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Journal of Economics and Management Sciences
Fall 2021, Volume 2, No.2, pp 13-26
CRITICAL FACTORS OF PATIENT SATISFACTION IN
PRIVATE HEALTHCARE SECTOR OF LAHORE
Muhammad Ghulam Shabeer
1
, Shoukat Riaz
2
& Faheem Riaz
3
_____________________________________________________________________
ABSTRACT
This study attempts to explain the factors of satisfaction in the patient's perspective from
the private healthcare sector of Lahore. The data was collected from in-patients of eight
major hospitals in Lahore city of Pakistan. The study distributed 450 questionnaires among
patients of different hospitals for data collection and received 322 fully filled
questionnaires for data analysis. The study applied different statistical tools to analyze the
data. The findings show that among all six variables, physical facility is the most
influential predictor of patient satisfaction in the private healthcare sector of Lahore. The
analysis further explored that all hypotheses of the study are proved to be true and
significant.
Key Words: Health care, Patient satisfaction, Public health
1
PhD Scholar, Department of Economics and Statistics, University of Management and
Technology, Lahore, Pakistan. Email: imgshabeer@gmail.com
2
National College of Business Administration & Economics, Lahore, Pakistan.
3
Department of Economics and Statistics, University of Management and Technology,
Lahore, Pakistan.
Shabeer, Riaz & Riaz 14
BACKGROUND OF THE STUDY
Patient satisfaction is the judgment and reaction of the patient before, during and after the
stay at the healthcare center. Patients are the sole beneficiary of healthcare system;
therefore, their satisfaction should be given full attention. The whole system of any
healthcare center directly depends upon the satisfaction of patients who visit and stay at
the healthcare center. Central challenge hospitals may face in developing countries is
identifying the possible ways to make them more clients oriented (Xesfingi & Vozikis,
2016).
Healthcare industry is one of the most rapidly growing industries, and there are different
factors responsible for this rapid growth in healthcare sector. For example, environmental
changes, competitive pressures, alternate healthcare mechanisms, new roles and
regulations imposed by governments to improve healthcare facilities, access of patients to
information, cost structures and many others contributed in this regard. So many
healthcare service providers realized that patient satisfaction is a key factor for long run
success of a hospital. Hence patient satisfaction is considered to be the desired outcome
for any hospital or healthcare service provider (Manary et al., 2013). Patient satisfaction
is an important profitable competitive strategy, and different studies (You et al., 2013;
Jenkinson et al., 2002) have shown that people are more concerned about those
organizations which provide high standards of care and attempt to satisfy their customers
in a better way. In their research studies, Hung et al. (2016) argued that hospitals with a
better image of patient satisfaction grab better market share and survive in competition.
Similarly, patients of today are more informed and educated about healthcare services as
compared to past. Due to their information and knowledge, they carefully chose a hospital
after observing different healthcare standards according to their needs. So availability of
information is a crucial factor due to which patients are much sensitive about the delivery
of healthcare services and facilities. According to Panchapakesan, Sai and Rajendran,
(2015), it is not the issue of whether patient is right or wrong, the issue is how a patient
feels during his or her stay at a particular hospital. Healthcare providers failing this
understanding that patient satisfaction is a crucial factor may invite trouble for their
hospitals.
Patients’ satisfaction is a key factor in patients’ decision making while choosing a specific
hospital. There are several general characteristics for patient satisfaction, such as
demographic, socioeconomic and general health status. Besides these general
characteristics, patient satisfaction is also decided by delivering healthcare services from
a hospital, for example, experience of doctor and healthcare delivery environment (You et
al., 2013). According to Hall (2014), continuity of care is also a crucial factor for patient
satisfaction, and it requires a partner like relationship between healthcare service provider
and patient. However, as the changes emerged in the healthcare sector, changes in
coverage of health insurance etc, may cause a forced discontinuity in patients’ satisfaction.
