Background
Hypotheses development and structural framework
Relationships among interpersonal-based medical service encounters, service quality, and patient satisfaction
Hypothesis 1
Hypothesis 2
Relationships among service quality, patient trust, and satisfaction
Hypothesis 3
Hypothesis 4
Structural framework of the theoretical relationships
Methods
Research design and participants
Instrument
Construct/ variable | Operational definition | Cronbach’s α ( > .6) | References | |
---|---|---|---|---|
Interpersonal-Based Medical Service Encounter
| ||||
Professional Personnel | Patients’ perceptions of the medical professional skill and communication attitude of the physicians and nurses in the service encounter. |
0.92
| ||
General Administrative Personnel | Patients’ perceptions of the communication attitude, sympathy, and empathy of the general service personnel in the service encounter. |
0.89
| ||
Environment and Space (Physical Symbol) | Patients’ perceptions of the other tangible factors that may help the implementation of medical service in the service encounter. |
0.90
| ||
Service Quality
| ||||
Response | Hospital’s capabilities of providing services that instantly and rapidly respond to patients’ demands in the service encounter. |
0.88
| ||
Reliability | Hospital’s capabilities of providing services that correctly delivery the service requested by patients in the service encounter. |
0.90
| ||
Assurance | Hospital’s capabilities of providing services that really earn patients’ confidence in the service encounter. |
0.93
| ||
Patient Trust
| ||||
Patient Trust | Patients’ perceptions of the confidence in the reliability and integrity of medical service in the service encounter. |
0.91
| ||
Patient Satisfaction
| ||||
Patient Satisfaction | The psychological state of patient involves their positive or negative feelings or attitudes toward their experience and some specific aspects in the service encounter. |
0.91
|
Construct | Variable / question item | Standard loading | Composite reliability > 0.6 | AVE > 0.5 |
---|---|---|---|---|
Interpersonal-Based Medical Service Encounter
|
Professional personnel
| 0.85 | 0.54 | |
1. I feel the physicians are professional during the whole treatment process. | 0.71* | |||
2. The physicians will recommend adequate medical treatment according to patients’ needs. | 0.71* | |||
3. The physicians are able to provide answers that solve my doubts. | 0.74* | |||
4. The physicians will inform patients about treatment plan. | 0.79* | |||
5. I feel the nurses are professional during the whole treatment process. | 0.72* | |||
General administrative personnel
| 0.92 | 0.74 | ||
1. Service counter personnel are trustworthy. | 0.84* | |||
2. Service counter personnel are able to take the initiative in assisting the procedures of registration, pharmacy, and cashier to make them smooth and efficient. | 0.97* | |||
3. Service counter personnel are able to provide answers that solve my doubts. | 0.92* | |||
4. Service counter personnel have a good service attitude. | 0.67* | |||
Environment and space (physical symbol)
| 0.91 | 0.71 | ||
1. The hospital has clear directions inside. | 0.85* | |||
2. The hospital has wide and comfortable waiting rooms. | 0.77* | |||
3. The hospital has well-illuminated waiting rooms. | 0.90* | |||
4. The hospital has clean toilets. | 0.84* | |||
Service Quality
|
Response
| 0.77 | 0.53 | |
1. The entire service process has a good feedback system and management. | 0.56* | |||
2. The entire service process allows questions to be answered easily. | 0.82* | |||
3. The entire service process can complete service in a short period of time. | 0.78* | |||
Reliability
| 0.94 | 0.83 | ||
1. The entire service process has complete record of transaction details. | 0.94* | |||
2. The entire service process is able to correctly complete designated service items. | 0.85* | |||
3. The entire service process has no error. | 0.94* | |||
Assurance
| 0.81 | 0.60 | ||
1. The entire service process can fulfill its promise to customers. | 0.75* | |||
2. The entire service process has a good security mechanism. | 0.97* | |||
3. The entire service process is trustworthy. | 0.55* | |||
Patient Trust
| 1. Medical care personnel will honestly inform patients about the result of diagnosis. | 0.88* | 0.87 | 0.58 |
2. Medical care personnel will honor the agreement made with the patients. | 0.76* | |||
3. My medical issues can be handled through the help from general service personnel. | 0.79* | |||
4. I can trust medical care personnel’s judgment on my sickness. | 0.69* | |||
5. I rely on medical care personnel to solve medical issues. | 0.66* | |||
Patient Satisfaction
| 1. The entire service provided by the hospital makes me feel happy. | 0.89* | 0.89 | 0.68 |
2. After consumption, I believe choosing this hospital is a correct decision. | 0.85* | |||
3. I will recommend the medical service of this hospital to other people. | 0.85* | |||
4. I am very satisfied with the entire service provided by this hospital. | 0.69* | |||
PATTERN |
χ
2
|
d. f.
