Perceived Service Quality and Behavioural Intention: A Survey of Corporate Hospital’s Patients

1. INTRODUCTION

The healthcare industry is the backbone of any nation‘s well-being, and the major part of the healthcare industry is hospitals. The Indian health care sector is getting tremendous success worldwide with some special medical treatments offered. India is now recognized as a health destination attracting medical tourism due to the cost advantage derived from the available large pool of well-trained medical professionals at a low cost (Ali et al., 2018). In recent years, there has been increasing interest in hospital services, as standards of living have changed and there is a demand for better medical care to improve lifestyles (Amin and Nasharuddin, 2013). However, hospitals that fail to understand the importance of delivering service quality and customer satisfaction may be inviting a possible loss of patients (Andaleeb, 1998). In other words, the more satisfied the customers are, the greater the customer retention (Anderson and Sullivan, 1993) and willingness to recommend (Zeithaml and Bitner, 1996). Thus, enhancing behavioural intention should be a key driver for hospitals in maintaining a long-term relationship with their patients (Jandavath and Byram, 2016).

Zeithaml et al. (1996) defined behavioural intention as a signal of whether customers will remain or exit the relationship with the service provider. Additionally, Zeithaml et al. (1996) identified two dimensions to measure behavioural intention – favourable and unfavourable. Thus, enhancing behavioural intention should be a key driver for hospitals in maintaining a long-term relationship with their patients. Excellent service is a profitable strategy because it results in more new customers, more business with existing customers, fewer lost customers, more insulation from price competition and fewer mistakes requiring the re-performance of service (Parasuraman et al., 1985). Therefore, in this research, we try to investigate effect of service quality in health services on behavioural intention.

behavioural intention. H2: Perceived reliability significantly influence the behavioural intention. H3: Perceived responsiveness significantly influence the behavioural intention. H4: Perceived assurance significantly influence the behavioural intention. H5: Perceived empathy significantly influence the behavioural intention.

We adopted the three items scale developed by Choi et al. (2004) to measure the behavioural intention. Additionally, we measured the perceived service quality (tangibility, reliability, responsiveness, assurance, and empathy), using the items from Babakus and Mangold (1992) research. We framed a modified structured questionnaire to collect responses on perceived service quality and behavioural intention. We distributed 310 questionnaires to patient after they diagnosed and received 300 questionnaires. Out of 300, 280 questionnaire found suitable and filled in all respect and used to find desired relationship. We used the structural equation modeling technique to investigate the impact of perceived service quality dimension on behavioural intention in corporate hospital in Delhi-NCR.

This research represents the 53.57% female (n=150) and 46.43% male customers (n=130) along with majority of respondents are married (71.43) (see table 1). 46.43% of respondents are show the 35-50 age group. Further, this research shows the 10.71% respondents are follow the less than 35 years age group. 89% of total patients have health insurance and only 11% of respondents do not have health insurance. 46% sampled patients engaged in non-government profession. Additionally, 46 % respondents work in government sector.

Assurance, Empathy and Behavioural Intentions show the reliability more the 0.60 (recommended). All the latent variables have more than .80 threshold limit of cronbach‘s alpha that indicate high reliability of variables. Observed statement shows the high factor loadings. Observed variables show the more than .68 standard factor loadings.

We analyzed the proposed relation among service quality dimensions and behavioural intention of customer using the structural equation modeling (SEM) with help of the IBM Amos software. The authors used the χ2 statistic (χ2 (280) = 404.45, p< .000) indices to confirm the fitness of hypothesized research model. We observed that model fit indices χ2 statistic (divided the value of χ2 by its degree of freedom) is 3.01 (it should be 1.00 > and <3.00) that is near to 3.00. The research hypothesized model is strongly fitted to behavioural intention. The value of goodness of fit index (GFI=0.93), comparative fit index (CFI=.92) and root mean square error of approximation (RMSEA=0.04). We find significant correlation among latent variables. Perceived service tangibility (β =.64, p<0.001), responsiveness (β =.56, p<0.000), assurance (β =.67, p<0.001) and empathy (β =71, p<0.000) except reliability (β =.03, p>0.16) of corporate hospitals significantly positively impacted the behavioural intentions of patients (see figure I). The dimensions of perceived service quality in corporate hospitals (tangibility, responsiveness, assurance and empathy) explained the 62% variation in behavioural intention and residual value is .38 (see figure I). Additionally, perceived reliability (β =.03, p>0.16) failed to explain variation in customer satisfaction.

The purpose of this research is to investigate the relation between service quality in corporate hospitals in Delhi-NCR and behavioural intention of patients. Perceived service tangibility, responsiveness, assurance and empathy except reliability of corporate hospitals significantly positively impacted the behavioural intentions of patients. This research supports the H1, H3, H4 and H5 hypotheses. Further, this research reveals that patients visited in corporate hospitals posses the health insurance. Additionally, perceived reliability of corporate hospitals does not show the significant relation with behavioural intention of customers.

Anderson, E.W. and Sullivan, M.W. (1993). ―The antecedents and consequences of customer satisfaction for firms‖, Marketing Science, Vol. 12 No. 2, pp. 125-143. Andaleeb, S.S. (1998). ―Determinants of customer satisfaction with hospitals: a managerial model‖, International Journal of Health Care Quality Assurance, Vol. 11, pp. 181-187. Clinical Governance: An International Journal, Vol. 18 No. 3, pp. 238-254. Amin, M. and Zahora Nasharuddin, S. (2013). ―Hospital service quality and its effects on patient satisfaction and behavioural intention", Clinical Governance: An International Journal, Vol. 18 No. 3, pp. 238-254. https://doi.org/10.1108/CGIJ-05-2012-0016 Babakus, E. and Boller, G.W. (1991). ―An empirical assessment of the SERVQUAL scale‖, Journal of Business Research, Vol. 24 No. 3, pp. 253-268. Choi, K.S., Cho, W.H., Sunhee, L., Hanjoon, L. and Kim, C. (2004), ―The relationship among quality, value, satisfaction and behavioral intention in healthcare provider choice: a South Korean study‖, Journal of Business Research, Vol. 57 No. 8, pp. 913-921. Naik Jandavath, R. and Byram, A. (2016), "Healthcare service quality effect on patient satisfaction and behavioural intentions in corporate hospitals in India", International Journal of Pharmaceutical and Healthcare Marketing, Vol. 10 No. 1, pp. 48-74. Parasuraman, A., Berry, L. and Zeithaml, V. (1994). ―Reassessment of expectations as a comparison standard in measuring SQ: implications for future research‖, Journal of Marketing, Vol. 58, pp. 111-124. Parasuraman, A., Zeithaml, V. and Berry, L. (1985). ―A conceptual model of service quality and its implications for future research‖, Journal of Marketing, Vol. 49, pp. 41-50. Parasuraman, A., Zeithaml, V. and Berry, L. (1988). ―SERVQUAL: a multiple-item scale for measuring consumer perceptions of service quality‖, Journal of Retailing, Vol. 64 No. 1, pp. 12-40. Parasuraman, A., Zeithaml, V.A. and Berry, L.L. (1991), ―Refinement and reassessment of the SERVQUAL scale‖, Journal of Retailing, Vol. 67 No. 4, pp. 420-450. Rahman, M., Mannan, M., Hossain, M. and Zaman, M. (2018). ―Patient‘s behavioral intention: public and private hospitals context", Marketing Intelligence & Planning, Vol. 36 No. 3, pp. 349-364. https://doi.org/10.1108/MIP-08-2017-0155

Research Scholar, Institute of Hotel and Tourism Management, MDU Rohtak