Primera Entraga PI (Calificado)

Faculty of Engineering
INDUSTRIAL ENGINEERING
Implementation project - 2020
ANALYSIS OF NPS OF HOSPITAL PATIENTS
MANPAL FROM THE PERSPECTIVE OF A FEMINIST FOUNDATION.
Valeria Angarita Camargo 1a, c, Miguel Martinez Torres 2a, c, DanielFernando
Camel 3a, c, Juan Camilo xx 4a, c
Juan Sebastián Gil Castro b, c
a
Industrial Engineering Student
b
Profesorl, Department of Industrial Engineering
c
Pontificia Universidad Javeriana, Bogota, Colombia
_____________________________________________________________________________________________________
_
Summary: The main purpose of the project is to identify variables related to the NPS
results of Manipal hospitals with respect mainly to service detractors from the
perspective of directors of a feminist foundation whose mission is to ensure equality
in the quality of life of women in India. The methods to be used will be the analysis
and interpretation of relationships between variables, with graphs and inference
formulas being used, collected through surveys conducted at the national level. The
results obtained are expected to respond to the impact being had on the part of patients,
provide solutions to the problem of quality and corporate strategy and thus allow to compare
and therefore improve the service received by women and men, so that Manipal hospitals
ensure gender equity in India.
Keywords: Detractor, variables, NPS results.
1. JUSTIFICATION AND APPROACH TO THE PROBLEM
The relationship between patient satisfaction and expectations has a crucial factor in
determining the quality of health care (1). This is why hospital administrative boards
have resorted to using processes to collect the opinion of their patients. One of the
most common is the NPS or net promoter score which categorizes consumers into
three large groups: Detractors, liabilities and promoters. Numerical analysis of this
tool would allow hospitals to make better decisions based on what their patients
want.
Medical service providers should receive feedback from their patients to identify their
lacks and guide their quality programs to them (2), therefore and based on the
above, we will take the example of Manipal Hospitals, a health corporation
responsible for managing different hospitals. Those who want to have a study that
helps them make decisions that improve the quality of their care and therefore the
satisfaction of their customers, as well as potentialize the role of the patient as the
main focus of strategy. Organizations are at a stage where they are no longer mostly
measured by financial indicators that determine the cost-benefit ratio. But for its
quality of service (3).
Taking into account the above and from our role as Directors of a Feminist
Foundation, this work aims to analyze the most important factors that influence the
quality of service delivery at Manipal Hospitals with the aim of comprehensively
improving service strategies and therefore increasing the satisfaction experienced by
patients. However, our main objective is to compare the quality of service provided
by men and women, to identify aspects to improve gender equity and differential
processes towards women in order to promote a health system where men and
women receive the same opportunities, care and treatment.
2. BACKGROUND
According to the analysis of The B&J Journalen's article based on NPS tests of 6186
national health service patients at a university hospital in the United Kingdom,the ratio of
thequantifiable value of the resulting NPS scores to the administrative fallacy endured
by that hospital was identified, the findings of this study served to improve and renew
their articulated customer service system and therefore allowed them to improve their
competitive strategy and boost their hospital in the market. This study also managed
to compare this service with that of other non-medical services to finally evaluate what
factors influence the satisfaction or distraction of its patients. This article is an
important precedent for our project, not only because they were also based on
methods of statistical inference but because of their discoveries in concepts such as
speed, extra services (food, tv, etc.) and patient-doctor relationship (4).
A study of patient satisfaction in a tertiary reference hospital (NSICU) also shows us

the behavior of people's satisfaction, in which it was observed that the overall level of
satisfaction of doctors ranged from 89.29% to 99.6%, unlike the Mahapatra study and
others (2001), in which patient satisfaction with respect to the technical quality of
doctors reached only 63% 4.
The percentage of assistants satisfied with nursing care was slightly lower. NSICU is
an area with the highest bed occupancy rate in the entire Institute (155% to 230%
during the period January to October 2002). (5)
Despite the restricted entry of attendees and the most critical condition of patients,
NSICU attendees were more satisfied with the total services provided by the
department. This reflects the fact that the level of satisfaction of attendees depended
closely on three variables, namely cleanliness, orderly environment and staff
discipline, which remained much better in the intensive care unit. The overall level of
interaction of attendees with hospital paramedics was poor compared.
On the other hand, research conducted by Syafrizal Helmi Situmorang in Indonesia.

