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Vol. 4 No. 1 (January-June 2015)

Analysis of Pregnant Woman Satisfaction to Hospital Service by

SERVQUAL Method: A Case Study of Mahosot Referral Hospital
Bounsathien Phimmasenh* and Dr.Khamlusa Nouansavanh**

The purpose of this research is to investigate the pregnant woman satisfaction to Health
care service in the Department of Mother and Child, Mahosot Referral Hospital by SERVQUAL
five dimensions. This survey can give information and evaluation materials to be basis
management for improve the hospital. There are five dimensions SERVQUAL comprising
Tangibles, Responsiveness, Reliability, Empathy and Assurance with theirs 20 attributes which
is the evaluation target from service quality factor. The result of study show that some service
quality dimensions need to improve such as regarding tangible hospital should improve the
visual appealing environment and physical facilities, concerning to empathy dimension hospital
should be improved by offering personalized attention to pregnant woman and the assurance
dimension is still need to build up the human source of hospital.
Keywords: Pregnant Woman, Health Care, Service Quality, SERVQUAL

Referral Hospital Services in Lao People Democratic Republic are as main implementing
facility of Health sector which involving not only for treatment and curative the patients but also
for the promotion, capacity building to the rural hospital and Health centers and in order to
prepare for Asian Economic Community (AEC) membership in the year 2015and supporting the
Governments commitment to achieving the Millennium Development Goals (MDGs) and
identifies improved access, equity, quality and strengthening the health workforce as key
goalsespecially the health status of mother and child.
Mahosot Referral Hospital is one of five central hospitals, which established as the first
hospital of Laos since 1930 and located in the Vientiane Capital. This hospital provides the
medical serve general societies as well.The growth of health service awareness in the society is
followed by the social economic development, education level, knowledge and Medical
technology. Hospitaltherefore should not only provide a medical aspect, but also the process
business to customers, in the hospital should be served professionally such as registration,
administration process, quick responds and warm welcome from the health providers.
The aim of this research is to investigate the pregnant woman satisfaction as from
feminist perspectives to Health care service in the Department of Mother and Child, Mahosot
Referral Hospital by SERVQUAL five dimensions. This survey can give information and
evaluation materials to be basis management for improve the hospital. There are five dimensions
SERVQUAL comprising Tangibles, Responsiveness, Reliability, Empathy and Assurance with
theirs 20 attributes which is the evaluation target from service quality factor. The result of study

Ph.D. Student, Faculty of Economics and Business Management, National University of Laos ; E-mail:
Professor, Faculty of Economics and Business Management, National University of Laos



Vol. 4 No. 1 (January-June 2015)

show that some service quality dimensions need to improve. The paper proceeds by reviewing
the literatures related, methodology used, findings and discussion and finally conclusions.

Literature Review
Service quality is defined as the discrepancy between customers perceptions of services
offered by the company and their expectations about offering services of the company. The
customers expectations are derived from their perception of the ideal care standards of their
previous experiences in the use of services. According to Grnroos (2001), Service quality is the
difference between customer expectations and perceptions as it is being received by the customer
(Parasuraman et al., 1988 & Ijaz,2011). Thus it is necessary for health care providers to monitor
how well the customers expectations have been met after delivering the services (Zarei, Arab,
Froushani, Rashidian, & Tabatabaei, 2012).
Measurement of service quality has been conducted in various service organizations and
in difference service sectors, the SERVQUAL model proposed by Parasuraman et al.(1985,
1988) has been used in awide variety of studies to assesses both the customers service
expectations and perceptions of the providers performance (Zarei et al., 2012; Ladhari, 2009;
Pakdil & Aydin, 2007). According to Parasuraman et al. (1985), the SERVQUAL scale was
based on the fifth gap and the original ten dimensions were further consolidate into five
dimensions of service quality namely Tangibles, Reliability, responsiveness, Assurance and
Empathy. These dimensions are described as follows:
1) Tangibles-physical facilities, equipment, appearance of personnel and communication
2) Reliability-the ability of the service provider to perform the promised service
responsibly and accurately.
3) Responsiveness-the willingness of employees to help and provide prompt service to
4) Assurance-the knowledge, courtesy and competence of employees and their ability to
inspire trust and confidence in the customer towards the service provider.
5) Empathy-the caring, individualized and personalized attention provided to customers.
The SERVQUAL scale contained 22 pairs of items spanning across five dimensions
covering key issues of service quality. It comprises two sets of similar statements; the first is a
customer expectations measure (E) and the second is a measure of customers perceptions as to
the actual service delivered by the provider (P). The instrument measures the quality as the
difference between expectations and perceptions (E-P). This tool has been widely applied by
researchers in diversity of service settings, including hospital to assess the difference in service
quality between the public and private hospital (Andaleeb,2000; Arasli, Ekiz & Katircioglu,
2008; irfan & Ijaz, 2011; Polsa et al., 2011; Taner & Antony, 2006).

