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Effects of hospital service quality on patients satisfaction and behavioural

intention of doctors and nurses

Article · June 2017

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DOI: 10.21276/sjmps

Saudi Journal of Medical and Pharmaceutical Sciences ISSN 2413-4929 (Print)

Scholars Middle East Publishers ISSN 2413-4910 (Online)
Dubai, United Arab Emirates
Website: [Link]

Original Research Article

Effects of hospital service quality on patients satisfaction and behavioural

intention of doctors and nurses
Mubashra Maqsood,* Humera Maqsood,Robina kousar,Chanda jabeen,Ali Waqas, [Link] Amir
Gillani
Lahore School of Nursing (LSN), the University Of Lahore, Pakistan.

*Corresponding Author:
Mubashra Maqsood
Email: mubimubashra87@[Link]

Abstract: Service quality is a broad term and can be define as, critical differences among the patient’s observation and
belief of the facility and the actual act of the service received by the client providing by the organization at a certain
period of time and it has effect on client or patients’ satisfaction and behavioural intention. To investigate the effect of
service quality on patient satisfaction and behavioural intention of doctors and nurses. Study design used in this study
was descriptive cross sectional study design and 171 patients were selected for the study from indoor department of Lady
Willingdon Hospital, Lahore through simple random method and all of the participants were female Result of the study
reveal that hospital service quality greatly influences behavioural intention and patients. Finding show that most of the
respondents were strongly agrees that service quality increase patient satisfaction and behavioural intention. While
Regression analysis shows that service quality significantly positive effect on patient satisfaction and have negative effect
on behavioural intention. Better Service quality is important for any organization especially in healthcare organization.
They play important roles in customer/patient satisfaction and behavioural intention. Better Service quality has positive
affect on patient satisfaction and behavioural intention. The results of this show that any hospital providing good service
to their patients then will be satisfied and recommend their friends and neighbours for treatment to this hospital.
Keywords: Service quality, patient, practices, nurse, Pakistan

INTRODUCTION of patients who will satisfy increases and patients will

In recent decades, concern has been increased continue to visit their hospitals [3].
in hospital service, as human standards of living have
changed and therefore to improve lifestyles better Currently, different scholars have established
medical care is required. To provide effective service to service quality concepts through different states but in
patients it is important to bring enhancement in the developing countries [6] found that hospital service
quality of giving medical care has become a quality consists of 7 dimensions (Infrastructure,
main/primary concern for patients and it is also Personnel quality, administrative process, process of
important for hospitals to enhance their service quality clinical care, overall experience of medical care, safety,
in respect of satisfying and retaining patients [1]. and social responsibility [12]. also developed public
hospital service quality based on 5 dimensions which is
Service quality is a broad term and can be used almost all over the world: discharge process,
define as, critical differences among the patient’s overall service, admission, medical service, and social
observation and belief of the facility and the actual act responsibility.
of the service received by the client providing by the
organization at a certain period of time and it has effect Hospitals service quality can be measure by
on client or patients’ satisfaction and behavioural different dimension firstly admission criteria of the
intention [7] hospital like hospitals will give prompt discharge to
their patients and hospitals should be willing to help the
In order to improve service quality of the patients. It is also important of any hospital to have
health care system patient’s evaluation of service knowledgeable and experience doctors, nurses and other
quality will play a key role to enhance the present medical staff to improve their service quality. Hospitals
health care system consequences, therefore, the number should also have the ability to handle emergency
situation well and give quick service to their patient.