It aimed to analyze the competition of 95 brands from 12 categories based on
customer experience, emotional value and the use of NPS. All this through data
collection to middle-class Muslim women in the city of Medan was done by accidental
sampling. The study was conducted using descriptive statistical tests, by calculating
the average value of the customer experience, emotional value, and NPS results. (6)
While there has previously been research that provides important factors against the
study of the net promoter score in hospitals, the differential factor of this case project
is based on promoting and comparing the role of gender equity in patient care in
Manipal hospitals, where not only is the quality of service system increased at the
conclusion of this study but procedures and treatments that do not discriminate by gender to
any patient within a country as controversial to women as India is.
3. OBJECTIVES
3.1 GENERAL OBJECTIVE
Test the existence of the correlation between npS and satisfaction indicators,
performing analysis of qualitative-quantitative, qualitative-qualitative and quantitative-
quantitative variables and their respective problems in data collection.
3.2 SPECIFIC OBJECTIVES
1. Propose based on the data obtained, viable solutions of how to increase the level
of npS to increase the participation of women who would recommend the hospital
to its knowns and the level of satisfaction analyzed from the point of view of a feminist
entity of patients who are discharged, after having analyzed the possible
relationships between the variables: qualitative-qualitative, quantitative-
quantitative and qualitative-quantitative.
2. To analyze comparatively the treatment and conformity perceived from various

biases in the male and female population served,and thus be able to know if it is
alofty factorfrom the point of analysis of the feministfoundation. Other than that,
analyze which variables are most influential in the NPS from this point of view..
3. Analyze the variance of the data to see if you can see what behavior the sample
data tends to
4. Analyze the respective NPS values for this population section (Hindu
women)and see if the overall service being provided in this area is relevant in contrast
to the male population, and associate that it influences patient loyalty
4. CASE STUDY
MHE (Manipal Health Enterprises), one of the largest service providers of multiple
specialties in the area of health in India, MHE relies on research into and
management of both technical health services; presenting itself as an innovative,
competent entity in the field of health services which wants to offer the best possible
customer experience. With the advent of innovative projects and the need to
understand customer concerns, MHE is looking for new systems that make it easier
for you to collect data and manage quick decision-making information. Previously,
the company collected information about customers through manually made and
registered forms, which was quite inefficient. In addition, the need to have this data
in real time and be analyzed quickly led to MHE implementing iPads on-premises in
order to speed up the process of collecting and recording customer information
(randomly selected) that went through its health services. Thanks to this
implementation, they presented good results in data collection time and evidence of
possible points to be improved. For MHE prioritizing the concept and opinion of the
customer towards their business is one of the most important margins because the
customer experience is the most relevant in the construction of voice-to-speech as a
means of high-impact propaganda. In addition, MHE wants to offer a good hospital
environment, where there is high quality care, a good environment of people
compassionate and ethical with customer service. With this, MHE is motivated to
implement new metrics and methodologies, to correct certain fallacy, such as
receiving incomplete surveys, thus not being able to highlight the possible concerns
of customers in their entirety. These new metrics, such as NPS and Likert scale,
seek to better understand customer concerns.
5. STATISTICAL MODEL
Raising information
The database to be studied has 50 variables obtained from the processes,

characterized by being quantitative and qualitative. Some of them are dichotomical as
for the case of sex and polytomical for the category of the room.
As for quantitative ones there are continuous ones such as the estimated and discrete
cost as the number of days hosted. It is also important to note that some are expressed
in percentage form, mainly for the case of satisfaction levels, being 0% (not satisfied
or does not meet) and 100% (meets or very satisfied).
Although everything in the database is important for the development of the study
there are departments such as guest or patient information that only serve to keep a
record and have an adequate traceability of each que se individual, therefore, tanto, it
does not enter the profile of interest sought in this study since they do not provide r
elevation informationto the objective of the same. Moreover, there is the department of
the discharge process that is more related to theprocessing of the information than to the
service itself so it is not relevant consid erado in a comparative analysis with bias in the
sexuality of the patient..
Research question
To ensure quality in the provision of service to women in Manipal hospitals should

technical and emotional aspects be taken into account?
Discrete Quantitatives
o Satisfaction: Measures a patient's satisfaction rate in relation to the entire

service.
o ComodVisitas: Measures the level of satisfaction for the companions or
visitors of each patient.
o At_: Measures the percentage of response when a patient arrive at the
emergency department.
o Doctor Attitude: Measures the percentage of satisfaction with respect to
the medical personal that cares for the patient.
o Nurse Attitude: Measures the percentage of satisfaction with respect to the
nursing personal that cares for the patient.
o Number of days: Indicates the number of days the patient remains in the
hospital.
Continuous Quantitative
o Cost: Indicates the average cost per patient in the hospital.

