Costumer perception towards private hospitalsIntroduction

Customer perception is an important component of relationship with the customers. Perceptions

vary from person to person. Different people perceive different things about the same situation.

But more than that, we assign different meanings to what we perceive. And the meanings might

change for a certain person. One might change one's perspective or simply make things mean

something else. The concept of customer perception does not only relate to individual customers

in consumer markets. It is also valid in business to business situations.

For example, a competitor benchmarking survey of a large industrial supplier revealed that the market leader, although recognised for excellent quality and service and known to be highly innovative, was perceived as arrogant in some regions. If we take into consideration that there are about four other large players with a similar level of quality and innovative ideas, this perceived arrogance could develop into a serious problem. Customers here are well aware the main characteristics of all the offerings available at the market are largely comparable. So they might use the development of a new product generation of their own to switch to a supplier that can serve them not better or worse, but with more responsiveness and understanding. 

Patel Hospital have great pride and pleasure to introduce them self as one of the most reputed 150 bedded multi-speciality and super-speciality hospital in Northern India, equipped with ultra modern and state-of-the-art facilities for comprehensive care – right from OPD Consultations and routine health check-ups to Intensive Care and Specialized & Super-specialized surgeries. While their hospital stands one step ahead

of other similar institutions in the region in terms of facilities as well as patient care, they feel proud to inform that they are the only such hospital affordable to all the section of the society with indoor facilities available in all categories such as general wards, Semi-deluxe/deluxe and Super-Deluxe rooms with a capacity to accommodate one hundred and fifty patients at a time. In the present era, when the pace of life is so challenging, competitive and multitasking, time saving is a priority, hence affecting  the life styles. Eating  right & healthy, physical exercise  and  stress management  is a  distant  dream, we tend  to  ignore  the amazing and complex machine -'OUR BODY', medical  screening  is able to identify some of the risk factors, be it a significant family history, an abnormal physical finding or an abnormal  laboratory investigation. At present, people all over the world are realising that preventive healthcare holds a lot of

significance and requires attention. Western countries have become cognizant of the fact that investing on preventive healthcare is more economical than to think about a hospital at times of distress. Therefore, we aim to emphasize the merits of preventive healthcare and to help people view health positively, which would lead to good health and good life.

Problem statement

The problem which we are going to discuss would be, patients perception towards private hospitals in jalandhar in context with Patel hospital.

Objective of study

To study patients perception towards Patel hospital. To study what influences patients to go a particular hospital. To check the satisfaction level of patients towards hospital and health care service

provided by hospital.

Research methodology

Sample size

According to the study sample size will be taken as 100. 50 from the General Practitioner and 50

from patients of Patel hospital.

Sampling Area

The area to be covered for the research will be the jalandhar.

Sampling type

Cluster Sampling was used to collect the data from the respondents.

Sources of data

Both primary and secondary methods will be used for collection of data. Structured questionnaire

comprising different parts will be used for as primary source for collection of data whereas

library research (journals, dissertations books, etc.) will be used as secondary source for

collecting data.

Research design

The research will be a self reported survey, so research design will be the survey to be conducted

in the area of study.

Hypothesis

H0- There is no significant difference of patient perception towards Patel hospital in jalandhar.

H1- There is significant difference of patient perception towards Patel hospital in jalandhar.

Data Analysis

Data was analyzed with the help of excel .

Review of literature

Humayun et al conducted study on “Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore”. The principles confidentiality and privacy were often neglected during patient care in developing countries. The study was conducted at medical OPDs of two tertiary care hospitals (one public and one private hospital) of Lahore, selected using multi-stage sampling. 93 patients were selected from each hospital. Doctors' adherence to the principles of informed consent, privacy and confidentiality was observed through client flow analysis performed by trained personnel. Overall patient perception was also assessed regarding these practices and was compared with the assessment made by our data collectors. Some degree of informed consent was obtained from only 9.7% patients in the public hospital and 47.8% in the private hospital. 81.4% of patients in the public hospital and 88.4% in the private hospital were accorded at least some degree of privacy. Complete informational confidentiality was maintained only in 10.8% and 35.5% of cases in public & private hospitals respectively. Informed consent and confidentiality were better practiced in the private compared to the public hospital (two-sample t-test > 2, p value < 0.05). There was marked disparity between the patients' perspective of these ethical practices and the assessment of our trained data collectors.

