Research Journal of Recent Sciences _________________________________________________ ISSN 2277-2502 Vol. 3(7), 34-38, July (2014) Res.J.Recent Sci. International Science Congress Association 34 Patients’ Satisfaction and Quality Health Services: An Investigation from Private Hospitals of Karachi, Pakistan Ahmed Rizwan Raheem, Ahmad Nawaz, Nasir Fouzia1 and Khoso Imamuddin2 Department of Business Administration& Commerce, Indus University, Karachi, PAKISTAN Institute of Business Administration, Sindh University, Jamshoro, PAKISTANAvailable online at: www.isca.in , www.isca.me Received 8th April 2014, revised 22nd May 2014, accepted 21st June 2014Abstract Patient satisfaction is the critical issue for healthcare providers. Health care organizations are working in a competitive environment. In these days hospital needs to enhance the level of satisfaction if they want to remain in the competition with other hospitals. Patient satisfaction is basically satisfying patients’ expectations and understanding their needs. Patients’ feedback can affect the overall quality, to improve organizational learning and development agenda and provide an opportunity. The aim of this study was to determine the patient satisfaction at Private hospital of Karachi for the in-patient departments. This study concludes that the majority of the patients are satisfied with the services provided by the in-patient departments of selected Private hospitals of Karachi. Specially, the patients and their attendants’ are very much satisfied from Patient ward services, Laboratories services, food services, reception staff services, welfare services & healthcare services provided by the hospitals to the in-patient departments, therefore, this shows significant impact on overall patients’ satisfaction. The strengths of the healthcare organizations as highlighted by patients must be continuing. However, some services need more care and focus when overall planning & strategies’ will be made for planning & managing the health care system. Keywords: Patient satisfaction, healthcare services, reception staff services, healthcare organizations, private hospitals. IntroductionThis study was conducted to determine patients’ satisfaction level against health services provided by private hospitals of Karachi City. The purpose of the research is a better understanding and identifying of barriers and critical success factors, which are affecting the level of patient satisfaction. The patients were selected non-randomly and a questionnaire was used to evaluate the health services provided like (diagnosis services, OPD services, and ward services, housekeeping staff services, food services, and billing department services, emergency services, pharmacy services, Laboratory services, reception services, physical appearance and layout of the hospital). This study has adopted a qualitative approach for orientation and hypothesis in private hospitals of Karachi. This study can help to show the patient satisfaction in-patient (admitted in wards) department. Information strained from the results can be used, as guidelines to implement better policies than the existent policies. This study focuses on the level of patient satisfaction on the healthcare services provided by provide hospitals. This study also helps to the HealthCare organizational future growth. The respondent of the study were only the discharged patients from the private hospitals. A questionnaire was used to evaluate their satisfaction level for the services provided. The study was conducted among 200 admitted patients of five private hospitals of Karachi during the period from September 2011, June 2012.Hospitals play a vital role in the health care system. Hospital is a place that provides a wide range of medical services to sick and injured patients. Ahmedet al., reported that Patient satisfaction is a critical issue for healthcare providers. Diversity in patient’s demographics also molds their perceptions about hospital facilities and services. This study measures the changes brought in the patient satisfaction of admitted patients in different wards of the public sector hospitals in the D.I. Khan district. He further concludes that the female patients were more satisfied than the male patients regarding treatment and healthcare management issues. According to Larsson and Olivia, Perception of the quality of care and patient satisfaction are very much associated to each other and cannot be perceived standalone. According to Chassin, and Wysong, hospitals arecommon place to measure healthcare quality and use these measurements to promote the improvement of healthcare services, and also increase transparency in this regard. As reported by Brooks Carthonin his study that his study is the first one, which, demonstrates nurses evaluation regarding quality measures and patient satisfaction in healthcare organizations. McKinleyand Bleichreported that many factors depend on Patient satisfaction. He also studied the discrepancies between expectations and received a reduction in services in related to satisfaction in hospitals. Andaleeb9,10 established the relationship that if greater