AN EMPIRICAL STUDY ON AVAILABILITY OF RURAL HEALTH CARE SERVICES IN ZAROL VILLAGE AS PER THE INDIAN PUBLIC HEALTH
STANDARDS
Anupam Mitra
TeamLease Skills University India
E-mail: anupam.mitra@teamleaseuniversity.ac.in
Shivangi Shukla
TeamLease Skills University India
E-mail: shivangi.s@teamleaseuniversity.ac.in
Submission: 25/04/2018
Revision: 10/05/2018
Accept: 15/06/2018
ABSTRACT
A study on availability of Health care
services in Zarol village as per the Indian Public Health Standards has been
undertaken with the main objective to find out the prevailing gap between
expected health standards and actual Indian Public health standards. A sample
of 80 respondents was undertaken for the survey. Data were collected through
structured closed ended questionnaire using Non-probability convenience
sampling method through personally interviewing the respondents. The Service
Quality Dimensions were used to measure the Service Quality Assurance of Public
Health care services. Research result reveals that means
score of major service quality dimensions is
relatively high indicating higher level
of patient’s satisfaction from PHC of Zarol. Whereas the mean score of only
personnel quality and safety measures having relatively low score indicating lower level of patient’s satisfaction.
Keywords: Quality Assurance, Service Quality Dimensions, Indian
Public Health Standards, Public Health Care Services
1. INTRODUCTION
“Services are economic activities
offered by one party to another. Often time-based, performances bring about
desired results to recipients, objects or other assets for which purchasers
have responsibility. In exchange for money, time and effort, service customers
expect value from access to goods, labor, professional skills, facilities,
networks and systems, but they do not take ownership of any of the physical
elements involved” [1]
As per the Planning Commission, a
town with a most extreme populace of 15,000 is viewed as provincial in nature.
The National Sample Survey
Organization (NSSO) characterizes 'rural' as the area with a populace density
of up to 400 for every square kilometer. Villages with clear reviewed limits
yet no city board and at least 75% of male working populace engaged in
agribusiness and associated exercises.
Health care sector is playing a
dynamic role for the overall health of our country. Despite the fact that there
are such a large number of changes in the setting of Indian Rural Health Care
Services yet with regards to country's overall health care scenario.
Guidelines are a methods for
depicting a level of value that the health care centers are relied upon to
meet. A Primary Health Center fills in as the first port of call to a qualified
specialist in the public health care division in provincial zones giving a
scope of Curative, Promotive and preventive health care services. A PHC
furnishing 24 hours services and with proper linkages, assumes a critical part
of expanding institutional conveyances accordingly diminishing maternal
mortality and infant mortality.
2. RURAL HEALTHCARE SYSTEM IN INDIA
The rural healthcare services
framework in India has been created as a three level framework containing the
following:
a)
The
Community Health Center (CHC) - A 30 bed clinic/referral unit for 4 PHCs with
authority administrations. (Rustic Health Statistics in India 2012)
b)
The
Primary Heath care center (PHC) - A referral unit for 6 (4-6 bed) sub focuses
staffed by a medical officer in charge and 14 paramedics. (RUSTIC HEALTH
STATISTICS IN INDIA, 2012)
c)
3.The
Sub Center-The most fringe purpose of contact between the Primary Healthcare
system and the community, staffed by 1
Health Worker-Female (HM-F)/Auxiliary Nurse Midwife (ANM) and 1 Health
Worker-Male (HW-M) (RURAL HEALTH STATISTICS IN INDIA, 2012)
2.1.
Primary
Health Centers (PHCs)
PHC
is the main contact point between village community and the Medical Officer.
The PHCs were imagined to give an incorporated curative and preventive health
care to the country populace with emphasis on preventive and primitive parts of
medicinal services. The PHCs are set up and kept up by the State Governments
under the Minimum Needs Program. PHC acts as a referral unit for 6 Sub Centers
and has 4-6 beds for patients. The activities of PHC involve curative,
Preventive, Promotive and family welfare services.
3. LITERATURE REVIEW:
3.1.
Mosad
Zineldin, (2006)
Service
quality is a multidimensional concept and in order to operationalize it many
variables have to be considered. SERVQUAL is a widely used scale to measure
different quality dimensions. Originally, as developed by Parasuraman, Zeithaml
e Berry (1985), scale consisted ten dimensions used by the customer to Judge
Company’s service, which were reduced into five major dimensions (CRONIN;
TAYLOR, 1992): tangibles, reliability, responsiveness: assurance and empathy.
The
SERVQUAL constructs impact is used to measure service quality and to identify
service quality gaps but not their root causes for which other approaches are
needed (WISNIEWSKI; WISNIEWSKI, 2005).
Some
efforts have been invested to improve the methods. In this research we describe
a study involving a new instrument and a new method that assures a reasonable
level of relevance, validity and reliability, while being explicitly change
oriented.