Anbori et al (2005) conducted a study on “Patient satisfaction and loyalty to the private hospitals in Sana'a, Yemen”. A cross-sectional, population-based study was conducted between May and September of 2005. Eight hundred and nineteen respondents who were admitted for at least 1 day in a private hospital within last 6 months from the date of interview. The scores on the modified SERVQUAL market research instrument including six domains (tangibility, reliability, responsiveness, assurance, empathy and cost) that identify perceptions of service quality. In addition, the respondents were asked whether or not they would return to the same facility when they need future medical care (loyalty). Loyalty was higher among females.

Anisah et al (2008) depicted a study on “Patients’ perception of the ambulance Services at Hospital University Sains Malaysia” A six-month prospective cross-sectional Study to look at patients’ perception of Hospital University Sains Malaysia’s (HUSM)Ambulance service was conducted from February2006 to July 2006. Upon arrival at the hospital, patients or their relatives (who used hospital’s ambulances) were interviewed with set of questions regarding their perception of the ambulance services and were asked to rate the perception on a Likert Scale from 1 to 10. A convenient sampling method was applied. A total of 87 samples were obtained. Despite the many problems faced by the ambulance service in HUSM, the mean score for each of the questions on patient’s perception, ranged from 9.33 to 9.70 out of 10. The

questions with the highest mean score, which were both 9.70 each, were related to staff attentiveness and staff gentleness.

Fomba et al (2010) conducted a research on “Patient's utilization and perception of the quality of curative care in community health centres of the fifth commune of Bamako”. They studied that Community health centres were an important component of the health system in Mali. Despite the adhesion of the populations and the commitment of the authorities, many things could be done to improve the quality of care provided in those structures. The objective of study was to know the patients' utilization and perception of the curative care in the community health centres of Bamako and the physicians' satisfaction of their work condition and perspective in the community health sector. A cross-sectional study was conducted in nine community health centres of Bamako in 2008. A total of 270 patients were interviewed through a face-to-face interview. Thirteen physicians took a self-administrated questionnaire relating to their material and financial conditions and their plan for the future. The sample was characterized by the low literacy (32.6%) and socio-economic level (15.9% of steady income).139 patients claimed the nearness as the reason of the choice of the health centre whereas only 51 claimed the health staff skill. The women felt more satisfied than men and illiterates felt more satisfied than bachelor’s .The patients claimed the reduction of waiting time, the improvement of information and the creation of news services. 30.80% of physicians were satisfied from their material and financial conditions, 38.46% were motivated and 76.92% planned to leave their health centre. Although a high level of satisfaction regarding the provided service was observed, user reported some shortage in the quality of care.

Jha et al conducted study on “Patients’ Perception of Hospital Care in the United States” .Patients’ perceptions of their care, especially in the hospital setting, were not well known. Data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provided a portrait of patients’ experiences in U.S. hospitals. They assessed the performance of hospitals across multiple domains of patients’ experiences. They examined whether key characteristics of hospitals that were thought to enhance patients’ experiences (i.e., a high ratio of nurses to patient-days, for profit status, and non academic status) were associated with a better experience for patients. They also examined whether a hospital’s performance on the HCAHPS survey was related to its performance on indicators of the quality of clinical care. They found moderately high levels of satisfaction with care (e.g., on average, 67.4% of a hospital’s patients said that they would definitely recommend the hospital), with a high degree of correlation among the measures of patients’ experiences (Cronbach’s alpha, 0.94). As compared with hospitals in the bottom quartile of the ratio of nurses to patient-days, those in the top quartile had a somewhat better performance on the HCAHPS survey (e.g., 63.5% vs. 70.2% of patients responded that they “would definitely recommend” the hospital; P<0.001). Hospitals with a high level of patient satisfaction provided clinical care that was somewhat higher in quality for all conditions examined. For example, those in the top quartile of HCAHPS ratings performed better than those in the bottom quartile with respect to the care that patients received for acute myocardial infarction (actions taken to provide appropriate care as a proportion of all opportunities for providing such actions, 95.8% vs. 93.1% in unadjusted analyses; P<0.001) and for pneumonia (90.5% vs. 88.6% in unadjusted analyses, P<0.001).

Gupta et al (2009) conducted a research on “Patient perception of pain care in hospitals in the United States”. The study was done inorder to know the assessment of patients’ perception of pain control in hospitals in the United States. Limited data were available regarding the quality of pain care in the hospitalized patient. That was particularly valid for data that allowed for comparison of pain outcomes from one hospital to another. In March 2008, the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were released for review for health care providers and researchers. That survey included a battery of questions for patients upon discharge from the hospital including pain-related questions and patient satisfaction that provided valuable data regarding pain care nationwide. That study had reviewed the results from the pain questions from this available data set and evaluate the performance of these hospitals in pain care in relationship to patient satisfaction. Furthermore, this analysis had provided valuable information on how hospital size, geographic location and practice setting may play a role in pain care in US hospitals. The data indicates that 63% of patients gave a high rating of global satisfaction for their care, and that an additional 26% of patients felt that they had a moderate level of global satisfaction with the global quality of their care.

