A STUDY ON THE SERVICE QUALITY IN HEALTH CARE

SYSTEM: IN DEPTH EXPLORATION TO UNANI

TREATMENT IN KERALA WITH SPECIAL REFERENCE TO
MIHRAS HOSPITAL, CALICUT
Project Report

Submitted in partial fulfillment of the requirements for the award of the degree of

BBA.LLB
Offered by the University of Calicut

Submitted by MOHAMMED SHIHAB Z

(LMASLBA028)

Under the guidance of

MS. SITHARA RAJAN K

Assistant Professor

Dept. of Management Studies

MARKAZ LAW COLLEGE

Affiliated to the University of Calicut and approved by BCI

MARKAZ KNOWLEDGE CITY

Kannoth (PO), Kaithapoyil, Kozhikode

November – 2022
 CERTIFICATE

This is to certify that the Project report entitled “A STUDY ON THE SERVICE QUALITY
IN HEALTH CARE SYSTEM: IN DEPTH EXPLORATION TO UNANI
TREATMENT IN KERALA WITH SPECIAL REFERENCE TO MIHRAS
HOSPITAL, CALICUT” is a bonafide record of the work done by MOHAMMED
SHIHAB Z with Register Number LMASLBA028 in partial fulfillment of the requirement
for the award of degree of BBA; LL.B offered by the University of Calicut.

Guide Principal
 DECLARATION

I, MOHAMMED SHIHAB Z, hereby declare that the project work entitled “A STUDY ON
THE SERVICE QUALITY IN HEALTH CARE SYSTEM: IN DEPTH
EXPLORATION TO UNANI TREATMENT IN KERALA WITH SPECIAL
REFERENCE TO MIHRAS HOSPITAL, CALICUT” is a record of independent and
bonafide project work carried out by me under the supervision and guidance of MS.
SITHARA RAJAN K, Assistant Professor, Department of Commerce, MARKAZ LAW
COLLEGE, Kozhikode.

The information and data given in the report is authentic to the best of my knowledge. The
report has not been previously submitted for the award of any Degree, Diploma, Associate
ship or other similar title of any other university or institute.

Place: Kaithapoyil MOHAMMED

SHIHAB Z

Date: LMASLBA028
 ACKNOWLEDGEMENT

I am sure that this work couldn’t be able to be as it now without the fervent support of a clan
of personalities. This Project Report is the result of the efforts of those people and me is the
one who got an opportunity to bring the concepts, ideas, and views of such dignitaries to
light.

Firstly, I submit myriads of praises and reverences to the LORD the Almighty who
enlightened my barren mind with thoughtful ideas, endowed me with his blessings, solaces,
and flair, and fluency perversely at times of stumble, boredom, and desultory. And without
whom this work could never be started, continued, and completed.

I wish to express my sincere indebtedness to the Honorable Principal DR. ANJU N PILLAI
for her keen encouragement, impetus, and profound cooperation given to me until the
completion of this report.

Forthrightly, I place my heart full thanks to the DR. SHAMSUDDEEN P V, EXECUTIVE

DIRECTOR , MIHRAS HOSPITAL who accepted my request for this project and
provided me with all required facilities, including their precious time for the collection of
data and timely successful completion of the project.

I extend my cordial gratitude to my Guide to the project MS. SITHARA RAJAN K,

Assistant Professor, and MARKAZ LAW COLLEGE for his relentless guidance from the
onset to the last of this project clearing all the ambiguities and angsts, endowing more ideas
to the topic, and emboldening at every stage of the project.

I am also thankful to all staff of MIHRAS HOSPITAL who have cooperated patiently with
the data collection during their work time and provided sincerely accurate data upon which
this project has entirely depended.

Apart from all, I put forward my bold thankfulness to my parents who stand in great cheer
and support for me in each step regardless of success or failure, and to my family members,
teachers, bold colleagues, and my friends who unceasingly succoured me infusing exultations
within me.

Place: Kaithapoyil MOHAMMED SHIHAB

Z

Date: LMASLBA028
 CONTENT

SL.NO TITLE PAGE NO

1.
INTRODUCTION 8-14
1.1 INTRODUCTION 9-10
1.2 OBJECTIVES OF STUDY 11
1.3 SCOPE OF STUDY 11
1.4 STATEMENT OF PROBLEM 11
1.5 RESEARCH METHODOLOGY 12-13
1.6 PERIOD OF STUDY 14
1.7 LIMITATION OF STUDY 14
LITERATURE REVIEW AND THEORETICAL
2.
FRAMEWORK 15-33
2.1 LITERATURE REVIEW 16-22
2.2 THEORETICAL FRAMEWORK 23-33
3. PROFILES 34-51
3.1 INDUSTRIAL PROFILE 35-43
3.2 COMPANY PROFILE 44-45
3.3 PRODUCT AND SERVICE PROFILE 45-51

4. DATA ANALYSIS AND INTERPRETATION

52-66

5. FINDINGS AND SUGGESTION

67-70
5.1 FINDINGS 68
5.2 SUGGESTION 69
5.3 CONCLUSION 70
71
5.4 BIBLIOGRAPHY

72-76
APPENDIX
 LIST OF TABLE

SL.NO TITLE PAGE NO

4.1 GENDER WISE CLASSIFICATION 53
4.2 AGE LEVEL CLASSIFICATION 54
ATTENTIVENESS OF UNANI TOWARD THE CONCERNS
4.3 55
OF PATIENTS.
RECEIVE CONFLICTING INFORMATION FROM
4.4 56
DIFFERENT PROFESSIONALS
WORK HOURS EFFECTIVENESS TO TREAT THE
4.5 57
CONCERNS OF PATIENTS
AVAILABILITY OF UNANI TREATMENT FROM
4.6 58
PATIENT’S DESTINATION
4.7 QUALITY OF SERVICES RECEIVED 59
AWARENESS OF ALL HEALTHCARE SERVICES UNANI
4.8 60
TREATMENT OFFER
4.9 DOCTOR’S EMPATHETIC TO PATIENT’S CONCERNS 61
ABILITY OF DOCTORS TO ANSWERS PATIENT’S ALL
4.10 62
QUESTIONS
THROUGH WHICH PATIENT HEARD UNANI
4.11 63
TREATMENT
SENSE OF RECOMMENDATION OF UNANI TREATMENT
4.12 64
TO OTHERS
MEETING OTHER TREATMENT BEFORE FOR SAME
4.13 65
CONCERN
TREATMENT WHICH PATIENT MET BEFORE UNANI
4.14 66
TREATMENT
 LIST OF CHART

SL.NO TITLE PAGE NO

4.1 GENDER WISE CLASSIFICATION 53
4.2 AGE LEVEL CLASSIFICATION 54
ATTENTIVENESS OF UNANI TOWARD THE CONCERNS
4.3 55
OF PATIENTS.
RECEIVE CONFLICTING INFORMATION FROM
4.4 56
DIFFERENT PROFESSIONALS
WORK HOURS EFFECTIVENESS TO TREAT THE
4.5 57
CONCERNS OF PATIENTS
AVAILABILITY OF UNANI TREATMENT FROM
4.6 58
PATIENT’S DESTINATION
4.7 QUALITY OF SERVICES RECEIVED 59
AWARENESS OF ALL HEALTHCARE SERVICES UNANI
4.8 60
TREATMENT OFFER
4.9 DOCTOR’S EMPATHETIC TO PATIENT’S CONCERNS 61
ABILITY OF DOCTORS TO ANSWERS PATIENT’S ALL
4.10 62
QUESTIONS
THROUGH WHICH PATIENT HEARD UNANI
4.11 63
TREATMENT
SENSE OF RECOMMENDATION OF UNANI TREATMENT
4.12 64
TO OTHERS
MEETING OTHER TREATMENT BEFORE FOR SAME
4.13 65
CONCERN
TREATMENT WHICH PATIENT MET BEFORE UNANI
4.14 66
TREATMENT
 CHAPTER-1
INTRODUCTION
1.1. INTRODUCTION

Service quality is generally viewed as the output of the service delivery system, especially in the
case of pure service systems.Moreover, service quality is linked to consumer satisfaction. Service
quality is a perception of the customer. The word of quality comes from the Latin word
‗quālitātem‘ meaning performance upon expectation.
The word service comes from Latin servitium meaning 'slavery' and/or from servus meaning
'slave'.

A service is the non-ownership equivalent of a good. Service provision has been defined as an
economic activity that does not result in ownership and is claimed to be a process that creates
benefits by facilitating either a change in customers, a change in their physical possessions, or a
change in their intangible assets.

Service quality is a measure of how an organization delivers its services compared to the
expectations of its customers. Customers purchase services as a response to specific needs.

Some of the definitions given by various authors are:

According to Valarie A. Zeithaml and Mary Jo Bitner mentioned that, ‗Service quality is a
focused evaluation that reflects the customer‘s perception of specific dimensions of service namely
reliability, responsiveness, assurance, empathy, tangibles.‘ Based on the assessment of service
quality provided to the customers, business operators are able to identify problem quickly, improve
their service and better assess client expectation.

In recent years, health tourism has become one of the fastest growing industries in the world, even
though the desire for recuperation and relaxation has been a major driver of patients flows since
the distant past. Concern for the preservation of health and quality of life are leading health
motivation .Numerous studies have pointed out the role of health tourism in improving the quality
of life. However, the role of AYUSH especially of Unani treatment in health improvement has not
been researched so far. Unani treatment provide medical services to people

Service quality and customer satisfaction Evidence abounds in the literature that service quality
leads to patient satisfaction. Good customer care, which takes into consideration customer
communication, employee demeanour, helping and attending to patients can influence customer
9|P age
satisfaction with services. Atinga, established that patient satisfaction is dependent upon
supporting patients, reducing waiting time and improving the health facility‘s environment. Taylor
and Baker showed that the moderating effect of customer satisfaction on service quality and
purchase intentions was significant in several services such as communication, travel, recreation
except healthcare. De Ruyter, concluded that the relationship between service quality and service
loyalty differed, based on industry type. In an industry characterised by heavy switching costs (e.g.
healthcare setting), customers would be loyal. Tucker and Adams, in their public hospital patient
satisfaction study, found that service quality was positively related to customer satisfaction.
Rhodes et al. noted that US family members were satisfied if they were regularly informed about
their patient‘s conditions.

Healthcare consumers in developing countries are increasingly becoming aware of their right to
quality healthcare. Consequently, providing quality services in healthcare organisations is gaining
momentum in the extant literature). Many health sector stakeholders, government
agencies/institutions and healthcare consumers are now emphasising service quality delivery as a
mechanism to avoid adverse treatment outcomes and to meet consumer demand and value for
money. Rational healthcare consumers prefer to use services that provide quality and best-value
care. This suggests that, unless service users are expediently provided with best value care and
adverse outcomes minimised, healthcare organisations could suffer operational setbacks. In line
with global efforts to provide quality care, Ghana‘s health system has gone through several
reforms over the years with the main aim of bringing significant improvements in healthcare
delivery. One such reform was the implementation of the medium-term health strategy by the
Ministry of Health (MOH) that stressed two important healthcare quality dimensions: improving
access to basic health. The Institutional Care Division was subsequently established as a Ministry
of Health (MOH) body mandated to monitor and periodically evaluate service delivery. In 2003,
the health sector witnessed another major turning-point. A financial reform crystallised the
National Health Insurance Scheme (NHIS) with a key objective to improve health service access
and utilisation.

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1.2 OBJECTIVES OF THE STUDY

The main research objectives of this study are:

a) To study the correlation between the perception of physical quality of life and the life
satisfaction of patients who have attended in a Unani treatment for medical rehabilitation;
b) To establish the effectiveness of Unani treatment throughout healthy life journey
c) To study the quality of service provided by Unani treatment in selected esteemed hospital
after using the hospital‘s services; and
d) To establish awareness of customer about health care services of Unani treatment offers.