Application of SERQUAL Model

Anderson (1995) applied the SERVQUAL model to measure the quality of Health Care
Service offered by a public university of health clinic. The findings of the research pointed out
that the clinic was poor on the assurance dimension.
Lam (1997) examined the validity, reliability and predictive validity of SERVQUAL and
analyzed its applicability to the health sector in Hong Kong. The study result proved that



Vol. 4 No. 1 (January-June 2015)

SERVQUAL is a reliable model to measure health care service quality. However, factor analysis
on five dimensions indicated that the scale could b treated as one-dimensional for the results
identified one dominating factor representing expectations and perceptions.
Karassavidou (2007) applied SERVQUAL model to measure a services quality on
three dimensions viz. a) human aspects, b) physical environment and infrastructure of the care
unit and c) access.
Mangkolrat (2008), in her recent work on patient satisfaction measurement, suggested a
conceptual framework where she measured the gap between patients expectation and their
perception in the light of service quality.
Akter (2008), in their research on service quality perception and satisfaction,
applied SERVQUAL model considering three new dimensions viz. communication (a system to
convey message to patients and patient parties), discipline (control of non-performance of
prescribed duties and non-adherence to written rules), tips or Baksis(extra compensation in
order to receive satisfactory service) replacing other three dimensions viz reliability, tangibles
and empathy suggested by Parasuraman to determine the gap between patient expectation
and perception of service quality.
Qin (2009) considered the perceived quality as one of the antecedents of patient
satisfaction and compared perceived quality with the expected service quality on the basis of
SERVQUAL model to measure the satisfaction level of a patient regarding waiting time in a

Research Methodology
The study was conducted between March to June 2014 in the Department of Mother and
child, Mahosot Referral Hospital in Vientiane Capital, Lao PDR.
Survey instrument
The study questionnaire was composed of 2 parts; the first part assessed demographic
characteristics of the hospital patient, such as age, education and occupation. In the second part,
The SERVQUAL questionnaire was used to assess the pregnant womans expectation and
perceptions of service quality that included 20 items across 5 dimension: Tangibles (4 items),
reliability (4 items), responsiveness (4 items), assurance (4 items) and empathy (4 items). The
SERQUAL scale was translated into the Lao and back-translated into English from Parasuraman
et al. (1991).
A 5-point likert-type scale was used, ranging from strongly disagree (1) to strongly agree
(5) to access the level of expectations and perceptions of patient service quality. The survey
questionnaires were collected 242 sets which totally distributed 250 sets, 3 sets were not returned
and 5 sets were not completely responses. The demographic distribution of the pregnant woman
indicated as following:



Vol. 4 No. 1 (January-June 2015)
















Dip lo ma














Co mpany








Dip lo ma

Occupati on


Five Dimensions SERVQUAL Method

SERVQUAL Method divide service quality into 5 dimensions with 20 attributes, they

SERVQUAL Attri bute


Physical building are visually appealing
Up to date equipment and in good working
Hospital Employee are appeal neat
Availability of Medical devices
Hospital employee attitude to pregnant woman
Having great confidence and safe in their
interaction with Doctors
Attention and patience of the nurs es
Experience and knowledge of doctors
Politeness of the staff to pregnant woman
10 Ease of communication
11 Doctor know what type of problem arises to
pregnant woman
12 Doctor know what type of pregnant woman
13 Speed of service
14 Speed of registration
15 Telling pregnant woman exactly when services
will be performed
16 Desire for helping
17 Handling and comprehensive action
18 Reputation of doctors
19 Qualification of staff
20 Accuracy of treatment







Vol. 4 No. 1 (January-June 2015)

Research Framework
Research framework had shown in this following figure. This research used primary data
collected directly through questionnaire given to pregnant woman from three group demography
from age, education and occupation. Indicators in the questionnaire were taken from the five
dimensions of SERVQUAL tangible, assurance, empathy, responsiveness and reliability, each of
which contains four statements.