o Age: Indicates the age in years and months of a patient.
Nominal Qualitatives
o Specialty: Indicates the specialty to which the patient belongs in the hospital.
Ordinal Qualitatives
o NPS Status: Indicates the type of loyalty the user has with the hospital.
o Room type: Indicates the room type assigned to each patient.
o Membership Type: Indicates the type of affiliation the patient enters the
hospital for.
Target population
Set of female patients who arelinked to the health systemsof theManipal Hospitals
Questions
1) Whatis the percentage for women hospitalized in India?
2) What is the level of satisfaction with the service, taking into account parameters
such as the state of the establishment (equipment, food, etc....)?
3) What is the percentage of hospital occupancy by Indian state zone?
4) What is the group of older women in years who are less pleased with the
immediate care received? Young population (0.3 - 18), Adult population (+18 -
45.7), Older adult population (45.7+).
5) What is the average stay of the Hindu woman compared to the man?
6) How do the costs of the female Hindu population fluctuate compared to the male
population?
7) How fast is the hospital's care for the Hindu woman?
8) How is the overall satisfaction rate of women versus that of men in the hospital?
9) How do the prices of Hindu women's treatments vary from those of men?
10) What is the percentage of women insured compared to men in the Hospital?
Calculation of sample size and pilot test
Being strictly accurate the present does not have a sample size calculation since the
implemented data were supplied as a basis and was not a collection of own
authorship.
6. STATISTICAL ANALYSIS
Quantitative variables: These quantitative variables were chosen in percentages

because they were those of the lowest percentage index which was between 73%-
76%, to subsequently perform an analysis with the NPS and evaluate its relationship.
o Food quality. (Categorical- Nominal)

o Food delivery time. (Categorical- Nominal)
o Attendance food. (Categórica- Nominal)
Qualitative variables: these two types of qualitative variables were chosen which are
divided into those that evaluate the NPS which are promoter, passive, detractor and
those that evaluate some of our variables of the form, satisfied and not satisfied
1) What is the percentage of women hospitalized in India?
As you can see in the graphs, the percentage of the hospitalized Indian population is
higher with men than with women.
2) What is the level of satisfaction with the service, taking into account parameters
such as the state of the establishment (equipment, food, etc....)?
o Satisfaction level (Ordinal character variable that represents how satisfied the
patient felt during the hospital stay).
As you can see on the bar chart the level of satisfaction of men and women
considering the food is generally good, with the sample box diagrams we can see
how the food quality is the lowest rated because the lower quartile goes from
about 52 to 67, while the delivery of feeding time and food attendance is
approximately 58 to 70; While for room cleaning and room equipment 75%
remains over 75, on the other hand the peace room and room atmosphere 75%
is approximately more than 73%, so in general the hospital has an excellent
establishment.

Food quality Food
88,39% 93,95% 91,72%
5000
4000
3000
2000
1000
0
Food quality Food delivery Attendance
food.
Food quality Food delivery Attendance food.

INSATISFECHO 579 302 413
SATISFECHO 4410 4687 4576
Atteendance food
Room cleanliness Room peace

Room equipment Room ambience

3) What is the percentage of hospital occupancy by Indian state zone?
As we can see in the diagram in general men and women are kept distributed in
a similar way in the different state areas, however, you can see how in the south
with a very large difference is the state area with the most occupation of the
hospital, this information is quite valuable as it gives us to indicate that this is one
of the most vulnerable areas of India of both women and men , more than 50% of
the hospital is occupied by people from the south, while internationally it is almost
null and void, implying that foreigners are cared for very well.
Central This International North On Unknown West

Women 5 152 1 11 1894 35 19
Men 5 273 0 18 2417 27 23
4) What is the group of older women in years who are less pleased with the
immediate care received? Young population (0.3 - 18), Adult population (+18 -
45.7), Older adult population (45.7+).
As we can see in the diagrams shown below, we have a much smaller population of
women under the age of 18, however, we can see that the average satisfaction of the
three populations is the same among them.
5)What is the average stay of the Hindu woman compared to the man?
o Average number of days of stay (Discrete quantitative variable) that will show
us what the relationship of stay with man is like
Analyzing the histogram and the scattering of points in terms of the woman's stay
compared to that of men we can see that most of the data of both are located
approximately in the same area, this can lead us to predict that the average stay of
the man as of the woman will be very similar. And analyzing the box diagram we see
how 75% of the data of men both women are located below 10 days of stay.
6) How do the costs of the female Hindu population fluctuate compared to the
male population?
For the section of this sample we use non-probabilistic sampling, by trial, where it was
decided to equalize the number of women as men, in order to have a more accurate
reference range, therefore, we use a sample of 976 people where half corresponds to our
target population and the other half to the male population. The need to compare our graphs
of the target population, with the male population is to find irregularities in the hospital
process, or injustices. Analyzing the graph superficially we can see that women's costs are
higher than that of men, where the average price of the male population is $64,785 unlike
women is dand $73743,this gives a differentiation and priceof approximately $8958 per
patient. $
7) How satisfied are Hindu women with the time spent in the hospital?
The average satisfaction with respect to the time used by the hospital is
81.01%while the man's time is 81.4% we can see thanks to the diagrams how
minimal the difference is, and by the box chart as more than 75% of the data of both
cases are above 60% showing results that the hospital has a good time management
for both genera.
8) What is the percentage of overall satisfaction of women compared to that of men