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
Hospitals should also have to keep their environment Every action have a reaction, same like that if
clean and free of hazards to prevent hospital acquired the hospitals provide better service quality to their
infection. One of the most important things for any patients and doctors and nurses are always present to
hospitals to improve their service quality is to focus on support the patients then the patients behaviour will be
the patients problems and show interest to solve it. change and give good response and come to the hospital
for next time treatment. If the behaviour of the doctor
Patient satisfaction is totally depending on and nurses are good then they will affect the patient’s
service quality which conforms to the needs and behaviour. Because behaviour of any person can depend
requirements of the patient. Better the service how you will treat him.
conformance to the needs and requirements of the
patients, the healthier is the service quality and In any medical services when patients are satisfied
therefore the more is the patient satisfaction and loyalty then it is a key factor of significant status in the process
[11]. of upholding and building relationships [1]. Therefore,
improving behavioural intention is very important force
When the meets of the Patients are fulfilled for any hospital in maintaining a long-term relationship
and the service provided by the hospital is according to with their patients.
their expectation then patients are satisfied with the  To identify the effect of hospital service
apparent act. Patients will be satisfied only when the quality on patients satisfaction.
hospital apparent performance according to patient’s  To investigate the effect of hospital service
expectations of services. When the services provided quality on patients behaviour intention of
are not according to patient’s expectation, patients are doctors and nurses.
dissatisfied [18]. Up-to-date health care method,
effective indoor services, good technical facilities, What is the effect of hospital service quality on
concern for patient participation, satisfaction of patients patient’s satisfaction?
from supporting staff and doctors and visiting hospital What is the effect of hospital service quality on
for all treatments [11]. So, in any hospital, patients’ patient’s behaviour intention of doctors and nurses.
satisfaction shows a significant role in assessing the
quality of care and continuing their services [10]. It is observed in many hospitals especially in
public hospitals that there is no proper implantation of
Patients will be satisfied only from the service standard service quality of care and therefore the
quality of the hospital if the indoor service provided to patients and their family are not satisfied with the care
the patients are satisfactory and health care members provided to him and also there is no behaviour intention
like doctors and nurses are honourable to their duties in public hospitals to maintain or build a long-term
and response to the patients what they want and listen relationship with the patients [10]. So, the current study
them carefully. Patients will be fully satisfied if the goes to identify the effect of hospital service quality and
overall technical facilities like, blood bank, X-ray its effects on patient satisfaction and behavioural
facilities provided to him and their expectation from the intention.
hospital meets in a good manner.
Behaviour of nurses and doctors are very
Behaviour of the patients is another factor important to provide service quality to the patient for
which is also greatly affected by hospital service their satisfaction. Finding of this study would enable
quality, patients continue their relationship with the organization to enhance its good image and improve the
hospital or not. Those patients who are satisfied from service quality of the hospital by knowing the gaps in
the hospital recommend their relatives to continue their its service quality and behavioural intention of nurses
treatment in the same hospital [13]. Noted in his study and doctors towards their patients.
that satisfaction of patients meaningfully effect patients’
purpose to return to a hospital. If a patient is happy with After conducting this research, data will be
the overall process of the hospital like admissions, prepared with higher authority by arranging a meeting.
discharge, treatment etc. As a result patient will This study will also helpful for patients as they will
continue their visit to the same hospital and return to receive the quality care which has beneficial effects on
that hospital for further treatment [15].point out in his their health
study that many people like family members,
neighbours and peers have key effect on future clients “Results of an assessment process where the
when they making decisions to select a hospital, and clients compares his beliefs with the service he has
suggestion from friends and family member are very received [16]. Patient’s satisfaction is meeting the
important for patients to select any hospital for Patient’s expectations of services by comparing with the
treatment [6]. perceived performance. If the perceived performance

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
matches patient’s expectations of services, they are began to search for new patient’s satisfaction assessing
satisfied tools/methods [5].

Significant growth has been done in the Gill et al. [9]mention in his study that patients
literature concentrating on how to measure the Service satisfaction are intellectual style, warmly influence, and
quality, but there are variety of ways to assessed service verbal perception of the patients, moreover, they also
quality at any hospital industry can be [3]. Responses highlighted that the interactive associations among the
from patients and data on satisfaction levels is one of medical staff and patients is important cause of patients
the method to assess service quality while others satisfaction . Similarly, the quality of the association
measure service and clinical quality as well as among patients and care provider has a significant
proficiency of care [5]. Patient expectations and influence on the patient satisfaction measure [9].
satisfaction is the most important, because both medical
outcome and patient satisfaction and behavioural Lehman et al. [22] mention in his study that
intention can be affected by various factors [7]. describe patients are often unable to assess the practical quality
in his study that the patient’s perception about the of services especially medical services appropriately
service quality positively effect hospital choice; it is not and as these services are main in self-assurance
easy for patient to recognize the level of service quality qualities useful value is usually the chief reason of
given to him because hospital is a complex setting that patients’ insights of quality. The growing symbol to
is new in all its characteristics which may include offer that this apparent quality is the only important
various tools to assess or measure service. For example, movable working clients perceptions of worth, and they,
due to lack of knowledge and skill patients do not in turn, disturbs their aim to come back to the hospital
properly judge quality of medical service for the or purchase products or services.
practical aspects of services, such as surgeon’s skills or
practitioner’s diagnostics. Patients are easily measure Singh Gaur et al. [8] conducted a study in
functional quality dimensions, such as lab cleanliness, which he found a significant association between
than practical quality aspects. Furthermore, to make behavioural intention and patient satisfaction. The
effective service quality in the hospital, institute is finding suggests that when the confidence of the
required to know the flora of service quality and how to increase then it will enhance the satisfaction
apply and regulate it in the context of hospital culture relationship with the doctors and ultimately patient’s
[7, 17] clear in his study that quality of healthcare behaviour will be improve. Subsequently, the study also
system can be improved through social acceptability, rolls out that if the patients are satisfied from the
standards of efficiency and cost effectiveness. In the doctors then these patients will meaningfully return to
idea of social acceptability, the patient’s insight is the same hospital for treatment. So patients behaviour
clearly highlighted. By assessing mortality and will be improve base on fast experience to the service
morbidity, a health system can only provide provided by the hospital [8].
independent assessment of its capability [17].
National Health Policy [23] stated that most of
Aagja et al. [14] emphasized in his study that the health care organization is far from satisfaction and
scales are added to account for hospital-specific they do not care that patients are satisfied or not. In
characteristics. Although gaining information about most of the health care organization the outdoor
practical problems on patients/customer expectations, facilities is inadequate because of less number of
more studies continue to use the “gap model.” This medical staff is present than required by standards,
model allows the documentation of softness and powers budget is inadequate to meet the demand, instrument
in specific quality attributes. Henceforth, the “gap mostly old and out of work and the building are too old
model” of service quality has been adopted for the and were in run down state. Same situation is for indoor
present research [14]. treatment facilities, essential drugs are not available or
less in number, instruments used were too old, less
A study conducted in Turkey on patient’s number of beds in the wards, which leads to congestion,
satisfaction to identify the problems and areas that need and therefore service quality care, are not provided to
improvement, to formulate quality improvement the patients. Outcome of such insufficient services
objectives, to occasionally measure the effect of patients’ expectation are not meet and hence will not be
changes and improvement activities, and to make satisfied from the hospital service quality which results
monitoring tools that can be used by hospital in decline in their behavioural intention (National
administration and by other medical, nursing, logistics Health Policy).
and operation staff. Though, because of these
evaluations in recent decades have shown that patient’s Tam J.L., [19] show in his study that clients
satisfaction remains at high levels in our hospital will be satisfied only when the hospitals use effective
network. To confirm the better service quality, we methods to solve their problems. This describes that

