time.
Adequate transport and communication facilities should be
available where the hospitals are located. Hospitals should be
located at easily accessible places i.e. areas which have an easy
access to all modes of transport. Every hospital must provide
transport by way of properly equipped ambulances to deal with
emergencies.

The service product is closely linked to its delivery and nature of

the delivery system also has a powerful impact on the patient
experience. Example: Tata memorial hospital specializes in
cancer treatment and is located at a center place unlike other
normal hospitals, which you can find all over other places

PROMOTION

Promotion is an element in an organization’s marketing mix

that serves to inform, persuade and/or remind people about
an organization’s or individual’s goods, services, image,
ideas, community involvement or impact on society.
Promotion is used in hopes of influencing the recipient’s
feeling, beliefs, or Behaviour through any form of
communication.
 In Hospital Sector, it is considered to be extremely
“UNETHICAL” to advertise or promote one’s medical
services. This is so because, it is not a good thing to say that
you can save someone’s life better than somebody else. Also
it is very bad to say that you are profiteering from people’s
misery.

Hospitals conduct camps in rural areas to give medical check

ups at a reasonable price so that the rural people approach
the hospital again in the future. Hospitals generally advertise
in health and fitness magazines.

Promotional Strategies

• Word of Mouth

This strategy is considered to be the godfather of

promotional strategies in Hospital sector. A patient who has
been successfully treated in a hospital will always suggest
this to another customer. This is also used to create
customer loyalty among potential customers before any
actual service has been rendered to them. This is why most
of the hospitals have to be very efficient in the service
delivery.
• Periodicals

Several Medical Magazines, newspapers and Journals are

printed in order to create awareness about the hospitals
among the general public. This system is also used by
specialists to make a great doctor referral network of
specialists in other fields.

• e-Promotions

Websites of several hospitals are coming up as a means of

promoting oneself without breaking the “ethical code”. The
websites serve as information medium to those people who
seek treatment for a particular problem. Also they can be
used to provide some tangible evidence about the facilities.

• Mail Campaigns

These can be called as post service techniques used to

enhance one’s image in eye of the patient. In this technique
the doctor’s send a review mail inquiring about the patients’
health and also asks for a feedback regarding the facilities.
This is also being started by the hospitals in order to spread
good word of mouth among potential customers.
 • Education of Customers

In this system hospitals inform the general public about a

particular disease i.e. they create awareness about a
particular disease and inform these people about all the
necessary symptoms of the disease. This serves in creating
customers and a trust among the two as well as this serves
as increasing ones market access, this happens as these
people who have been informed will further spread the word
out thus, increasing coverage. This is termed as
“MISSIONARY PROMOTION”.

• Referrals

Doctors who operate from clinics, polyclinics give referrals of

Hospitals to get the treatment of their patients done. For the
service provided by the referrer the Hospital gives an
acknowledgement in the form of a commission also called as
a referrer fee. This leads to internal promotion of both the
hospital as well as the doctor.

PEOPLE

People refer to both the people inside the organization

(employees) as well as outside the organization (customers).
People in Service Sector Marketing represent both the employees
of the company as well as the customers of the company.
However, in case of hospital sector the customer cannot be relied
on as this is an extremely high knowledge driven sector where it
is difficult to filter down the complex information in simpler forms
for the customers. The people have to be trained properly in order
to keep the customer satisfied. The employees have to be trained
properly so that they interact well with the customer. Employee
here does not only mean the high level ones but also the lower
level ones. Employees are the Human Face to the service delivery
provided by a service provider.

Clinical Employees
 Doctors
 Nurses
 Medical Assistants
 Paramedics: Provide Physiotherapeutic treatment to
recovering patients
 Pharmacists

Non – Clinical Employees

 Ward Boys: Aids to nurses who run errands for them
 Cleaners: Sweepers, toiletry maintenance etc…
 Laundry Department: Replacing and Washing linens
 Sterilizers: Sterilizing Equipment and Facilities
 Equipment Handlers: X-Ray Machine Operators etc…
  Administrative Staff: Accountants, Cashiers, Bills Collection
etc…
 Catering & Dietetics: Provide for nutritional needs of the
patients

PHYSICAL EVIDENCE

The physical evidence is defined as the environment in which the

service is delivered and where the firm and the customers
interact; and any tangible commodities that facilitate
performance or communicate the service. It plays a role in
enhancing customer’s perception of the service quality. The
acceptance of services is communicated through the physical
evidence; therefore, it is of great significance to the service
marketers.

