European Journal of Business and Management                                                                            www.iiste.org
ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online)
Vol 4, No.13, 2012



   A Comparative Study on Patients’ Satisfaction in Health care Service
                                                    Dr.R.Kavitha
Assistant Professor of Commerce ,Padmavani Art& Science College for women ,Salem, 11, Tamilnadu, India
Tel: 98658-29410         * Email: kavithayohanmugil@gmail.com

Abstract
Nowadays, patients’ satisfaction is an integral part of hospital management across the world. The health care industry in
recent years has restructured its service delivery system. The restructuring has focused on finding effective ways to satisfy
the needs and desires of the patients. Patients’ satisfaction is a basic requirement for healthcare provider because, the
satisfaction related to quality of healthcare is provided by hospitals. The main focus of the study is to measure the patients’
satisfaction in healthcare service provided by the two hospitals. In these two hospitals, a sample of 400 in- patients were
selected to collect the primary data through SERVQUAL model and also Donabedian’s framework was used to measure the
patients’ satisfaction. The finding of the study shows that the private hospital is performing better in providing service
quality and give satisfaction according to the needs of the patients.
Keywords: Hospital, Satisfaction, Healthcare, SERVQUAL, Patient

1. Introduction
          Nowadays, as people need to live without any illness, quality healthcare is crucial to any health system anywhere
in the world. Many researchers have suggested that the quality health care service is ability to meet the patients’ expectation
(Pui-Mun Lee, 2006). Evans & Lindsay (1996) defined the quality of healthcare service as “all characteristics of the service
related to its ability to satisfy the given needs of its customers”. Service quality and patients’ satisfaction are closely related.
Service is an attitude formed by a long term overall evaluation of a hospital’s performance. A survey of opinion of patients’
regarding the healthcare service provided by hospitals is one of the main tools to measure the quality of service. Nowadays,
the patients’ satisfaction is an integral part of hospital management across the world. It has been accepted that the
effectiveness of healthcare depends on the patients’ satisfaction with the services provided by the hospitals. Supporting this
view, many studies have been conducted and concluded that satisfied patients would only follow the advice given by the
doctors, follow the information provided by the doctors and would continue using the services provided by the hospitals.
(Andaleeb, 2000 and 2007).
          As such, the examination of patients’ satisfaction with regard to the services provided by two important hospitals
could review the effectiveness of the hospital management. Therefore, this study is focused on the examination of patients’
perceptions that significantly influence the overall satisfaction with healthcare services provided at the two hospitals in
Salem city.
2. Objective of the Study
          The objective of the study is to analyze the overall patients’ satisfaction of select hospitals.
3. Methodology
        The study covers two hospitals viz. Mohan Kumaramangalam Hospital (Public hospital) and Sri Gokulam Hospital
(p) Ltd ( Private hospital). A sample of 400 in-patients (each having 200 samples) is selected to measure the patients’
satisfaction of service quality. Only the primary data were collected from in-patients of the two hospitals by using
SERVQUAL model .It consists of 44 items each having two sections: One, the expectations of the patients from the
hospitals and the other, the perceptions of the patients. Based on the theoretical knowledge gained by the researcher while
surveying the literature, the null hypothesis has been formulated for the study such as “There exists no significant
relationship between hospitals and the level of satisfaction”. Further, the patients’ satisfaction is calculated using the
Donabedian’s framework as the guiding principle, viz., the following 16 primary service quality sentinels covering all the
principal attributes of hospital services, viz.,

        1.   Catering
                 a. Menu
                 b. Food quality
        2.   Hospital environment
                 a.    Furniture
                 b. Cleanliness
                 c. General presentation
        3.   Professional and technical quality
                                                               156
European Journal of Business and Management                                                                              www.iiste.org
ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online)
Vol 4, No.13, 2012