1.3 SCOPE OF THE STUDY

This project covers a survey among customers of MIHRAS HOSPITAL, by taking 63 more
customers as sample size. The study is conducted to know the effectiveness of Unani treatment
given by MIHRAS HOSPITAL and to give suggestions on the various techniques and methods
adopted by them for medical treatment

1.4 STATEMENT OF THE PROBLEM

The problem of this project report titled ―A STUDY ON THE SERVICE QUALITY IN
HEALTH CARE SYSTEM: IN DEPTH EXPLORATION TO UNANI TREATMENT IN
KERALA WITH SPECIAL REFERENCE TO MIHRAS HOSPITAL, CALICUT” is to
determine the effectiveness of Unani treatment given by MIHRAS HOSPITAL. In order to keep
the institution vibrant and, success one it is very important to boost the services, for the purpose of
increasing the services it is very much important to have provide good and satisfied medical
treatment , quality of services is the one of the major promotion of treatment and institution. Only
a good medical treatment should be effective and attractive to everyone. Through this study we are
deeply studying the medical treatment effectiveness of MIHRAS HOSPITAL. This project study is
mainly focus on the employees and the customers of MIHRAS HOSPITAL.

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1.5 RESEARCH METHODOLOGY

A research methodology defines what the activity of research is, how to proceed, how to measure
the program and what constitutes success. It is essentially a symmetric enquiry seeking fact
objective variable method in order to discover the relationship among them. It comprises of
defining and redefining problems formulating hypothesis suggested solutions, collecting,
organizing and evaluating data.

1.5.1 RESEARCH DESIGN

Research design gives the outline of a research work that involves planning for data and analyse
the collected data. The research design is the conception structure with in which research is
conducted. The basic types of research designs are:
 Exploratory research design
 Descriptive and diagnostic research design
 Hypothesis-testing research design
For this study descriptive research design is used. Descriptive research studies are those studies
which are concerned with describing the characteristics of particular, or of a group.
1.5.2 POPULATION

A population is district group of individuals, whether that group comprises a nation or a group of
people with a common characteristic. In statistics, a population is the pool of individuals from
which a statistical sample is drawn for a study. Thus, any selection of individuals grouped together
by a common feature can be said to be a population.

1.5.3 SAMPLE DESIGN

A sample is some part of a large body specially selected to represent the whole. Sampling the
process by which this process by which this part is chosen. Sampling then is taking any portion of
a population or universe.
1.5.4 SAMPLE SIZE
Sample size used for the study is 63 samples among the customer of MIHRAS HOSPITAL.

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1.5.5 SOURCES OF DATA COLLECTION

 Primary data
 Secondary data

A. Primary data:
It refers to the first-hand information collected by the researcher, specify to the research problem.
It includes using different primary data collection tools such a personal interview using
questionnaire, telephone survey and mailed survey etc. For the present study, primary data was
collected by survey method using questionnaire .
B. Secondary data:

It is the information that already exists for another purpose. This refers to all those data which are
collected for some earlier research work. This secondary data for this work was obtained from
company profile, company magazine, website, newspapers, internet, textbooks, reports and form
company brochures and other promotional material.

1.5.6 TOOLS FOR ANALYSIS

Sample size of the survey consist 63 respondents from the customers of MIHRAS HOSPITAL. A
questionnaire was framed to conduct this survey. The investigation used various tools for analysis
such as percentages, tables, diagrams, graphs, etc.….
 SIMPLE PERCENTAGE ANALYSIS: -
Percentage refers to a special kind of ratio in making comparison between two or more data and to
describe the relationship. Percentage can also be used to compare the related terms the distribution
of two or more sources of data

Number of respondent

Percentage of respondents= ---------------------------------------------X 100

Total no. of respondents

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1.6 PERIOD OF THE STUDY

Period of study was Twenty one (21) days

1.7 LIMITATIONS OF THE STUDY

Though the present study aimed to achieve the above stated objectives in full earnest and accuracy,
it was hampered due to certain limitations. Some of these limitations are as follows:
 Busy of the institution.
 Data was collected on sample basis as such result may not give an exact representation of the
population.
 The views of the people are may be biased therefore it does not reflect true picture.
 The study was limited only to one institution.
 Time period of the study also short

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 CHAPTER-2

LITERATURE REVIEW &

THEORETICAL FRAMEWORK

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2.1 LITERATURE REVIEW

An overview of various issues related to the study directly or indirectly has been presented through
review of literature in this chapter. The research made in the previous studies has been of great
significance in understanding ins and outs of the issue taken in the study. It has also help to find
the research gap in the particular study. But unfortunately little bit studies on present study, and
because of emerging health care system, Unani treatment

Ejas ahmed , national institute of Unani Medicine(2020) in his article titled Patient Satisfaction
With Medical Services Provided at Unani Medicine Hospital, Bengaluru: A Cross-Sectional Study
research about the different features of Effectiveness of health service and care A hospital-based
cross-sectional study was conducted at the National Institute of Unani Medicine Hospital, Bengaluru, from April
2019 to October 2019 on 500 patients sampled from various service delivery points of the health facility. Data
were gathered through exit interviews of patients after obtaining their written informed consent. A predesigned
and pretested questionnaire on patient satisfaction patient satisfaction questionnaire The study found that overall
patients were highly satisfied with the medical services provided by the health facility. Furthermore, the study
finds that treatment effectiveness has a more significant effect on patients‘ satisfaction compared with other
factors. Effectiveness was found to be significantly associated with the satisfaction score (P = .002).

Md. M. Nabi , Unani and Ayurvedic Medicine, Hamdard University, Sonargaon,

Narayanganj, Bangladesh (2015) in his article named a study on attitude and satisfaction of
patients towards Unani health care service within medical pluralism in the context of Bangladesh
studied about the customer loyalty to Unani health services and its properties Unani heath care
system is considerable areas of medical treatment in Bangladesh where patient can avail it from
different Govt. or private hospital. This cross-sectional study was undertaken to find out the
satisfaction of patients attending in this health care system from January to April 2014. A total of
240 respondents were interviewed with an interviewer administered semi-structured questionnaire.
Among the respondents majority of them was aged ranging from 21- 40 years. It was found that
more than 80% respondent got satisfactory and good behaviour from pharmacist and concerned
stuff of the hospital. Regarding health service delivery system of the hospital, It was found that
maximum respondents said they will come again for health services here in the hospital
Healthcare systems capable of ensuring equitable and efficient services are essentials for a general
and continuous improvement of the population‘s health status. In time, the efficiency of the

16 | P a g e
healthcare system has become synonymous with health expenditures. Furthermore, for both the
economies with a high development index and the economies with a medium development index,
the increase in the efficiency of the expenditures seems to be the only option that would allow
public systems to overcome the pressure of the expenditures associated with age and tax increase

Heller et Hauner,(2006).In his paper, ―Public Spending on Health Care: How are Different
Criteria Related?‖ Musgrove (1999) identifies at least nine relevant criteria which should be
considered when adopting health expenditures decisions, including: the economic efficiency
criterion (public goods, externalities, and cost-efficiency), moral grounds (fighting, poverty,
vertical and horizontal equity), and political considerations (special requests from the population).

In analysing the efficiency of the healthcare systems from the public point of view of health
expenditures, an important contribution was made by Rivera (2010), Cicea et Pirlogea., (2009),
in papers focusing on the relation between public health expenditures and health status self-
estimation. Thus, in his paper, Rivera starts from the hypothesis that an increase in public health
expenditures would automatically lead to an improvement in the self-estimated health status and
aims at identifying and quantifying the relations between the various levels of health and the
resources in the domain by taking into account a group of biological and socio-economic factors
that influence the individual‘s health. In building his model, Rivera (2010) takes into account the
way health expenditures are built, and emphasizes that investing in preventive treatments can
become a more important factor than the expenditures themselves, while it emphasizes the
permanent necessity to research the impact of unemployment rate changes on the population‘s
health status. By applying a regression model on health data for people over 16 years old, the
results proved that the probability to estimate a certain health status is significantly influenced by
health expenditures; it is more probable that an individual will self-estimate a better health status
as health expenditures increase.

McLaughlin CP, Kaluzny AD.(2006)in his paper named Continuous quality improvement in
health care. 3rd Ed. Sudbury, MA: Jones & Bartlett Publishers;Healthcare service quality is even
more difficult to define and measure than in other sectors. Distinct healthcare industry
characteristics such as intangibility, heterogeneity and simultaneity make it difficult to define and
measure quality. Healthcare service is an intangible product and cannot physically be touched, felt,
viewed, counted, or measured like manufactured goods. Producing tangible goods allows

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quantitative measures of quality, since they can be sampled and tested for quality throughout the
production process and in later use. However, healthcare service quality depends on service
process and customer and service provider interactions. Some healthcare quality attributes such as
timeliness, consistency, and accuracy are hard to measure beyond a subjective assessment by the
customer.

Mosadeghrad AM.(2012) in his paper titled ―Towards a theory of quality management: an

integration of strategic management, quality management and project management‖. International
Journal of Modelling in Operations Management. 2012; It is often difficult to reproduce consistent
healthcare services. Healthcare services can differ between producers, customers, places, and
daily. This ‗heterogeneity‘ can occur because different professionals (e.g. physicians, nurses, etc.)
deliver the service to patients with varying needs. Quality standards are more difficult to establish
in service operations. Healthcare professionals provide services differently because factors vary,
such as experience, individual abilities, and personalities.

Ladhari R.(2009) in paper titled A review of twenty years of SERVQUAL research. International
Journal of Quality and Service Sciences. Healthcare services are simultaneously produced and
consumed and cannot be stored for later consumption. This makes quality control difficult because
the customer cannot judge ‗quality‘ prior to purchase and consumption. Unlike manufactured
goods, it is less likely to have a final quality check. Therefore, healthcare outcomes cannot be
guaranteed.

Planning Commission Report (2010).Health is an essential component of nation‘s development and is

vital to the growth of economy and internal stability of the country. Assuring a minimal level of healthcare
to its population is a critical constituent of the development process. Since independence, India has built up
a vast health infrastructure and health personnel at primary, secondary and tertiary care in public, voluntary
and private sectors. The Indian healthcare system include medical care providers, physicians, specialist
clinics, nursing homes, hospitals, medical diagnostic centres, pathology laboratories and paramedical
institutions including Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH)
institutions, which have been set-up for producing skilled human resources

Rahman and Qureshi,( 2009); Dasanayaka , (2012); Sohail( 2003);Numerous studies are available on
Indian healthcare focusing on various healthcare aspects and related issues such as SQ, SQ dimensions, SQ
model, customer satisfaction (CS) and many others. Some of the studies have been undertaken to measure

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the perception of patient/beneficiaries of hospital services regarding SQ (. Despite these attempts, there is
still lack of literature available on development of an integrated quality model for Indian HCEs. Some of
the selected studies on healthcare and related issues in Indian context as reported in the healthcare literature
are presented in table below

Table 2.1
Study Major Objective Methodology/approach Major findings
findings
Padma To provide strategic Patient and attendant Patients and attendants
(2014) recommendations to perceptions were have different
Indian hospital collected using a perceptions. Different
administrators for questionnaire customers have different
improving SQ by needs of which
analysing performance providers need to be
dimensions and the aware to better serve
importance attached to their consumers
them by patients and
attendants
Deshwal To identify the SQ Questionnaire survey The dimensions that
(2014) dimensions that play an using convenience affects patient
important role in patient sampling method was satisfaction were: staff
satisfaction in campus used to approach professionalism; clinic
clinics in Delhi and respondents staff reliability; clinic
assess student accessibility and basic
satisfaction with service facilities; tangibles;
and suggest ways to cleanliness; awareness
improve areas of of the clinic/diseases
dissatisfaction and how clinic staff
deals with emergencies

In recent years, SQ and patient satisfaction has gained increasing attention especially in healthcare
context (Azam, 2012; Badri, 2009; York and McCarthy, 2011; Owusu-Frimpong, 2010). Also,
past studies showed that there is a strong link between SQ and patient satisfaction (Andaleeb,
2001; Badri, 2009; Kitapci, 2014). In the healthcare literature, SQ and patient satisfaction have

19 | P a g e
been considered as two major issues. Importance of patient satisfaction especially service
encounters is well documented in the marketing and management literature (Meirovich and
Bahnan, 2008). SQ in service encounters is frequently depicted as being the outcome of an
interactive process between the service provider and the service receiver. The interactive features
of SQ in service encounters are thus, crucial to the ultimate outcome (Owusu-Frimpong, 2010).
Further, patient satisfaction in healthcare organisations is considered crucial when planning,
implementing, evaluating service delivery, as well as in quality improvement, overall customer
relationship management (CRM) and strategic planning initiatives (Evenhaim, 2000). In fact,
meeting patient‘s needs and developing healthcare standards are obligatory for high quality care
(Badri , 2009).