the responsiveness, Assurance, Research Journal of Recent Sciences ______________________________________________________________ ISSN 2277-2502Vol. 3(7), 34-38, July (2014) Res. J. Recent Sci. International Science Congress Association 35 tangibility of health care providers, then there will also be greater the satisfaction of patients. According to Soleimanpour11 and Lin12 reported that Satisfaction is a significant health issue now. Emergency department (ER) is known as the backbone of hospitals where the initial treatment is provided to the patients, which is considered to be the gatekeeper role. Emergency department must provide quality services in order to achieve the customer satisfaction. According to Nichols13 the Quality of life and Patient satisfaction both are essentials in the monitoring and valuation of healthcare. As reported by Wu14, Mekoth15 and Hansen16 in the competitive health care industry, the impact of hospital brand image on the attitudes and behaviors of patients towards hospitals has become an important issue The study suggesting that brand image has both direct and indirect effects on loyalty and positive brand image for hospitals. Draper17, Goldstein18 and Umar19 have done different surveys on the same subject matter and the results of those surveys showed that quality healthcare services always influence the patient satisfaction and retention in long-run. According to Chakraborty20, Rezaei21, Aniza22 and Chaaker23, the Satisfaction is a psychological concept, which is defined in different ways. The satisfaction of patient should be address in a continuous manner for organizational growth. Both medical cost and quality of services are important in this aspect24,25,26. Material and MethodsThe study was conducted from the period of September 2011 to June 2012 in five leading private hospitals of Karachi. Questionnaires were filled through face-to-face discussion with the respondents i.e. patients. Questionnaire Survey methods: T his is a descriptive and causal study. Primary data has been collected through survey method; both quantitative and qualitative research methodologies were adopted. Sampling Technique: The interviews technique and non-random, purposive, and opportunistic sampling technique were used during the study27. Patients were conversant regarding the purpose of the study and were informed that their participation will be unpaid and Patients were successively selected. Inclusion Criteria: Discharged patients of all age group in private hospitals of Karachi were taken in the study. Moreover, patients admitted in- patient department of these hospitals were included in the study. Exclusion Criteria: Patient seeking consults or outpatient department (OPD) was excluded. Admitted patients to intensive care unit (ICU) and those who are not able to communicate easily for the reason of their severe illness are also excluded. Data Analysis: The data collected through questionnaire were inputted in the system and was run in the SPSS software. Two different tests of significance (t-Test and ANOVA) have been used to find out the significance of differences. Results and Discussion Majority of the patients was satisfied with the current services offered by the in-patient department of private hospitals. Patient ward services, food services, reception staff services, welfare services also showed significant impact on patients’ satisfaction. On the contrary in some cases, this showed no significant impact on patients’ satisfaction (such as physical appearance, pharmacy services, laboratory services, blood bank services, x-rays, ultrasound services, billing services, OPD services, emergency and housekeeping services). Other factors were having significant role for determining the satisfaction of patients’ about the healthcare services provided by the private hospitals in Karachi. Table-1 Reliability Analysis Case Processing Summary N % Cases Valid 185 92.5 Excluded a 15 7.5 Total 200 100.0 a. Listwise deletion based on all variables in the procedure.Reliability Statistics: Cronbach’s alpha describes internal consistency of the instrument. Reliability statistics shows .932 i.e. excellent. Table-2 Reliability Statistics Reliability Statistics Cronbach's Alpha Cronbach's Alpha Based on Standardized Items N of Items .932 .950 129 In table 3 the data showed that (�70%) patients were satisfied with physical layout, OPD services, emergency services, ultrasound services. So these components tend to contribute to move to their satisfaction level. While (61-70%) patients were satisfied with reception staff services, Laboratory Services, blood bank services, x-ray services, billing services, housekeeping services, welfare services, and patient ward services. On the other hand (57-60%) patients were satisfied with food services, pharmacy services. These however seem to contribute to their dissatisfaction level. In table 4 model summery reflects that explained variation of the model is 15.8% which is significant as F-statistics of ANOVA is greater than 4. Furthermore, the difference between R-square and Adjusted R-square is 2.1%, which is less than 5% that shows there is