in the hospital?
The average overall satisfaction that women have in front of the hospital is 99% as
well as that of men, this information can be seen thanks to the comparison of our 2
circular diagrams, while with our diagrams of sample boxes we can see how the
attitude of staff, nurses and doctor is too similar in men and women , and considered
satisfied greater than 50, only atypical data would be below this classification, for this
reason 1% dissatisfied.
Staff attitude women vs men
Attitude of nurse women vs men

Doctor's attitude women vs men

10) What is the percentage of women insured compared to men in the Hospital?
Using the database, we classified Indian women with insurance and then compared
it to men, so we realized that the percentage of women with insurance is 38% which
is slightly higher than that of men which is 37%, so you could say that there is
gender equality in this regard.
References
1) Finkel, M. L. (1997). The importance of measuring patient satisfaction. Employee

benefits journal , 22 (1), 12-15.
2) Rubin, H. R. (1990). 1. Patient Evaluations of Hospital Care: A Review of the

Literature. Medical care , 28 (9), S3-S9.
3) Faltejsková, O., Dvoráková, L., & Hotovcová, B. (2016). Net promoter score
Integration into the enterprise performance measurement and management system
a way to performance methods develop e+m Ekonomie a Management, 19(1), 93-
107.
4) Hamilton, D. (2014). Assessing treatment outcomes using a single question .
Available at: https://online.boneandjo int.org.uk [Accessed 4 Mar. 2020].
5) Mahapatra P, Srilatha S, Sridhar P. A Patient Satisfaction survey in public
hospitals. Journal of Academy of Hospital Administration 2001; 13:11-15.
6) Situmorang, S., Rini, E. and Muda, I. (2017). Customer Experience, Net Emotional
Value and Net Promoter Score on Muslim Middle Class Women in Medan . Available
at http://322758292 [Accessed 4 Mar. 2020].

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Faculty of Engineering

ANALYSIS OF NPS OF HOSPITAL PATIENTS

MANPAL FROM THE PERSPECTIVE OF A FEMINIST FOUNDATION.

Valeria Angarita Camargo 1a, c, Miguel Martinez Torres 2a, c, DanielFernando

Camel 3a, c, Juan Camilo xx 4a, c

Juan Sebastián Gil Castro b, c

1. JUSTIFICATION AND APPROACH TO THE PROBLEM

A study of patient satisfaction in a tertiary reference hospital (NSICU) also shows us

On the other hand, research conducted by Syafrizal Helmi Situmorang in Indonesia.

3.1 GENERAL OBJECTIVE

3.2 SPECIFIC OBJECTIVES

2. To analyze comparatively the treatment and conformity perceived from various

The database to be studied has 50 variables obtained from the processes,

To ensure quality in the provision of service to women in Manipal hospitals should

o Satisfaction: Measures a patient's satisfaction rate in relation to the entire

o Cost: Indicates the average cost per patient in the hospital.

1) Whatis the percentage for women hospitalized in India?

3) What is the percentage of hospital occupancy by Indian state zone?

7) How fast is the hospital's care for the Hindu woman?

Calculation of sample size and pilot test

Quantitative variables: These quantitative variables were chosen in percentages

o Food quality. (Categorical- Nominal)

1) What is the percentage of women hospitalized in India?

Food quality Food delivery Attendance food.

Room cleanliness Room peace

Room equipment Room ambience

3) What is the percentage of hospital occupancy by Indian state zone?

Central This International North On Unknown West

8) What is the percentage of overall satisfaction of women compared to that of men

Staff attitude women vs men

Attitude of nurse women vs men

Doctor's attitude women vs men

1) Finkel, M. L. (1997). The importance of measuring patient satisfaction. Employee

2) Rubin, H. R. (1990). 1. Patient Evaluations of Hospital Care: A Review of the

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