Shabbir (2010) also examines the quality of service and adding a variable word of mouth (WOM)
and trusts to predict consumer satisfaction hospitals in Pakistan. . in 2011 examines customer
satisfaction with the quality attributes to predict patient loyalty at the healthcare industry in
Taiwan. They examine how the overall customer satisfaction and customer satisfaction associated
with attributes of quality of medical services offered in Taiwan using the integrated model of Kano
and Customer Satisfaction Index (CSI).

Shabbir (2011) studied the influence of the brand image of the hospital to service quality, patient
satisfaction and loyalty. apply integrated model that describes the relationship between the
hospital's brand image, quality of care, patient satisfaction, and loyalty.

Brahmbhatt (2011) examines the use of the dimensions of service quality (SERVQUAL) on
hospital services. The purpose of the research is to test and measure the service quality comparison
of public and private hospitals in Gujarat.

Haque(2012) examine the effect of quality of service desired (perceived service quality) of
consumer to consumer satisfaction in the private health care centers in Malaysia. Research of
Haque aimed to develop and test the modified SERVQUAL models to measure the quality of
private health services in Malaysia.

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Ramez (2012) examines thepatient's perception of the quality of health care, satisfaction and
behavioral intention. Thepurpose of the research is to evaluate the level of service quality
healthcare provider inBahrain by using SERVQUAL to determine the relationship between the
dimensions ofservice quality and overall patient satisfaction and behavioral intention to analyze
the patient.

Patawayati (2013) also examines the quality of service and patient satisfaction, a
variable that is added is trust and commitment serve as a mediator in the service quality
measure loyalty in the General Hospital of Southeast Sulawesi. The purpose of the research
is to test empirically the mediator and explain the relationship between patient satisfaction,
trust, commitment and loyalty to the patient at a public hospital in Southeast Sulawesi,
Indonesia.

Ware, Snyder, Wright, and Davis, (1983) stated that patient satisfaction in health
care evolving from the concept of consumer satisfaction, but different in many respects, is
considered as a process of interaction between patient expectations and patient perceptions
or actual experiences with health care. Patients can have expectations on many different
aspects of care, and satisfaction with specific aspects of care has independent effects on
patients‘ satisfaction

Acharyulu,GVRK,Shekbar B Raja (2012)studied the supply chain management aspects and

identify the areas in which they can improve the quality of service for efficient patient care. The
purpose of this paper was to know the performance of the corporate hospitals in India based on
well established criteria of what constitutes a quality supply chain system and concluded that
Indian hospitals need to strengthen each activity in the value chain by focusing on continuous
improvement in supply chain operations.

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C Joseph and S Nicholas (2007) conducted the study over 200 patients who visited Diabitic and
renal public health clinic with the aim to access patient satisfaction and their quality of life to
improve the health status of people by promoting wellness and providing quality health care in
an efficient ,equitable and sustainable manner

DomenicoMastandrea,AngeloMarino,AntonioLasora,ScottLeuchten,Juan F, Oata,
D.O.DavidYens (2008)conducted a review on patient satisfaction of an Inner city level one trauma
center ‗s emergency department through survey of the patients coming to the hospital with the
objective of to bring about some changes in the emergency department waiting room as per the
perceptions of the patient and to increase the usage and performance of the emergency department
as satisfiedpatients are most likely to recommend the hospital to others.

Emmanuel Kabengele, Mpinga and Phillipe Chastonay (2011) worked with the objective to
know the concept of patient satisfaction and understand the parameters for measuring
Patientsatisfaction levels and to correlate them with patients right to health through various
literatures and concluded that patient satisfaction and studies related to it have very important and
useful political, social and ethical impact to further strengthen and monitor the progress of the
sector toprotect the right to health of the population.

GhizlaneSoufi,JihaneBelayachi,SalmaHimmich,Samir,AHID,MehdiSoufi,Aicha Zekraoui,
Redouane Abouqual (2010) studied Patient Satisfaction in an acute medicine department in
Morocco. They performed structured face to face interviews with patients and used to measure
patient satisfaction. They concluded that demographics, socioeconomics and health characteristics
may influence in patient satisfaction.

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2.2 THEORETICAL FRAME WORK
2.2.1 CUSTOMER

A consumer is the person who actually consumes the products or services, whereas the customer is
simply the purchaser & need not be the consumer. The intermediate customers are never
consumers as they buy for re-sale. The purchaser of industrial goods & services is called industrial
customers or business to business customers. And the customer is an individual or business that
purchases the goods or services produced by a business. Attracting customers is the primary goal
of most public-facing businesses, because it is the customer who creates demand for goods and
services.

The term ―customer‖ in the health care systems differs from that in other industries. Namely,
customers in the health care system include a group of external customers (i.e., patients, family
members of patients and potential customers) and internal customers almost authors of previous
studies concerning customer satisfaction in the health care industry, the term refers to the patients
of medical institutions ,so in this project , ―customer‖ will refer only to patients and not to other
parties

2.2.2 TYPES OF CUSTOMERS:

 Loyal Customers- These types of customers are less in numbers but promote more sales
and profit as compared to other customers as these are the ones which are completely
satisfied. These customers revisit the organization over times hence it is crucial to interact
and keep in touch with them on a regular basis and invest much time and effort with them.
Loyal customers want individual attention and that demands polite and respectful responses
from supplier.
 Discount Customers- Discount customers are also frequent visitors but they are only a part
of business when offered with discounts on regular products and brands or they buy only
low cost products. More is the discount the more they tend towards buying. These customers
are mostly related to small industries or the industries that focus on low or marginal
investments on products. Focus on these types of customers is also important as they also
promote distinguished part of profit into business.

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  Impulsive Customers- These customers are difficult to convince as they want to do the
business in urge or caprice. They don‘t have any specific item into their product list but urge
to buy what they find good and productive at that point of time. Handling these customers is
a challenge as they are not particularly looking for a product and want the supplier to
display all the useful products they have in their tally in front of them so that they can buy
what they like from that display. If impulsive customers are treated accordingly then there is
high probability that these customers could be a responsible for high percentage of selling.
 Need Based Customers- These customers are product specific and only tend to buy items
only to which they are habitual or have a specific need for them. These are frequent
customers but do not become a part of buying most of the times so it is difficult to satisfy
them. These customers should be handled positively by showing them ways and reasons to
switch to other similar products and brands and initiating them to buy these. These
customers could possibly be lost if not tackled efficiently with positive interaction.
 Wandering Customers- These are the least profitable customers as sometimes they
themselves are not sure what to buy. These customers are normally new in industry and
most of the times visit suppliers only for confirming their needs on products. They
investigate features of most prominent products in the market but do not buy any of those or
show least interest in buying. To grab such customers they should be properly informed
about the various positive features of the products so that they develop a sense of interest.

LOYAL
CUSTOMERS

IMPULSIVE DISCOUNT
CUSTOMERS CUSTOMERS

CUSTOMERS

NEED BASED WANDERING

CUSTOMERS CUSYOMERS

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2.2.3 CUSTOMER SATISFACTION AND LOYATY

Customer loyalty is a marketing term that measures how products or services supplied by a
company meet or surpass a customer's expectation. Customer satisfaction is important because it
provides marketers and business owners with a metric that they can use to manage and improve
their businesses

Customer loyalty is in the focus of attention of all marketing experts. As with many other
concepts, when defining the concept of customer loyalty, there is no unique point of view among
scholars. However, taken together Customer loyalty in the literature is usually defined as the result
of a cognitive process described by the disconfirmation of expectations theory). It is a post
consumption evaluative judgment concerning a specific product or service , loyalty is "the
customer's fulfilment response. It is a judgment that a product/ service feature, or the product or
service itself, provided (or is providing) a pleasurable level of consumption-related fulfilment
including levels of under- or over-fulfilment.

" Zeithaml and Bitner (2003) define customer satisfaction as the customer's evaluation of a product
or service in terms of whether that product or service has met their needs and expectations.
Customer satisfaction can be viewed as the result of particular transactions or cumulatively, as a
result of previous transactions that the customer had with a particular company. Both forms of
satisfaction include pre-selection of products, the purchase and certain experience with its use
Customer satisfaction leads to customer loyalty.

According to Oliver who defines customer loyalty as ―a deeply held commitment to re-buy or
repatronize a preferred product or service consistently in the future, thereby causing repetitive
same-brand or same brand-set purchasing, despite situational influences and marketing efforts
having the potential to cause switching behaviour‖. It is believed that satisfaction leads to repeat
purchase and positive word-of-mouth, which are the main indicators of loyalty There have been
numerous studies that examine the concept of customer satisfaction and loyalty in the specific field
of the health care industry .However, the role of Unani treatment in enhancing quality of life and
customer satisfaction has been poorly researched. Hence this pilot study is deemed justified and
represents a platform for further research.

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2.2.4 CUSTOMER BUYING PROCESS

The customer buying process (also called a buying decision process) describes the journey your
customer goes through before they buy your product. Understanding your customer‘s buying
process is not only very important for your salespeople, it will also enable you to align your sales
strategy accordingly.

There are mainly five stages of Customer buying process,

1. Problem/need recognition

This is often identified as the first and most important step in the customer‘s decision process. A
purchase cannot take place without the recognition of the need. The need may have been triggered
by internal stimuli (such as hunger or thirst) or external stimuli (such as advertising or word of
mouth).

2. Information search

Having recognised a problem or need, the next step a customer may take is the information search
stage, in order to find out what they feel is the best solution. This is the buyer‘s effort to search
internal and external business environments, in order to identify and evaluate information sources
related to the central buying decision. Your customer may rely on print, visual, online media or
word of mouth for obtaining information

3. Evaluation of alternatives

As you might expect, individuals will evaluate different products or brands at this stage on the
basis of alternative product attributes – those which have the ability to deliver the benefits the
customer is seeking. A factor that heavily influences this stage is the customer‘s attitude.
Involvement is another factor that influences the evaluation process. For example, if the
customer‘s attitude is positive and involvement is high, then they will evaluate a number of
companies or brands; but if it is low, only one company or brand will be evaluated.

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4. Purchase decision

The penultimate stage is where the purchase takes place. Philip Kotler (2009) states that the final
purchase decision may be ‗disrupted‘ by two factors: negative feedback from other customers and
the level of motivation to accept the feedback. For example, having gone through the previous
three stages, a customer chooses to buy a new telescope. However, because his very good friend, a
keen astronomer, gives him negative feedback, he will then be bound to change his preference.
Furthermore, the decision may be disrupted due to unforeseen situations such as a sudden job loss
or relocation.

