SERVICE QUALITY OF DIAGNOSTIC FINE NEEDLE ASPIRATION CYTOLOGY IN A TERTIARY CARE HOSPITAL OF LAHORE (PROCESS MEASURE AS PATIENT’S PERSPECTIVE)
AbstractBackground: Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation’s health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient’s perspectives provide valuable information on quality of process, therefore, patient’s perception in terms of satisfaction with the service was measured. Methods: In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely “procedure, sterilization, conduct and competency of doctor” was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was ‘good quality’. Whereas <60% was ‘poor quality’ dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05) Results: Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as ‘poor’ by the patients. Only practitioner competency (67.4%) was perceived as ‘good’. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05) Conclusion: The study suggests that service quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients’ point of view as most aspects of service quality in public hospitals of Pakistan, require improvements. In this manner patient’s satisfaction regarding use of services in public hospitalscan be made better.Keywords: FNAC; SERVQUAL; Service quality measurement instrument; Patient perspective
Chakraborty R, Majumdar A. Measuring consumer satisfaction in health care sector: The applicability of servqual. Int Refereed Res J 2011;2(4):149–160.
Williams SJ, Calnan M. Convergence and divergence: assessing criteria of consumer satisfaction across general practice, dental and hospital care setting. Soc Sci Med 1991;33(6):707–16.
Peyrot M, Cooper PD, Schnapf D. A consumer satisfaction and perceived quality of outpatient health services. J Health Care Mark 1993;13(1):24–33.
Zeithaml VA. Service quality, profitability, and the economic worth of customers: what we know and what we need to learn. J Acad Mark Sci 2000;28(1):67–85.
Calnan M. Towards a conceptual framework of lay evaluation of health care. Soc Sci Med 1988;27(9):927–33.
Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann 1983;6(3-4):185–210.
Choi KS, Cho WH, Lee S, Lee H, Kim C. The relationships among quality, value, satisfaction and behavioral intention in health care provider choice: A South Korean study. J Bus Res 2004;57(8):913–21.
Ygge B, Arnetz J. Quality of paediatric care: application and validation of an instrument for measuring parent satisfaction with hospital care. Int J Quality Health Care 2001;13(1):33–43.
Donabedian A. The quality of care: how can it be assessed? JAMA 1988;260(12):1743–8.
Wisniewski M, Wisniewski H. Measuring service quality in a hospital colposcopy clinic, Int J Health Care Qual Assur Inc leadersh Health Serv 2005;18(2-3):217–28.
Lin DJ, Sheu IC, Pai JY, Bair A, Hung CY, Yeh YH, et al. Measuring patient's expectation and the perception of quality in LASIK services. Health Qual Life Outcomes 2009;7:63.
Kamo N, Dandapani SV, Miksad RA, Houlihan MJ, Kaplan I, Regan M, et al. Evaluation of the SCA instrument for measuring patient satisfaction with cancer care administered via paper or via the Internet. Ann Oncol 2011;22(3):723–9.
Andaleeb SS. Service quality perceptions and patient satisfaction: a study of hospitals in a developing country. Soc Sci Med 2001;52(9):1359–70.
Ahmed R, Samreen H. Assessing the service quality of some selected hospitals in Karachi based on the servqual model. Pak Bus Rev 2011;32(5):266–314.
Irfan SM, Ijaz A. Comparison of service quality between private and public hospitals: Empirical evidences from Pakistan. J Qual Technol Manag 2011;7(1):1–22.
Haddad S, Fournier P, Machouf N, Yatara F. What does quality mean to lay people? Community perceptions of primary care services in Guinea. Soc Sci Med 1998;47(3):381–94.
Baltussen RM, Ye Y, Haddad S, Sauerborn RS. Perceived quality of care of primary health services in Burkina Faso. Health Policy Plan 2002;17(1):42–8.
Kang GD, James J. Service quality dimensions:An examination of Gronroos’s service model Manag Serv Qual 2004;14(4):266–77.
BLEŠIĆ I, Ivkov-Džigurski A, Stankov U, STAMENKOVIĆ I, Bradić M. Research of expected and perceived service quality in hotel management. Rev Tur-Stud Si Cercet Tur. 2011;11:6–14.
Parasuraman A, Zeithaml VA, Berry LL. Servqual: A multiple-item scale for measuring consumer perc. J Retail 1988;64(1):12–40.
Reidenback ER, Sandifer-Smallwood B. Exploring perceptions of hospital operations by a modified SERVQUAL approach. J Health Care Mark 1990;10(4):47–55.
Lever JV, Trott PA, Webb AJ. Fine needle aspiration cytology. J Clin Pathol 1985;38(1):1–11.
Linsk JA, Franzén S, editors. Clinical aspiration cytology. Lippincott Williams & Wilkins; 1989.
Kline TS. Handbook of fine needle aspiration biopsy cytology. CV Mosby; 1981.
WHO. Quality of care: a process for making strategic choices in health systems. Geneva: WHO; 2006. p.38.
Rao K D, Peters DH, Bandeen-Roche K. Towards patient-centered health services in India—a scale to measure patient perceptions of quality. Int J Qual Health Care 2006;18(6):414–21.
Wagstaff, A. Poverty and health sector inequalities. Bull World Health Organ 2002;80(2):97–105.
Westaway MS, Rheeder P, Van Zyl DG, Seager JR. Interpersonal and organizational dimensions of patient satisfaction: the moderating effects of health status. Int J Qual Health Care 2003;15(4):337–44.
Omer K, Cockcroft A, Andersson N. Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies. BMC Health Serv Res 2011;11(Suppl 2):S10.
Westaway MS, Viljoen E, Chabalala HP. Satisfaction with family planning services-interpersonal and organisational dimensions. Curationis 1998;21(4):3–7.
Shabbir S, Kaufmann HR, Shehzad M. Service quality, word of mouth and trust: Drivers to achieve patient satisfaction. Sci Res Essays 2010;5(17):2457–62.