Andaleeb (2001) conducted a study on “Service quality perceptions and patient satisfaction: a study of hospitals in a developing country “.Patients’ perceptions about health services had largely ignored by health care providers in developing countries. That such perceptions, especially about service quality, had shaped confidence and subsequent behaviours with regard to choice and usage of the available health care facilities is reflected in the fact that many patients avoid the system or avail it only as a measure of last resort. Those who could afford it seek help in other countries, while preventive care or early detection simply falls by the wayside. Patients’ voice must begin to play a greater role in the design of health care service delivery processes in the developing countries. That study was, therefore, patient-centred and identifies the service quality factors that were important to patients; it also examines their links to patient satisfaction in the context of Bangladesh. A field survey was conducted. Evaluations were obtained from patients on several dimensions of perceived service quality including responsiveness, assurance, communication, discipline, and baksheesh. Using factor analysis and multiple regression, significant associations were found between the five dimensions and patient satisfaction. Implications and future research issues are discussed.

Jaaha (2007) conducted a study on “Service Quality in Private Hospitals in Turkey”. Health reforms realized in Turkey over the course of last several years the patients, who had social security, had started to benefit from private hospitals. How they were satisfied from the services given by private hospitals thus becomes an important issue. It was evident that more than half of private hospitals along the country were found in Istanbul. That leads, eventually, to a high level of competition among private hospitals in the level of Istanbul. It was a matter of fact that the customer satisfaction plays important role in the competition among private hospitals more than ever before in this city. Considering that reality that study emphasizes on the consumer satisfaction in the private hospitals found in Istanbul. Based upon a survey that study uses a dynamic model in determining the quality of hospital and the consumer satisfaction.

Analysis of patient survey form

1. RATE YOUR SATISFACTION ____________________________________________________

1 2 3 4 5

Very Poor Poor Average Good excellent

A. Access to medical care ________________

Rating V.Poor Poor Average Good ExcellentNo: Of Respondents 2 1 6 34 7

V.POOR4% POOR

2%

AVERAGE12%

GOOD68%

EXCELLENT14%

Analysis: out of 50 patients, 14% responded as excellent, 68% responded good for the easy

access to medical care of Patel hospital, 12% gave the average response, 2% gave poor response

and 4% gave very poor response to it.

B. The time you spend in waiting room for doctor._____________

Rating V.Poor Poor Average Good ExcellentNo: Of Respondents 0 3 7 15 25

POOR6%

AVERAGE14%

GOOD30%

EXCELLENT50%

Out of 50 patients, 50% gave excellent response the time they spend in waiting room for doctor,

30% gave good response,14% gave average response, 6% gave poor response. The response

which they gave was for the perception which they have towards the hospital which they visit

often.

C. The staff willingness to help you._______________

Rating V.Poor Poor Average Good ExcellentNo: Of Respondents 0 0 10 10 30

AVERAGE20%

GOOD20%

EXCELLENT60%

Out of 50 patients, 60% gave excellent response for the staff willingness to help, 20% gave good

response,20% gave average response. The patients were quite satisfied with the helping nature of

staff

D. Cleanliness in hospital. ____________

Rating V.Poor Poor Average Good ExcellentNo: Of Respondents 0 0 0 15 35

GOOD30%

EXCELLENT70%

Out of 50 patients, 70% gave excellent response for the cleanliness of hospital. 30% gave good

response. This is the reason patients cure so easily and early, as hygiene plays an important role.

E. Behavior of administrator. ____________

Rating V.Poor Poor Average Good ExcellentNo: Of Respondents 0 0 2 45 3

AVERAGE4%

GOOD90%

EXCELLENT6%

Out of 50 patients, 6% gave excellent response for the behaviour of the staff members with

them,, 96% gave good response,4% gave average response.

2. Which hospital you prefer to go in your city? Satyam Pasricha Oxford Patel Beri

Hospitals Satyam Pasricha Oxford Patel BeriNo: Of Respondents 2 5 3 38 2

SATYAM4% PASRICHA

10%

OXFORD6%

PATEL76%

BERI4%

Out of 50 patients, 76% prefer to go Patel hospital for whatever problem they are suffering from,

10% prefer to go Pasricha , 6% preferred oxford and Satyam and Beri hospital got equal

response ie 4% each.