Critical Factors of Patient Satisfaction In Private Healthcare Sector 15
Similarly, the extent to which patients’ are satisfied with a healthcare provider also
depends on patient characteristics and why they are visiting certain hospitals. For example
, in serious cases, patients may not wait even for one day to see their concerned doctor
(Black, 2013). Previous research (Xesfingi & Vozikis, 2016; Batbaatar et al., 2017) also
indicated continuity is important in building the patient's trust in some particular hospital
or healthcare service provider. According to Dragovich et el. (2017), there is a strong
interaction between continuity and satisfaction and this interaction is complex in nature
that involve patients’ characteristics and healthcare factors provided by a specific hospital.
Patient satisfaction is associated with many factors. It may include the waiting time at
healthcare center (Adamu & Oche, 2014), physical structure and cleanliness (Mehra,
2016) and responsiveness and assurance (Karekar, Tiwari & Agrawal, 2015). Furthermore,
there are abundant factors that contribute to patient satisfaction at healthcare centers. It
may include privacy, tangibility, staff courtesy, clinic environment, registration process
and consultation time. The outpatient department (OPD) of any hospital is the shop
window of any healthcare centers. Therefore, the patient's reaction at OPD reflects the
overall satisfaction level of patient for that specific healthcare unit. Existing literature also
advocates that drivers of patient satisfaction vary at public and private healthcare centers.
Even there may be different factors associated with patient satisfaction in developed,
developing and least developing countries. It is due to the factor of infrastructure provided
by the government to the healthcare centers.
Healthcare Sector of Pakistan
Pakistan is the 6th largest state globally, but the budget allocated to health is 1.5% of the
entire budget. Healthcare sector in Pakistan is running under Ministry of Health. There are
two sectors public and private. Public sector provides basic health facilities at very low
cost, whereas private sector is charged heavily (Nishtar et al., 2013). In Pakistan, there are
127,859 doctors and 12,804 health facilities for the treatment of over 200 million people.
Public sector is serving with 968 hospitals,
In Pakistan, the infrastructure of health sector is moderate, which consists of Rural
Dispensaries (RD), Basic Health Units (BHU), Rural Health Centers (RHCs) and the
District hospitals. The wide network of healthcare facilities consists of 4755 Rural
dispensaries (RD), 5349 Basic Health Units (BHUs), 572 Rural Health Centers (RHCs),
945 Tehsil and District headquarter hospitals (THQ, DHQ), 903 maternal child health
centers (MCHs) and 290 TB Centers (Existing Infrastructure of Healthcare in Pakistan
(Khan, 2019).
This research aims to determine the factors that affect patient satisfaction in the private
healthcare sector of Pakistan. The present study contributes to existing literature in
following ways. First, it provides guidelines to the management of heath department by
determining the significant factors that determine patient satisfaction in hospitals.
Shabeer, Riaz & Riaz 16
Secondly, this study considers a wide range of factors contributing to better patient
satisfaction in healthcare centers. It includes waiting time, physical facilities at healthcare
centers, diagnostics services, staff behavior, cleanliness of hospitals and cost charges by
hospitals.
LITERATURE REVIEW
Generally, the term patient, user and consumer are generally used synonymously in the
existing literature, but there is a precise difference between these words in health
executives, normal citizens and business man. Tsai, Orav and Jha (2015) defined a patient
as a person facing some ailment and visiting the healthcare provider to seek some
treatment. Hasan et al. (2013) explained that when patients gather the relevant information
about the ailment and seeking health services, such patients may be labeled as consumers.
The role of patient is increasing day by day in the healthcare process. This exponential
shift in the role of patient in healthcare process leads towards the importance of patient
satisfaction. There is wide range of literature on the subject of satisfaction of patient in
healthcare sector. Javed & Liu (2018) recommended that patient satisfaction is directly
linked with the quality of services in healthcare sector. Further, Hall (2014) explored
patient satisfaction and suggested that it is all about the judgments and reactions of patients
during the whole healthcare process i.e. before, during and after the healthcare provider's
visit. Therefore patient satisfaction is linked with prior expectations and set of beliefs of
patients.
Existing literature in patient satisfaction advocates a relationship between patient
satisfaction and service provided before, during, and after healthcare provider visits
(Kärnä, 2014). There may be a chance that patients are dissatisfied with some health
services but satisfied with overall services provided by healthcare unit. Researchers are
continuously struggling to determine the optimal mix of healthcare services which forces
the patients to come back again for treatment of the diseases at same healthcare unit.
