Atributos de la calidad

IDENTIFYING HEALTH CARE QUALITY ATTRIBUTES
ROSHNEE R. RAMSARAN-FOWDAR
University of Mauritius, Reduit, Mauritius

ABSTRACT
Evaluating health care quality is important for consumers, health care providers, and society. Developing a measure of health care service quality is an important precursor to systems and organizations that value health care quality. SERVQUAL has been proposed as abroad-based measure of service quality that may be applicable to health care settings. Results from a study described in this paper verify SERVQUAL dimensions, but demonstrate additional dimensions that are specific to health care settings.

INTRODUCTION
Customer satisfaction and service quality remain critical issues in most service industries and are even more important in the health care sector.Nowadays, patients’ expectations have changed and there is increasing consumerism and choice. Indeed, today’s buyers of health care services are more informed and will not hesitate to switch to alternative health care professionals if they do not obtain satisfaction. Patients increasingly expect to receive the same service from health care which they have come to expect in shops and otherservices. Providing customer satisfaction and quality service should thus be recognised as a key strategy and a crucial element of long-run success and profitability for health care providers. Patients have always been careful when choosing a health care professional whom they expect will cure their health problem, will not harm them in any way and will not

JHHSA SPRING 2005

429

cost too muchmoney. Ensuring service quality is beneficial not only for patients but also for the health care provider as well. Patients who perceive they are content with service experiences are likely to exhibit favourable behavioural intentions that are beneficial to the long-term success of the health care provider. Zeithaml et al. (2000) described how customers intend to express such intentions in positiveways: ‘praising the firm, preferring the company over others, increasing their volume of purchases or agreeably paying a price premium.’ Moreover, retention of existing customers was found to be more profitable than attracting new customers by Clancy et al. (1994) who calculated that the cost of attracting new customers is approximately five times the cost of keeping current customers happy. Onthe other hand, customer dissatisfaction may lead to unfavourable behavioural intentions, such as negative word-of-mouth, doing less business or switching to alternative service providers. Therefore, health care providers have much to gain if they can understand patients’ expectations of them since this would assist them in serving their patients better and build long-term relationships with them.This study therefore aims to provide a service quality framework to health care providers. More specifically, the research enquires into attributes patients use to evaluate their physicians’ service quality. This information would be useful for health care providers who would like to control and improve the performance of their service. This information will also be important to consumers and tosocieties struggling to develop highquality health care systems. The paper first reviews the literature on service quality which is then followed by a section on the methodology employed to gather data. The discussion section presents the findings and the last part of the article is devoted to a summing up of strategic implications and suggestions for future research.

430

JHHSA SPRING 2005BACKGROUND
In health care, one of the traditional methods used to assess service quality was the Donabedian’s structureprocess-outcome model (1980) where the structure includes the settings of the health care facility, the process refers to how care is technically delivered and outcome is the result of medical care on the health or welfare of the patient. This model diagnosed quality as...