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
hospitals must be aware of the patient’s problem and published in Journal of Indian Business Research [11].
provides fast treatment to solve it. In this case, The questionnaire to measure behavioural intention will
behavioural of the patients was based on interest to be adopted from article published in Journal of Applied
suggest the same hospital to others, and to inform other Psychology [20]. A five likert scale questionnaire was
people about the benefits of the hospital and come back used to investigate the effect of hospital service quality
to the same hospital for future treatment [19]. on patient’s satisfaction and behavioural intentions in
public hospitals Lahore.
MATERIAL & METHODS
Descriptive cross sectional study design was Questionnaires were distributed among 171
used to investigate the effect of hospital service quality participants for the purpose of collecting data through
on patient’s satisfaction and behavioural intentions in convenient sampling method. Complete instructions
public hospitals Lahore. The site of the study was Lady were given to the participants about the questionnaire to
Willingdon Hospital, Lahore. Targeted population of fill and return the questionnaire to best of their ability.
the study was the patients of Lady Willingdon Hospital, After that the data were analysed through spss and
Lahore. Simple size for this study was 171 patients different tables, charts were computed.
calculated according Slovin’s formula n=N/1+ (N) (E) 2
“ Sufficient information was given to the
participants about the research with the help of consent
The study was done through convenient form and this was accomplished through a letter attach
sampling method. All indoor admitted patients of Lady to the questionnaire. Confidentiality of the participants
Willingdon Hospital, Lahore were including were was keep by providing information.
including in this study. All other patients of Lady
Willingdon Hospital, Lahore were excluding from the RESULTS AND DISCUSSION
current study. Demographic data analysis & results
Data analysis chapter consist of three parts.
Self-administered questionnaire were used as a Demographic analysis was analysed firstly. Three
tool and were adopted from different articles. variables were used for descriptive analysis. One was
Questionnaire will be adopted from three different independent variable (Service Quality) and two were
articles. The questionnaire to measure service quality in dependent variables (Patient Satisfaction and
public hospital will be adopted from article published in Behavioural Intention). It tells us about the effect of
International Journal of Pharmaceutical and Healthcare hospital service quality on patient’s satisfaction and
Marketing [12]. The questionnaire to measure patient behavioural intentions in public hospitals Lahore.
satisfaction will be adopted from another article

Table-1: Demographic characteristic of Patients (n=171)

Frequency Percentage
Male 0 0%
Gender Female 171 100%
Total 171 100%
20-25yrs 13 7.6%
Age 26-30yrs 66 38.6%
31-35yrs 53 31%
36-40yrs 39 22.8%
Total 171 100%
Qualification Illiterate 116 67.8%
Literate 55 32.2%
Total 171 100%
Marital Status Married 171 100%
Unmarried 00 00%
Total 171 100%

Data was collected from female Patients only. The range of patients’ age was between 20 to
Total no of 171, respondents from LadyWillingdon 40 years. According to data received from patients
Hospital, Lahore was contributed in the research. (Table 1) below analysis is found that the mostly
According to table 1, all participants were female and selected sample was based on 26-30 years of students
contributing of 171 (100%). which were 66 (38.6%) and the 31-35 years 53 (31%),
36-40 years of age were 39 (22.8%) and some patients
20-25 years old age were 13 (7.6%).