Patient satisfaction can depend on multiple factors. It may relate to individuals and
location of hospitals. More precisely, it starts from the location of healthcare, parking
facility, admission procedures, physical facilities such as stretcher, wheel chair, waiting
area etc. It further includes the pharmacy, nursing services, behavior, cleanliness of staff
in hospital and cost (Manary et al., 2013). As per Hundt et al. (2013), 10 main factors
contribute towards patient satisfaction in healthcare sectors. It includes accessibility,
resources, continuation in services, efficiency in services, finance, humaneness,
information gathering and giving, overall environment and quality of services. Tasneem
et al. (2010) conducted a comprehensive study on patient satisfaction and compared the
finding of teaching hospitals with district headquarters (DHQ) in Lahore at Pakistan. They
further investigated the level of patient satisfaction with treatment by staff at hospitals, the
infrastructure of staff and overall awareness to patients about the services at hospitals.
Critical Factors of Patient Satisfaction In Private Healthcare Sector 17
Based upon 140 patients, they found that overall patient is more satisfied with DHQ as
compare to the teaching hospitals.
The doctor-patient relationship is an important element for patient satisfaction. The regular
meetings between a doctor and a patient positively impact patient satisfaction (McFarland
et al., 2016; Fu et al., 2013; Farin et al., 2013). These regular meetings involve a high ego
by the patient and require complex communication patterns and customer problems. The
long relationship of doctor with the patient helps him see customer needs and evaluate him
on his credence attributes (Blanch-Hartigan et al., 2013). This serves as an industry that
builds a customer franchise through his satisfaction word of mouth recommendations (Ha
& Longnecker, 2010).
Many studies help us understand more about patient evaluation (Andaleeb, 1998; Bennett
et al., 2011; Alrubaiee & Alkaa'ida, 2011). These studies explored the importance of the
service encounter in determining overall satisfaction. Andaleeb (1998) found, "Three out
of the five factors leading to customer satisfaction with hospitals had to do with patient-
staff interaction". Similarly, Verlinde et al. (2012) found, "three of five factors affecting
service quality perception of hospitals were related to the interactions with doctors or other
staff". For alleged quality of physicians, professional expertise, validation of patient
beliefs, interactive communication, image, and antithetical performance are concerned
with meeting with the patient.
The managerial staff associated with healthcare units has to keep in mind that the top
quality of service, in delivering the healthcare goods, has a direct bearing on patient
satisfaction. This act of maintaining high class quality, in delivering healthcare products,
also gives birth to the concept of achieving market competitiveness in healthcare products.
(Speroni et al., 2014). So it is very important and desirable for the managers, who are
assigned the task of delivering quality services, to identify and have a vision of all those
points, which are of great significance to maintain patient’s satisfactory desire (Price et
al., 2014). The scholars like Aliman and Mohamad (2013) also worked a lot on this aspect,
to the extent they highlighted domains like societal, relational, ethical, technological
knowledge and honest values also have a great role to play in patient’s satisfaction. The
researchers, who are working on 3rd world countries, have deputed certain dependent and
independent variables to study the satisfactory level of patients.
Traditionally, the emphasis on designing healthcare settings was on the functional delivery
of healthcare (Ulrich 1995). Gradually, this emphasis shifted towards designing healthcare
environments that are ‘psychologically supportive’ (Djukic et al., 2013) also referred to as
healing environments (Stichler, 2001; Sloan, Devlin & Arneill, 2003; Schweitzer et al.,
2004). The concept of healing environments suggests that the physical environment of
healthcare settings ‘can make a difference in how quickly the patient recovers from or
adapts to specific acute and chronic conditions’ (Stichler 2001). Understanding physical
environmental stimuli in healthcare facilities will allow us to create environments that
Shabeer, Riaz & Riaz 18
positively affect patients' healing process and well-being. Healing environments are
claimed to have beneficial effects on various health indicators, such as anxiety, blood
pressure, postoperative recovery, the use of analgesic medication, and the length of stay
(Iqbal, Khan & Fahim, 2019). Moreover, if relatively inexpensive alterations such as
introducing plants or colors can indeed shorten the length of stay, then these environmental
changes may also prove to be highly cost effective. Previously conducted reviews on this
topic (Winter et al., 2020) clearly state that environmental stimuli in the healthcare
environment affect patient outcomes. These reviews each contribute to the field, whether
by including non-clinical evidence or by taking a broad scope involving both patients and
staff and including stimuli that provide a direct physiological hazard. However, a critical
overview of methodologically rigorous studies is still lacking. Such an overview of the
available conclusive evidence is needed to formulate practice guidelines for evidence-
based design of healing healthcare facilities.