How important is the physical evidence of “Wockhardt” or

“Lilavati”. In a city like Mumbai where the income of people is
higher as compared to the other parts of India, one is ready to
spend on one’s health and hence the look of a hospital too would
matter.
The environment in which the service is delivered and where the
customers and firm interact, and any tangible components that
facilitate performance or communication of the service.

The physical evidence of services includes all of the tangible

representations of the services such as brochures, letterhead,
business cards, report formats, signage and equipment. Physical
evidence makes a huge impact on the customer. Physical
evidence provides customers means of evaluating the service

Elements of Physical Evidence

Often customer evaluates the services on the tangible clues of
physical evidence, before its purchase. The general elements of
physical evidence are:
EXTERIOR ELEMENTS OF HOSPITALS

Exterior elements include the outer look of the place of delivery of

service. The exterior gives a formal introduction to the customer
as to the kind of service he/ she is to receive. In the case of
hospitals, the physical evidence is a very crucial element as one
is seeking medical help relating to one’s health and no one would
take chances in such cases. Hence, exterior as well as interior
factors should be kept in mind.

Some of the exterior factors essential in Hospitals are as follows:

• Exteriors Design
 • Entrance
• Signage
• Parking
• Surrounding Environment
• Security
INTERIOR ELEMENTS OF HOSPITALS

In case of hospitals, the interiors play a very vital and important

role. If the hospital is not hygienic, does not look up to the
standard as it promises to be and the equipment used is not of
good quality, patients would hesitate coming for any treatment to
such a hospital.

Given below are some interior elements in context of hospitals:

• Interior Design
• Safety Signs
• Rooms
• Washrooms
• Equipment

OTHER TANGIBLES

Along with the exterior and interior elements in hospitals, other tangibles also help
in putting up a good impression of the hospital in the eyes of the customer.
Sometimes, small elements too may make a big difference. This section refers to
those small elements. The other tangibles are as follows:
 Uniforms.
 Staff
 Equipment
 Visiting Card
 ATM Centers
 Telephone service
 Ambulances
 Service sector management

PROCESS

Process is a set of activities that take an input, convert it and add

value to the input and finally, create an output. Process has only
recently been given much attention in the service sector although
it has been the subject to study in manufacturing for many years.
Blueprints design processes, which sets a standard for action to
take place and to implement the service.

Joining Phase

The Intensive
Consumption
Phase

Detachment
Phase

Feedback

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 Service sector management

1. The joining phase – which includes

The arrival of the patient
Registration – where a patient has to make an initial deposit
at the inpatient billing counter after which a file is opened in
the patient’s name to know the patient’s medical history.

2. Intensive consumption phase – which includes

Diagnosis – where the consultant diagnoses the illness by
making the patient undergo various tests
Treatment – where the illness is treated with proper
medication or surgery
Information about further actions – the consultant will
instruct the patient regarding the diet to be followed, the
medication to be taken etc.

3. Detachment phase – which includes

Discharge of the patient
Payment – after the patient is discharged, the bill will be paid
at the billing counter.

4. Feedback – at this stage, the patient is requested to fill an

evaluation form, which helps the hospital authorities to know
the level of satisfaction derived by the patient. Patient’s
suggestions are always considered for improving the hospital
services.

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General Process Organization in a Hospital

Finance Dept Billing

Purchase Stores Doctors Patient

Dept ( External
customer)

Nurses

Within the hospital, if we look at each individual department, we

notice that each department serves the needs of another
department, for instance, the purchase department serves the
need of the stores, the billing department serves of the finance
department etc. So in each way, each department is a customer
to another department, while at the same time it might be a
supplier to another department. Each department is an ‘internal
customer’ or the other departments.

Only when each unit of the hospital understands who their

customers are and what their needs are, will the hospital develop
basis for giving the best service in the most efficient way to the
patient.

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Market Segmentation

Market segmentation is a useful business tool to identify new and

expanded ways to improve services and enhance revenues. This
tool identifies unique subsets of the population to target for
specialized services and marketing initiatives.

SEGMENTING

Segmenting variables such as geographic, demographic,

Psychographic and behavioral segmentation helps in knowing
consumer wants needs and responses of various services and
products. It is very essential to know which segment would be
right for setting up our hospital as only after studying the diseases
and the people who are diseased or at high risk of getting those
diseases form our segment.