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were 55 (32.2%) in numbers. Table no 1 shows that all
Respondent qualification represents (Table and of the respondents 171 (100%) participating in this
Fig 3) that all most of the respondents were illiterate116 study was married.
(67.85) and some the respondents were literate which

Table 1: Service Quality

[Link]
SERVICE QUALITY SD DA NEU A SA
Total
1 Hospitals will give prompt 11 29 22 66 43
100%
discharge to their patients. (6.4%) (17%) (12.9%) (38.6%) (25.1%)
2 The employees handling
11 20 34 54 52
admission in hospitals should be
(6.4%) (11.7%) (19.9%) (31.6%) (30.4%) 100%
polite.
3 Hospitals handled emergency 00 45 27 56 43
100%
situations well. (00%) (26.3%) (15.8%) (32.7%) (25.1%)
4 Hospitals have well-functioning 84 10 17 41 19 100%
ambulance service. (41.9%) (5.8%) (9.9%) (24%) (11.1%)
5 Hospitals have knowledgeable 01 54 42 50 24
and experience doctors. (0.6%) (31.6%) (24.6%) (29.2%) (14%) 100%
6 Hospitals have knowledgeable 00 23 31 73 44
and experience nurses. (0.0%) (13.5%) (18.1%) (42.7%) (25.1%) 100%
7 Hospitals have knowledgeable 11 22 32 74 32
and experience staff members. (6.4%) (12.56%) (18.7%) (43.3%) (18.7%) 100%
8 Hospitals take precautions to
68 19 14 20 50
prevent hospital acquired 100%
(39.8%) (11.1%) (8.2%) (11.7%) (29.2%)
infection to the patients.
9 Materials associated with
19 14 20 88 30
services will be visually 100%
(11.1%) (8.2%) (11.7%) (51.5%) (17.5%)
appealing in hospitals.
10 When patients have problems,
4 36 35 51 45
excellent hospitals will show a 100%
(2.3%) (21.1%) (20.5%) (29.8%) (26.3%)
sincere interest in solving it,
11 Hospitals have clean
8 47 23 53 40
washroom, cleans room/wards
(4.7%) (27.5%) (13.5%) (31.0%) (23.4%)
without foul smell. 100%
12 Hospitals will give prompt 42 24 26 52 27 100%
service to customers. (24.6%) (14%) (15.2%) (30.4%) (15.8%)
13 Hospitals will always willing to 14 46 38 41 32
help patients. (8.2%) (26.9%) (22.2%) (24%) (18.7%) 100%
14 Hospitals will never be too busy 6 24 15 63 63
to respond to patient’s request. (3.5%) (14%) (8.8%) (36.8%) (36.8%) 100%
15 Hospitals have the best interest 20 35 33 58 25
in hearts. (11.7%) (20.5%) (19.3%) (33.9%) (14.6%) 100%
16 Patient of hospital will be given 23 27 25 63 33
prompt discharge. (13.5%) (15.8%) (14.6%) (36.8%) (19.3%) 100%
17 Employees of hospital will
2 16 28 74 51
explain precaution to be taken 100%
(1.2%) (9.4%) (16.4%) (43.3%) (29.8%)
by patients after discharge.
18 Hospitals should provide good
4 11 22 82 52
service at reasonable cost, but 100%
(2.3%) (6.4%) (12.9%) (48%) (30.4%)
not at the expanse of quality.
19 Employees of hospitals should 00 45 36 38 52
have a sense of responsibility, (00 %) (26.3%) (21.1%) (22.2%) (30.4%) 100%

For the better exploration of effect of the level of about 43 (25.1%) of participants were strongly
service quality category is divided into 19 subthemes. In agree and 66 (38.6%) are agree, 22 (12.9%) were
context of service quality, Table no. 1 reported a high neutral, 29 (17%) disagree and 11 (6.9%) were strongly