3.2.
Leo
van der Reis Qian Xiao Grant Savage, (2007)
To
achieve the goal of a truly caring commonwealth, we must improve quality and
safety in health care, increase access and utilization of technology, promote
greater consumer involvement at all stages, restructure the medical malpractice
system to reach all who may be injured by systemic errors, and develop
sustainable financing less subject to the vagaries of state revenues.
However,
the access issue still remains a basic and important problem we have to
confront. The rapidly evolving nature of the health care system presents both
enhanced opportunities to address the access problem and new threats to the
fragile health care system. However, with the efforts and resources of
communities, providers, government, and others to create viable long-term
solutions, a good tendency can be expected.
For
example, Senate Bill No. 738 – the Health Access and Affordability Act, a
petition from the Committee on Health Care Financing – appears strongest in its
objectives to offer full health care coverage that is universal and continuous,
and is affordable to individuals and families (MOORE, 2005).
3.3.
Gyan
Prakash, (2015)
There are few relevant healthcare
regulations and their enforcement is weak. Social regulation is at best weak
and economic regulation is non-existent. Patients have poor role-awareness, do
not appreciate their responsibilities and their rights are limited.
Partnership and coordination among
various health institutions are weak and managers in each institution are more
concerned about their functions. Self-regulation among healthcare professionals
is fragile and services are inefficient. The author contributes to the
healthcare literature, first, by synthesizing the literature and identifying
healthcare issues and challenges, and emphasizes regulation in molding healthcare
service delivery.
Broader experiences in the
literature suggest that governments in emerging economies are yet to synergize
technical and functional quality for an all-encompassing service delivery.
These issues seem to be well resolved in developed economies; however,
healthcare shattering, long waiting times and underlying payment mechanisms
need attention.
3.4.
Hardeep
Chahal Shivani Mehta, (2013)
Theoretically, the study confirmed
that all patient satisfaction dimensions are significant in assessing patient
satisfaction which validate the existing findings of various researchers such
as Raftopoulous (2005), Kang and James (2004), Chahal and Sharma (2004);
Sardana (2003); Brady and Cronin (2001); Corbin et al. (2001); Newman et al.
(1998); Gilson et al. (1994).
Besides, model testing conducted
also provides new insight to understand the relationship between patient
satisfaction dimensions and loyalty. The study also contributes in the
understanding of patient behavior and their medical needs in general, which can
be used for increasing patient satisfaction in particular.
It is also found that to retain
patients and to improve relations with the patients; the medical staff must
show concern and sympathy for the patients, which results in easy recovery, improved
services, and above all, improved patient satisfaction and loyalty. The
findings suggest that training programs on patient relationship management at
least once a year, along with spiritual discourses should be considered and
organized to inculcate the changes in the attitude and behavior of staff
towards patients.
The patient-staff interactions
(physicians, nurses and supportive staff) and their impact on satisfaction and
loyalty are significant to understand patients’ behavior and to improve the
image of the hospital over competitors. Further, the patient-oriented approach
will help the Indian health service provides in linking their technological and
non-technological factors to the unserved needs of the patients which, in turn,
will help in enhancing the degree of patient satisfaction.
Strategies such as responding to
patients’ enquiry promptly, bridging the communication gap between patients and
medical personnel, becoming more friendly and understanding to the problems of
patients, maintaining cleanliness in the units, both internally and externally,
providing regular report regarding the patients’ progress without waiting for
them to demand, providing a grievances system in the unit, conducting surveys
to know about the attitude of the patients with regard to the employees,
adopting patient-oriented policies and procedures, solving patient-related
problems immediately and providing every type of essential facility should be
implemented by the hospitals in India for improving and maintaining high
patient satisfaction.
4. RELEVANCE OF THE STUDY
The fundamental issue hidden for
rural health care is because of health issues or poor health services, the work
efficiency of provincial people is at great hazard. It has been seen in a few
villages that, the accessibility and nature of health care services are in the
extremely poor state regardless of immense consumption and endeavors from the
government.
Along these lines, there are such a
significant number of issues have turned out; this research will unquestionably
yield the constructive results on the said issues to Government and to the
village individuals
Due to
non-accessibility to Public Health care and low quality of medicinal services
benefits, a major share of individuals in India swing to the nearby local
private health center as their first decision of care. In any case, private
medicinal services are costly, regularly unregulated and variable in quality.
Other than
being temperamental for the unskilled, it is additionally not affordable by
lower income groups. The key difficulties in the public health care services
are low nature of care, poor responsibility, lack of awareness, and restricted
access to facilities.
Individuals
in rural zones confront some unique medical problems than individuals who live
in towns and urban areas. Getting health care services can be an issue when
individuals live in a remote zone. They won't not have the capacity to get to a
healing center rapidly in a crisis. They additionally might not have any desire
to venture out long separations to get normal registration and screenings.