                   a. Nursing care
                   b. Medical care
                   c. Apparatus used
         4. Patient amenities
                   a. Comfort
                   b. Privacy
                   c. Visiting hours
         5. Service personalization
                   a. Confidentiality
                   b. Information given
                   c. Personal attention
         6. Accessibility
                   a. Waiting list
                   b. Stay length
          The patients are asked to give their score based on the five point scale, ranging from “strongly dissatisfied” to
“strongly satisfied” on the level of satisfaction.
4. Findings and Results
          Table 1 examines an analysis is made to study the overall satisfaction between private hospital and public hospital.
In order to know the association between these hospitals and the overall satisfaction, Chi-square test is employed to test the
hypothesis. It is found that most of the patients have medium level of satisfaction i.e., 70% in the case of public hospital and
97% in the case of private hospital. Comparatively almost all the patients have medium level of satisfaction in the private
sector hospital. In order to ascertain whether the level of satisfaction is found at the same in both the hospitals, Chi-square
test is adopted. Table 2 refers the test is highly significant and hence the null hypothesis is rejected, i.e., there is significant
relationship between hospitals and the level of satisfaction. Therefore, it can be concluded that the satisfaction level varies
from the public hospital to the private hospital. The perceptions of service as a component of satisfaction are higher in the
case of private hospital as compared to public sector hospital.
          Perceived service quality is closely related to satisfaction. A simple correlation analysis is made for each of the
dimensions. In case the perceptions are higher, there will be high satisfaction and if the perceptions are found lower, then
there will be low satisfaction. If the perception happens to be neutral, then the satisfaction is neither low nor high. In this
section, correlation analysis is made to know whether the perception is related to satisfaction.
          The table 3 presents correlation between perceptions score and satisfaction dimension-wise for the public hospital.
The Co-efficients are not significant with respect to any of the dimensions. This shows that the perception does not influence
satisfaction, i.e., the higher the level of perceptions, the lower is the satisfaction level and hence there is no correlation
between the perceptions and satisfaction. When all the dimensions are put together, the Correlation between satisfaction and
the perceptions are found to be not significant which shows that the patients are not satisfied with the low level of satisfaction
with respect to all dimensions.
          Correlation co-efficients are calculated in respect of the perceptions and the satisfaction in the case of private hospital
and are presented in the table 4. It shows that the correlation co-efficients are found to be significant with respect to all
dimensions except Tangibles dimension, which shows that the perceptions of service are higher. There is very good
correlation between the perceived score and the satisfaction score in the case of dimensions Reliability, Responsiveness,
Assurance, Empathy and also all dimensions. But in the case of Tangibles dimension, the perceived service is low and hence
there is no significant correlation between the perceptions and satisfaction. Therefore, it can be concluded that the patients in
the private hospital are fully satisfied with the service. It confirms the earlier finding that the quality of service as perceived by
the patients is more than equal to that of the expected service.
5. Summary and Conclusion
          The level of satisfaction associated with two hospitals reveals that the satisfaction varies from the private hospital to
the public sector hospital. It is found that in the case of public hospital, there is no significant difference between satisfaction
and the perceived service with regard to all dimensions and this is confirmed by using the simple correlation co-efficient. But
in the case of private hospital, there is significant correlation between the perceived service and satisfaction with respect to all
dimensions except Tangibles dimension and hence the perceptions of service quality are higher than the expected service.
Therefore, the result shows that the private hospital is performing better in providing service quality according to needs of the
patients.

References
                                                                157
European Journal of Business and Management                                                                     www.iiste.org
ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online)
Vol 4, No.13, 2012

