Kamu ve özel hastanelerde hizmet kalitesi, hasta tatmini ve tercihi arasındaki ilişki: Karşılaştırmalı bir analiz

Bu çalışma, Türkiyede kamu ve özel hastanelerde karşılaştırmalı olarak SERVQUALin uygunluğunu ve algılanan hizmet kalitesi, hasta tatmini ve hasta tercihi (hastaneye yeniden gitme niyeti) arasındaki ilişkiyi araştırmıştır. Keşifsel ve doğrulayıcı faktör analizi sonuçları, SERVQUALin Türkiyede sağlık hizmetlerinin kalitesini ölçmede geçerli ve güvenilir bir ölçek olduğunu göstermekle birlikte boyutlarını doğrula- mamıştır. Kamu hastanelerinin kalitesi iki boyuttan (i. güvenilirlik-somutluk ve ii. yanıt verebilirlik-güvence - empati), özel hastanelerin kalitesi ise üç boyuttan (i. güvenilirlikgüvence, ii. somutluk ve iii. empati) oluşmuştur. Yapısal eşitlik analizi sonuçlarına göre her iki hastane tipinde de hizmet kalitesinin hasta tatmini, hasta tatmininin de hasta tercihi üzerinde pozitif etkisi vardır. Diğer taraftan analiz sonuçları, hizmet kalitesinin hasta tercihini kamu hastanelerinde doğrudan, özel hastanelerde ise hasta tatmini sayesinde dolaylı etkilediğini göstermiştir.

The Relationships between Service Quality, Patient Satisfaction and Preference in Public and Private Hospitals in Turkey: A Comparative Study

This study comparatively explores the suitability of SERVQUAL and the relationship between perceived service quality, patient satisfaction, and patient preference (intent to revisit the hospital) for the public and private hospitals in Turkey. The results of exploratory and confirmatory factor analysis indicated that SERVQUAL is a valid and reliable instrument to measure health care service quality in Turkey. However, the dimensions of SERVQUAL are not confirmed. Public hospitals’ quality is composed of two dimensions (i. reliability-tangibility and ii. responsiveness-assurance-private hospitals’ quality is composed of three dimensions (i. reliabilityssurance, ii. tangibility and iii. empathy). Structural equation analysis showed that perceived service quality has a significant positive impact on patient satisfaction and patient satisfaction has a significant positive impact on patient preference both in public and private hospitals. On the other hand, perceived service quality directly affects patient preference in public hospitals while the same effect is indirect thanks to patient satisfaction in private hospitals.

___

  • Aksoy, Ramazan (2005), “Zonguldak’ta Ayakta Tedavi Tüketicilerinin Sağlık Hizmeti Kalite Değerlemesi”, ZKÜ Sosyal Bilimler Dergisi, Cilt 1, Sayı 1, s. 91-104.
  • Alexandris, Konstantinos-Dimitriadis, Nikos-Markata, Dimitra (2002), “Can Perceptions of Service Quality Predict Behavioral Intentions? An Exploratory Study in the Hotel Sector in Greece”, Managing Service Quality, Vol. 12, No: 4, s.224-231.
  • Andaleeb, Syed S.-Siddiqui, Nazlee-Khandakar, Shahjahan (2007), “Doctors’ Service Orientation in Public, Private, and Foreign Hospitals”, International Journal of Health Care Quality Assurance, Vol. 20, No: 3, s. 253-263.
  • Araslı, Huseyin-Ekiz Erdogan H.-Katircioglu, Salih T. (2008), “Gearing Service Quality into Public and Private Hospitals in Small Islands Empirical evidence from Cyprus”, International Journal of Health Care Quality Assurance, Vol. 21, No: 1, s. 8-23.
  • Baker, D.A.-Crompton, J.L. (2000), “Quality, Satisfaction and Behaviour Intentions”, Annals of Tourism Research, Vol. 27, No: 3, s. 785-804.
  • Bou Llusar, Juan C.-Camison-Zornoza, Cesar-Escrig Tena, Ana Belan (2001), “Measuring the Relationship Between Firm Perceived Quality and Customer Satisfaction and its Influence on Purchase Intentions, Total Quality Management, Vol. 12, No: 6, s. 719-734.