3. According to you which hospital is best in jalandhar?

The survey was conducted in Patel hospital and out of 50 patients different patient gave different

view point regarding the best hospital according to their need. Most of patient responded as Patel

to be the best hospital as they gave different reasons for it, according to the facilities which they

get from hospital, the care , concern of doctors, they get attention of doctor whenever it is

needed.

4. Which hospital is economical to you?

This was also a controversial question, a rational person will prefer that hospital which is

reasonable, or its free of cost i.e. Civil Hospital, but when the survey was conducted it was found

that patient doesn’t go for price, but prefer quality which they get from that hospital, where they

come certain i.e. Patel Hospital.

But when it comes to economic wise then government hospitals are preferred as compare to

private hospitals.

5. Do your family doctors refer you to Patel hospital?

Yes no

RESPONSE YES NONO OF RESPONDENTS 44 6

YES88%

NO12%

Out of 50 patients 88% responded that their family doctors refer them to Patel

hospital and this the main fact that they visit Patel hospital, because they trust their

family doctors and they always prefer to take advice from their family doctor only

and on the other hand those patients whose family doctors doesn’t refer to them, still

they visit Patel hospital were 12% and the reason was that they were highly satisfied

with the doctors and the staff.

6. How you describe your health condition after treatment from hospital? Excellent Good Fair Poor Worst

Rating Worst Poor Fair Good ExcellentNo: Of Respondents 0 0 2 45 3

FAIR4%

GOOD90%

EXCELLENT6%

Chart Title

out of 50 patients , 6% gave excellent response regarding their health condition after treatment from hospital, 90% gave good response, 4% gave fair response. This is the reason that they are loyal patients .

7. Do you want any change in your health service which is provided to you by hospital?

Yes no

RESPONSE YES NONO OF RESPONDENTS

13 37

YES26%

NO74%

Out of 50 patients 74 % responded that they don’t need any change in the services

which they are already getting and 26 % replied that they need change ie food should

be given to patient for free of cost, ambulance should reach on time whenever

required.

8. .How can you rate the service you received from the healthcare professionals?

Very Satisfactory Somehow satisfactory Not too satisfactory Not satisfactory

Rating Very Satisfactory Somehow Satisfactory

Not Too Satisfactory

Not Satisfactory

No: Of Respondents

33 12 0 5

VERY SAT-ISFACTORY

66%

SOMEHOW SAT-ISFACTORY

24%

NOT SATISFACTORY10%

Out of 50 patients 66% were very satisfied from the health services received from the

hospitals, 24% were somewhat satisfied, 10% were not satisfied with the services.

9. Would you seek healthcare service again from this hospital?

Yes no

RESPONSE YES NONO OF RESPONDENTS

38 12

YES76%

NO24%

Out of 50 patients, 76% replied that they would like to come again if they need health care

treatment again. 24 % responded that they would not like to come again and the reason which

they mentioned was time which they spend, and access to medical care was one of the reasons.

ANALYSIS OF DOCTOR SURVEY RESPONSE

1. Which hospital you refer to your patient when he is in critical condition?

Satyam Pasricha Patel Oxford Berry

Hospitals Satyam Pasricha Oxford Patel BeriNo: Of Respondents 7 10 3 28 2

Satyam14%

Pasricha20%

Oxford6%

Patel56%

Beri4%

The survey was conducted from the general practitioners, out of 50 GP, 56% replied that they

refer their patients to Patel hospital, 20% refer them to Pasricha, 14% to Satyam, 6% to oxford

and 4% to Beri.

2. According to you which hospital is best in jalandhar?

Out of 50 doctors 74 % doctors replied that from the economic point of view Guru Nank

Mission, civil hospital is best in jalandhar, but from the quality point of view Patel hospital is

best ion jalandhar because it is one of the most reputed 150 bedded multi-specialty and super-

specialty hospital in Northern India, equipped with ultra modern and state-of-the-art facilities for

comprehensive care – right from OPD Consultations and routine health check-ups to Intensive

Care and Specialized & Super-specialized surgeries . 12 % replied that according to them SGL

Charitable Hospital in Jalandhar is among the best hospitals of Punjab SGL Charitable Hospital

in Jalandhar offers a number of specialized services such as cancer surgery, surgical

gastroenterology, hem dialysis, joint replacement, nephrology, etc. An estimate of the specialized

services available at SGL Charitable Hospital are Gastrointestinal Endoscopy, Endoscopic Spine

Surgery. 14 % doctors refer other hospitals near by.