5. Post-purchase behaviour

In brief, customers will compare products with their previous expectations and will be either
satisfied or dissatisfied. Therefore, these stages are critical in retaining customers. This can greatly
affect the decision process for similar purchases from the same company in the future, having a
knock-on effect at the information search stage and evaluation of alternatives stage.
If your customer is satisfied, this will result in brand loyalty, and the Information search and
Evaluation of alternative stages will often be fast-tracked or skipped altogether.

2.2.5 CHARACTERISTICS OF GOOD CUSTOMER SERVICE

Customer service is the act of taking care of the customer's needs by providing and delivering
professional, helpful, high quality service and assistance before, during, and after the customer's
requirements are met. Customer service is meeting the needs and desires of any customer. Some
characteristics of good customer service include:

 Promptness:

Promises for delivery of products must be on time. Delays and cancellations of products should be
avoided.

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 Politeness:

Politeness is almost a lost art. Saying 'hello,' 'good afternoon,' 'sir', and 'thank you very much' are a
part of good customer service. For any business, using good manners is appropriate whether the
customer makes a purchase or not.

 Professionalism:

All customers should be treated professionally, which means the use of competence or skill
expected of the professional. Professionalism shows the customer they're cared for.

 Personalization:

Using the customer's name is very effective in producing loyalty. Customers like the idea that
whom they do business with knows them on a personal level.

PROMOTNESS

GOOD
PROFESSIONALISM CUSTUMER POLITENESS

SERVICE

PERSONALIZATION

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2.2.6 PURPOSE OF CUSTOMER SATISFACTION

1. It drives customer loyalty

Satisfied customers tend to share their positive experiences with friends and family. But the
opposite is also true: An unhappy customer tells more people about their negative experiences than
a happy customer does.

Social media makes social proof more powerful than ever before, with 79 percent of people in the
United States using social media to connect and share their experiences. Today, a customer can
easily share feedback on a bad experience with millions of people with a single click (so make sure
that review is going to be a positive one).

You are more likely to gain positive referrals if you use customer feedback to priorities top-of-the-
line service. For example, our report found that 89 percent of people think quick responses are
important when deciding which company to buy from. If you want to improve your company‘s
response time to support that data, you might incorporate AI technology, like our AI-powered
Answer Bot, to send prompt responses.

2. Customer satisfaction metrics reflect your support team's performance

Customer satisfaction benchmarks and metrics do not just help you gauge how happy your
audience is—they also tell you how your support team is doing. Use a variety of team metrics to
understand customer satisfaction levels:

 Your support team’s initial response time: In our customer experience report, the most
frustrating part of bad service was long wait times. Faster support team response times not only
lower customer frustration, but also give you a measure of your team‘s speed and efficiency.
 The length of time it takes your team to resolve a customer issue: If it is taking your
team hours to resolve issues that could be dealt with quickly, it might be time to tweak your
internal processes. Do not just strive to respond quickly—resolve quickly, too.
 How many times a ticket or call required a transfer to find a resolution: Few things are
more frustrating than having to wait to be transferred to a new agent and repeat your issue to get
your request completed. If transfer occurrence drops, customer satisfaction should rise.
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Considering our study found that the aspect for good customer service was quick issue resolution,
your team‘s efficiency in these areas says a lot about customer satisfaction. Our built-in analytics
function is a great way to observe how well your support team serves customers historically and in
real time. With the help of AI, teams can even predict customer satisfaction during a
conversation—before a customer takes a survey.

3. It encourages repeat purchases

A satisfied customer is a loyal customer, who will stick with your company year after year. So,
how do you get those repeat customers? By hitting your customer support efforts out of the park.
Our trends report agrees: 57 percent of consumers say excellent customer service is a factor in
their brand loyalty.

There are two different ways to answer this question. The first is to directly poll customers using
a net promoter score survey, or to ask questions like:

 ―Would you speak to your friend about our brand?‖

 ―How often do you speak to your friends about our brand?‖

These questions can shed some light on customers‘ likelihood of being brand ambassadors.

The second method is to observe customer behavior. For example, you can track repeat
purchases with loyalty programs and referral posts for your business on social media. Reading
conversations in your community forum can also give you insight into how customers feel about
their experience with your product or service.

4. It increases customer lifetime value

75 percent of customers are willing to spend more to buy from market that give them a good
customer experience, according to our Trends Report. Satisfied customers are not only more likely
to remain loyal and less likely to churn.

5. It boosts new customer acquisition

At the onset of the pandemic, companies with the most satisfied customers were also 3.3x more
likely to have grown their customer bases. Customer service is not just important for supporting

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existing customers, it is also key to bringing in potential customers and supporting them when they
reach out. If a prospect does not have a positive experience when they interact with your support
team, they will be less likely to purchase. The main difference between service today and service
10 years ago is that customers expect premium service to be built-in from the first sales or
marketing interaction and carry through to the moment they ask for help, post-purchase and back
again. To position themselves for success, businesses must integrate service into the journey at
every interaction point.

2.2.7 QUALITY OF LIFE

Quality-of-life studies have engaged the attention of numerous researchers for many decades. is a
multidimensional construct that can be viewed from different perspectives. Basically, the quality-
of-life concept has two dimensions: macro and micro. At the macro level, quality of life is rooted
in the physical and artificial environment. Quality of life at the micro level refers to the perceptions
of the individual. In the same social, political and cultural setting, two different people will
experience life and the quality of life in different ways , we deem it appropriate to accept the
definition of the World Health Organization which defines quality of life as ―an individual‘s
perception of their position in life in the context of the culture and value systems in which they
live, and in relation to their goals, expectations, standards and concerns. Other terms, such as life
satisfaction, subjective well-being and happiness, are often used instead of ―quality of life‖,
although they are not actually synonyms. Namely, life satisfaction ―is the degree to which a person
positively evaluates the overall quality of his/her life. In other words, how much the person likes
the life he/she leads. Life satisfaction is part of the broader concept of subjective well-being, which
encompasses life satisfaction as a cognitive component, together with positive and negative
feelings as an affective component. It involves judgments of the fulfilment of one‘s needs, goals,
and wishes. Throughout their lifetimes, people play a variety of roles in their families and in
society, so their lives evolve through different areas or domains.

Campbell, Converse and Rodgers, the main proponents of the life domain approach to the study of
quality of life, argue that life satisfaction is a combination of satisfaction with various domains
within the life space. In previous studies, researchers established the existence of a differing
number of domains in which quality of life is achieved, but what is common to all is the domain of
health as one of the most important determinants of quality of life and life satisfaction.

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According to research by Michalos, Zumbo and Hubley (2000), about 53% of variations in the
answers of respondents regarding subjective satisfaction referred to satisfaction with health status
and other indicators in the domain of health and health care. Studies conducted in the European
Union also suggest that where quality of life is concerned, health is the first priority to respondents
in all EU countries. Satisfaction with good health is generalized and reflected in general life
satisfaction. Many factors in this domain affect quality of life, such as general state of health,
functioning ability, number of symptoms, length of illness, health care, satisfaction with health
care and hospital treatment, satisfaction with the quality of health services, etc.. In accordance with
the above, it can be concluded that health care institutions that improve patients‘ health, help in
their rehabilitation or provide preventative health care, together with companies that offer leisure
and relaxation, have a positive effect on the quality of life and life satisfaction of patients. In this
respect, specialty hospitals for medical rehabilitation contribute significantly towards the quality of
life of their patients and guests.

2.2.8 SERVICE QUALITY COMPONENTS

Several authors have identified various service quality components. Gro¨nroos categorised service
quality into technical and functional. The former refers to diagnostic processes and accuracy while
the latter describes healthcare delivery methods. ovretveit used patient quality (giving patients
what they want), professional quality (giving them what they need) and management quality (using
the least resources without error or delays in giving patients what they want and need).
Cunningham (1991) preferred the terms clinical quality, economic or finance-driven quality and
patient-driven quality. Clinical quality is related to morbidity, mortality and infection rates, while
economic or finance-driven and patient-driven quality broadly represents service-quality. Several
service-quality models have evolved based on these frameworks. A modified version of service
quality determinants was proposed by Parasuraman et al. whose study culminated in SERVQUAL
and has since exercised enduring influence on contemporary writers. Parasuraman et al. defined
service quality as comparing patients‖ perceptions and expectations. Expectations are consumer
wants; that is, what they feel an ideal service provider should offer. Perceptions refer to the
consumer‘s service evaluation. Service quality is thus, a function of the differences or gaps
between customer perception and expectation. This is called the Gap Model. The SERVQUAL
scale has five dimensions:

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  reliability,
 responsiveness,
 assurance,
 empathy and
 tangibles.

•
ASSURANCE
RELIABILITY

RESPONSIV
ENESS

TANGIBLES
•
EMPATHY

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 CHAPTER-3

PROFILES

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 3.1 INDUSTRY PROFILE

3.1.1 HEALTH CARE

Health care (or healthcare) is the diagnosis, treatment, and prevention of disease, illness, injury,
and other physical and mental impairments in humans. Health care is delivered by practitioners in
medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers. It
refers to the work done in providing primary care, secondary care, and tertiary care, as well as in
public health.

Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment,
amelioration or cure of disease, illness, injury, and other physical and mental impairments in
people. Health care is delivered by health professionals and allied health fields. Medicine,
dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational
therapy, physical therapy, athletic training, and other health professions all constitute health care.
It includes work done in providing primary care, secondary care, and tertiary care, as well as in
public health.

3.1.2 HEALTHCARE INDUSTRY

The health care industry, or medical industry, is a sector that provides goods and services to treat
patients with curative, preventive, rehabilitative, or palliative care. The modern health care sector
is divided into many sub-sectors and depends on interdisciplinary teams of trained professionals
and paraprofessionals to meet the health needs of individuals and populations. The health care
industry includes establishments ranging from small-town private practices of physicians who
employ only one medical assistant to busy inner-city hospitals that provide thousands of diverse
jobs. The Healthcare industry is littered with risks and challenges as it is an industry that requires
constant innovation under increased regulations.
The health care industry is one of the largest industries in the world, and it has a direct effect on
the quality of life of people in each country.

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 3.1.3 IMPACT OF HEALTHCARE INDUSTRY ON ECONOMY:

The health care industry is tremendously important to people around the world as well as to the
national economies. It is one of the fastest-growing industries in the world. Consuming over 10
percent of gross domestic product (GDP) of most developed nations, a correlation exists between
income levels and expenditure on health care in various countries. For example, some of the large
developing economies, such as Brazil, India, China, and Russia, spend less on health care than
more industrialized economies, such as the United States or France.
The health care industry also plays an important role as being the largest employer in the global
economy, if we add up the number of people working in each sector across the world. In most
countries, the employment growth rate of the health industry is higher than that of other
industries. However, the healthcare industry as it exists today is highly fragmented and divided
among many different companies and different players. No single firm/corporation has a large
enough share/monopoly of the market to be able to influence the industry's direction or price
levels.