Rural areas mostly have fewer specialists and dental practitioners, and certain
experts won't be available at all
In rural areas health care services are mainly provided by:
a)
Government / government sponsored health centers or
hospitals.
b)
A charitable trust run health centers or hospitals.
c)
Private practitioners.
4.1.
Objectives:
To analyze the actual scenario of
Rural Health Care Services in Zarol village and to measure the satisfaction level
of patients
4.2.
Research
methodology
Research Design is a framework
or blue print for conducting the marketing research project. It specifies the
details of the procedures necessary for obtaining the information needed to
structure and solve marketing research problems. For this
study, we used survey method
by personally interviewing respondents through closed ended questionnaire
4.2.1. Scope
of the Study
The scope
of study is Zarol village in the state of Gujarat.
4.2.2. About
Zarol:
Zarol is a
village situated in Nadiad Taluka of Kheda district, Gujarat with total 293
families residing. The Zarol village has a population of 1379 of which 707 are
males while 672 are females as per Population Census 2011. [2]
4.2.3. The
sample
The
actual user of specific service will constitute the sample of the study. Sample
of 80 respondents has taken for the survey.
4.2.4. Statistical
Analysis
For Data analysis, various
statistical tests were used such as, Frequency distribution, Cronbach’s alpha
for checking reliability, Mean, Standard Deviation as Descriptive Statistics,
and Independent Sample T-test for equality of means and Analysis of Variance
(ANOVA).
Quantitative research methods were
used to measure availability of health care services by applying above
mentioned statistical tests.
4.2.5. Interview
Script
|
Name |
|
|
|
|
|
|
Gender |
Male |
Female |
|
|
|
|
Age group |
Below 25 |
25 to 35 |
36 to 45 |
46 or above |
|
|
Qualification |
Illiterate |
SSC |
HSC |
Bachelors |
Masters |
|
Marital status |
Single |
Married(Not
having kids) |
Married
(Having kids) |
Divorced |
|
|
Village |
|
|
|
|
|
Table 1: Factors and
Satisfaction
|
FACTORS |
|
SD |
D |
N |
A |
SA |
|
A.
Infrastructure |
This Health
Care Centre is always well-ventilated with natural lights |
|
|
|
|
|
|
|
There is
always a minimal noise pollution in Health Centre |
|
|
|
|
|
|
|
There is a
prevalent security available in the Centre |
|
|
|
|
|
|
|
Required
basic medicines are always available on time |
|
|
|
|
|
|
|
Doctors are
always available when needed |
|
|
|
|
|
|
|
Food quality
is always good at Health Centre |
|
|
|
|
|
|
|
All basic
medical equipment are in working condition |
|
|
|
|
|
|
|
Good
housekeeping facilities are always available (eg. Pillows, buckets, mugs,
dressing material etc.) |
|
|
|
|
|
|
|
Overall, You are satisfied by infrastructure of
health Centre you visited |
|
|
|
|
|
|
B.
Personnel
quality |
Behavior of
hospital staff is always courteous with you |
|
|
|
|
|
|
|
Nurses always
care for you deeply |
|
|
|
|
|
|
|
Doctors are
regularly visiting their ward rounds |
|
|
|
|
|
|
|
Doctors who are diagnosing are fully skilled |
|
|
|
|
|
|
|
Overall, You
are satisfied by staff behavior |
|
|
|
|
|
|
C Clinical Care |
You always
get proper medical counselling by doctors at the time of your discharge |
|
|
|
|
|
|
|
Post
treatment explanation is given by doctors thoroughly |
|
|
|
|
|
|
|
Information
about unexpected complications is given to you properly |
|
|
|
|
|
|
|
Overall, you
are satisfied by clinical care |
|
|
|
|
|
|
D Administrative
procedures |
You have to
wait longer in Health Centre |
|
|
|
|
|
|
|
Clear
information about hospital rules and regulations is always given |
|
|
|
|
|
|
|
Admission
procedure to Health Centre is very simple |
|
|
|
|
|
|
|
Overall, you
are satisfied by administrative procedures |
|
|
|
|
|
|
E. Safety measures |
PHC staff is
always wearing the hygienic gloves |
|
|
|
|
|
|
|
PHC
environment is infection free |
|
|
|
|
|
|
|
Overall, you
are satisfied by safety measures |
|
|
|
|
|
|
F. Image |
Ethics are
always followed by this Health Centre |
|
|
|
|
|
|
|
According to
you, this Health Care Centre has good reputation |
|
|
|
|
|
|
|
You are
always treated honestly |
|
|
|
|
|
|
|
overall, you
are satisfied by goodwill of your Health Centre |
|
|
|
|
|
|
G.