| △χ
2
|
---|---|---|---|
Interpersonal-Based Medical Service Encounter
| |||
Unlimited Measurement Pattern | 62.35 | 52 | ----- |
Professional Personnel and General Administrative Personnel | 132.08 | 53 | 69.73** |
Professional Personnel and Environment and Space (Physical Symbol) | 116.31 | 53 | 53.96** |
General Administrative Personnel and Environment and Space (Physical Symbol) | 145.22 | 53 | 82.87** |
Service Quality
| |||
Unlimited Measurement Pattern | 87.69 | 31 | ----- |
Response and Reliability | 122.58 | 32 | 34.89** |
Response and Assurance | 136.25 | 32 | 48.56** |
Reliability and Assurance | 114.36 | 32 | 26.67** |
Data analysis methods
Ethical approval
Results
Characteristics of Samples
Description | Frequency | Percentage (%) |
---|---|---|
Gender
| ||
Male | 145 | 50.9 |
Female | 140 | 49.1 |
Age
| ||
20 years and below | 19 | 6.7 |
21-30 years | 26 | 9.1 |
31-40 years | 68 | 23.9 |
41-50 years | 87 | 30.5 |
51-60 years | 56 | 19.6 |
61 years and above | 29 | 10.2 |
Education level
| ||
Elementary school and below | 27 | 9.5 |
Junior high school | 53 | 18.6 |
Senior high school | 103 | 36.1 |
University / College | 91 | 31.9 |
Postgraduate | 11 | 3.9 |
Occupation
| ||
Student | 3 | 1.1 |
Service sector | 141 | 49.5 |
Military, public servant, teacher | 30 | 10.5 |
Industry | 32 | 11.2 |
Commerce | 43 | 15.1 |
Agriculture | 17 | 6.0 |
Freelance | 12 | 4.2 |
Other | 7 | 2.5 |
Department
| ||
Internal Medicine | 111 | 38.9 |
Obstetrics & Gynecology | 24 | 8.4 |
Rehabilitation | 39 | 13.7 |
Psychiatry (Physical & Mental) | 12 | 4.2 |
Cancer Center | 57 | 20.0 |
Ophthalmology | 30 | 10.5 |
Pediatrics | 6 | 2.1 |
Other | 6 | 2.1 |
Results of structural equation modeling (SEM)
Path | Path name | Path coefficient |
tValue |
---|---|---|---|
Interpersonal-Based Medical Service Encounter (ξ1)→ Service Quality (η1) ( H1 )
| γ11 | 0.57 | 5.27** |
Interpersonal-Based Medical Service Encounter (ξ1)→ Patient Satisfaction (η3) ( H2 )
| γ31 | 0.23 | 2.11* |
Service Quality (η1)→ Patient Trust (η2) ( H3 )
| β21 | 0.49 | 4.58** |
Patient Trust (η2)→ Patient Satisfaction (η3) ( H4 )
| β32 | 0.33 | 4.26** |
Interpersonal-Based Medical Service Encounter (ξ1)→ Professional Personnel (x1) | λ1 | 0.89 | 7.21** |
Interpersonal-Based Medical Service Encounter (ξ1)→ General Administrative Personnel (x2) | λ2 | 0.68 | 5.52** |
Interpersonal-Based Medical Service Encounter (ξ1)→ Environment and Space (Physical Symbol) (x3) | λ3 | 0.77 | 6.86** |
Service Quality (η1)→ Response (y1) | λ4 | 0.75 | 6.70** |
Service Quality (η1)→ Reliability (y 2) | λ5 | 0.87 | 7.03** |
Service Quality (η1)→ Assurance (y 3) | λ6 | 0.97 | 7.96** |
Goodness of fit χ2 / d.f.= 2.19, GFI = .91, AGFI = .89, NFI = .91, RMSR = .058. |