Chahal & Kumari (2010) suggest that patients base their perception of healthcare service
quality on three dimensions: physical environment (comprising ambient condition, social
factor and tangibles), interaction quality (comprising attitude and behaviour, expertise and
process quality), and outcome quality (comprising waiting time, patient satisfaction and
loyalty). Meanwhile, Rossettini et al. (2018) identified six service quality dimensions in
public and private hospitals: empathy; giving priority to the inpatient needs; relationship
between staff and patients; professionalism; food and the physical environment.
Additionally, Brady and Cronin (2001) defined interaction quality, physical environment
quality, and outcome quality as dimensions to measure service quality in the healthcare
sector. Furthermore, Brady and Cronin (2001) explained that those three dimensions lead
to service quality perceptions. In this context, interpersonal interaction between patients
and services has the greatest impact on service quality perceptions. The patients’
experience with hospital services, and the relationship between patients and the hospital
are mainly influenced by functional and technical quality dimensions (Brady et al., 2006).
Research conducted by Chahal and Kumari (2010) identified that the persons requiring
medical treatment focus on three areas like physical environment (comprising ambient
condition, social factor and tangibles), interaction quality (comprising attitude and
behavior, expertise and process quality), and outcome quality (comprising waiting time,
patient satisfaction and loyalty). Another team of researchers, Brady and Cronin (2001),
discussed additional three areas which deal with valued observations. Furthermore, Brady
and Cronin (2001) discussed interaction quality, physical environment quality, and
outcome quality as major areas to judge top class facilities provided in the medical
segment. Presently, social contacts between medical seekers and facilities have a
significant influence on provision of class observations. Practical and procedural valued
areas mostly incline patient relationship with medical units and patient association with
medical units.
Critical Factors of Patient Satisfaction In Private Healthcare Sector 19
Due to the alteration in one living method, the medical needs of the human beings are also
altered as heart and blood sugar related problems have also come up. The age of population
has been reduced due to the reduction in newly born babies. This factor has increased the
pressure on old people, resulting in the fall of the economy (Nadiri & Hussain, 2016). This
factor enhanced the requirement of various investigations, conducted at medical centers.
This has further increased the requirement of medical apparatus. Although there is a lot of
gap, medical units will still have a lot of business in the coming days, and this sector will
rise (CII-McKinsey, 2007).
Treatment seekers drive pleasure, if they get out class treatment and utilizing, their future
appointment, is directly related to it. It is said with authority, that the class matters. It is
very much desired that the value related stuff must be observed with lot of care of those
who are seeking treatment and try to find out the link in sick person’s opinion with his
disease and his sickness performance. During the treatment process, physician try to care
for his mental and sensitiveness while recommending the next appointment (Chung et al.,
2008). This recommendation is directly related to the desire of sick person that how much
he is attached with this clinic about its cost, way he is treated, amount of medical care he
has received and how much his problem is addressed? There is a strong feeling that oral
physicians have to raise the standard and enhance the fulfilment level of a person who visit
them so that the person seeking oral treatment may visit them again. It is assumed that he
should become their ambassador. The study revealed that providing only oral treatment is
not enough. The other areas, like the service charges, atmosphere, approachable and
cleanliness also need attention at the clinic (Alkazemi et al., 2019)
The level of attention lies in sick person’s treatment but it revolves around hygienic
conditions. The neat and clean environment of whole the institute has an impact. It is also
beneficial that regular studies may be conducted about sick person’s fulfilment standards.