  • Butt, Mohsin M.-de Run Ernest C. (2010), “Private Healthcare Quality: Applying a SERVQUAL Model”, International Journal of Health Care Quality Assurance, Vol. 23, No: 7, s. 658-673.
  • Bülbül, Hasan-Demirer, Ömür (2008), “Hizmet Kalitesi Ölçüm Modelleri Servqual ve Serperf’in Karşılaştırmalı Analizi”, Selçuk Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, Cilt 20, s. 181-198.
  • Chong, Vincent K.-Rundus, Michael J. (2004), “Total Quality Management, Market Competition and Organizational Performance”, The British Accounting Review, Vol. 36, No: 2, s. 155-172.
  • Cui, Charles C.-Lewis, Barbara R.-Park, Won (2003). “Service Quality Measurement in the Banking Sector in South Korea”, International Journal of Bank Marketing, Vol. 21, No: 4, s. 191-201.
  • Cronin, Joseph J. Jr.-Taylor, Steven A. (1992), “Measuring Service Quality: a Reexamination and Extension”, Journal of Marketing, Vol. 56, No: 3, s. 55-68.
  • De Man, Stefanie-Gemmel, Paul-Vlerick, Peter-Van Rijk P.-Dierckx, Rudi (2002), “Patients’ and Personnel’s Perceptions of Service Quality and Patient Satisfaction in Nuclear Medicine”, European Journal of Nuclear Medicine, Vol. 29, No: 9, s. 1109-1117.
  • Devebakan, Nevzat-Aksaraylı, Mehmet (2003), “Sağlık İşletmelerinde Algılanan Hizmet Kalitesinin Ölçümünde Servqual Skorlarının Kullanımı ve Özel Altınordu Hastanesi Uygulaması”, Dokuz Eylül Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, Cilt 5, Sayı 1, s. 38-54.
  • Dey, Prasanta K.-Hariharan, Seetharaman-Brookes, Naomi (2006), “Managing Healthcare Quality Using Logical Framework Analysis”, Managing Service Quality, Vol.16, No: 2, s. 203-222.
  • Fornell, Claes - Larcker, David F. (1981), “Evaluating Structural Equation Models with Unobservable Variables and Measurement Error,” Journal of Marketing Research, Vol. 18, No: 1, s. 39-50.
  • Furrer, Olivier-Ching-Liu, Ben S.-Sudharshan, D. (2000), “The Relationship Between Culture and Service Quality Perceptions”, Journal of Service Research, Vol. 2, No: 4, s. 355-370.
  • Gounaris, Spiros (2005), “Measuring Service Quality in B2B services: an Evaluation of the SERVQUAL Scale vis-a-vis Scale the INDSERV Scale”, The Journal of Service Marketing, Vol. 19, No: 6, s.421-435.
  • Gülmez, Mustafa-Kitapçı, Olgun (2008), “Hastane Hizmet Kalitesi ve Bir Uygulama”, H.U. İktisadi ve İdari Bilimler Fakültesi Dergisi, Cilt 26, Sayı 1, s. 165-186.
  • Gürbüz, Esen-Büyükkeklik, Arzum-Avcılar, M. Yüksel-Toksarı, Murat (2008) “Algılanan Hizmet Kalitesinin Tatmin ve Davranışsal Niyet Üzerine Etkisi: Niğde İlindeki Süpermarketler Üzerine Bir Araştırma”, Ege Akademik Bakış, Cilt 8, Sayı 2, s. 785-812.
  • Hair, J.F.Jr., Andreson ,R.E., Tahtam, R.L., Black, W.C. (1998), Multivariate Data Analysis, Fifth Ed. Prentice Hall Inc., New Jersey.
  • Hellier, Philip K.-Geursen, Gus M.-Carr, Rodney A.-Rickard, John A. (2003), “Customer Repurchase Intention: A General Structural Equation Model”, European Journal of Marketing, Vol. 37, No: 11/12, s. 1762-1800.
  • Herrick, Devon M. (2011), “Medical Tourism: Global Competition in Health Care” http://w.medretreat.com/templates/UserFiles/Documents/Medical%20Tourism%20- %20 NCPA %20Report.pdf (10.10.2011).