Geographic Segment

It calls for dividing the market into different geographical units

such as nations, states, regions, countries, cities or neighborhood.
One can operate in few geographic areas, or operate in all but pay
attention to local variations. It is advisable to target all sections of
people, by and large the entire mass by delivering varied services
to a specific disease.

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Demographic Segment

The market is divided into groups on the basis of variable such as

age, family size, family lifecycle, gender, income, occupation,
education, religion, race, generation, nationality and social class.
With these variables of segmentation we get to know the
preferences and the usage rates associated with different
consumers

Psychographic Segment:

This segmentation is done as per the lifestyle, personality of the

people. Different people have different lifestyles and different
personality, so for them the expectation of service also differs, so
keeping all such points in mind the hospitals provide services.

People living with very high level of sophisticated lifestyle prefer

hospitals which provide best quality service.

On the other hand people having very simple lifestyle may also go
to public hospital.

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Behavioral Segmentation

In this the segmentation is done as per the following variables i.e.

knowledge of, attitude towards, use of, or response to a product
or a service. These behavioral variables – occasions, benefits, user
status, user rate, loyalty status, buyer readiness stage and
attitude- are the best starting points for constructing market
segments. For e.g person having diabetes would go to the hospital
after knowing the facilities that they offer and the care, comfort
they provide. This would help in creating loyal patients and create
goodwill for our hospital.

Quality dimensions

Quality refers to the inherent or distinctive characteristics or

properties of a person, object, process or other thing. Such
characteristics or properties may set a person or thing apart from
other persons or things, or may denote some degree of
achievement or excellence. When used in relation to people, the
term may also signify a personal character or trait.

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For example, hospitals have to decide what quality of food to buy

for their patients. The buying objective here is not profit, because
the food is provided to the patients as part of the total service
package. Nor is cost minimization the sole objective, because poor
food will cause patients to complain and hurt the hospital’s
reputation. The hospital purchasing agent has to search for
institutional food vendors whose quality meets or exceeds a
certain minimum standard and whose prices are low. Knowing
this, many food vendors set up a separate division to respond to
the special needs of institutional buyers. Thus, Heinz, for example,
will produce, package, and price its ketchup differently to meet
the different requirements of hospitals, colleges, and prisons.

Quality dimensions by Parasuraman

The quality customer service is the foundation for long run

businesses. This quality dimensions will regulate the business
process, solutions and services. Quality of service is the most
important and the most critical component for a customer. These
are five quality dimensions, which can be taken into account for
the assessment of service quality.

BY Parasuraman et al – Parasuraman, Valerie Zeithaml and

Leonard Berry identified five dimensions with which consumers
judge services.

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RELIABILITY

It shows the ability of the service provider to perform the

promised service accurately and dependably. It means that the
service provider should be able to identify and provide business
solutions to their customers to achieve their goals and objectives.
Reliability assures performing the promise given to the customers
in the most effective and efficient manner.

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In the case of hospital industry it is consistently shown to be the

most important determinant of service quality because this is the
main reason why the customer i.e. patient comes to a hospital for
his treatment and as soon as he enters in a hospital, it becomes
an implied promise of the management of the particular hospital
that they will try their level best to treat him properly. A person
should be assured of the acute physical and mental disorders also.
So this is the most vital promise which a hospital gives to its
customers and if it is broken then it will cause a great problem to
its customer as well as it affects the reputation of the hospital but
as such there is no hard and fast rule in any of the hospital that a
patient will be cured.

Basically the main service, which a hospital gives, is cure and

treatment only and they shouldn’t compromise a bit in this
criteria. Hospitals should hire the best doctors affordable and
available to them in the industry, which can provide the best of
the services. Hospitals should also provide all the other services
like the accommodation, medicines, timely appointments,
appropriate diagnosis, and etc. to their level best to the patients.

ASSURANCE

Assurance is all about trust and confidence. It comes with the

brand equity, trust and loyalty towards consumers. Consumers
should be assured about the service and they should have trust

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on the brand. This dimension is particularly important for hospital

industry because it involves a high risk and there is a great
uncertainty of the outcomes. Trust and confidence may be
embodied in the person who links the customers directly to the
company for example securities brokers, insurance agents, etc.
but in the hospital industry the customer is not directly linked to
the whole organization but with only a part of it in the way of
some particular doctors and attendants.