This will certainly help in reviewing the systems and develop a better business. It is desired
that hygiene should be at top priority with all medical institutions. Now a days, sick
persons have got a variety of medical institutions to select, from where they can get their
medical treatment. As per the different reports on the subject, showed that the sick persons
gave lots of weightage to hygiene. In fact, this is the only factor that determines his next
visit. Keeping in view, the hygiene standard, they decide about the quality and standard of
that medical institution.
DATA AND METHODOLOGY
In this study, each dimension of patient satisfaction serves as an independent variable
while dependent variable is patient satisfaction. In order to find out the causal relation, the
study has conducted an empirical research in private health sector of Pakistan. This
research study has employed a survey strategy to collect data through questionnaire as it
is suitable for identifying the patients’ viewpoints regarding healthcare standards and
Shabeer, Riaz & Riaz 20
overall satisfaction. The population of this study is all the patients (In-Patients) who got
treatment in private hospitals of Lahore. The list of all private hospitals in Lahore is given
below, but due to time and resource constraints, the researcher was unable to include all
these hospitals in the survey for data collection. For this reason the researcher chose a total
of eight hospitals for the sake of data collection. The study distributed 450 questionnaires
among respondents of different hospitals but eventually the researcher received 322 fully
filled questionnaires that were usable for further analysis. The questionnaire has been
comprised six dimensions as independent variable and overall patient’s satisfaction as
dependent variable. To measure patient satisfaction and waiting time the scale developed
by Adamu and Oche (2014) was adapted. The scale for patient satisfaction consisted of 9
items whereas the scale for waiting time consisted of 4 items. Similarly, the scales for
variables like physical facilities (6 items), diagnostic services (5 items), staff behavior (6
items), cleanliness of hospitals (5 items) and hospital cost (5 items) were adapted from
Andaleeb, Siddiqui, and Khandakar, (2007).
FINDINGS OF THE STUDY
From a total of 322 respondents, there were 56.2% males, majority aging between 26-35
i.e. 33.2%, mostly having undergraduate degree, and belong to agriculture sector.
Table 1: Participants Profile
Gender
Frequency
Percentage
Male
181
56.2
Female
141
43.8
Total
322
100.0
Age Group
15-25
86
26.7
26-35
108
33.5
36-45
65
20.2
Above 45
63
19.6
Total
322
100.0
Education Level
Under Graduate
133
41.3
Graduate
107
33.2
Post Graduate
82
25.5
Total
322
100.0
Profession
Govt. sector
16
5.0
Private Sector
72
22.4
Business
56
17.4
Agriculture
125
38.8
Unemployed
53
16.5
Total
322
100.0
Critical Factors of Patient Satisfaction In Private Healthcare Sector 21
The study used “KMO and Bartlett’s Test” to check the independence of the items. Table
shows the KMO value of this study to be 0.818 superceding the acceptable value i.e. 0.7.
Similarly, “Bartlett’s Test” provided us probability value 0.000 which indicates that the
items are dependent to form indices.
Table 2: KMO and Bartlett's Test
Kaiser-Meyer-Olkin Measure of Sampling Adequacy.
.818
Bartlett's Test of Sphericity
Approx. Chi-Square
2135.904
Df
303
Sig.
.000
Following table provides the lodings and chronbach’s alpha. 40 factors of 7-variables i.e.
Patient Satisfaction, Waiting Time, Physical Facilities, Diagnostic Services, Behavior of
Staff, Cleanliness, Cost were loaded above the criterion of cut-off value. Three items were
below to 0.5 threshold level but these were very close to 0.5 and for that reason these were
not excluded from analysis. Similarly, the results of reliability tests were found good
enough as all the values of Cronbach alpha were above 0.6. The results of Pearson
correlations shows that all variables are positively and significantly associated.