no sample error. Research Journal of Recent Sciences ______________________________________________________________ ISSN 2277-2502Vol. 3(7), 34-38, July (2014) Res. J. Recent Sci. International Science Congress Association 36 ANOVA table shows overall fitness of the model. It is prominent from p-value (sig. =0.000) which is less than 0.01 that overall model is significant at 1%. Table-3 Descriptive Statistics Descriptive Statistics Mean Std. Deviation N Av % Patient. Satisfaction 3.8913 .82994 200 77.83 Physical. Appearance 3.5910 .56124 200 71.82 Record-room. Services 3.5383 .87312 200 70.77 Reception staff. Services 3.4267 .78701 200 68.53 Pharmacy. Services 2.9856 .78459 200 59.71 Laboratory. Services 3.2875 .75535 200 65.75 Blood bank. Services 3.4220 .67958 200 68.44 X-ray. Services 3.4360 .66401 200 68.72 Ultrasound. Services 3.5610 .77827 200 71.22 Billing. Services 3.4290 .71773 200 68.58 OPD. Services 3.6195 .98895 200 72.39 Patient-ward. Services 3.3938 .62247 200 67.88 Emergency. Services 3.5894 .63049 200 71.79 Housekeeping. Services 3.4725 .80933 200 69.45 Food. Services 2.8992 .94353 200 57.98 Welfare. Services 3.4250 .90469 200 68.50 Table-4 Model Summary Model Summary Model R R Square Adjusted R Square Std. Error of the Estimate 11 .423 k .179 .158 .76153 k. Predictors: (Constant), welfare services, record room services, food services, patient ward services, reception staff Services Table-5 ANOVA ANOVA l Model Sum of Squares Df Mean Square F Sig. 11 Regression 24.565 5 4.913 8.472 .000 k Residual 112.507 194 .580 Total 137.072 199 k. Predictors: (Constant), welfare Services, record room Services, food Services, patient ward Services, reception staff Services, l. Dependent Variable: Patient Satisfaction. Table-6 CoefficientsCoefficients a Model Unstandardized Coefficients Standardized Coefficients T Sig. Co linearity Statistics B Std. Error Beta Tolerance VIF 11 (Constant) 2.417 .407 5.944 .000 Record-room. Services -.226 .072 -.238 -3.124 .002 .730 1.370 Reception staff. Services .163 .079 .154 2.046 .042 .745 1.342 Patient-ward. Services .158 .091 .118 1.742 .083 .917 1.090 Food. Services .106 .061 .120 1.728 .086 .876 1.142 Welfare. Services .255 .062 .278 4.104 .000 .920 1.087 a. Dependent variable: Patient satisfaction Research Journal of Recent Sciences ______________________________________________________________ ISSN 2277-2502Vol. 3(7), 34-38, July (2014) Res. J. Recent Sci. International Science Congress Association 37 The data was run through backward method with the help of SPSS, 10 variables were excluded being insignificant and remaining 5 are significant. Patient ward services and food services are significant at 10%, reception staff service is significant at 5%, and record room and welfare services are significant at 1%. Record room services have got inverse relationship with Patient satisfaction, whereas rest of the variables is positively associated with Patient satisfaction. Moreover, there is no significant association among predictors i.e. any multicolinearity as shown by Variance Inflationary Factor (VIF) because the value of VIF is less than 2 for all variables. Discussion: Previous studies showed significant influences of demographics on independent as well as dependent variables of satisfaction from healthcare organizations. In this study it has been noted that Patient ward services, food services, reception staff services, welfare services showed significant impact on patients’ satisfaction. On the contrary in some cases, this showed no significant impact on patients’ satisfaction (such as physical appearance, pharmacy services, laboratory services, blood bank services, x-rays, ultrasound services, billing services, OPD services, emergency and housekeeping services). Consistent improvement in the system can have overall impact the level of patient satisfaction in any hospital. Other factors were significant having crucial role for determining the satisfaction of patients’ about the healthcare services in private hospitals in Karachi. Conclusion This study concludes that the majority of the patients are satisfied with the services provided by the in-patient department of private hospitals in Karachi. In this study it has been noted that Patient ward services, food services, reception staff services, welfare services showed significant impact on patients’ satisfaction. On the contrary in some cases, this showed no significant impact on patients’ satisfaction (such as physical appearance, pharmacy services, laboratory services, blood bank services, x-rays, ultrasound services, billing services, OPD services, emergency and housekeeping services). Consistent improvement in the system can have overall impact the level of patient satisfaction in any hospital. Other factors were significant having crucial role for determining the satisfaction of patients’ about the healthcare services in private hospitals in Karachi. The strengths of the healthcare organizations as highlighted by patients must be continuing however, some services need more focus while planning and managing the health care system. 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