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
disagree that hospitals will give prompt discharge to In response to 88 (51.1%) of respondents respond to
their patients. agree and 30 (17.1%) were strongly agree which show
positive response that materials associated with services
Table no.1 also reveal that most of the will be visually appealing in hospitals. 20 (11.7%) of
responded were agree 54 (30.4%) and 52 (31.6%) were respondents are neutral about this statement, 14 (8.2%)
strongly agree about the question. 34 (19.9%) were of respondents were disagree and only 19 (11.1%) were
neutral about the above question. Some Female were strongly disagree to the statement.
disagree 20 (11.7%) and 11 (6.4%) were strongly
disagree about the above 2nd question. In question 10 mostly participants 51 (29.8)
were agree and 45 (26.3%) of the participants were
Response of the participants to the 3rd strongly agree to the above mention statement. And 35
question in which most of the participants were strongly (20.5%) were response to neutral and 36 (21.1%) of the
agree 43 (25.1%) and 56 (32.7%) were agree to the participants were disagree and only 4 (2.3) were
statement. 27 (15.8%) of the participants were neutral strongly disagree. To illustrate response to 11 th
and 45 (26.3%) were disagree to the question that question in which 53 (31%) were agree and 40 (23.4%)
hospital handled emergency situation well. were strongly agree to the statement. Very little number
of the students were neutral which was 23 (13.5%) and
Table 1 reveal that maost of the participants 47 (27.5%) were disagree and 8 (4.7%) were strongly
were agree. 41 (24%) and 19 (11.1) were strongly agree disagree to the above mention statement. And responses
that hospitals have well functioning ambulance service. to 12th the participants to the above question in which
The neutral participants about the question were 17 41 (24%) of the participants respond to agree and 32
(9.9%) , 10 (5.8%) were disagree and most of the (18.7%) to strongly agree which show these participants
responded were 84 ( strongly disagree (9.3%) strongly believe that hospitals will always willing to help
disagree 84 (49.1%)out the statement. patients. 38 (22.2%) of the students remained neutral.
46 (26.9%) of students stayed disagree and 14 (8.2%)
Above the table also shows that most of the was strongly disagree to the statement. In question 12 th
respondents 50 (29.2%) were response to agree and 24 Response to question 13 show that 41(24%) of
(14%) were response to strongly agree which show participants the respond to agree and 32(18.7%) to
positive response to this question. 42 (24.6%) strongly agree which show that these participants
respondents were neutral about this statement. And 54 believe that hospital will always willing to help patients.
(31.6%) respondents were response to disagree and only 38(22.2%) of the patients remain neutral. 46 (26.9%) of
1 (.6%) were strongly disagree to above statements. patients stayed disagree and 14(8.2%) was strongly
disagree to the statement. Question no 14 predicted
Above given table describe the response of 6th response of respondents in which 63 (36.8%) were
question which 73 (42.7%) of the respondents were strongly agree and agree respectively 15 (8.8%) of
agree and 44 (25.7%) were strongly agree that hospitals respondents were neutral about this question. 24 (14%)
have knowledgeable and experience nurses, 31 (18.1%) of the respondent’s response to disagree and 6 (3.5%) of
of the respondents were neutral, 23 (13.5%) were the respondents were strongly disagree to this question
disagree about the question and response to question no its means that they show negative response. Table 1
7th. show response to 15th above question in which 58
(33.9%) of the respondent’s response to agrees and 25
Show that much of the participants 74 (43.3%) (14.6%) were strongly agree to the question “Hospitals
were agreed and 32 (18.7%) were strongly agreed and have the interest in hearts”. 33 (19.3%) of the
show positive response. They say that hospitals have respondents were neutral about this question. And 35
knowledgeable and experience staff members. 32 (20.5%) of the respondents were disagree and 20
(18.7%) of participants were neutral, 22 (12.9%) of (11.7%) were strongly disagree. Response 16th question
respondents disagree and 11 (6.4%) were strongly of this contrast “Patient of hospital will be given
disagree agree to this statement, Response to question prompt”. 63 (36.8%) of the respondent’s response to
“Hospitals take precautions to prevent hospitals agree and 33 (19.3%) were strongly agree to this
acquired infection to the patients”. In which most 50 question which were positive response. 25 (14.6%) of
(29.2%) of respondents were respond strongly agree the respondents were neutral about this question, 27
and 20 (11.1%) of the respondents were agreed to this (15.8%) were disagree and 23 (13.5) were strongly
statement. 14 (8.2%) of respondents are neither agree disagree to the question. response to the above question
nor disagree to the statement. Only 19 (11.1%) of the “Employee of hospitals will precaution to be taken by
respondents were disagree and 68 (39.8%) of the patients after discharge”. 74 (43.3%) of the
respondents were strongly disagree to the question. respondent’s response to agree and 51 (29.8%) were
strongly agree about this question. And 28 (16.4%) of
the respondents were neutral, 16 (9.4%) were disagree

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and 2 (1.2%) were strongly disagree to this question.
response to question in which, 82 (48%) respondents IN question 18, 82(48%) respondent were response to
were response to agree and 52 (30.4%) was response to agree 52(30.4%) was response to strongly agree. And
strongly agree. And 22 (12.9%) of the respondents were 22(12.9%) of the respondent were neutral, (116.4%)
neutral, 11 (6.4%) were disagreed and 4 (2.3%) were were disagree to above mention statement. Response to
strongly disagree to the above mention statement. last question of this contrast “Employ of this hospital s
response to last question of this contrasts “Employee of should have a sense of responsibility .52(30%)
hospitals should have a sense of responsibility”. 52 respondent response to strongly agree and 38 (22.2)
(30%) respondents response to strongly agree and 38 were agree to question.36 (21.1%) of the respondent
(22.2%) were agree to the question. 36 (21.1%) of the were neutral and 45(26.3) were disagree, they think that
respondents were neutral and 45 (26.3) were disagree, employee should not have sense of responsibility.
they think that employee of hospitals should not have a
sense of responsibility.