Table 3: Factor Analysis
Variable
Item/ Factor
Factor Loading (EFA)
Cronbach’s Alpha
Patient Satisfaction
PS1
0.568
.795
PS2
0.533
PS3
0.562
PS4
0.811
PS5
0.916
PS6
0.645
PS7
0.491
PS8
0.818
PS9
0.879
Waiting Time
WT1
0.765
.703
WT2
0.813
WT3
0.577
WT4
0.488
Physical Facilities
PF1
0.818
.737
PF2
0.879
PF3
0.538
PF4
0.585
PF5
0.826
PF6
0.857
Diagnostic Services
DS1
0.868
.784
DS2
0.769
DS3
0.616
DS4
0.600
Shabeer, Riaz & Riaz 22
DS5
0.672
Behavior Of Staff
BS1
0.790
.765
BS2
0.772
BS3
0.853
BS4
0.852
BS5
0.825
BS6
0.644
Cleanliness
CL1
0.579
.748
CL2
0.698
CL3
0.857
CL4
0.754
CL5
0.568
Cost
CST1
0.503
.680
CST2
0.720
CST3
0.867
CST4
0.747
CST5
0.604
Table 4: Correlation Analysis
Patient
Satisfaction
Waiting
Time
Physical
Facilities
Diagnostic
Services
Behavior
Of Staff
Cleanliness
Patient
Satisfaction
1
Waiting Time
0.428**
1
Physical
Facilities
0.784**
0.500**
1
Diagnostic
Services
0.476**
0.213**
0.358**
1
Behavior Of
Staff
0.535**
0.165**
0.349**
0.507**
1
Cleanliness
0.270**
0.037
0.616*
0.508**
0.597**
1
Cost
0.379**
0.165**
0.184**
0.407**
0.451**
0.494**
**. Correlation is significant at the 0.01 level (1-tailed).
*. Correlation is significant at the 0.05 level (1-tailed).
Critical Factors of Patient Satisfaction In Private Healthcare Sector 23
The Regression Analysis:
The impact of explanatory variables on the dependent variable (patient satisfaction) is
given in table 5.
Table 5: Regression Analysis, Model Summary & ANOVA
Hypothe
sis
Variables
Beta
Valu
e (B)
Standar
d Error
t-
value
p-
valu
e
Collinearity
Statistics
Toleranc
e
VIF
H1
Waiting
Time
-
.357
.042
-8.460
0.00
0
1.000
1.00
0
H2
Physical
Facilities
.727
.032
22.62
3
0.00
0
1.000
1.00
0
H3
Diagnostic
Services
.396
.041
9.676
0.00
0
1.000
1.00
0
H4
Behavior of
Staff
.438
.039
11.34
1
0.00
0
1.000
1.00
0
H5
Cleanliness
.194
.039
5.009
0.00
1.000
1.00
H6
Cost
.290
.040
7.327
0.00
1.000
1.00
To check the “cause and effect” relationship between independent variable Waiting Time
and dependent variable Patient Satisfaction, Regression Analysis, Model Summary &
ANOVA was run by researcher. The value of β is -.357 (negative), T-Value is -8.460 (less
than 2.00) and P-value is 0.000 (less than 0.05). Hence by keeping in view these results,
researcher concluded that Waiting Time and Patient Satisfaction have highly significant
negative relationship. Based on this conclusion, null hypothesis is rejected and alternative
hypothesis H1 is accepted.
For the “cause and effect” relationship between independent variable Physical Facilities
and dependent variable Patient Satisfaction, Regression Analysis, Model Summary &
ANOVA was run by researcher. The value of β is .727 (positive), T-Value is 22.623
(greater than 2.00) and P-value is 0.000 (less than 0.05). Hence by keeping in view these
results, researcher concluded that Physical Facilities and Patient Satisfaction have highly
significant positive relationship. Based on this conclusion, null hypothesis is rejected and
alternative hypothesis H2 is accepted.
To check the “cause and effect” relationship between independent variable Diagnostic
Services and dependent variable Patient Satisfaction, Regression Analysis, Model
Summary & ANOVA was run by researcher. The value of β is .396 (positive), T-Value is
9.676 (greater than 2.00) and P-value is 0.000 (less than 0.05). Hence by keeping in view
these results, researcher concluded that Diagnostic Services and Patient Satisfaction have
highly significant positive relationship. Based on this conclusion, null hypothesis is
rejected and alternative hypothesis H3 is accepted.