3.1.4 CLASSIFICATION OF HEALTHCARE INDUSTRY:

The modern health care sector is divided into many sub-sectors and depends on interdisciplinary
teams of trained professionals and paraprofessionals to meet the health needs of individuals and
populations. The health care industry is one of the world's largest and fastest-growing industries
and forms an enormous part of a country's economy. The delivery of modern health care depends
on groups of trained professionals and paraprofessionals coming together as interdisciplinary
teams. This includes professionals in medicine, nursing, dentistry, and allied health, plus many
others such as public health practitioners, community health workers, and assistive personnel,
who systematically provide personal and population-based preventive, curative, and rehabilitative
care services. For purposes of finance and management, the health care industry is typically
divided into several areas.
As a basic framework for defining the sector, the United Nations International Standard Industrial
Classification (ISIC) categorizes the health care industry as generally consisting of:

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a. Hospital Activities
b. Medical and Dental Practice Activities
c. Other human health activities
This third class involves activities of, or under the supervision of, nurses, midwives,
physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities,
or other allied health professions, e.g. in the field of optometry, hydrotherapy, medical massage,
yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy,
chiropractic, acupuncture, etc.
The Global Industry Classification Standard and the Industry Classification Benchmark further
distinguish the industry as two main groups:
1. Health care equipment and services
Health care equipment and services comprise companies and entities that provide medical
equipment, medical supplies, and health care services, such as hospitals, home health care
providers, and nursing homes.
2. Pharmaceuticals, biotechnology, and related life sciences
The second industry group comprises sector companies that produce biotechnology,
pharmaceuticals, and miscellaneous scientific services.
3.1.5 BRIEF HISTORY OF HEALTH CARE

Healthcare industry started with home remedies. It began as a purely reactionary, medical practice
in which people learnt about the medicinal properties of a plant through trial and error,
documented it and passed on to others. The use of plants as healing agents is a long-standing
practice.

TRADITIONAL AND ANCIENT HEALTHCARE

Healthcare eventually started as traditional healthcare where different cultures did a purposeful
study on healthcare. One of the oldest examples comes from Mesopotamia known as ―Treatise of
Medical Diagnosis and Prognoses,‖ where they made tablets based on rational observations of the
body. 19th Century turned out to be a turning point in the healthcare industry. There were
numerous advances in the technological, chemical and biological fields which also gave the
physicians an opportunity to learn more about the diseases and better understanding to treat
ailments.
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 Impacts of various stages in history

I find it very interesting that even colonialism had an impact at the healthcare
industry. Colonialism not only helped in exchange of trade and goods but also the exchange of
diseases. Physicians now had to also worry about the diseases that were coming in because of the
urbanization and increasing population densities. This also gave a rise to development of new
trends in medical systems. And new developments were taking shape – Vaccinations, prevention
and Treatments.

 Therapeutic revolution

In 20th Century though, the focus from the generalized pathology shifted to specific diseases. It is
also known as the therapeutic revolution also understood as the moment when medicine began to
work. Now practitioners wanted to focus on the effectiveness of the medicines. It all began with
Pasteur – father of germ theory. There were great advances in relation to diseases such as leprosy,
anthrax, tuberculosis, plague, and malaria. I can‘t even imagine what life could have been without the
development of treatments for these diseases.

 Eradication campaigns

Eradication campaigns were different campaigns launched by WHO designed to specifically eradicate
diseases causing widespread deaths like smallpox, malaria. While very effective in industrialized
countries, the diseases were still haunting the developing nations. These campaigns also made people
in the healthcare industry aware of how vulnerable they are despite the modern advances in the
technology.

 Alma Ata Declaration

―Health for all‖ was a goal setup in 1978‘s Alma Ata Declaration/International Conference on
Primary Health Care. Its main agenda was to express the need for urgent action by all governments,
all health and development workers, and the world community to protect and promote the health of
all people.

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 Development movement

Development movement coincided with the post-World War II era and was based on the belief that
increasing economic development would benefit the entire world, despite inequalities that might
result. The development ideology held both the implicit and explicit goal of a globalized, modern
world that left behind ancient philosophies in pursuit of economic progress.

Even though now Healthcare is a global industry but because the healthcare has always traditionally
been considered a local industry, specific to regions and countries the practices and development of
healthcare across countries vary. When some of the countries have been successful in establishing a
robust healthcare system, some countries still lag behind by lot of factors.

3.1.6 HEALTH CARE IN INDIA

Healthcare industry in India is projected to reach $372 bn by 2022

India‘s healthcare delivery system is categorized into two major components - public and private

The government, i.e. public healthcare system, comprises limited secondary and tertiary care
institutions in key cities and focuses on providing basic healthcare facilities in the form of primary
healthcare centers (PHCs) in rural areas. The private sector provides majority of secondary, tertiary,
and quaternary care institutions with major concentration in metros, tier-I and tier-II cities.

Healthcare industry in India comprises of hospitals, medical devices, clinical trials, outsourcing,
telemedicine, medical tourism, health insurance, and medical equipment. The healthcare sector is
growing at a tremendous pace owing to its strengthening coverage, services, and increasing
expenditure by public as well private players.

• The hospital industry in India, accounting for 80% of the total healthcare market, is witnessing a
huge investor demand from both global as well as domestic investors. The hospital industry is
expected to reach $132 bn by 2023 from $61.8 bn in 2017; growing at a CAGR of 16-17%.
• In 2020, India‘s Medical Tourism market was estimated to be worth $5-6 Bn and is expected to
grow to $13 Bn by 2026
• The diagnostics industry in India is currently valued at $4 bn. The share of the organized sector is
almost 25% in this segment (15% in labs and 10% in radiology).
• The primary care industry is currently valued at $13 bn. The share of the organized sector is
practically negligible in this case.
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• 70,000 Ayushman Bharat centers, which aim at providing primary health care services to
communities closer to their homes, are operational in India
• The market size of AYUSH has grown by 17% in 2014-20 to reach $18.1 bn and the industry is
projected to reach $23.3 bn in 2022
• Health insurance contributes 20% to the non-life insurance business, making it the 2nd largest
portfolio. The gross direct premium income underwritten by health insurance grew 17.16% year-on-
year to reach $6.87 bn in FY20
• India is a preferred destination for Medical Value Travel (MVT) where patients from all over the
globe come to "Heal in India" and is growing as huge opportunity area in the Healthcare market.

3.1.7 FUTURE OF HEALTH CARE

India‘s healthcare sector is extremely diversified and is full of opportunities in every segment, which
includes providers, payers, and medical technology. With the increase in the competition, businesses
are looking to explore the latest dynamics and trends which will have a positive impact on their
business. The hospital industry in India is forecast to increase to Rs. 8.6 trillion (US$ 132.84 billion)
by FY22 from Rs. 4 trillion (US$ 61.79 billion) in FY17 at a CAGR of 16–17%.
India is a land full of opportunities for players in the medical devices industry. The country has also
become one of the leading destinations for high-end diagnostic services with tremendous capital
investment for advanced diagnostic facilities, thus catering to a greater proportion of the population.
Besides, Indian medical service consumers have become more conscious towards their healthcare
upkeep. Rising income levels, an ageing population, growing health awareness and a changing
attitude towards preventive healthcare is expected to boost healthcare services demand in the future.
Greater penetration of health insurance aided the rise in healthcare spending, a trend likely to
intensify in the coming decade. The Government aims to develop India as a global healthcare hub,
and is planning to increase public health spending to 2.5% of the country's GDP by 2025.

3.1.8 TRADITIONAL MEDICAL SYSTEM

Modern western practitioners suffer from ethnocentricity. Many believe that their medicine is the
ultimate, and the only one that really works. We often forget that modern scientific medicine reaches
only a relatively small group of people, and that perhaps over a third of the world has no share in it.

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Allopathic medicine is too expensive and capital intensive for a developing country like India.
Modern medical doctors are too few in certain areas and are not always ready to live with the poor in
the slums, the desert areas, the remote forests, or the high mountains . Along with it, the longer
expectancy of life and life style related diseases have led to an increased risk of chronic, debilitating
diseases such as heart disease, diabetes, cancer and mental disorders. Although new treatments and
technologies for dealing with them are plentiful, nonetheless more and more patients are now looking
for simpler, gentler therapies for improving the quality of life and avoiding iatrogenic problems .
Traditional medical systems are easily accessible, cheaper and relatively safer than other conventional
medicines. Hence, the search for alternative products continues and natural phytochemicals isolated
from plants used in traditional medicine are considered as good alternative s to synthetic chemicals .

3.1.9 UNANI TREATMENT SYSTEM

Ibn-e- Sina popularly known as Avicenna, one of the greatest scholars of Unani Tibb (medicine), has
defined Unani Medicine as "It is the science in which we learn various states of body in health and
when not in health and the means by which health is likely to be lost and when lost, is likely to be
restored".
Unani-tibb or Unani Medicine is a form of traditional medicine practiced in Middle- East and
South-Asian countries. It refers to a tradition of Graeco-Arabic medicine, which is based on the
teachings of Greek physician Hippocrates and Roman physician Galen and developed into an
elaborate medical system in middle age era by Arabian and Persian physicians, such as Rhazes (al-
Razi), Avicenna (Ibn-e-Sina), Al-Zahrawi,and IbnNafis.
It originated in Greece almost 2500 years back, which is herbo- animo- mineral in origin
(Approximately 90% herbal, 4-5% animal and 5-6 % mineral). It is not only the original science of
medicine but also a rich store house of principles and philosophies of medicine which can be of
immense value to the medicine in particular and science in general.
It is a comprehensive medical system, which meticulously deals with the various states of health and
disease. It provides primitive, preventive, curative and rehabilitative healthcare. The fundamentals,
diagnosis and treatment modalities of the system are based on scientific principles and holistic
concepts of health and healing. Accordingly it considers individual in relation to his environment and
stresses on health of body, mind and soul. Temperament (Mizaj) of a patient is given great
importance in diagnosis and treatment of diseases. Temperament is also taken into consideration for
identifying the most suitable diet and lifestyle for promoting the health of a particular individual. In
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spite of continuous neglect, this healing art is not only surviving but also complimenting other
systems of medicine.
The Unani System of Medicine offers treatment of diseases related to all the systems and organs of
the human body. The treatments for chronic ailments and diseases of skin, liver, musculo-skeletal and
reproductive systems, immunological and lifestyle disorders have been found to be highly effective
and acceptable. The use of elatives, exhilarants, aphrodisiacs, organ-specific tonics and
immunomodulatory drugs, temperament specific drugs, correctives for adverse effects, coctives and
purgatives etc. are unique features of Unani System of Medicine. Cosmoceutics, Nutraceutics,
Aromatics and corresponding therapies are important parts of treatment in Unani System of
Medicine.
Unani physicians give prime importance to diet and the state of digestion in a person, in both health
and disease. Specific dietary regimens are recommended while treating patients according to their
temperament. Proper diets are assumed to produce good humours (Akhlā\Sāliha) while improper ones
produce bad humours (Akhlā\ Radiyya). Thus, the humoral imbalance can be corrected by medication
coupled with proper diet. The physician prescribes the drugs according to the temperament of patient,
causative humour, faculty of organ involved and severity of the disease. These drugs are classified as
per the specific temperament (Mizāj) and are graded in the first, second, third and fourth degree
according to their potency.
It is presently practiced in India, Bangladesh, Pakistan, Sri lanka, Nepal, China, Iran, Iraq, Malaysia,
Indonesia, Central Asian and Middle Eastern Countries. In India the system has been developed
scientifically, nurtured and systematically integrated into healthcare delivery system over the years.
The World Health Organization (WHO) has recognized the Unani System of Medicine (USM) as an
alternative system to cater the health care needs of human population. Unani is one of the most well-
known traditional medicine systems and draws on the ancient traditional systems of medicine of
China, Egypt, India, Iraq, Persia and Syria .
Unani healing is vibrant and vigorous today and is being practiced, taught and researched under its
local names in over 20 countries including Afghanistan, China, India, Canada, Denmark, Germany,
Finland, Netherlands, Norway, Poland, Korea, Japan, Saudi Arabia, Sweden, Switzerland, Turkey,
UK and USA . India has accepted it as one of the alternative health care system and has given it
official status.
Unani system of medicine also benefited from the native medical systems in vogue at the time in
various parts of Central Asia. That is why this system is known, in different parts of the world, with

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different names such as Greco-Arab Medicine, Ionian Medicine, Arab Medicine, Islamic Medicine,
Traditional Medicine, Oriental Medicine etc.
By considering the importance of various traditional or complementary alternative medical systems
(CAM), we have reviewed the basic concepts and role of the five major CAM systems used in India
i.e. AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy). In the present study we have tried
to explore the role of Unani system of medicine.
Unani-tibb or Unani Medicine also spelled YUnani Medicine (in Arabic, Hindi-Urdu and Persian)
means ―Greek Medicine.‖ Its origin is traced back to the Greek literature, which zand Persians into
an elaborate medical science. Since that time Unani Medicine has been known as Greco-Arab
Medicine .
Unani system of medicine is a great healing art as well as science. It treats a person as a whole not as
a group of individual parts. It is aimed at treating body, mind and soul. This system is based on
hippocratic theory of four humors viz. blood, phlegm, yellow bile and black bile.

