CHAPTER 3

Research Methodology

3.1 Definitions

3.2 Objectives

3.3 Hypothesis

3.4 Sample size and Selection

3.5 Research Tool

3.6 Tools for Data Collection

3.6.1 Hospital Marketing Strategy Scale

3.7 Tools for Data Analysis

3.7.1 Test for Normality

3.7.2 Test for Reliability and Validity

3.7.3 T-Test

3.8 Limitation and Scope

 Research Methodology

3.1 Definitions

1. In our Study, we categorized hospital as “Private Hospital” if it has

private/trust ownership and is operating only in Indore city. However, any
hospital having private/trust ownership but is operating in multiple
locations in India including Indore is considered as “Corporate Hospital”.
2. For the purpose of analysis the respondent private hospitals were grouped
based on the bed capacity. The Table 3.1 details the definition of hospitals
based on hospital bed capacity.

Table 3.1: Classification of Hospitals on the basis of Bed Capacity

Group Number Bed Capacity Geographical Ownership
Area of Operation
1 Less than 25 Beds Indore city only Private/Trust
2 26-50 Beds Indore city only Private/Trust
3 51-100 Beds Indore city only Private/Trust
4 Above 100 Beds Indore city only Private/Trust
5 Corporate Hospitals Multiple locations Private/Trust
in India including
Indore

3.2 Objectives

The present study explores the current marketing practices adopted by private
and corporate hospitals of Indore city. The study also performs a comparative
study of marketing practices adopted by private hospitals and corporate
hospitals, to identify the similarities and dissimilarities of marketing strategies
of these hospitals.

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This study was conducted considering following objectives:

i. To study the current marketing strategies adopted by various

private hospitals of Indore.
ii. To compare the marketing strategies of private hospitals with
corporate hospitals of Indore
iii. To study the elements of marketing mix which are most and least
emphasised by private hospitals of Indore.

3.3 Hypothesis

HO: There is no significant difference between marketing strategies of private

hospitals and corporate hospitals of Indore.

HI: There is significant difference between marketing strategies of private

hospitals and corporate hospitals of Indore.

3.4 Sample Size and Selection

The sample comprised of private and corporate hospitals operating in Indore

city. Total number of hospitals operating in Indore city is 194. Out of these total
194 hospitals, 72 hospitals are either government hospitals or they are not using
any marketing practice. Thus for our study total of 122 hospitals are eligible.
The Table 3.2 gives the details about the formation of these 122 hospitals and
the sample size of each group of hospitals.

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Table 3.2: Hospital Group wise Sample Size details

Group Eligible number of hospitals for Number of
Number our research Respondents
(Sample Size)
1 77 64

2 18 18

3 14 14

4 6 6

5 6 6

As can be seen in Table 3.2 the total population for group 2, group 3, group 4
and group 5 hospitals is very small. Hence we have conducted the survey for all
the hospitals in these groups without incorporating any sampling method.
However, for group 1 hospital out of total population of 77, we selected the
sample of 64 hospitals using convenience sampling method.

From the above discussion, it can be established that our sample has balanced
mix of small, medium and big size private hospitals of varying bed capacities. It
is good representative of private hospitals operating in Indore. The total of 108
participants participated in the survey. The respondents were holding
managerial positions in the hospitals. Fig. 3.1 shows the sample distribution.
The distribution is based on number of beds in hospital.

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Sample Distribution
Group 4 GrouP5

Fig. 3.1

3.5 Research Tool

The research tool consisted of structured questionnaire (Appendix 1).

3.6 Tools for Data Collection

The primary data for this study was collected from the hospital management

personnel or marketing managers by using self administered scale. Review of

literature revealed unavailability of standard instruments for studying the

marketing strategy used by private hospitals or corporate hospitals in Indian

context. Therefore a scale for studying marketing strategy of private and

corporate hospitals was self-developed and administered. The additional data

needed to support the study was also collected from secondary sources like:

online publications, journals, magazines, books, etc. The description of the

developed scale used to collect primary data is as follows:

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3.6.1 Hospital Marketing Strategy Scale

The standard procedure was followed for developing and standardizing the
scale. List of 54 items was prepared after reviewing the relevant literature. The
initial screening by eliminating the repetition and irrelevant items provided 42
items. The selected 42items were presented to a sample of 18 judges (10 from
private and corporate hospitals and 8 from academia representing marketing
specialisation) along with definition of private and corporate hospitals for
assessing content and construct validities of each. The list of 30 items (with
71.43% acceptance amongst judges) was finalised. Then each item was
presented on five point likert scale ranging from ‘Strongly Agree (5)’ to
‘Strongly Disagree (1)’ and finally administered on the sample of 108
respondents.

Respondents were posed with questions related to their marketing strategy.

Extreme care has been observed while selecting the respondent. We have
collected the data only from the respondent whose functional responsibility
involved decision making regarding marketing practice of the hospital. Thus the
respondent could have been the management personnel or marketing manager.

Collected data was analysed for eliminating the weak or insignificant items by
measuring internal consistency through item-total correlation. In the first
iteration, values of correlation coefficient between each ‘item and ‘total of
items’ was found. One item (item no.l 1-1 believe website help us promote our
services) was found insignificant, hence it was dropped. In the second iteration
remaining 29 items were again subjected to item-total correlation. None of these
items were found to be insignificant and therefore all 29 items were selected for
final scale.