Abdul Kalam, A.P.J. and Sivathanu Pillai, A., Envisioning and Empowered Nation, New Delhi: Tata McGraw Hill
Publishing Co. Ltd, 2004.
Andaleeb, S. S., 2000. Service quality in public and private hospitals in urban Bangladesh: a comparative study. Health
policy 53: 25-37.
Andaleeb, S. S. S. N. K. S., 2007. Patient satisfaction with health care services in Bangladesh. Health Policy and
Planning 22: 263-273.
Babakus, E. Mangold, W.G., “Adapting the SERVQUAL Scale to Hospital Services; An Empirical Investigation”, Health
Services Research 26(6), 1992, pp.767-786.
Balaji, B., Service Marketing and Management, New Delhi: S.Chand and Company Ltd, 2002.
Comm, L.L, and Mathaisel., “Assessing Employee Satisfaction in Service Firms: An example in Higher Education”.
Journal of Business and Economic Studies 6(1), 2000, pp.43-53.
Evans, J. & Lindsay, W., 1996. The Management and Control of Quality. Cincinnati: West Publishing Company
Krishnasamy, O.R. and Ranganathan.M., Methodology of Research In Social Sciences, Mumbai: Himalay
Publishing House, 2005.
Kui-Son Choi, Hanjoon Lee, Chankon Kim and Sunhee Lee., “The Service Quality Dimensions and Patient
Satisfaction Relationships in South Korea: Comparisons Across Gender, Age and Types of Service,” Journal
Marketing, Vol.19, No.3, 2005, pp.140-149.
Lassar, W.M. Manolis, C. and Winson, R.D., “Service Quality Perspectives and Satisfaction in Private Banking”,
Journal of Service Marketing, 14(3), 2000, pp.244-271.
Parasuraman, A. Zeithaml, V.A. and Berry, L.L., “A Conceptual Model of Service Quality and its Implications for Future
Research” Journal of Marketing, Vol.49, fall, 1985, pp.41-50.
Parasuraman, A. Zeithaml, V.A. and Berry, L.L., “SERVQUAL : a multiple item scale for measuring customer perceptions
of service quality”, Journal of Retailing 64, Spring, 1988, pp.12-40.
Parasuraman, A. Zeithaml, V.A. and Berry, L.L., “Refinement and re-assessment of the SERVQUAL scale”, Journal of
Retailing, 67(4), 1991, pp.12-40.
Priya Deshpande., “Service Quality Perspective and Satisfaction in Health Care System – A study of select hospitals in
Hyderabad,” The Indian Journal of Marekting, Vol.XXXVI, NO.4, April 2006, Jagriti Offset Press, pp.3-6.
Pui-Mun Lee, P. K. D. N. G., 2006. Impact of deficient healthcare service quality. The TQM Magazine 18(6): 563-571
Srinivasan, R., Services Marketing, New Delhi: Prentice – Hall of India (P) Ltd., 2004.


                                          Table -1 Level of satisfaction between hospitals
                            Hospital                        Level of satisfaction                Total

                                                      Low                    Medium

                             Public                  60(30%)                140 (70%)           200 (100)

                             Private                 6 (3%)                 194 (97%)           200 (100)

                              Total                 66 (16.5%)             334 (83.5%)          400 (100)
                                         (Figures in parentheses are percentages to total)
                                 Table – 2 Level of satisfaction between hospitals-chi-square test
                                                 Chi- Square          df            “P” value       Result
                                                    value

                         Pearson                   52.912              1              0.000         Highly
                        Chi-square                                                                Significant




                                                                    158
European Journal of Business and Management                                                                        www.iiste.org
ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online)
Vol 4, No.13, 2012

                Table - 3 Simple correlation of each of the dimensions with satisfaction level (public hospital)
                Dimension (Perception)          Simple correlation          “P” Value              Result
                                                    co-efficient
                       1. Tangibles                    0.020                    0.780           Not significant

                      2. Reliability                   0.096                    0.175           Not significant

                   3. Responsiveness                   0.127                    0.073           Not significant

                      4. Assurance                     0.046                    0.515           Not significant

                       5. Empathy                      0.091                    0.198           Not significant

                     All Dimensions                    0.097                    0.172           Not significant




                         Table – 4 Correlation between perceptions and satisfaction for private hospital
                         Dimensions                  Correlation            “P” value            Result
                                                     Co-efficient

                         1. Tangibles                   0.130                 0.067          Not significant

                         2. Reliability                 0.152                 0.032            Significant

                      3. Responsiveness                 0.212                 0.003            Significant

                         4. Assurance                   0.154                 0.029            Significant

                          5. Empathy                    0.184                 0.009            Significant

                        All dimensions                  0.207                 0.003            Significant




                                                                159
This academic article was published by The International Institute for Science,
Technology and Education (IISTE). The IISTE is a pioneer in the Open Access
Publishing service based in the U.S. and Europe. The aim of the institute is
Accelerating Global Knowledge Sharing.

More information about the publisher can be found in the IISTE’s homepage:
http://www.iiste.org


The IISTE is currently hosting more than 30 peer-reviewed academic journals and
collaborating with academic institutions around the world. Prospective authors of
IISTE journals can find the submission instruction on the following page:
http://www.iiste.org/Journals/

The IISTE editorial team promises to the review and publish all the qualified
submissions in a fast manner. All the journals articles are available online to the
readers all over the world without financial, legal, or technical barriers other than
those inseparable from gaining access to the internet itself. Printed version of the
journals is also available upon request of readers and authors.