Table-2: Patient Satisfaction

[Link]
PATIENT SATISFACTION SD DA NEU A SA
Total
1 Indoor services are satisfactory. 7 49 31 61 23
100%
(4.1%) (28.7%) (18.1%) (35.1%) (13.5%)
2 Hospital is not fully conscious 39 29 32 46 25
of your problems. (22.9%) (17.0%) (18.7%) (26.9%) (14.6%) 100%
3 Hospitals never welcome your 08 42 34 45 42
100%
suggestion. (4.7%) (24.6%) (19.9%) (26.3%) (24.6%)
4 Doctors are available throughout 7 26 22 73 43 100%
their duty. (4.1%) (15.2%) (12.9%) (42.7%) (25.1%)
5 Up-to-date health care 18 31 24 45 53
techniques are well maintained. (10.5%) (18.1%) (14%) (26.3%) (31%) 100%
6 Overall supportive facilities are 43 19 33 62 14
100%
excellent. (25.1%) (11.1%) (19.3%) (36.3%) (8.2%)
7 The technical facilities blood 5 17 19 69 61
bank, lab, etc. are good. (2.9%) (9.9%) (11.1%) (40.4%) (35.7%) 100%
8 You always visit this hospital 7 15 13 99 37
for all types of treatments. (4.1%) (11.1%) (8.2%) (57.9%) (21.6%) 100%
9 Your expectations are fully meet
14 48 45 25 30
with regard to doctors. 100%
(7.6%) (28.7%) (26.3%) (14.6%) (22.8%)
10 Your expectations are fully meet 37 24 46 46 18 100%
with regard to nurses. (21.6%) (14%) (26.9%) (26.9%) (10.5%)

Table 2 show response to patient satisfaction strongly agree to the question “Hospitals never
question, Response to question 1, 61 (35.7%) of the welcome your suggestion”. 34 (19.9%) of the
participants respond to agree and 23 (13.5%) to strongly respondents were neutral of about this question. 42
agree which show that Indoor services are satisfactory. (24.6%) of the respondents were disagree and 8 (4.7%)
31 (18.1%) of the participants remained neutral. 49 was strongly disagree to the question and they show
(528.1%) of participants stayed disagree and 7 (4.1%) negative response.
was strongly disagree to the statement. Reponses to 2 nd
question of this contrast “Hospital is not fully conscious Response of the participants to question 4 in
of your problem”. 46 (26.9%) of the respondent’s which most of the participants were agree 73 (42.7%)
response were agree and 25 (14.6%) were strongly and 43 (25.1%) were strongly agree to the statement. 22
agree to this question which were positive response. 32 (12.9%) of the participants were neutral and 26 (15.2%)
(18.7%) of the respondents were neutral about this were disagree. The participants who were strongly
question. 29 (17%) of the respondents show disagree disagreeing to the question were 7 (4.1%).Table no 1
and 39 (22.8%) of the respondents were strongly reveal that maost of the participants were strongly
disagree to this question. agree 53 (31%) and 45 (26.3) were agree Up-to-date
health care techniques are well maintained. The neutral
In response to 3rd question 45 (26.3%) of the participants about the question were 24 (14%) , 31
respondent’s response to agrees and 42 (24.6%) were

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
(18.1%) were disagree and 18 (10.5%) strongly response in question 8. They say that you always visit
disagree about the statement. this hospital for all types of treatment. 13 (7.6%) of
participants were neutral, 15 (8.8%) of respondents
Response of the participants to the 6th question disagree and 7 (4.1%) were strongly disagree to this
in which 62 (36.3%) of respondents were response to statement.
agree and 14 (8.2%) were response to strongly agree
which show positive response to this question. 33 Fig no 35 show response to the above question
(19.3%) respondents were neutral about this statement. in which 39 (22.8%) of respondents were respond
And 19 (11.1%) respondents were response to disagree strongly agree and 25(14.6%) of the respondents were
and 43 (25.1%) were strongly disagree to above agreed to this statement. 45 (26.3%) of respondents are
statements. neither agree nor disagree to question 9. Only 49
(28.7%) of the respondents were disagree and only 13
69 (40.4%) of the respondents were agree, 61 (7.6%) of the respondents were strongly disagree which
(35.7%) were strongly agree that technical facilities show negative response for this question.
blood bank, lab, etc are good in question of this
contract. 19 (11.1%) of the respondents were neutral, 17 The 46 (26.9%) and 18(10.5%) of the
(7.9%) were disagree and 5 (2.5%) were strongly participants were strongly agree to the question 10 of
disagree. this contrast .And only 46 (26.9%) were response to
neutral and 24 (14%) of the participants were disagree
99 (57.9%) of the respondents were agreed and and 37 (21.6%) were strongly disagree to the above
37 (21.6 %) were strongly agreed and show positive given question.