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3.2 COMPANY PROFILE
3.2.1 ABOUT
MIHRAS HOSPITAL aims to provide excellent medical care at an affordable cost. It also intends to
foster a scientific health culture among people by teaching lessons about healthcare and immunity
along with prescribing remedies for different types of illnesses. Markaz Knowledge City has hired
well qualified and experienced medical practitioners for the treatment and medication at the hospital.
It aims to incorporate the holistic approach in the health industry to provide human care on an
affordable scale. The low-cost wellness health care facility will help to get many wellness and other
treatments from different medical streams – Unani, Allopathy, and Naturopathy, for people from
different walks of life.

3.2.2 VISION
To be an internationally recognized Unani center for health care activities that provides high quality
excellence in healthcare

3.2.3 MISSION
To provide Hope, Care and Cure, to provide compassionate, accessible, high quality, cost effective
healthcare to one all, to develop, share and apply new knowledge and technology in the delivery of
patient care through research and technology integration. And to play an active role in promoting
and improving health within our community and to build a strong, integrated system for regional
health-care delivery.

3.2.4 VALUES
Integrity
Act with honesty by keeping the highest benchmark of spiritual and ethical values in the professional
space.

Excellence
Set high ambitions for innovations through research and teamwork.

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Respect
Be patient centric by empathizing and understanding the individual differences.

Commitment
Commitment to the society and understand the people without any biases based on any differences.

Compassion
Concern about other people‘s needs without any judgment and appreciate their perspectives or
situations.

3.3 PRODUCT AND SERVICE PROFILE

3.3.1 REGIMENTAL THERAPY (ILLAJ-BIL-THADBEER)

 FASD (VENESECTION/ BLOODLETTING)

Among various modes of regimental therapies (Ilaj- bil- tadbeer), fasd (venesection) is one of the
oldest medical techniques, having been practiced from very ancient times from peoples including
the Egyptians, the Mesopotamians, and the Greeks. It is done for the withdrawal of blood from a
patient‘s punctured vein to cure or prevent illness or disease. For bloodletting an incision is made to
superficial veins only. The main purpose is to create a balance in the humors by removing excess in
it.

In this procedure, an incision is given to any of the superficial veins, and the blood, containing
―Madda-e- faasida‖ (waste material) is allowed to flow outside the body. The purpose is evacuation
of ―Madda-e- faasida‖ (waste material) in order to maintain proper balance to maintain health.

 HAMMAM (TURKISH BATH)

The ―Hammam‖ (Turkish bath) also known as therapeutic bath is one of the oldest Unani regimen
used for the treatment of some ailments. Hammam is done in a place used for bathing which consists
of several rooms with one room attached/ leading to the other with specific provisions and
conditions customized according to the disease to be treated. While cold bath is preferable in normal
health, hot bath is generally applied for the cure of diseases like muscle wasting after massage and
paralysis.

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 HIJAMAT/ MAHAAJIM (CUPPING THERAPY)

Cupping therapy (Hijamat/ Mahaajim) is an ancient technique/ procedure of Unani medicine. It is

used as a method of regimental therapies (Ilaj- bil-tadbeer), in which a local suction is created on the
skin. This mobilizes blood flow in order to promote healing or to cure diseases.

It is a special technique used for local evacuation or diversion of morbid humors. A horn is attached
to the surface of the skin of the diseased part through which negative pressure is created by vacuum.
The vacuum is created by the introduction of heat or suction.

Now a days the horn is being replaced with glass cup and hence the procedure came to be known as
cupping. In cupping basically the skin is gently drawn upwards by creating a vacuum in a cup over
the target area of the skin.

Types of cupping: It is of two types:

 Hijamat bil shurt i.e. cupping with bloodletting

 Hijamat bila shurt i.e. cupping without bloodletting

The second technique can be done in two ways

 Hijamat bil Naar: In this process vacuum is created by using fire

 Hijamat bila Naar: In this process vacuum is created without using fire

 DALAK (MASSAGE)

Dalak (Massage) is a therapeutic technique or systematic manipulation of body tissues with the
hands. It involves working and acting on the body with gentle pressure by using expertise hands
sometimes with fingers, elbows, knees, forearm, feet, or with a massage device. Massage can
promote relaxation and well-being of the patient.

Several types of Dalak (Massage) have been mentioned in Unani system of Medicine e.g. Dalak-e-
sulb (hard massage), Dalak-e- layyin (soft massage) etc. Similarly prolonged and moderate massages
are also recommended by Unani physicians based on the requirement of the disease conditions and
body.

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 RIYAAZAT (EXERCISE)

Riyaazat (exercise) is an activity that enhances or maintains physical fitness and ensures overall
health and wellbeing of an individual. It is a voluntary movement performed with the purpose of
evacuation of waste materials (Tanqiya-e- mawaad) from the body of sick individual. Riyazat
(exercise) plays an important role not only in maintaining good health but also in preventing certain
diseases as well.

Apart from that it is also performed for various reasons, including strengthening of body muscles
and the cardiovascular system, weight loss or weight maintenance, or for sheer enjoyment. Frequent
and regular physical exercise boosts the immune system and helps prevent the diseases specially life
style diseases such as heart disease, cardiovascular diseases Etc.

SOME OTHER REGIMENTAL THERAPIES UNANI UREATMENT OFFERED

 TA‘REEQ (SWEATING)
 IDRAR-E- BAUL (DIURESIS)
 KAI (CAUTERIZATION)
 ISHAAL (PURGATION)
 QAI (EMESIS/ VOMITING)
 TA‘LEEQ (LEECHING)
 TAKMEED (FOMENTATION)
 NUTOOL (IRRIGATION/ POURING OF MEDICATED WATER)
 ZIMAAD WA TILA (OINTMENTS/ MEDICATED PASTE AND LINIMENTS)
 DIAPHORESIS (TA‘AREEQ/ SWEATING)
 HUQNA (ENEMA)
 IMALA (DIVERSION OF MORBID MATERIALS)

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3.3.2 PHARMACOTHERAPY (ILAJ-BIL- DAWA)

This treatment methodology is considered by Unani physicians to be natural, eco-friendly, and less
intrusive and more effective than many other methods. The Unani system‘s pharmacopoeia is vast,
enriched with more than 2700 medicines derived from various herbal, mineral, and animal sources.

Unani System of Medicine emphasizes on maintaining health by natural ways and means through
change in life style, regular exercise, regulation of diet, normal sleeping habits and by avoiding
factors, which may adversely affect the quality of life.

Pharmacotherapy (Ilaj-bil- Dawa) or treatment through drugs is recommended in conditions, where

these procedures are not adequate in correcting the alterations in health.It is significant that this
system is based on crude/whole drug therapy in which active principle of a drug is not isolated but is
allowed to co-exist with other natural parts of a plant to counteract the side effects.

In this crude drug therapy, in most of the cases, there is no direct attack on the causative organism of
the disease but the internal atmosphere of the body is altered, due to that, the causative organisms are
either killed or become inactive. There are herbs that act as immuno- modulators in the body by
encouraging the defense mechanism of a person.

In the field of Pharmacotherapy the Unani system of medicine displays a unique wealth of
knowledge and experience which went into the building up of this treatment modality. According to
Unani System of medicine drugs having states opposite to those present in the diseases should be
applied. Natural drugs like plants, minerals and animal drugs are more advisable in this system.

In drugs of herbal origin, these are either parts of plants e.g. seeds, roots, flowers, stem, fruits,
leaves, barks, latex, exudates or the entire plant as such are used as medicine.

In drugs of animal origin, it can either be animal products like milk, urine or animal parts such as
hoofs and nails, hair, flesh, organs, fats or animal as a whole e.g. crab, scorpion, earthworm etc.

In drugs made of mineral, the minerals existing in nature are also used for therapeutic purposes and
consist of ores, metals and precious stones, salts, stones, clay etc.

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Some other principles related to Pharmacotherapy may be mentioned as under.

This type of treatment involves the use of naturally occurring drugs, mostly herbal. Natural drugs
only are used because they are locally available and have minimal or no after- effects on the body.

 DARAJAAT-E- ADVIA (POTENCY OF DRUGS)

 KAIFIYAAT (DIVISION OF DRUGS ACCORDING TO QUALITY)

3.3.3 SURGERY (ILAJ-BIL-YAD)

In Unani System of Medicine since very ancient times, Surgery (Ilaj-bil- Yad) has always been a
part of treatment. It is the treatment of injuries or disorders of the body by incision or manipulation,
especially with the help of some instruments.

Surgery (Ilaj-bil- Yad) is an ancient medical specialty that uses operative manual and instrumental
techniques on a patient to investigate and/or treat a pathological condition such as disease or injury,
to help improve bodily function or appearance or to repair unwanted ruptured area (for example, a
perforated ear drum).

Unani physicians were pioneers in surgery and had developed their own instruments and techniques.
They practiced surgery and wrote many remarkable books on the subject like, Kitab-al-Tasreef by
Abul Qasim Zahravi, Kitab-al-Umda fil Jarahat by Ibn-al-Quf Masihi, Kamilus San‘a by Ali Abbas
Majoosi etc.

An Arab Unani physician,Abul Qaasim Zahrawi, wrote a book entitled Kitab al-Tasrif li-man ‗ajiza
‗anit -Ta‗leef with illustrations of surgical instruments, consisted of 30 volumes on topics of
medicine, surgery, pharmacy and other health sciences. The last volume of the book, comprising 300
pages, is dedicated to only Surgery related topics. He treated Surgery as a separate subject for the
first time in the history of Medicine. He described several procedures, inventions, and techniques,
including tonsillectomy, tracheotomy, craniotomy, thyroidectomy, extraction of cataract, removal of
kidney stones, caesarian section, dentistry etc.

In ancient times, Unani surgeons did perform several surgeries like brain surgery, laparotomy and
plastic surgery. In spite of the apathy generated by colonial rule, the faith of people in their culture
and traditional medicine kept the remaining branches of Unani alive. It is because of this mass base

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and utility that after Independence, the Government of India took several steps to further this health
science.

In Unani System of Medicine, certain categories of drugs are used in cases where surgical
interventions are needed.