IISTE Knowledge Sharing Partners

EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open
Archives Harvester, Bielefeld Academic Search Engine, Elektronische
Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial
Library , NewJour, Google Scholar

A comparative study on patients’ satisfaction in health care service

  • 1.
    European Journal ofBusiness and Management www.iiste.org ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online) Vol 4, No.13, 2012 A Comparative Study on Patients’ Satisfaction in Health care Service Dr.R.Kavitha Assistant Professor of Commerce ,Padmavani Art& Science College for women ,Salem, 11, Tamilnadu, India Tel: 98658-29410 * Email: [email protected] Abstract Nowadays, patients’ satisfaction is an integral part of hospital management across the world. The health care industry in recent years has restructured its service delivery system. The restructuring has focused on finding effective ways to satisfy the needs and desires of the patients. Patients’ satisfaction is a basic requirement for healthcare provider because, the satisfaction related to quality of healthcare is provided by hospitals. The main focus of the study is to measure the patients’ satisfaction in healthcare service provided by the two hospitals. In these two hospitals, a sample of 400 in- patients were selected to collect the primary data through SERVQUAL model and also Donabedian’s framework was used to measure the patients’ satisfaction. The finding of the study shows that the private hospital is performing better in providing service quality and give satisfaction according to the needs of the patients. Keywords: Hospital, Satisfaction, Healthcare, SERVQUAL, Patient 1. Introduction Nowadays, as people need to live without any illness, quality healthcare is crucial to any health system anywhere in the world. Many researchers have suggested that the quality health care service is ability to meet the patients’ expectation (Pui-Mun Lee, 2006). Evans & Lindsay (1996) defined the quality of healthcare service as “all characteristics of the service related to its ability to satisfy the given needs of its customers”. Service quality and patients’ satisfaction are closely related. Service is an attitude formed by a long term overall evaluation of a hospital’s performance. A survey of opinion of patients’ regarding the healthcare service provided by hospitals is one of the main tools to measure the quality of service. Nowadays, the patients’ satisfaction is an integral part of hospital management across the world. It has been accepted that the effectiveness of healthcare depends on the patients’ satisfaction with the services provided by the hospitals. Supporting this view, many studies have been conducted and concluded that satisfied patients would only follow the advice given by the doctors, follow the information provided by the doctors and would continue using the services provided by the hospitals. (Andaleeb, 2000 and 2007). As such, the examination of patients’ satisfaction with regard to the services provided by two important hospitals could review the effectiveness of the hospital management. Therefore, this study is focused on the examination of patients’ perceptions that significantly influence the overall satisfaction with healthcare services provided at the two hospitals in Salem city. 2. Objective of the Study The objective of the study is to analyze the overall patients’ satisfaction of select hospitals. 3. Methodology The study covers two hospitals viz. Mohan Kumaramangalam Hospital (Public hospital) and Sri Gokulam Hospital (p) Ltd ( Private hospital). A sample of 400 in-patients (each having 200 samples) is selected to measure the patients’ satisfaction of service quality. Only the primary data were collected from in-patients of the two hospitals by using SERVQUAL model .It consists of 44 items each having two sections: One, the expectations of the patients from the hospitals and the other, the perceptions of the patients. Based on the theoretical knowledge gained by the researcher while surveying the literature, the null hypothesis has been formulated for the study such as “There exists no significant relationship between hospitals and the level of satisfaction”. Further, the patients’ satisfaction is calculated using the Donabedian’s framework as the guiding principle, viz., the following 16 primary service quality sentinels covering all the principal attributes of hospital services, viz., 1. Catering a. Menu b. Food quality 2. Hospital environment a. Furniture b. Cleanliness c. General presentation 3. Professional and technical quality 156
  • 2.