To examine the “cause and effect” relationship between independent variable Behavior of
Staff and dependent variable Patient Satisfaction, Regression Analysis, Model Summary
& ANOVA was run by researcher. The value of β is .438 (positive), T-Value is 11.341
(greater than 2.00) and P-value is 0.000 (less than 0.05). Hence by keeping in view these
Shabeer, Riaz & Riaz 24
results, researcher concluded that Behavior of Staff and Patient Satisfaction have highly
significant positive relationship. Based on this conclusion, null hypothesis is rejected and
alternative hypothesis H4 is accepted.
For the “cause and effect” relationship between independent variable Cleanliness and
dependent variable Patient Satisfaction, Regression Analysis, Model Summary &
ANOVA was run by researcher. The value of β is .194 (positive), T-Value is 5.009 (greater
than 2.00) and P-value is 0.000 (less than 0.05). Hence by keeping in view these results,
researcher concluded that Cleanliness and Patient Satisfaction have highly significant
positive relationship. Based on this conclusion, null hypothesis is rejected and alternative
hypothesis H5 is accepted.
For the “cause and effect” relationship between independent variable Cost and dependent
variable Patient Satisfaction, Regression Analysis, Model Summary & ANOVA was run
by researcher. The value of β is .290 (positive), T-Value is 7.327 (greater than 2.00) and
P-value is 0.000 (less than 0.05). The value of beta is positive and T value is also positive
that is against the statement of alternate hypothesis H6 so based on results we cannot
accept alternate H6 and null hypothesis is proved to be true. Hence cost and patient
satisfaction are not negatively related according to results of regression analysis.
CONCLUSION AND POLICY OPTIONS
The present study has some important contribution for policy makers and top
management of hospitals as it is proved by the results of present study that hospital top
management should be careful about patient satisfaction as it is very important factor for
the success of any hospital. Decision makers need to understand that they should listen
their customer more and more and there should be good interaction between hospital staff
and patients and make every step to reduce the long waiting time as it strongly disturbs
the level of satisfaction in patient. Similarly, patient wants a changed environment as it is
nature of human being that he wants change so hospital managers should try to make their
hospital physical environment innovative and distinctive in such a way that it leaves
pleasant impression on patients. The current model of the study may be used for other
hospitals which seek to improve their service quality and its delivery as the present model
will not only indicate their weak areas but also help them to identify the stronger areas
and refine them in order to attract more and more patients. The present study is the pioneer
one in the context of Pakistan which opens new horizons in healthcare sector as it clearly
mentions that the present era belong to patient’s needs and wants and the hospital must
understand that it is now patient centric not the healthcare provider centric so they need
to give patients more and more importance.
Critical Factors of Patient Satisfaction In Private Healthcare Sector 25
References
Alkazemi, M. F., Bayramzadeh, S., Alkhubaizi, N. B., & Alayoub, A. (2019). The physical
environment and patient satisfaction ratings on social media: an exploratory
study. Facilities.
Andaleeb, S. S., Siddiqui, N., & Khandakar, S. (2007). Patient satisfaction with health
services in Bangladesh. Health policy and planning, 22(4), 263-273.
Batbaatar, E., Dorjdagva, J., Luvsannyam, A., Savino, M. M., & Amenta, P. (2017).
Determinants of patient satisfaction: a systematic review. Perspectives in public
health, 137(2), 89-101.
Chung, S. H., Kim, J. Y., Lee, W. G., Sohn, E. Y., Choi, Y. H., & Song, G. B. (2008).
Changes in the characteristics and satisfaction level of the patients at the Kyungpook
National University's Dentistry. J Korean Acad Dent Health, 28(2), 235-247.
Collier, D. A. (1994). The service/quality solution: Using service man
Committee on Quality of Health Care in America. (2001). Crossing the quality chasm.
Washington, DC: National Academy Press.
Dragovich, A., Beltran, T., Baylor, G. M., Swanson, M., & Plunkett, A. (2017).
Determinants of patient satisfaction in a private practice pain management
clinic. Pain Practice, 17(8), 1015-1022.