  • Hume, Margee (2008), “Understanding Core and Peripheral Service Quality in Customer Repurchase of the Performing Arts”, Managing Service Quality, Vol. 18, No: 4, s. 349-369.
  • Jabnoun, Naceur-Khalifa, Azaddin (2005), “A Customized Measure of Service Quality in the UAE”, Managing Service Quality, Vol. 15, No: 4, s.374-388.
  • Jabnoun, Naceur-Mohammed Chaker (2003), “Comparing the Quality of Private and Public Hospitals”, Managing Service Quality, Vol. 13, No: 4, s. 290-299.
  • Jeong, Miyoung-Oh, Haemoon-Gregoire, Mary (2003), “Conceptualizing Web Site Quality and its consequences in the lodging industry”, International Journal of Hos- pitality Management, Vol. 22, No: 2, s. 161-175.
  • Jonsson, Patrik (2000) “An Empirical Taxonomy of Advanced Manufacturing Technology”, International Journal of Operations & Production Management, Vol. 20, No: 12, s. 1446-1474.
  • Lai, Fujun-Hutchinson, Joe- Li, Dahui-Bai, Changhong (2007), “An Empirical Assessment and Application of SERVQUAL in Mainland China’s Mobile Communica- tions Industry”, International Journal of Quality & Reliability Management, Vol. 24,No: 3, s. 244-262.
  • Lam, Simon S. K. (1997), “SERVQUAL: A Tool for Measuring Patients Opinions of Hospital Service Quality in Hong Kong, Total Quality Management, Vol. 8, No: 4, s. 145-152.
  • Law, Anges K.Y-Hui, Y.V.-Zhao, Xiande (2004), “Modeling Repurchase Frequency and Customer Satisfaction for Fast Food Outlets”, The International Journal of Quality & Reliability Management. Vol. 21, No: 4/5, s. 545-563.
  • Lonial, Subhash-Menezes, Dennis-Tarim, Mehves-Tatoglu, Ekrem-Zaim, Selim (2010), “An evaluation of SERVQUAL and Patient Loyalty in an Emerging Country Context”, Total Quality Management, Vol. 21, No: 8, s. 813-827.
  • Molinari, Lori K.-Abrat, Russell-Dion, Paul (2008), “Satisfaction, Quality and Value And Effects on Repurchase and Positive Word-of-Mouth Behavioral Intentions in a B2B Services Context”, Journal of Services Marketing, Vol. 22, No: 5, s. 363-373.
  • Nagata, Haruki-Satoh, Yoshinori-Gerrard, Sarah- Kytömaki, Paivi (2004), “The Dimensions that Construct the Evaluation of Service Quality in Academic Libraries”, Performance Measurement and Metrics, Vol. 5, No: 2, s. 53-65.
  • Nunnally, Jum C. (1978), Psychometric theory, McGraw-Hill, New York. Odebiyi Daniel O.-Aiyejusunle, C. B.-Ojo, T. S.-Tella, B. A. (2009), “Comparison of Patients’ Satisfaction with Physiotherapy Care in Private and Public Hospitals”, Journal of the Nigeria Society of Physiotherapy, Vol. 17, s. 23-29.
  • Oh, Haemoon (1999), “Service Quality, Customer Satisfaction, and Customer Value: a Holistic Perspective”, International Journal of Hospitality Management, Vol. 18, No: 1, s. 67-82.
  • Owusu, Frimpong N.-Nwankwo, Sony-Dason, Baba (2010), “Measuring Service Quali- ty and Patient Satisfaction with Access to Public and Private Healthcare Delivery”, International Journal of Public Sector Management, Vol. 23, No: 3, s. 203-220.
  • Padma, Panchapakesan-Rajendran, Chandrasekharan-Lokachari, Prakash S. (2010), “Service Quality and its Impact on Customer Satisfaction in Indian hospitals: Perspectives of Patients and their Attendants”, Benchmarking: An International Journal, Vol. 17, No: 6, s. 807-841.
  • Parasuraman, A.-Zeithaml, Valarie A.-Berry, Leonard L. (1988). “SERVQUAL: A Multiple-Item Scale for Measuring Consumer Perceptions of Services Quality”, Journal of Retailing, Vol. 64, No: 1, s. 12-40.