    European Journal ofBusiness and Management www.iiste.org ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online) Vol 4, No.13, 2012 a. Nursing care b. Medical care c. Apparatus used 4. Patient amenities a. Comfort b. Privacy c. Visiting hours 5. Service personalization a. Confidentiality b. Information given c. Personal attention 6. Accessibility a. Waiting list b. Stay length The patients are asked to give their score based on the five point scale, ranging from “strongly dissatisfied” to “strongly satisfied” on the level of satisfaction. 4. Findings and Results Table 1 examines an analysis is made to study the overall satisfaction between private hospital and public hospital. In order to know the association between these hospitals and the overall satisfaction, Chi-square test is employed to test the hypothesis. It is found that most of the patients have medium level of satisfaction i.e., 70% in the case of public hospital and 97% in the case of private hospital. Comparatively almost all the patients have medium level of satisfaction in the private sector hospital. In order to ascertain whether the level of satisfaction is found at the same in both the hospitals, Chi-square test is adopted. Table 2 refers the test is highly significant and hence the null hypothesis is rejected, i.e., there is significant relationship between hospitals and the level of satisfaction. Therefore, it can be concluded that the satisfaction level varies from the public hospital to the private hospital. The perceptions of service as a component of satisfaction are higher in the case of private hospital as compared to public sector hospital. Perceived service quality is closely related to satisfaction. A simple correlation analysis is made for each of the dimensions. In case the perceptions are higher, there will be high satisfaction and if the perceptions are found lower, then there will be low satisfaction. If the perception happens to be neutral, then the satisfaction is neither low nor high. In this section, correlation analysis is made to know whether the perception is related to satisfaction. The table 3 presents correlation between perceptions score and satisfaction dimension-wise for the public hospital. The Co-efficients are not significant with respect to any of the dimensions. This shows that the perception does not influence satisfaction, i.e., the higher the level of perceptions, the lower is the satisfaction level and hence there is no correlation between the perceptions and satisfaction. When all the dimensions are put together, the Correlation between satisfaction and the perceptions are found to be not significant which shows that the patients are not satisfied with the low level of satisfaction with respect to all dimensions. Correlation co-efficients are calculated in respect of the perceptions and the satisfaction in the case of private hospital and are presented in the table 4. It shows that the correlation co-efficients are found to be significant with respect to all dimensions except Tangibles dimension, which shows that the perceptions of service are higher. There is very good correlation between the perceived score and the satisfaction score in the case of dimensions Reliability, Responsiveness, Assurance, Empathy and also all dimensions. But in the case of Tangibles dimension, the perceived service is low and hence there is no significant correlation between the perceptions and satisfaction. Therefore, it can be concluded that the patients in the private hospital are fully satisfied with the service. It confirms the earlier finding that the quality of service as perceived by the patients is more than equal to that of the expected service. 5. Summary and Conclusion The level of satisfaction associated with two hospitals reveals that the satisfaction varies from the private hospital to the public sector hospital. It is found that in the case of public hospital, there is no significant difference between satisfaction and the perceived service with regard to all dimensions and this is confirmed by using the simple correlation co-efficient. But in the case of private hospital, there is significant correlation between the perceived service and satisfaction with respect to all dimensions except Tangibles dimension and hence the perceptions of service quality are higher than the expected service. Therefore, the result shows that the private hospital is performing better in providing service quality according to needs of the patients. References 157
  • 3.