So in the early stages customer may use the tangible evidence to

assess the assurance dimension like the degrees, honors, awards,
and special certifications in this type of professional services. So if
the hospital is rated 5 star, than the patient may be assured that
at least they are getting treated by the best professionals in the
industry and the probability of they getting cured is high in a
critical disease with such hospital other than low graded hospitals.
So here the knowledge, skills, credentials and reputation of
hospital and its employees is of immense importance to assure
the customers about the service.

TANGIBILITY

Tangibility means representing the service physically. It stands for

the appearance of facilities, equipments, personnel and
communication material. Making customers happy with business

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environment is the motto of service providers. All of these

provide physical representations or images of the service that
customers, particularly new customers, will use to evaluate
quality.

Hospital is a type of service in which the customer himself comes

to the service factory hence there is more interaction with the
tangible cues. In a hospital the tangibles are the waiting rooms,
examination rooms, surgical and operational tools, and facilities
inside the rooms, modern infrastructure, essential drugs,
equipments for investigations, etc. on which a patient can make
out the service quality of a particular hospital.

Hospitals should also take good care of their kitchen and

canteens. They should be kept absolutely clean and clear to
insure hygiene. This is the main aim for a hospital to attract more
and more customers. As there is no particular tangible service like
in real estate industry or in catering industry in which you can
actually try a product and then can approve it. But in this case a
patient can’t just try the service of the doctors in the hospital so
he will have to rely on these type of tangible goods and the profile
of the surgeons and doctors to take a decision to get admitted in a
particular hospital.

EMPATHY

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Empathy means the individualized attention and customized

service given to the customers by the organization. Understanding
the customer’s needs, goals, and objectives and providing
solutions with good quality and helping them to overcome their
problems. A hospital should acknowledge patient as a person,
should remember his previous problems and should than hear to
him with patience to treat him in the best possible manner. This
industry is all about giving customized service to everyone
because every patient has different problems so he should be
treated with a great empathy.

More than the treatment, what a patient wants is care and

comfort. A patient gets distressed when he is alone, when there is
no one to hear him and there is nothing to pass his time on. So
staff and doctors should always be friendly and there should be a
friendly environment in the hospital because it relieves the mental
pressure of the patient and so he can be recovered soon. He
should be given the best of the food and best of the services,
which he demands taking care of his treatment so that he feels
good.

A patient is the customer of the hospital but not a regular

customer so whatever he is experiencing and getting will be his
perception throughout his lifetime and this is the only time when a
customer can be satisfied and there will be no second chance.

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This will also create the word of mouth publicity when he is

discharged from the hospital and he will tell about his experiences
to others.

RESPONSIVENESS

Responsiveness reveals the service providers awareness in

problem solving with viable business solutions. It can be defined
as the way the service provider responds to the customers and his
willingness to help. The foremost thing is that the service provider
must be accessible to solve the problem whenever it occurs and
there the service provider should see through it that there should
be no waiting after that. Than the service provider should be
willing to listen to the problem and solve it as soon as possible.

Attentiveness and promptness is something on which a hospital

should emphasis on while dealing with them at the time of their
treatment, problems and complaints. To excel in this dimension
the hospital must view the process of service delivery and
handling the requests from the patient’s point of view and should
try to minimize the time taken to respond to the patient problems.
Speed and the promptness are the two main criteria, on which a
hospital’s responsiveness dimension can be evaluated.

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In the case of any emergency or critical matter the

responsiveness of doctors and staff are very important so they
should be alert for such situations at any time of the day. So
responsiveness of a hospital is communicated to the patient by
the length of time taken to assist them, answer their questions or
giving attention to their problems. Training is the most vital tool
given to the employees i.e. doctors and the staffs to deal with
even the worst conditions during emergency and they should be
responsible enough to deal with it then and there.

BY David A. Garvin eight dimensions of quality

were identified by Garvin:
1. Performance: every product is supposed to deliver benefits
and the measure of its quality is performance of the offer. A
dish scourer, which can clean plates completely and quickly,
would be a performance.

2. Features: these are in addition to the core product, which

does not come as standard ‘features’, like add-ons.

3. Reliability: this is a measure of the degree of probability of

the product delivery what had been promised.

4. Conformance: delivery quality meeting design standards.

5. Durability: this is a measure of the length of time that a

product can deliver benefits, without deterioration.

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6. Serviceability: if the product can be repaired with ease and

speed than it is a measure of quality. It could include the
behavioural dimension of service of personnel like their
politeness

7. Aesthetics: this is a measure of the product’s looks, design,

touch and feel.