  • Parasuraman, A.-Zeithaml, Valarie A.-Berry, Leonard L. (1991). “Refinement and Reassessment of the SERVQUAL Scale”, Journal of Retailing, Vol. 67, No: 4, s. 420-450.
  • Ravichandran, Thiagarajan-Arun, Rai (1999), “Total Quality Management in Infor- mation Systems Development: Key Constructs and Relationship”, Journal of Man- agement Information Systems, Vol. 16, No: 3, s. 119-156. Qin, Hong-Victor, R. Prybutok (2008), “Determinants of Customer-Perceived Service Quality in Fast-Food Restaurants and their Relationship to Customer Satisfaction and Behavioral Intentions”, The Quality Management Journal, Vol. 15, No: 2, s. 35-50.
  • Rigopoulou, Irini D.-Chaniotakis, Ioannis E.-Lymperopoulos, Constantine-Siomkos, George I. (2008), “After-sales Service Quality as an Antecedent of Customer Satisfaction the Case of Electronic Appliances”, Managing Service Quality, Vol. 18, No: 5, s. 512-527.
  • Sağlık Bakanlığı (2011), T.C. Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı 2010, SB Yayın No: 832, Kalkan Matb. San. ve Tic. Ltd. Şti, Ankara.
  • Saha, Gour C.-Theingi (2009), “Service Quality, Satisfaction, and Behavioural Intentions a Study Of Low-Cost Airline Carriers in Thailand”, Managing Service QualityVol. 19, No: 3, s. 350-372.
  • Schermelleh, E. Karin,- Moosbrugger, Helfried-Müller, Hans (2003), “Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodnessof-fit Measures”, Methods of Psychological Research Online, Vol. 8, No: 2, s. 23-74.
  • Suh, Young I.-Petersen, Poul M. (2010), “Participants’ Service Quality Perceptions of Fantasy Sports Websites: the Relationship Between Service Quality, Customer Sat- isfaction, Attitude, and Actual usage”, Sport Marketing Quarterly, Vol. 19, s. 78-87Şimşek, Ömer F. (2007), Yapısal Eşitlik Modellemesine Giriş: Temel İlkeler ve LİSREL Uygulamaları, Ekinoks Eğ. Dan. Hiz. ve Yay., Dağ., Ankara.
  • Tan, K. C.-Kannan, V. R.-Narasimhan, R. (2007), “The Impact of Operations Capabil- ity on Firm Performance”, International Journal of Production Research, Vol. 45, No: 21, s. 5135-5156.
  • Taner, Tolga-Antony, Jiju, (2006), “Comparing public and private hospital care service quality in Turkey”, Leadership in Health Services, Vol. 19, No: 2, s. i-x.
  • Taylor, S.A. (1994), “Distinguishing Service Quality from Patient Satisfaction in Developing Health-Care Marketing Strategies”, Hospital and Health Services Administration, Vol. 39, No: 2, s. 221-236.
  • Tsoukatos, Evangelos-Rand, Graham K. (2006), “Path Analysis of Perceived Service Quality, Satisfaction and Loyalty in Greek Insurance”, Managing Service Quality, Vol. 16, No: 5, s. 501-519.
  • Uzun, Özge (2001), “Patient Satisfaction With Nursing Care at a University Hospital in Turkey”, Journal of Nursing Care Quality, Vol. 16, No: 1, s. 24-33.
  • Yağcı, Mehmet İ.-Duman, Teoman (2006), “Hizmet Kalitesi-Hasta Memnuniyeti İlişkisinin Hastane Türlerine Göre Karşılaştırılması: Devlet, Özel ve Üniversite Hastaneleri Uygulaması”, Doğuş Üniversitesi Dergisi, Cilt 7, Sayı 2, s. 218-238.
  • Zhao, Xiande-Bai, Changhong-Hui, Y.V. (2002). “An empirical Assessment and Application of SERVQUAL in a Mainland Chinese Department Store”, Total Quality Management, Vol. 13, No: 2, s. 241- 254.
  • Zineldin, Mosad (2006), “The Quality Of Health Care And Patient Satisfaction: an Exploratory Investigation of the 5Qs Model at Some Egyptian and Jordanian Medical Clinics”, International Journal of Health Care Quality Assurance, Vol. 19, No: 1, s. 60-92.