The Study Findings and Discussion

The SPSS for Windows was used to analyze data. The mean expectation and
scores for all 5 dimensions and 20 attributes are presented in the table for the
Department of Mother and child, Mahosot referral Hospital to the pregnant woman
with the mean service quality gap score calculated using Service Quality (SQ).The
shown in the following table:

service of
result are

Service Quality (SQ) =Perception (P)-Expectation (E)

1. Tangibles

This table shows the mean service quality for four attributes in the tangible dimension for
Department of mother and child, Mahosot referral Hospital. The first and second highest of gap
score of 20 attributes occurring in this dimensions such as SQ1 =3, 47 and SQ2 =3.03. The result
for items measuring that the pregnant woman need the hospital urgent improve for physical
facility and medical equipments supporting visual appealing and good working condition. In
addition the remain two items, i.e.,SQ3 and SQ4 representative to the appeal neat of staff and
medical devices are request to looking after by the Director and Manager of Hospital. The
tangible dimension is the priority to making better of the service in the feminist views.



Vol. 4 No. 1 (January-June 2015)

2. Assurance

There are two mean significant gap score in the Assurance Dimension, SQ5=1.27 and
SQ7=1.35 which representative to hospital staff attitude, attention and patience to pregnant
woman. One gap score, SQ8=0 which indicate that the experience and knowledge of Doctor are
accepted. This assurance dimension is still need to build up the human source of hospital.
3. Empathy

Measuring the empathy dimension show that the gap score SQ10= 1.01 as representative
of attribute on easy of communication and SQ9=0.77 as representative of the attribute of
politeness of staff to customers are suggested for adjustment the service mechanism and
concerning to be more pay attention and polite to patients.
4. Responsiveness

In the dimension of responsiveness, the measuring of gap score of quality service indicate
that three attributes are essential improvement to meet the first helping of the pregnant woman
required while arriving the hospital such as SQ13=1.56 as speed of service, SQ16=1.27 as desire
for helping and SQ14=0.29 as speed of registration. These attributes are related to routine
performance of hospital staff.



Vol. 4 No. 1 (January-June 2015)

5. Reliability

The result in testing for measuring on reliability was 0.31 in average while the biggest
number of gap score of service quality is 0.84 for the SQ17 which representative of the handling
and comprehensive action of hospital staff to the pregnant woman.
6. Overall Service quality

The overall mean values of service quality gap score for the Mahosot Referral Hospital
was 0.86 respectively. Among the five dimensions, the highest mean values was tangible (1.94);
followed by assurance (0.82), responsiveness (0.78), empathy (0.53) and the lowest for reliability
(0.31). Concerning to the measuring of the service quality gap score on the 20 attributes, the
highest mean values was physical building to be visually appealing (SQ1 =3, 47) and the lowest
was the qualification of staff (SQ19=0.13). Additionally there are four attributes having the
testing gap score equal zero such as SQ8 as experience and knowledge of doctors, SQ11 as in
which doctor know what type of problem arises to pregnant woman, SQ15 as the telling exactly
when service will be performed and the final attribute SQ18 as reputation of doctor. It was note
that no positive means values of service quality gap score in any attributes.

The findings from this study show that some service quality dimensions and attributes of the
department of mother and child, Mahosot hospital need to improve in order to meet the required
of the customer satisfaction and expectation as well as the pregnant woman. The respond of the
performance in 16 attribute are not strong agree and not agree while service attribute which is the
main priority has not implement yet. Only four performance attribute are acceptable and should
be kept to serve the customer. It is important for service organization to know how well they are
serving customer and they therefore could improve and maintain the quality of hospital services.



Vol. 4 No. 1 (January-June 2015)

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