After ensuring the content and construct validities of the items selected, the
reliability of the scale was determined by Cronbach’s Alpha method. The

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reliability coefficient alpha (a) was found to be 0.838 that showed high
reliability of the scale. The closer the reliability coefficient alpha (a) is to 1.00,
the greater the internal consistency of items in the instrument being assessed
(George, Darren and Mallery, 2011). When a scale is developed for a particular
situation and no other standardised instrument is available the reliability index
based on reliability coefficient (square root of reliability coefficient) can be
taken as equivalent to validity of the scale (Zikmund, 2003). Since the scale
developed for present study was also unique in nature, the validity was taken to
be equivalent to reliability index and computed as 0.954.

Profile

Tool : Hospital Marketing Strategy Scale

Author : Self

Subject : Hospital Management Personnel or Marketing Manager

Nature : Verbal

Structure : 29 items, 5 point Likert Scale

Duration : No time limit

Reliability : 0.0911

Validity : 0.954

Source : Self

Description

1. The scale is self-administering.

2. The subject is asked to interpret each item by himself/herself.
3. The subject is expected to (x) mark on any one of ‘one to five choices’
against each statement. The choices range from strongly agree to strongly

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disagree. There is no right or wrong answer hence subject is free to give

his/her opinion on each item.
4. Unwanted expectation or apprehensions are not raised in the mind of the
subject.
5. The scale yields the hospital marketing strategy.

Scoring

1. Scoring is done manually.

2. Each item is awarded 5 for strongly agree, 4 for agree, 3 for neutral, 2 for
disagree, and 1 for strongly disagree.
3. Mean Values were then calculated for individual statement. Appropriate
statistical tools were then used on these means values to draw meaningful
conclusions.

3.7 Tools for Data Analysis

The following statistical tools were applied using Statistical package of Social
Science (SPSS 17.0) and MS Excel 2007 for the analysis of collected data and
to arrive at meaningful conclusions.

3.7.1 Test for Normality

As the subsequent experiments required the assumption of normal distribution

of the sample as the pre-requisite for the analysis, it became necessary to test
the veracity of the assumption of normal distribution of collected data on
hospital’s marketing strategy. Normality test statistics by ‘Kolmogorov-
Smimov Test’ assesses that whether a particular distribution differs
significantly from normal distribution (Carver and Nash, 2009). Thus the total
score calculated from the responses of 108 respondents collected using
‘Hospital marketing strategy Scale’ were tested for veracity of the assumption
of normal distribution by using Kolmogorov-Smimov Test. The significance

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value (p-value) for this test was found to be 0.579 (greater than 0.05) and
indicated that the distribution of final points does not differ significantly from
normal distribution. This inferred that the assumption of normality with respect
to the sample chosen was valid. Therefore the experiments and analysis based
on normality concept could be carried out with the sample of 108 respondents

Skewness and Kurtosis as the measures of deviation from normality were also
calculated. A value between +/-2.0 for both skewness and kurtosis is acceptable
for showing normality of data (George, Darren and Mallery, 2011). The value
of skewness was found to be -1.926 and for kurtosis it was 0.434. In both the
cases values fell within acceptable range of +/- 2.0. The values of standard error
for kurtosis (0.917) and skewness (0.099) found sufficiently small, which were
indicating greater stability of data.

3.7.2 Test for Reliability and Validity

As mentioned above in the description of ‘Hospital marketing strategy Scale’,

Item-total correlations and Chronbach’s alpha method were used to test the
reliability of the scale. The reliabilities of each identified dimensions were also
determined by Chronbach’s alpha method. The content and construct validities
of the scale assessed qualitatively by the panel of 18 judges. The validity of the
scale in quantitative terms was assessed by reliability index (Square root of
reliability coefficient).

3.7.3 T-Test

This test is used only when the two population variances are assumed to be
different (the two sample sizes may or may not be equal) and hence must be
estimated separately. In our study, as the population variance of private hospital
and corporate hospital is assumed different and sample sizes are known to be
different, hence T-test is used to compare the marketing strategy of private
hospital with corporate hospital.

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The t statistic to test whether the population means are different can be
calculated as follows:

t=
Xt - x2
A 1-A2

where,

SXi-Xi
7l\ ft 2

2
Where s is the unbiased estimator of the variance of the two samples, n =
number of participants, 1 = group one, 2 = group two. Note that in this case,
_ a
A’i-A'2 is not a pooled variance. For use in significance testing, the distribution
of the test statistic is approximated as being an ordinary Student's t distribution
with the degrees of freedom calculated using

Hf =_____ o;/tti + 4/n2y2_____

(s?/»i)2/(«i - 1) + (slln2)2l(n2 - 1)'

In our study we used T-test to compare the marketing strategies of different

group of private hospitals with corporate hospitals. All the service marketing
mix elements of all private hospital groups (1,2,3,4) of Indore city are
compared with the respective corporate hospital’s (Group 5) service marketing
mix element on the basis of mean scores and standard deviation values.

3.8 Limitation and Scope

The present study was conducted amongst private and corporate hospitals of
Indore city alone. This limits its generalisation to other cities and states of India.

Again this study was conducted only on private hospitals, hence it limits its
application to government hospitals and hospitals which are not using any
marketing practices.

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