8. Perceived Quality: consumers develop a perception due to

company – controlled stimuli like advertising, publicity and
brand promotion, and social effects like word-of-mouth.

Quality
Some matters which influence perception of quality of service in a
hospital are

• While making inquiries or giving instruction, nurses and other

staff refer to patients by bed numbers or by the disease he
suffered from. It makes a lot of difference if the patient is
identified by his name.

• Letting patients know what they are suffering from, what is

being done to them, why particular tests are being
conducted, what they can expect in terms of discomfort,
caused by a particular medical procedure, etc. Open
communication is very satisfying.

• Letting patient having an option regarding their treatment or

continued hospitalization, because of high costs involved.

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Hospitals tend to treat patient like captives or hostages, who

cannot escape, and on whom any treatment, at any cost, can
be forced, without their consent.

• Letting accompanying relatives know what is being done to

the patient and about options.

• Patients being escorted by someone senior when they have

to be taken else where, for X-rays, Scanning, etc. instead of
their being left alone in corridors on wheel chairs or
stretchers, waiting for their turn.

• Removing particular serious cases from general ward.

Patients get depressed when they see other patient in acute
distress, or in a terminal condition with a lot of anxious
relatives moving around and medical staff rushing about.

• A primary nurse being assigned, as an aid to every patient to

take care of his need throughout his stay in the hospital.

3-room Intraoperative MRI Suite (IMRIS)

This is India's first 3-room intra operative diagnostic and imaging

solution where the patient is never moved. IMRIS brings MRI
surgical imaging to patients undergoing surgery and enables
surgeons to leverage the unique ability to provide better
outcomes for their patients. It is the world's most patient-safe
intra-operative imaging solution that allows the surgeon to
accurately depict changes in brain position and anatomy during

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surgery. IMRIS provides complete 360° surgical access to the

patient and can service multiple operating rooms. At Kokilaben
hospital, a 1.5 Tesla ceiling-mounted MRI is stationed in a
diagnostic bay with two adjacent operating rooms on either side.

Orthopedic, ENT and Neuro Navigation Systems

World over, navigation systems are redefining the way surgeries

are performed. They enable surgeons to achieve greater precision
by providing electronic guidance using computers, infrared
cameras and wireless instruments. Surgeons can effectively make
data-driven decisions in the operating room by incorporating the
three technological innovations that provide a data-rich, visual
surgical environment that helps reduce procedure invasiveness,
risk and operative times.

Radiation Oncology Linac Suites

The Trilogy stereotactic system is the most advanced,

sophisticated machine of its kind in the world. As the leading
image-guided radiotherapy (IGRT) system, Trilogy marks the
beginning of a new generation of cancer care. The versatile
system combines imaging and treatment technologies, and can be
used to deliver the widest range of external beam radiotherapies:
3D conformal radiotherapy, IMRT, fractionated stereotactic
radiation therapy and intensity-modulated radiosurgery for cancer
and neurosurgical treatments. Advanced imaging capabilities built
into the system allow therapists to position patients for treatment
with sub-millimetre accuracy. A respiratory gating system

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 Service sector management

compensates for any tumour movement that occurs as a patient

breathes. The system at Kokilaben hospital is powerful and can
deliver radiotherapy doses at least 60 per cent faster than
conventional accelerators. This shortens the length of time
patients need to spend undergoing treatment. In addition, the
radiation beam is highly precise, allowing clinicians to deliver
treatments with unprecedented accuracy.

Stereotactic Radiosurgery

The Novalis Tx at Kokilaben hospital is among the world's first

whole radiosurgery systems for indications in the brain, liver,
pancreas, prostate and lung. It enables small, deep-seated
tumours to be treated by radiation without open surgery and
offers a versatile combination of advanced technologies for the
treatment of tumours and other anatomical targets. With this
platform, the Kokilaben hospital offers state-of-the-art, non-
invasive treatment for a wide range of cancers and other
potentially debilitating conditions, without harming nearby healthy
tissue and without involving traditional surgery.