Hu, H. H., Kandampully, J., & Juwaheer, T. D. (2009). Relationships and impacts of
service quality, perceived value, customer satisfaction, and image: an empirical
study. The service industries journal, 29(2), 111-125.
Iqbal, A., Khan, R. A., & Fahim, S. (2019). Determinants Of Patient Satisfaction At
Publicsectorhospitalsofkarachi. GSJ, 7(4).
Javed, S. A., & Ilyas, F. (2018). Service quality and satisfaction in healthcare sector of
Pakistan—the patients’ expectations. International Journal of Health Care
Quality Assurance.
Javed, S. A., & Liu, S. (2018). Evaluation of outpatient satisfaction and service quality of
Pakistani healthcare projects. Grey Systems: Theory and Application.
Khan, F. M. (2003). Implications for the practice of a patient expectation and satisfaction
survey, at a teaching hospital in Karachi, Pakistan. J. Pak. Med. Assoc., 53, 122-125.
Khan, S. A. (2019). Situation Analysis of Health Care System of Pakistan: Post 18
Amendments. Health Care Current Reviews, 7, 244.
Kumar, P. (2019). Determinants of Patient Satisfaction: A Study on Inpatients Care at Post
Graduate Institute of Medical Sciences (PGIMS), Haryana, India. Review of
Professional Management, 17(1), 27-37.
Kumar, S., & Tomar, S. (2014). Patient's perceived satisfaction on cleanliness in a tertiary
care hospital.
Lee, S., Groß, S. E., Pfaff, H., & Dresen, A. (2019). Waiting time, communication quality,
and patient satisfaction: An analysis of moderating influences on the relationship
between perceived waiting time and the satisfaction of breast cancer patients
during their inpatient stay. Patient education and counseling.
Li, L. X., & Collier, D. A. (2000). The role of technology and quality on hospital financial
performance: an exploratory analysis. International Journal of Service Industry
Management, 11(3), 202-224.
Shabeer, Riaz & Riaz 26
Lu, K. B., Vinocur, C. D., Burrows, J. F., & Rosen, P. (2017). Key Determinants of Patient
Satisfaction in the Ambulatory Pediatric General Surgery Setting. Clin Surg.
2017; 2, 1324.
Nadiri, H., & Hussain, K. (2016). Zone of Tolerance for Healthcare Services: A Diagnostic
Model of Public and Private Hospital Service Quality. Argumenta Oeconomica, (2
(37)), 245-280.
Nishtar, S., Boerma, T., Amjad, S., Alam, A. Y., Khalid, F., ul Haq, I., & Mirza, Y. A.
(2013). Pakistan's health system: performance and prospects after the 18th
Constitutional Amendment. The Lancet, 381(9884), 2193-2206.
Rossettini, G., Latini, T. M., Palese, A., Jack, S. M., Ristori, D., Gonzatto, S., & Testa, M.
(2018). Determinants of patient satisfaction in outpatient musculoskeletal
physiotherapy: a systematic, qualitative meta-summary, and meta-
synthesis. Disability and rehabilitation, 1-13.
Tasneem, A., Shaukat, S., Amin, F., & Mahmood, K. T. (2010). Patient satisfaction; a
comparative study at teaching versus DHQ level hospital in Lahore. Pakistan.
Journal of Pharmaceutical Sciences & Research, 2(11), 767-774.
Tomes, A. E., & Chee Peng Ng, S. (1995). Service quality in hospital care: the
development of an in-patient questionnaire. International journal of health care
quality assurance, 8(3), 25-33.
Winter, V., Schreyögg, J., & Thiel, A. (2020). Hospital staff shortages: Environmental and
organizational determinants and implications for patient satisfaction. Health
Policy.
Xesfingi, S., & Vozikis, A. (2016). Patient satisfaction with the healthcare system:
assessing the impact of socio-economic and healthcare provision factors. BMC
health services research, 16(1), 94.
Zhang, H., Wang, W., Haggerty, J., & Schuster, T. (2020). Predictors of patient
satisfaction and outpatient health services in China: evidence from the WHO
SAGE survey. Family Practice.