    European Journal ofBusiness and Management www.iiste.org ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online) Vol 4, No.13, 2012 Abdul Kalam, A.P.J. and Sivathanu Pillai, A., Envisioning and Empowered Nation, New Delhi: Tata McGraw Hill Publishing Co. Ltd, 2004. Andaleeb, S. S., 2000. Service quality in public and private hospitals in urban Bangladesh: a comparative study. Health policy 53: 25-37. Andaleeb, S. S. S. N. K. S., 2007. Patient satisfaction with health care services in Bangladesh. Health Policy and Planning 22: 263-273. Babakus, E. Mangold, W.G., “Adapting the SERVQUAL Scale to Hospital Services; An Empirical Investigation”, Health Services Research 26(6), 1992, pp.767-786. Balaji, B., Service Marketing and Management, New Delhi: S.Chand and Company Ltd, 2002. Comm, L.L, and Mathaisel., “Assessing Employee Satisfaction in Service Firms: An example in Higher Education”. Journal of Business and Economic Studies 6(1), 2000, pp.43-53. Evans, J. & Lindsay, W., 1996. The Management and Control of Quality. Cincinnati: West Publishing Company Krishnasamy, O.R. and Ranganathan.M., Methodology of Research In Social Sciences, Mumbai: Himalay Publishing House, 2005. Kui-Son Choi, Hanjoon Lee, Chankon Kim and Sunhee Lee., “The Service Quality Dimensions and Patient Satisfaction Relationships in South Korea: Comparisons Across Gender, Age and Types of Service,” Journal Marketing, Vol.19, No.3, 2005, pp.140-149. Lassar, W.M. Manolis, C. and Winson, R.D., “Service Quality Perspectives and Satisfaction in Private Banking”, Journal of Service Marketing, 14(3), 2000, pp.244-271. Parasuraman, A. Zeithaml, V.A. and Berry, L.L., “A Conceptual Model of Service Quality and its Implications for Future Research” Journal of Marketing, Vol.49, fall, 1985, pp.41-50. Parasuraman, A. Zeithaml, V.A. and Berry, L.L., “SERVQUAL : a multiple item scale for measuring customer perceptions of service quality”, Journal of Retailing 64, Spring, 1988, pp.12-40. Parasuraman, A. Zeithaml, V.A. and Berry, L.L., “Refinement and re-assessment of the SERVQUAL scale”, Journal of Retailing, 67(4), 1991, pp.12-40. Priya Deshpande., “Service Quality Perspective and Satisfaction in Health Care System – A study of select hospitals in Hyderabad,” The Indian Journal of Marekting, Vol.XXXVI, NO.4, April 2006, Jagriti Offset Press, pp.3-6. Pui-Mun Lee, P. K. D. N. G., 2006. Impact of deficient healthcare service quality. The TQM Magazine 18(6): 563-571 Srinivasan, R., Services Marketing, New Delhi: Prentice – Hall of India (P) Ltd., 2004. Table -1 Level of satisfaction between hospitals Hospital Level of satisfaction Total Low Medium Public 60(30%) 140 (70%) 200 (100) Private 6 (3%) 194 (97%) 200 (100) Total 66 (16.5%) 334 (83.5%) 400 (100) (Figures in parentheses are percentages to total) Table – 2 Level of satisfaction between hospitals-chi-square test Chi- Square df “P” value Result value Pearson 52.912 1 0.000 Highly Chi-square Significant 158
  • 4.
    European Journal ofBusiness and Management www.iiste.org ISSN 2222-1905 (Paper) ISSN 2222-2839 (Online) Vol 4, No.13, 2012 Table - 3 Simple correlation of each of the dimensions with satisfaction level (public hospital) Dimension (Perception) Simple correlation “P” Value Result co-efficient 1. Tangibles 0.020 0.780 Not significant 2. Reliability 0.096 0.175 Not significant 3. Responsiveness 0.127 0.073 Not significant 4. Assurance 0.046 0.515 Not significant 5. Empathy 0.091 0.198 Not significant All Dimensions 0.097 0.172 Not significant Table – 4 Correlation between perceptions and satisfaction for private hospital Dimensions Correlation “P” value Result Co-efficient 1. Tangibles 0.130 0.067 Not significant 2. Reliability 0.152 0.032 Significant 3. Responsiveness 0.212 0.003 Significant 4. Assurance 0.154 0.029 Significant 5. Empathy 0.184 0.009 Significant All dimensions 0.207 0.003 Significant 159
  • 5.
    This academic articlewas published by The International Institute for Science, Technology and Education (IISTE). The IISTE is a pioneer in the Open Access Publishing service based in the U.S. and Europe. The aim of the institute is Accelerating Global Knowledge Sharing. More information about the publisher can be found in the IISTE’s homepage: http://www.iiste.org The IISTE is currently hosting more than 30 peer-reviewed academic journals and collaborating with academic institutions around the world. Prospective authors of IISTE journals can find the submission instruction on the following page: http://www.iiste.org/Journals/ The IISTE editorial team promises to the review and publish all the qualified submissions in a fast manner. All the journals articles are available online to the readers all over the world without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. Printed version of the journals is also available upon request of readers and authors. IISTE Knowledge Sharing Partners EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open Archives Harvester, Bielefeld Academic Search Engine, Elektronische Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial Library , NewJour, Google Scholar