3 Tesla MRI

Patients today demand the highest quality of care, including a

comfortable exam experience and the assurance that the
diagnosis is the most accurate possible. When you combine 3T
with a 70 cm open bore, you give them just that. More space
limits claustrophobic rejections, fewer patients need to be
sedated, and sharper images are captured thanks to less anxiety-

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related movement. The 3T system at Kokilaben hospital

accommodates patients with special needs and conditions
including spinal deformities, respiratory problems and those with
pain and mobility issues. It also allows us to expand care to a
wider range of patients including obese, paediatric, elderly, ICU
patients or those dependent upon medical equipment. The 3T
broadens clinical possibilities with easy access in interventional
MRI and opportunities to perform more functional studies (using
the functional MRI tool).

40-slice PET/CT

India's first, Positron EmissionTomography - Computed

Tomography (PET-CT) is a medical imaging device that combines
both a Positron Emission Tomography and an x-ray Computed
Tomography, so that images acquired from both devices can be
taken sequentially, in the same session, from the patient and
combined into a single superimposed image. PET-CT has
revolutionised medical diagnosis by adding precision of anatomic
localisation to functional imaging, which was previously lacking.
For example, in cancers, surgical planning, radiation therapy and
cancer staging have been changing rapidly under the influence of
PET-CT.

Dual Source Cardiac CT (DSCT)

The latest revolution in CT is the new Dual Source CT technology

that pioneers new clinical opportunities. Our DSCT is faster than
every beating heart, c an obtain full cardiac detail at half the dose

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of radiation, serves as a one-stop diagnosis in emergencies, and

goes beyond visualisation with dual energy. Twice as fast as other
cardiac CT scanners and less influenced by irregular heart
rhythms, it eliminates the need for beta-blockers to slow down the
heart rate prior to cardiac scanning. The DSCT at Kokilaben
hospital opens the door to a new world of characterisation,
visualising the chemical composition of the human body. The
result: two spiral data sets acquired in a single scan providing
diverse information, which allows us to differentiate, characterise,
isolate, and distinguish the imaged tissue and material
composition.

SPECT

Single photon emission computed tomography (SPECT) is a

nuclear medicine imaging technique using gamma rays. SPECT
can be used to complement any imaging study where a true 3D
representation is needed, such as tumour, infection, thyroid or
bone imaging. As SPECT permits accurate localisation in 3D space,
it is used to provide information about localised functioning of
internal organs; for instance, functional cardiac or brain imaging.

CONCLUSION

The nature of surgical operations has changed considerably.

Alternate procedures, without resorting to conventional surgery,
are becoming available, thanks to new technology, using lasers,

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micro instruments, etc. therefore, there is little post surgical care.

Patients can return home the same day, with verry little
discomfort, and hardly any possibility of complications.

Patients, the world over, are finding it cheaper to arrange for

nurses and equipment at home, because of the heavy cost of
hospitalization. Equipments can be hired. Care provided at home
is more comforting.

For these reasons, the occupancy of hospital beds is going down.

Similar trends are expected in India. The data on patients, given
earlier, points to the need of restructuring hospitals, to meet new
usage patterns.

Speciality hospitals are being connected to similar hospitals in

other parts of the world, through satellite communication
networks. Through data exchanges and teleconferences, doctors
in one place can confer and consult with colleagues anywhere in
the world.

Doctors from one city, visit hospitals in other cities, other

countries, for short durations, to demonstrate their skills, to teach,
and to learn.

A good hospital is a place for learning, if the experience gained in

the case of a patient is properly recorded and stored in a library.
Doctors enhance their knowledge and skills by accessing such
records. The quality of both the doctor and the hospital can be
enhanced in this way.

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Bibliography

Websites
• www.expresshealthcaremgmt.com
• www.ficci.com
• www.dogpile.com
• http://en.wikipedia.org/wiki/Hospital
• http://en.wikipedia.org/wiki/Healthcare
• http://en.wikipedia.org/wiki/Tertiary_sector_of_the_economy
• http://www.economywatch.com/world-industries/services-sector/
• http://www.economywatch.com/world-industries/health-care/
• http://www.economywatch.com/world-industries/health-care/india.html
• http://www.himpub.com/frontend/home.asp?UserId=319903243

Reference Books:
• Christopher Lovelock and Jochen Wirtz, Service Marketing,
Pearson Education publication house, Fifth edition
• Zeithmal & Bitner, Services Marketing, 3rd edition
• C. Bhattacharjee, Service Sector Management- An Indian
perspective, Second Edition.
• Arun Kumar, Hospital Mangemnt, Second Edition.
• Talluru Sreenivas, Service sector in Indian Economy, 2nd Edition.

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• Vasanti Venugopal and Raghu V.N, Services Marketing, First

Edition

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