Methods of Measuring Health-Care Service Quality

Service quality is an elusive and abstract construct to measure, and extra actual medical outcome (O’Connor, Shewchuk, and Carney, 1994). A series of services marketing research, however, has effort is required to establish a valid measure. This study investigates the looked at the relationship between the services expected and psychometric properties of three different measurements of health-care the service actually perceived as received by recipients (Carservice quality as assessed by physicians. The multitrait-multimethod man, 1990; Finn and Lamb, 1991; Parasuraman, Zeithaml, approach revealed that convergent validity was established for measures and Berry, 1985, 1988; Zeithaml, Parasuraman, and Berry, based on the single-item global rating method and multi-item rating 1988). The services marketing approach places an emphasis method. On the other hand, almost no evidence of convergent validity on quality evaluation from the recipients’ perspectives, but was found for the measures based on the constant-sum rating method. ignores the necessity for including an evaluation of the techniFurthermore, discriminant validity for the seven health-care service qualcal skill of the provider and the nature of the medical outcome. ity dimensions measured by the three methods was not well established. Especially in the area of health-care service, the services marThe high levels of interdimensional correlations found suggested that the keting approach seems to neglect the important role of physiservice quality dimensions may not be separable in a practical sense. The cians in shaping patients’ service expectations. A balanced study suggested an ongoing effort is needed to develop a new service approach, therefore, utilizing aspects of service quality from quality scale suitable to this unique service industry. J BUSN RES 2000. both the services marketing and health-care approaches may 48.233–246.  2000 Elsevier Science Inc. All rights reserved. be required. At the same time, the physicians’ view toward the quality of their own services needs more research attention. For the success of health-care organizations, accurate measurement of health-care service quality is as important as The health-care delivery system has been undergoing understanding the nature of the service delivery system. Withformidable challenges in the 1990s. Rapid movement out a valid measure, it would be difficult to establish and toward systems of managed care and integrated delivimplement appropriate tactics or strategies for service quality ery networks has led health-care providers to recognize real management. The most widely known and discussed scale competition. To be successful or even survive in this hostile for measuring service quality is SERVQUAL (Parasuraman, environment, it is crucial to provide health-care recipients Zeithmal, Berry, 1988). Since the scale was developed, various with service that meets or exceeds their expectations. At the researchers have applied it across such different fields as secusame time, it is important to known which dimensions of rities brokerage, banks, utility companies, retail stores, and health-care services physicians believe are necessary to constirepair and maintenance shops. The scale has also been applied tute excellent service. It is crucial to have a better understandto the health-care field in numerous studies (Babakus and ing of service quality perceptions possessed by both recipients Mangold, 1992; Brown and Swartz, 1989; Carman, 1990; and providers when shaping the health-care delivery system. Headley and Miller, 1993; O’Connor, Shewchuk, and Carney, The traditional medical model has focused on the technical 1994; Walbridge and Delene, 1993). However, with a few nature of health-care events; the focus has been on the training exceptions, they did not systematically examine the psychoand updated skills of the physicians and the nature of the metric properties of their scale, because these studies dealt with pragmatic and managerial issues for health-care services. Address correspondence to Hanjoon Lee, Marketing Department, Haworth Validity of the SERVQUAL scale seems not to be fully estabCollege of Business, Western Michigan University, Kalamazoo, Michigan 49008, USA. lished. A more stringent psychometric test has been recom-