 DAFA-E- TA‗AFFUN ADWIYA: (ANTISEPTIC DRUGS)- CINNAMOMUM

CAMPHORA (KAAFOOR), AZADIRACHTA INDICA (NĪM), SANTALUM ALBUM
(SANDAL) ETC.
 HAABIS-E- DAM ADWIYA: (STYPTIC DRUGS)- ALUM (SHIBB YAMĀNĪ),
QUERCUS INFECTORIA (MĀZŪ),POLYGONUM BISTORATA (ANJIBĀR) ETC.
 MUDAMMIL-E- QUROOH ADWIYA: (WOUND HEALING DRUGS) - DRACAENA
CINNABARI (DAM AL-A KHWAYN), SOAP STONE (SANG JARAAHAT), RED
OCHRE (GERŪ) ETC.
 ANAESTHETICS: (MUKHADDIR ADWIYA)- DATURA INNOXIA (JAWZ AL-
MĀTHIL), HYOSCYAMUS ALBA (AJVĀ ‘IN KHURĀSĀNĪ), LACTUCA SATIVA
(KĀHŪ) ETC.
 MUSAKKIN-E- ALAM ADWIYA: (ANALGESICS)- COLCHICUM AUTUMNALE
(SURANJAAN), CONIUM MACULATUM (SHOKRAN), SYZYGIUM AROMATICUM
(QARANFAL).
 KHAATIM ADWIYA: (CICATRIZANTS)- CALCIFIED SHELL (SADAFSOKHTA),
SLAKED LIME (AAHAK MAGHSOOL), NUMMULITE (SHADINAJ) ETC.

3.3.4 DIETOTHERAPY (ILAJ-BIL- GHIZA)

Dietotherapy (Ilaj-bil- Ghiza) involves recommending a specific diet, which is the simplest and most
natural course of treatment by a hakim. For example, in fever, Unani medicine stresses a nutrient-
rich, low-roughage diet that might include dalia (porridge) and kheer (a milk broth), as such types of
diets are found to be very effective.

Before the initiation of treatment through drugs, Unani physicians as per their belief, advice
restriction or alteration in daily diet, as this pattern should be adjusted according to disease.
Sometimes they wait for few days, because some diseases can be cured even by diet so advised, and
even during the drug therapy, specific diets are advised according to disease.

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In Unani treatment modalities, food we consume plays a key role. Unani System of Medicine lays
great stress on treating certain ailments by administration of specific diets or by regulating the
quality and quantity of food.

In addition to nutritional properties, various foods have pharmacological actions too. For example,
many foods are laxative in nature, some may be diuretic and others may have diaphoretic properties.

Weakness of certain organs, is corrected by administering the same organ of an animal by way of
food; for instance, disorders and weakness of liver are treated by including goat liver in patient‘s
diet. Likewise, hearts, kidneys and brains of animals are recommended in the respective organ‘s
treatment of an individual.

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 CHAPTER-4

DATA ANALYSIS &

INTERPRETATION

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4 DATA ANALYSIS AND INTERPRETATION

4.1 GENDER WISE CLASSIFICATION

TABLE 4.1 SHOWING GENDER WISE CLASSIFICATION

SL. GENDER RESPONDENTS PERCENTAGE

NO
1. MALE 28 44.5%
2. FEMALE 35 55.5%
TOTAL 63 100%

FIGURE 4.1 ON GENDER WISE CLASSIFICATION

GENDER WISE CLASSIFICATION

MALE
44.5%
FEMALE
55.5%

INTERPRETATION:

The above Table & diagram shows that gender classification of respondents. Out of 63 respondents
44.5% are male and 55.5% are female.

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 4.2 AGE LEVEL CLASSIFICATION

TABLE 4.2 SHOWING AGE LEVEL CLASSIFICATION

SL AGE LEVEL RESPONDENTS PERCENTAGE

NO.
1. Under 18 6 9%
2. 18-24 26 41%
3. 25-34 16 25%
4. 35-44 10 16.6%
5. Above 45 5 8.4%
TOTAL 63 100%

FIGURE 4.2 ON AGE LEVEL CLASSIFICATION

AGE LEVEL SATISFICATION

8.4% 9%
16.6% Under 18
18-24
41% 25-34
25%
35-44
Above 45

INTERPRETATION

The above table and diagram shows that the age level of respondent, out of 63 respondents 9% fall
on the class Under 18 , 41% respondents fall on 18-24, 25% respondents fall on be 25-34 and 16.6%
respondents fall on 35- 44, 8.4% respondents above 45 years old.

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4.3 ATTENTIVENESS OF UNANI TOWARD THE CONCERNS OF
PATIENTS.
TABLE 4.3 SHOWING ATTENTIVENESS OF UNANI TOWARD THE
CONCERNS OF PATIENTS
SL.
ATTENTIVENESS OF UNANI RESPONDENTS PERCENTAGE
NO
1. Excellent 9 14.3 %
2. Good 28 44.5%
3. Average 19 30.2%
4. Below average 5 8%
5. poor 2 3%
Total 63 100%

FIGURE 4.3 ON ATTENTIVENESS OF UNANI TOWARD THE

CONCERNS OF PATIENTS

ATTENTIVENESS OF UNANI

8%3% 14.3% Execellent

Good
30.2% Average
Below Average
44.5% Poor

INTERPRETATION

The above table and diagram shows attentiveness of Unani towards the concern of respondents.
Out of 63 respondents, 14.3% respondents feels Excellent , 44.5% respondents feels Good, 30.2%
respondents feels Average, 8% respondents feels Below Average 3% respondents feels poor.

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4.4 RECEIVE CONFLICTING INFORMATION FROM
DIFFERENT PROFESSIONALS

TABLE 4.4 SHOWING RECEIVE CONFLICTING INFORMATION FROM

DIFFERENT PROFESSIONALS

SL. RECEIVE CONFLICTING RESPONDENTS PERCENTAGE

NO INFORMATION
1. Yes 2 3.2%
2. No 14 22.2%
3. Sometimes 4 6.4%
4. Never 43 68.2%
Total 63 100%

FIGURE 4.4 ON RECEIVE CONFLICTING INFORMATION FROM

DIFFERENT PROFESSIONALS

RECEIVE CONFLITING
80 INFORMATION 68.2%

60

40 22.2%

20 3.2%
6.4%

0
YES
NO
SOMETIMES
NEVER

INTERPRETATION

The above table and graph shows receive conflicting information from different professionals. Out
of 63 respondents, 3.2% respondents feels Yes , 22.2% respondents feels No, 6.4% respondents
feels Sometimes, 68..2% respondents feels Never.

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4.5 WORK HOURS EFFECTIVENESS TO TREAT THE CONCERNS OF
PATIENTS

TABLE 4.5 SHOWING WORK HOURS EFFECTIVENESS TO TREAT THE

CONCERNS OF PATIENTS

SL. WORK HOURS EFFECTIVENESS RESPONDENTS PERCENTAGE

NO

1. Effective 26 41.2%

2. Somewhat Effective 21 33.4%

3. Not so Effective 6 9.5%
4. Need to improve 10 15.9%
Total 63 100%

FIGURE 4.5 ON WORK HOURS EFFECTIVENESS TO TREAT THE

CONCERNS OF PATIENTS

50 41.2%
33.4% WORK HOURS EFFECTIVENESS
40
30
20 9.5% 15.9%
10
0
Effective
Somewhat
Effective Not so Effective
Need to
improve

INTERPRETATION

The above table and graph shows work hours effectiveness to treat the concerns of patients. Out of
63 respondents, 41.2% respondents feels Effective, 33.4% respondents feels Sometimes Effective,
9.5% respondents feels Not so Effective, 15.9% respondents feels Need to improve.

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4.6 AVAILABILITY OF UNANI TREATMENT FROM PATIENT’S
DESTINATION
TABLE 4.6 SHOWING AVAILABILITY OF UNANI TREATMENT FROM
PATIENT’S DESTINATION
SL. AVAILABILITY OF RESPONDENTS PERCENTAGE
NO TREATMENT
1. Easy 37 58.7%
2. Somewhat Easy 21 33.3%
3. Somewhat Difficult 4 6.4%
4. Very Difficult 1 1.6%
Total 63 100%

FIGURE 4.6 ON AVAILABILITY OF UNANI TREATMENT FROM

PATIENT’S DESTINATION
58.7%
60 AVAILABILITY OF TREATMENT
33.3%
40
20 6.4%
1.6%
0
Easy
Somewhat
Easy Somewhat
Difficult Very Difficult

INTERPRETATION

The above table and graph shows availability of Unani treatment from patient‘s destination. Out of
63 respondents, 58.7% respondents experiences Easy, 33.3% respondents experiences Somewhat
Easy, 6.4% respondents experiences Somewhat Difficult, 1.6% respondents experiences Very
Difficult.

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4.7 QUALITY OF SERVICES RECEIVED
TABLE 4.7 SHOWING QUALITY OF SERVICES RECEIVED
SL. QUALITY OF SERVICES RESPONDENTS PERCENTAGE
NO
1. Excellent 22 35%
2. Good 26 41.3%
3. Average 10 15.8%
4. Below average 3 4.7%
5. Poor 2 3.2%
Total 63 100%

FIGURE 4.7 ON QUALITY OF SERVICES RECEIVED

41.3%
35% QUALITY OF SERVICES
45
40
35
30
15.8%
25
20
4.7%
15 3.2%
10
5
0
Excellent Good Average Below average Poor

INTERPRETATION

The above table and graph shows quality of services received. Out of 63 respondents, 35%
respondents experiences Excellent, 41.3% respondents experiences Good,15.8% respondents
experiences Average, 4.7% respondents experiences Below average,3.2% respondents experiences
Poor.

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4.8 AWARENESS OF ALL HEALTHCARE SERVICES UNANI
TREATMENT OFFER
TABLE 4.8 SHOWING AWARENESS OF ALL HEALTHCARE SERVICES
UNANI TREATMENT OFFER
SL. AWARENESS OF ALL RESPONDENTS PERCENTAGE
NO HEALTHCARE SERVICES
1. Aware 21 33.3%
2. Well aware 6 9.5%
3. Somewhat aware 16 25.4%
4. Not so aware 15 23.8%
5. Not at all aware 5 8%
Total 63 100%

FIGURE 4.8 ON AWARENESS OF ALL HEALTHCARE SERVICES UNANI

TREATMENT OFFER

33.3%
AWARENESS OF ALL HEALTHCARE SERVICES
35
25.4% 23.8%
30
25
20
9.5%
15 8%
10
5
0
Aware Well aware Somewhat Not so aware Not at all
aware aware

INTERPRETATION

The above table and graph shows awareness of all healthcare services Unani treatment offer. Out
of 63 respondents, 33.3% respondents experiences Aware, 9.5% respondents experiences Well
aware,25.4% respondents experiences Somewhat aware, 23.8% respondents experiences Not so
aware,8% respondents experiences Not at all aware.

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4.9 DOCTOR’S EMPATHETIC TO PATIENT’S CONCERNS

TABLE 4.9 SHOWING DOCTOR’S EMPATHETIC TO PATIENT’S

CONCERNS

SL. DOCTOR‘S EMPATHETIC RESPONDENTS PERCENTAGE

NO
1. Empathetic 37 58.8 %
2. Somewhat Empathetic 19 30%
3. Not so Empathetic 5 8%
4. Not at all 2 3.2%
Total 63 100%

FIGURE 4.9 ON DOCTOR’S EMPATHETIC TO PATIENT’S CONCERNS

58.8%
DOCTOR’S EMPATHETIC
60
50
30%
40
30 8%
20 3.2%

10
0
Empathetic Somewhat Not so Not at all
Empathetic Empathetic

INTERPRETATION

The above table and graph shows doctor‘s empathetic to patient‘s concerns. Out of 63
respondents, 58.8% respondents experiences Empathetic, 30% respondents experiences
Somewhat Empathetic,8% respondents experiences Not so Empathetic, 3.2% respondents
experiences Not at all.