3. Which hospital will be economical to patients?

Out of 50 doctors 80% doctors said that civil hospital is the only hospital which is economical to

patients. 20 % doctors said that Patel hospital is economical to patients.

4. Do you refer your patients to Patel hospital?

Yes no

RESPONSE YES NONO OF RESPONDENTS

42 8

YES84%

NO16%

Out of 50 doctors 84 % agreed that they refer their patients to Patel hospital and 16 % said they refer to other hospitals.

FINDINGS

Patients are highly satisfied with the Patel hospital and the perception they have towards the hospital is due to the behaviour of doctors and staff.

Patients feel that they have been proper taken care by the doctors; they get proper concern whenever it is required, and this is the reason being expensive still they prefer to come to Patel hospital.

Family doctors also play crucial role. There is only one problem which patients face i.e. food, which they want that it

should be free of cost.

APPENDIX

Patient Satisfaction Survey Form

Respected Sir/Mam,

This information provided by you will be utilized in research project and will be kept confidential.

I will be thankful for the time & effort you will spend in filling the questionnaire

Age: __________________

Gender: ________________

Annual Income: Below 50,000

50,000- 100000

100000- 300000

More than 300000

10. RATE YOUR SATISFACTION ____________________________________________________

1 2 3 4 5

Very Poor Poor Average Good excellent

F. Access to medical care ________________G. The time you spend in waiting room for doctor._____________H. The staff willingness to help you._______________

I. Cleanliness in hospital. ____________J. Behaviour of administrator. ____________

11. Which hospital you prefer to go in your city? Satyam Pasricha Oxford Patel Beri

12. According to you which hospital is best in jalandhar?

-------------------------------------------------------------------

13. Which hospital is economical to you?

------------------------------------------------------------------------

14. Do your family doctors refer you to Patel hospital?

Yes no

15. How you describe your health condition after treatment from hospital? Excellent Good Fair Poor Worst

16. Do you want any change in your health service which is provided to you by hospital?

Yes no

17. If yes then what is it ?

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

18. .How can you rate the service you received from the healthcare professionals?

Very Satisfactory Somehow satisfactory Not too satisfactory Not satisfactory

19. Would you seek healthcare service again from this hospital?

Yes no

Doctor’s Survey Form

Respected Sir/Mam,

This information provided by you will be utilized in research project and will be kept confidential.

Age: __________________ Name______________

Gender: ________________ Experience of practice__________

Annual Income: Below 100000

100000- 300000

300000- 500000

More than 500000

I will be thankful for the time & effort you will spend in filling the questionnaire

5. Which hospital you refer to your patient when he is in critical condition?

Satyam Pasricha Patel Oxford Berry

6. According to you which hospital is best in jalandhar?

------------------------------------------------------------

7. Which hospital will be economical to patients?

--------------------------------------------------------

8. Do you refer your patients to Patel hospital ? Yes no

9. If yes then why?

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

REFERENCE

Humayun, Fatima, Naqqash, Hussain, Hussain(2008),” Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient

departments of two tertiary care hospitals of Lahore”. Published: 25 September 2008

http://www.biomedcentral.com/1472-6939/9/14

Anbori, Ghani, Yadav,Daher(2005),” Patient satisfaction and loyalty to the private hospitals in Sana'a, Yemen”. Published by Oxford University Press in association with the International Society.

http://intqhc.oxfordjournals.org/content/22/4/310.abstract

Anisah , Chew , Shaharuddin Shah , Hisamuddin (2008),” on “Patients’ perception of the ambulance Services at Hospital University Sains Malaysia”.

http://smj.sma.org.sg/4908/4908a6.pdf

Seydou , Yang , Huan , Qiaolan,Xiao(2010),” Patient's utilization and perception of the quality of curative care in community health centres of the fifth commune of Bamako”.

http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2010;volume=35;issue=2;spage=256;epage=261;aulast=Fomba;type=0

Ashish , John, Jie, and Arnold (2008),” Patients’ Perception of Hospital Care in the United States” .

http://www.nejm.org/doi/full/10.1056/NEJMsa0804116

Gupa, Sarah , Jeffrey , Hurley(2009),” “Patient perception of pain care in hospitals in the United States”. Published Date November 2009 , Volume 2009:2 Pages 157 - 164 DOI 10.2147/JPR.S7903

http://www.dovepress.com/patient-perception-of-pain-care-in-hospitals-in-the-united-states-peer-reviewed-article-JPR-recommendation1