Annexure-1

Managing customer perceived service quality in private healthcare sector in India

1. Introduction

Health and economic developments are so closely related that it is impossible to achieve one without the other. While the economic development in India is gaining momentum over the past few decades, our health system is at cross roads today (Ramani & Dileep, 2005). In this regard, health and health care need to be distinguished from each other for no better reason than that the former is often incorrectly seen as a direct function of the later. Proper healthcare is an indispensable basis for defining a societys sense of well being (Srinivasan. 2005). Health care covers not merely medical care but also all aspects of pro preventive care too. It has no longer limited to care rendered by or financed by government sector alone but recent time has seen massive participation of private players. Private sector in health care has gained a dominant presence in all the areas like medical education, sale of pharmaceuticals, construction of hospitals, and providing medical services etc. At the same time superior service quality in private health care sector has been a major concern as customers have to pay a huge amount of money and effort to avail the services. Like all other service sectors, the healthcare sector, particularly private healthcare units, have recognised the importance of relationship marketing. They have moved beyond patient satisfaction and perceived quality of care, to build mutually committed relationships and loyalty with the stakeholders (Peltier, Boyt and Schibrowsky, 2000) to develop better understanding of patient-provider relationships and establish long-term patient-provider bond. Health care service marketers have experienced that competition can be well managed by differentiating through service quality vis-a vis competitors. Service quality describes a comparison of expectations with performance of service delivery (Lewis & Booms, 1983) when customer encounters the service personnel. Customer satisfaction with service quality is defined by comparing perceptions of service received with the perception of expected service of the consumers. Present days quality has emerged as a major competitive element in healthcare service strategies. Perceived service quality mainly deals with the three issues. First it compares the gap model with the performance model; next it investigates the direction of causality between service quality and satisfaction. Finally it examines whether the influence of dimensions of the service quality vary across service type industries.

While patient interests are a fundamental part of service quality in modern health care systems, Grol et al. (2000) noted that care providers often react to patients on the basis of their own subjective perceptions of patients needs and experiences that often prove to be wrong. Alaloola and Albedaiwi (2008) observed that traditionally, managing service quality in health care entails such activities as checking providers credentials if they are qualified or not to provide the services; auditing clinical activities for the purposes of checking if clinical guidelines and protocols are being followed; auditing medical records as well as measuring outcomes in terms of whether the patients get better or not. The primary focus tends to be to protect patients from substandard care. The major problem however with the traditional way of managing quality in health services lies in its heavy reliance on technical clinical criteria and the absence of customers view on the services provided(Lee et al, 2000).. Because of this gap in the literature in the past, this research work is proposed to have a better understanding and managing the service quality perceptions possessed by both recipients and providers when shaping the healthcare delivery system 2. Proposed research questions & objectives:

Very few studies have sought to evaluate the service provider understanding of the patients perceptions of health service quality (OConnor et al., 1994), and again few studies of perceived private healthcare service quality have been undertaken (Sanchez-Perex et al., 2007). Brown (2006) highlighted that the patient is becoming an ever more silent partner in the health care system, as their views of quality have largely been side lined by the number of attempts to exclusively determine patient satisfaction with health care. Research that focuses on strengthening our understanding of the meaning, measurement, and management of perceived service quality from the patients perspective in healthcare is now arguably paramount. The research questions which are formulated to carry out the research in proper direction are: 1. What are the factors effecting the service quality of the private healthcare organisations? 2. How is customer satisfaction related to perceived service quality? 3. What is relationship between the perceived service quality of customers and corporate image and in the private health care sector? The objectives of the study are: To find out and study the diverse factors affecting service quality in healthcare industry. To identify causes of service failure and the process of service recovery in private healthcare industry. To study relationships between perceived service quality, patient satisfaction and behavioural intentions of service providers. To develop an instrument to measure perceived service quality in the private health care industry.

For the purpose of the present study, the following hypothesis has been derived on the basis of the literature reviewed. There exist a significant relationship between customer satisfaction and perceived service quality of customer in private healthcare sector There exist a significant relationship between customer loyalty and perceived service quality of customer in private healthcare sector There exist a significant relationship between service failure and perceived service quality of customer in private healthcare sector There exist a significant relationship between and perceived service quality of customer in private and corporate image 3. Proposed research methodology

Research methodology of the study includes identification of the research problem, formulation of hypothesis, collection of data, correlation of the data, and projection of the outcomes of the study through analysis Research design The proposed study will be an empirical one which is purely based on primary and secondary information collected from private healthcare organisation. Data source Data will be collected from the primary and secondary sources for analysis and interpretation and to justify the relevance of this study. Sampling Selection of the sample will be based on convenience sampling method and attempt will be made for reciprocal representation of respondents from customers & service providers of private health care sector. Methods of data collection Data collection Methods like direct observation, interviews, structured schedules, focused group discussions, etc. will be deployed to get value added information for the study. Data analysis Data will be analysed using SPSS package and the tools such as descriptive statistics, factor analysis, ANOVA, regression & correlation, and Structural Equation Modelling will be applied to draw meaningful conclusion of the study. 4. Anticipated outcome from research The piece of research may suggest for sound relationship mechanism between service quality management dimensions (quality management and patient service quality) and their impact on performance of the healthcare organizations. It may recommend the organizations to deliver service as perceived by customers. Further it may broaden their examination of quality from the conventional organizationoriented perspective to a dual, organization customer perspective. It may focus on the need for strategic determinants to improve service quality and performance, and to develop as performance excellence strategies. These strategies will then promote continuous performance improvement in quantity, quality and equity of service provision.

5. Tentative time line for research Description Steps 1 Preparation of the research scope document and broad objectives 2 Literature review and development of models for competency based performance management system 3 Preparation of questionnaires for collection of data from research units 4 Preparation of questionnaires for collection of data from research units 5 Data Analysis and Model Validation 6 Collection of Feedback from Industries 7 Preparation of Draft Synopsis 8 Comments and Feedback on Draft and Synopsis 9 Submission of Final Thesis

Methodology

Duration 2 months

Secondary research

6 months

4 months Data Analysis 4 months 4 months 4 months 4 months 4 months 4 months 36 months

Total References

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