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4.10 ABILITY OF DOCTORS TO ANSWERS PATIENT’S ALL
QUESTIONS

TABLE 4.10 SHOWING ABILITY OF DOCTORS TO ANSWERS

PATIENT’S ALL QUESTIONS

SL. ABILITY OF DOCTORS RESPONDENTS PERCENTAGE

NO
1. Much more able 42 66.7 %
2. Able 13 20.6%
3. Not able 8 12.7%
Total 63 100%

FIGURE 4.10 ON ABILITY OF DOCTORS TO ANSWERS PATIENT’S ALL

QUESTIONS

ABILITY OF DOCTORS
66.7%
80

60
20.6%
40 12.7%

20

0
Much more able Able Not able

INTERPRETATION

The above table and graph shows ability of doctors to answers patient‘s all questions. Out of 63
respondents, 66.7% respondents experiences Much more able, 20.6% respondents experiences
Able,12.7% respondents experiences Not able.

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4.11 THROUGH WHICH PATIENT HEARD UNANI
TREATMENT

TABLE 4.11 SHOWING THROUGH WHICH PATIENT HEARD UNANI

TREATMENT

SL. MEDIA RESPONDENTS PERCENTAGE

NO
1. Internet 10 15.9%
2. Friends 30 47.6%
3. Relatives 12 19%
4. Effective consumer 11 17.5%
Total 63 100%

FIGURE 4.11 ON THROUGH WHICH PATIENT HEARD UNANI

TREATMENT

47.6% MEDIA
50
40 15.9% 19% 17.5%
30
20
10
0
Internet Friends Relatives Effective
consumer

INTERPRETATION

The above table and graph shows through which patient heard Unani treatment. Out of 63
respondents 15.9% respondents heard from Internet, 47.6% respondents heard from Friends,19%
respondents heard from Relatives, 17.5% respondents heard from Effective consumer.

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4.12 SENSE OF RECOMMENDATION OF UNANI TREATMENT
TO OTHERS
TABLE 4.12 SHOWING SENSE OF RECOMMENDATION OF UNANI
TREATMENT TO OTHERS
SL. RECOMMENDATION OF UNANI RESPONDENTS PERCENTAGE
NO TREATMENT
1. Excellent 22 35%
2. Good 26 41.3%
3. Average 10 15.8%
4. Below average 3 4.7%
5. Poor 2 3.2%
Total 63 100%

FIGURE 4.12 ON SENSE OF RECOMMENDATION OF UNANI

TREATMENT TO OTHERS

41.3% RECOMMENDATION OF UNANI TREATMENT

45 35% TO OTHERS
40
35
30
15.8%
25
20
4.7% 3.2%
15
10
5
0
Excellent Good Average Below average Poor

INTERPRETATION

The above table and graph shows sense of recommendation of Unani treatment to others. Out of 63
respondents, 35% respondents experiences Excellent, 41.3% respondents experience Good,15.8%
respondents experiences Average, 4.7% respondents experiences Below average,3.2% respondents
experiences Poor.
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4.13 MEETING OTHER TREATMENT BEFORE FOR SAME
CONCERN
TABLE 4.13 SHOWING MEETING OTHER TREATMENT BEFORE FOR
SAME CONCERN
SL. MEETING OTHER RESPONDENTS PERCENTAGE
NO TREATMENT
1. Regularly 25 39.7%
2. Sometimes 26 41.3%
3. No 12 19%
Total 63 100%

FIGURE 4.13 ON MEETING OTHER TREATMENT BEFORE FOR SAME

CONCERN

MEETING OTHER TREATMENT

39.7% 41.3%
50

40

30 12%

20

10

0
Regularly Sometimes No

INTERPRETATION

The above table and graph shows meeting other treatment before for same concern. Out of 63
respondents, 39.7% respondents meet Regularly, 41.3% respondents meet Sometimes.19 %
respondents meet No other treatment.

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4.14 TREATMENT WHICH PATIENT MET BEFORE UNANI
TREATMENT

TABLE 4.14 SHOWING TREATMENT WHICH PATIENT MET BEFORE

UNANI TREATMENT

SL. OTHER TREATMENT RESPONDENTS PERCENTAGE

NO
1. Allopathic 28 68.3%
2. Ayurveda 8 19.5%
3. Homeopathy 5 12.2%
4. Naturopathy 0 0%
41 100%

FIGURE 4.14 ON TREATMENT WHICH PATIENT MET BEFORE UNANI

TREATMENT

68.3%

70 OTHER TREATMENT
60
50
40
19.5%
30 12.2%

20 0%

10
0
Allopathic Ayurveda Homeopathy Naturopathy

INTERPRETATION

The above table and graph shows treatment which patient met before Unani treatment. Out of 41
respondents, 68.3% respondents meet Allopathic, 19.5% respondents meet Ayurveda.12.2 %
respondents meet Homeopathy.0% respondents meet Naturopathy treatment.
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 CHAPTER-5
FINDINGS &
SUGGESTIONS

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5.1 FINDINGS

 The survey shows that most of the patients are avail health service in MIHRAS
HOSPITAL are female.
 The survey shows that most of the patients come to MIHRAS HOSPITAL for Unani
treatment at the age of 18-24.
 The survey shows that 44.5% of patients are marking good in attentiveness of Unani
toward the concerns of patients.
 The survey shows that 68.2% of patients commenting they never received any conflicting
information from different professionals in MIHRAS HOSPITAL. Which show the
accuracy of knowledge and availability of different contemporary study development in
Unani treatment matter
 The survey shows that 41.2% of patients saying that work hours of MIHRAS HOSPITAL
effective to treat their concerns.
 The survey shows that 58.7% of patients feels easy availability of Unani treatment from
their destination in MIHRAS HOSPITAL.
 The survey shows that 41.3% of patients experience good quality of services they
received from MIHRAS HOSPITAL
 The survey shows that 33.3% of patients aware about all healthcare services MIHRAS
HOSPITAL offer in Unani treatment
 The survey shows that 58.8% of patients experience those doctors in MIHRAS
HOSPITAL empathetic to their concerns.
 The survey shows that 66.7% of patients contented that much more ability of doctors to
answers their all questions.
 The survey shows that 47.6% of patients heard Unani treatment from friends.it shows it
capability and future of Unani treatment.
 The survey shows that 41.3% of patients recommend others that Unani treatment As good
health care facility availability in MIHRAS HOSPITAL
 The survey shows that 41.3% of patients of Unani treatment sometimes met other
treatment for same concern before availing Unani treatment. It shows the honesty and
prosperity of Unani treatment in MIHRAS HOSPITAL
 The survey shows that 68.3% of patients of Unani availed allopathic before Unani
treatment.
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5.2 SUGGESTIONS

 Attentiveness of Unani toward the concerns of patients should make more

 Make people bother of all healthcare services Unani treatment offer
 In health facilities Suitable physical environment like water, energy, sanitation arranged
more
 Well-trained and motivated Health Workers attended to handle the expectation of patients
 Concentrate on the Patients tailored to intimate good service quality
 Systems which affect patient accessibility should kept well
 Evidence-based health-care provision should provide
 Endeavour to encourage patient participation in successful treatment
 Decentralizing public health services by proper implementation of treatment service
 Infrastructural development should kept in mind
 For the availability of treatment service wherever patient want should increase the
number of Hospitals under esteemed institution.

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5.3 CONCLUSION

Health is a basic human right as well as a worldwide social aim. It is necessary for the
fulfillment of higher quality of life. Health is a factor that influences a country‘s overall
economic growth rate. Because excellent health is a prerequisite for progress, even the poorest
developing countries should priorities investments in the health sector. The study gives the
knowledge of the various view and their association with customer satisfaction. It based through
questionnaire pattern for the research and findings. This study results the customer satisfaction in
the following factors ( price, quality, variety, loyalty, location) Unani treatment treats their patient
with a very high quality . Many like likes to adopt towards Unani treatment because of quality
and promoting quotation as ‗Unani ‘ and ‗health and safety‘, it works very effectively for
promotion. It has a reasonable price. On considering this study, it can be concluded that Unani
treatment have gained significant place in the market and capture a huge lot of customers due to its
quality, price, variety, loyalty and location.

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5.4 BIBLIOGRAPHY

BOOKS

1. Joseph Hair Jr. F., Bush Robert P. and Ortinau David J. (2003), ―Marketing Research- within
a changing information environment‖, second edition, tata McGraw Hill Publishing
Company limited, New Delhi.

2. Ken Black (2006), ―Business statistics for contemporary decision making‖, fourth edition,
Wiley India publication.

3. Kotler Philip and Keller Kevin (2007), ―Marketing Management- A south Asian
perspective‖, twelfth edition, pearson education Inc...

4. Leon Schiffman and Laslie Kanuk (2007), ―Consumer Behavior‖, ninth Edition, pearson
Education Inc. 5. Lindquist D. Jay and Joseph Sirgy M (2003),‖Shopper, buyer and
Consumer Behavior: Theory and Marketing Applications‖, second edition, Biztantra
publication.

5. Levin Richard and Rubin David (2004), ―Statistics for Management‖, seventh edition,
prentice-Hall of India Pvt. Ltd.

WEBSITE

 https://www.researchgate.net
 https://www.markazknowledgecity.com
 https://www.mihrashospital.com
 https://scholar.google.com
 https://www.teamwork.com
 https://study.com

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 APPENDIX

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 A STUDY ON THE SERVICE QUALITY IN HEALTH CARE
SYSTEM: IN DEPTH EXPLORATION TO UNANI TREATMENT
IN KERALA WITH SPECIAL REFERENCE TO MIHRAS
HOSPITAL, CALICUT.

QUESTIONNAIRE:

Dear sir/madam

I am a BBA; LL.B student of MARKAZ LAW COLLEGE undertaking ―A STUDY ON THE

SERVICE QUALITY IN HEALTH CARE SYSTEM: IN DEPTH EXPLORATION TO UNANI
TREATMENT IN KERALA WITH SPECIAL REFERENCE TO MIHRAS HOSPITAL,
CALICUT‖. This exercise is a part of my project towards fulfilling the requirement of the
completion of the BBA; LL.B Degree course. I would be obliged if you could provide me with
some of your valuable time to answer a few question.

Name;

1. Gender

a) Male
b) Female

2. Age

a) Under 18
b) 18-25
c) 25-34
d) 35-44
e) Above 45

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 3. How satisfied were you with the attentiveness shown toward your concerns by Unani
treatment?

a) Excellent
b) Good
c) Average
d) Below average
e) Poor

4. How often did you receive conflicting information from different professionals at this
facility?

a) Yes
b) No
c) Sometimes
d) Never

5. Do you feel that our work hours are well suited and effective to treat your concern?

a) Effective
b) Somewhat effective
c) Not so effective
d) need to improve

6. How easy was it to available the Unani treatment from your destination?

a) Easy
b) Somewhat easy
c) Somewhat difficult
d) very difficult

7. How would you rate the quality of service received at our facility?

a) Excellent
b) Good
c) Average
d) Below average
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 e) Poor

8. Are you well aware of all the healthcare services Unani treatment offer?

a) Aware
b) Very aware
c) Somewhat aware
d) Not so aware
e) Not at all aware

9. Were our Doctors and staffs empathetic to your needs?

a) Empathetic
b) Somewhat empathetic
c) Not so empathetic
d) Not at all

10. Were we able to answer all your questions?

a) much more able

b) able
c) not able

11. Through what means do you heard about the Unani treatment ?

a) Internet
b) Friends
c) Relatives
d) Effective consumer

12. How likely are you to recommend Unani treatment to others

a) Excellent
b) Good
c) Average
d) Below average
e) Poor
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 13. Did you meet other treatment services for your same concern?

a) Regularly
b) Sometimes
c) No

14. Which treatment service was you met before Unani treatment ? if any

a) Allopathic
b) Ayurveda
c) Homeopathy
d) Naturopathy

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