Table 3: Behavioural intention

[Link]
Patient Satisfaction SD DA NEU A SA
Total
1 Doctors are honest to their 00 33 14 56 68
100%
profession. (0%) (18.3%) (8.2%) (32.7%) (39.8%)
2 Nurses are always helpful 7 21 24 95 24
and supportive. (4.1%) (12.3% (14%) (55.6%) (14%) 100%
3 Nurses are always ready to 08 16 30 49 68
100%
listen to what you had to say (4.7%) (9.4%) (17.5%) (28.7%) (39.8%)
4 Technical support staff is 7 53 30 52 29
very friendly and helpful. (4.1%) (31%) (17.5%) (30.4%) (17.0%) 100%
5 Supportive staff is always
5 36 19 66 49
present on their job during 100%
(2.9%) (21.1%) (11.1%) (38.8%) (29.9%)
working hours.
6 Overall attitude and
16 30 25 44 56
behaviour of doctors are
(9.4%) (17.5%) (11.6%) (25.7%) (32.7%) 100%
good.

Table no. 3 describes the responses of the 68 (39.8%) of the participants were respond to
participants to behavioural intention question. Response strongly agree and 49 (28.7%) to agree in question 2. 30
to question no1 “Doctors are honest to their profession”. (17.5%) of the participants remained neutral. 16 (9.4%)
In response to this question most of the participants of participants stayed disagree and 8 (4.7%) was
were strongly agree 68 (39.8%) and 56 (32.7%) were strongly disagree to the statement response of the
agree. Very little number of the participants were respondents to 4th question of this contrast in which
neutral which was 14 (8.2%) and 33 (19.3%) were most of the respondents 52 (30.4%) were agree 29
disagree to the above mention statement. (17%) were response to strongly agree. 30 (17.7%) of
respondents were neutral about this question. 53 (31%)
95 (55.6%) of respondents were strongly of the respondent’s response to disagree and 7 (4.1%) of
agreed and 24 (14 %) were agree to the statement and the respondents were strongly disagree to this question
said that nurses are always helpful and supportive. 24 its means that they show negative response.
(14 %) of respondents remained undecided for this
statement. 21 (12.3%) of respondents were disagree Response to above question in which 66
and 7 (4.1%) were strongly disagree and they reported (38.6%) of the respondent’s response to agrees and 45
that nurses are always helpful and supportive. (26.3%) were strongly agree to the question. 19 (11.1%)
of the respondents were neutral of about this question.

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
And 36 (21.1%) of the respondents were disagree and square is mostly used to explain the amount of variance
only 5 (2.9%) were strongly disagree. and same thing is explained by the adjusted r square but
in more accurate way.
Response to 6th question of this contrast
“Overall attitude and behaviour of doctors are good”. 56 The purpose of testing the stated hypothesis,
(32.7%) of the respondent’s response to strongly agree inferential statistics of Regression analysis was used.
and 44 (25.7%) were agree to this question which were
positive response. 25 (14.6 %) of the respondents were Hypothesis 1:
neutral, 30 (17.5%) were disagree and 16 (9.4) were H1a: There is a positive relationship between service
strongly disagree to the above given question. quality and patient satisfaction.
REGRESSION ANALYSIS H1o: There is a negative relationship between service
Regression analysis was used to test the quality and patient satisfaction.
relationship between variables. To test the relation of
the three variables of this study regression was used to Regression analysis of Service Quality with patient
test the relationship. In regression analysis value of r satisfaction:

Table-4: Model Summary of patient satisfaction

Model R R Square Adjusted R Std. Error of Change Statistics
Square the Estimate R Square F Change df1 df2 Sig. F
Change Change
1 .498a .248 .243 .359 .248 55.612 1 169 .000
a. Predictors: (Constant), Service quality

Model Unstandardized Standardized T Sig.

Coefficients Coefficients
B Std. Error Beta
(Constant) 1.035 .285 3.636 .000
Service quality .663 .089 .498 7.457 .000

Table no 4 shows the result of the regression

analysis. Finding shows that service quality positively Hypothesis 2
influence satisfaction of the patient. In the given table H2a: There is a positive relationship between service
the value of beta .498 (p=.000) showing positive quality and behavioural intention.
association between service quality and patient H2o: There is a negative relationship between service
satisfaction. The value of adjusted R² predict that 24 % quality and behavioural intention of doctors and nurses.
(p <.001) of change cause by service quality in patient
satisfaction. So alternative hypothesis which states that Regression analysis of service quality with
there is positive relationship between service quality behavioural intention
and patient satisfaction was accepted and null
hypothesis was rejected.

