While much is known generally about predictions of customer-perceived service quality, their application to health services is rarer. No attempt has been made to examine the impact of social support and patient education on overall service quality perception. Together with six quality dimensions identified from the literature, this study seeks to provide a more holistic comprehension of hospital service quality prediction. Although 79 percent of variation is explained, other than technical quality the impact of the remaining factors on quality perception is far from constant, and socio-economic variables further complicate unpredictability. Contrary to established beliefs, the cost factor was found to be insignificant. Hence, to manage service quality effectively, the test lies in how well healthcare providers know the customers they serve. It is not only crucial in a globalized environment, where trans-national patient mobility is increasingly the norm, but also within homogeneous societies that appear to converge culturally.
Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. These recommendations are developed by integrating the expertise of a multidisciplinary group of clinicians with the perspectives of consumers and the best available research evidence. However studies have raised concerns about the quality of guideline development, and particularly the link between research and recommendations. The reasons why guideline developers are not following the established development methods are not clear.We aimed to explore the barriers to developing evidence-based guidelines in eleven hospitals in Australia, Indonesia, Malaysia, the Philippines and Thailand, so as to better understand how evidence-based guideline development could be facilitated in these settings. The research aimed to identify the value clinicians place on guidelines, what clinicians want in guidelines developed in hospital settings and what factors limit rigorous evidence-based guideline development in these settings.
This article presents findings of the thermal comfort study in hospitals. A field survey was conducted to investigate the temperature range for thermal comfort in hospitals in the tropics. Thermal acceptability assessment was conducted to examine whether the hospitals in the tropics met the ASHRAE Standard-55 80% acceptability criteria. A total of 114 occupants in four hospitals were involved in the study. The results of the field study revealed that only 44% of the examined locations met the comfort criteria specified in ASHRAE Standard 55. The survey also examined the predicted percentage of dissatisfied in the hospitals. The results showed that 49% of the occupants were satisfied with the thermal environments in the hospitals. The field survey analysis revealed that the neutral temperature for Malaysian hospitals was 26.4 degrees C. The comfort temperature range that satisfied 90% of the occupants in the space was in the range of 25.3-28.2 degrees C. The results from the field study suggested that a higher comfort temperature was required for Malaysians in hospital environments compared with the temperature criteria specified in ASHRAE Standard (2003). In addition, the significant deviation between actual mean vote and predicted mean vote (PMV) strongly implied that PMV could not be applied without errors in hospitals in the tropics.
PURPOSE: The purpose of this paper is to advance healthcare service quality research using hierarchical component models.
DESIGN/METHODOLOGY/APPROACH: This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses.
FINDINGS: The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS.
RESEARCH LIMITATIONS/IMPLICATIONS: Only one hospital was evaluated.
PRACTICAL IMPLICATIONS: The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design.
ORIGINALITY/VALUE: Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.
KEYWORDS: Healthcare; Hierarchical perceived service quality; Population-based sampling
This study is a review of the Acute Pain Service in Hospital Kuala Lumpur for the years 1998 to 2001. 5042 records from post-operative patients were analysed. The majority of patients (81.8%) had satisfactory pain control. Eighty-two percent of patients experienced only mild pain at rest on the first post-operative day. The highest pain score occurred on the first day in 68.3% of patients. Nausea or vomiting occurred in 23.2% of the patients. Eight patients had respiratory depression. The low pain scores recorded by most patients and the low incidence of side effects reflect the efficiency of the service provided.
This is a study of patients referred to the Scoliosis Service of Hospital Kuala Lumpur. Three hundred and thirty five (335) consecutive patients who were seen between 1985 and 2000 were reviewed to determine the presentation of scoliosis, the treatment received and the compliance to follow up. Data were determined by measuring the frontal spinal radiographs. Two hundred and ninety eight (298) patients met inclusion criteria. Idiopathic scoliosis accounted for 203 patients (68.1%), 31 (10.4%) were neuromuscular scoliosis; and 44 (14.8%) had congenital scoliosis. Twenty-five point five percent of patients had surgery, 10.4% were treated with brace, while the remaining 69.1% of patients were observed, or had no treatment at all. Congenital scoliosis patients had better compliance compared to idiopathic or neuromuscular scoliosis patients.
The current status and directions for changes of issues related to quality care in health services in Asian countries--Malaysia, China, Singapore, Japan and Korea are overviewed. In countries with public sector dominated health care systems such as Malaysia. China and Singapore, governmental leadership in quality care is prominent along with legislative backup. Japan and Korea have private sector dominated health care systems and quality care activities are mainly carried out by non-governmental organisations. Hospital accreditation programs are in the developing stages in most countries, although China and Korea started in 1980. Most Asian countries are at the initial stages in quality care activities and focus has been placed on education and training. Asian countries are not exempted from efforts to enhance quality care activities and a new horizon in quality health care is emerging.