Table-5: Model Summary of behavioural intention

Model R R Square Adjusted R Std. Error of Change Statistics
Square the Estimate R Square F Change df1 df2 Sig. F
Change Change
1 .100 .010a .04 .274 .010 1.701 1 169 .194
b. Predictors: (Constant), Service quality

Model Unstandardized Standardized T Sig.

Coefficients Coefficients
B Std. Error Beta
(Constant) 3.540 .217 16.308 .000
Service .088 .068 .100 1.304 .194
quality

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
Table no 5 shows the result of the regression service quality followed by attitude and behaviour and
analysis. Finding shows that service quality positively process quality [7].
influence behavioural intention. In the given table the
value of beta .100 (p=.000) showing positive Patient satisfaction is greatly affected by the
association between service quality and behavioural hospital service. In the current study almost participants
intention. The value of adjusted R² predict that 4 % (p 61 (35.7%) were agree and 49 (28.7%) were strongly
<.001) of change cause by service quality in agree that they are satisfied from the indoor service of
behavioural intention. So alternative hypothesis which the hospital. Likewise, response to another question of
states that there is positive relationship between service patient satisfaction 53 (31%) of the responded were
quality and behavioural intention was accepted and null strongly agree and 45 (26.3%) were agree that Up-to-
hypothesis was rejected date health care techniques are well maintained. Finding
of the current study shows that most of the patients
DISCUSSION were satisfied from the service provided by the
This cross sectional study investigates the hospitals to them because the doctors and nurses were
effect of hospital service quality on patient’s helpful and supportive and always available for the
satisfaction and behavioural intentions among 171 patients. Through regression analysis it is also proved
patients in Lady Willingdon Hospitals Lahore. Finding that if the service quality provided to the hospital is
of this study indicated that hospital service quality good then patients will be satisfied more its means that
greatly affect the patients satisfaction and their there is positive relationship between service quality
behavioural intention. Finding also show that most of and patient satisfaction
the respondents 66 (38.6%) were agree and 43 (25.1)
were strongly agree that hospital will give prompt Finding of the current study is supported by [7]
discharge to their patients and 73 (42.7%) were agree discusses the finding of his study that better service
and 44 (25.7) were strongly agree that hospital have quality lead to patient satisfaction. The purpose is to
knowledgeable and experience nurses. Response of the satisfy the patients through present good health care
participants also show that most of the participants technique, concern for patient participation, good
88(51.5%) were agree and 30 (17.5) were strongly practical facilities, effective indoor services, satisfaction
agree that materials associated with services will be with supporting staff and doctors and visiting hospital
visually appealing to hospitals. Responses from the for all treatments. Study findings indicate that building
participants that hospitals must be always willing to effective trust, giving value, and known doctors are
help the patients were mostly agreeing and strongly important components of patient satisfaction. The
agree. The patients who take part in the study also agree satisfaction, when examine individually, direct that
that hospital should always be focus on patient’s service providers need to look concretely into the
problems and concentrate to solve it and should never service quality dimensions to improve service quality.
be too busy. Minimum waiting time in the hospital is also important
factor [7]
So finding of the current study show positive
response toward service quality question in which Results of the study shows that when service
almost respondent’s response to agree and strongly quality is better than behavioural intention is ultimately
agree that if the service quality of the hospital is better good and patient will be satisfied. The current study
than the patients will be satisfied reveals that most of the patients respond to strongly
agree 68 (39.8%) and 49 (28.7%) were agree and show
According to [7], Service quality of any positive response that nurses are always ready to listen
hospitals like hygienic condition of the hospital, good what you had to say. Responses to another question that
internal atmosphere for patients, arrangement for technical support staff is very friendly and helpful 52
natural light, quiet environment of the ward wards, (30.4%) were agree and 29 (17%) were strongly agree.
clean wards and proper placement of beds are important The result of the study reveals the overall responses
ambient items. If these things are arrange properly they from the participants about behavioural intention was
will affect 60% of the patients to come back to this not good and show negative response to behavioural
hospital for treatment. Other things like availability question. Same like that regression analysis also clarify
pure drinking water, oxygen services, availability of that there is negative relationship between service
telephone service for patients, well-equipped operating quality and behavioural intention which means that null
theatres and good technical services affect the 70% of hypothesis was accepted and alternative hypothesis was
the patients to be satisfied from the hospitals. rejected.
Availability of these things leads to best service quality
provided by the hospital to their patients. Finding of the Tam J.L., [19] show in his study that clients
study also indicate that proficiency or expertise of staff will be satisfied only when the hospitals use effective
is comparatively more important in terms of degree of methods to solve their problems. This describes that

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Mubashra Maqsood et al.; Saudi J. Med. Pharm. Sci.; Vol-3, Iss-6B (Jun, 2017):556-567
hospitals must be aware of the patient’s problem and outdoor patients need also to be contracted in future
provides fast treatment to solve it. In this case, studies to examine the suitability.
behavioural of the patients was based on interest to
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