Trustworthiness |
You have full
confidence in the doctors who treated you |
|
|
|
|
|
|
|
Health care
Centre is always delivering the promised services |
|
|
|
|
|
|
|
Privacy and
confidentiality of information is always being carried by health care Centre |
|
|
|
|
|
|
|
Overall, you
are satisfied by trustworthiness of
your Health Centre |
|
|
|
|
|
|
H. Social Responsibility |
This Health
care Centre is organizing free check ups during epidemic cases |
|
|
|
|
|
|
|
This Service
provider is arranging medical camps for needy people |
|
|
|
|
|
SD=Strongly
Disagree D= Disagree N=Neutral A=Agree SA=Strongly Agree
Period
of this Interview- 1
month (March 2018)
Profile
of the interviewees: Demographic
information on 80 respondents who participated in an interview was obtained
from Zarol village. Of the 80, 40 (50%) were male and remaining 40 (50%) were
female. Equal division between masculine and feminine was intentional so that
by using independent sample T-test, we can analyze and compare the means and
find out if there is any significant difference between various dimensions of
service quality and gender.
Figure 1: Age Group Wise Distribution
Figure 2: Qualitication wise
distribution
Figure 3: Social Status Wise
Distribution
4.3.
Constructed
Hypothesis for the study
·
H01: mean of various dimensions of service quality
does not have significance difference across (or between) gender groups
·
H02: mean of various dimensions of service quality
does not have significance difference across (or between) age groups.
·
H03: mean of various dimensions of service quality
does not have significance difference across qualification
·
H04: mean of various dimensions of service quality
does not have significance difference across marital status
Figure 4: Main Thrust of the paper
5. RESULTS AND DISCUSSION
5.1.
Demographic
Factors
Cronbach’s alpha, α (or coefficient alpha), developed by Lee Cronbach in
1951, measure reliability or internal consistency. ‘Reliability’ is how well a
test measures what it should. Cronbach’s alpha tests to see if
multiple-question Likert scale surveys are reliable. These questions measure latent
variables — hidden or unobservable variables those are very difficult to
measure in real life. Cronbach’s alpha will justify if the test which have
designed is accurately measuring the variable of interest. [3]
We have used
Cronbach’s Alpha in this study to analyze that the service quality dimensions
used to measure availability of health care services are reliable or not. High
reliability means it measures availability of health care services and low
reliability means it measures something else (possibly nothing at all)
5.1.1. Following
table shows Cronbach’s Coefficient (Alpha) values for ensuring scale validity
for the given study:
Table 2: Reliability Statistics for Service quality dimensions
|
Sr. No. |
Dimensions |
Cronbach's Alpha |
No. of Items |
|
1 |
Infrastructure |
.890 |
2 |
|
2 |
Personnel quality |
.981 |
5 |
|
3 |
Clinical Care |
.951 |
3 |
|
4 |
Administrative procedures |
.968 |
3 |
|
5 |
Safety measures |
.980 |
2 |
|
6 |
Image |
.958 |
3 |
|
7 |
Trustworthiness |
.958 |
3 |
|
8 |
Social Responsibility |
.519 |
8 |
Table 3: Descriptive Statistics
|
Descriptive Statistics |
|||||
|
|
N |
Minimum |
Maximum |
Mean |
Std. Deviation |
|
Infrastructure |
80 |
1.00 |
5.00 |
3.5813 |
1.26902 |
|
Personnel quality |
80 |
1.00 |
5.00 |
2.7425 |
1.37912 |
|
Clinical Care |
80 |
1.00 |
5.00 |
3.6583 |
1.33014 |
|
Administrative procedures |
80 |
1.00 |
5.00 |
3.5417 |
1.36294 |
|
Safety measures |
80 |
1.00 |
5.00 |
2.2937 |
1.49618 |
|
Image |
80 |
1.00 |
5.00 |
3.7708 |
1.20430 |
|
Trustworthiness |
80 |
1.00 |
5.00 |
3.0792 |
1.33254 |
|
Social Responsibility |
80 |
1.13 |
4.38 |
3.0953 |
.64914 |
|
Valid N (list wise) |
80 |
|
|
|
|
Means
scores of Infrastructure, Clinical care, administrative procedures, Image,
trustworthiness, social responsibility are relatively high indicating
a higher level of patient’s satisfaction from PHC of Zarol. Whereas personnel
quality and safety measures are having relatively low score indicating a lower
level of patient’s satisfaction.
5.1.2. T-
Test
H01: mean of
various dimensions of service quality does not have significance difference
across (or between) gender groups
Table 4: T – Test for service quality of patient satisfaction between
female and male
|
|
Gender |
N |
Mean |
Std. Deviation |
T |
P-value |
|
Infrastructure |
Female |
40 |
3.7125 |
1.15408 |
.924 |
.358 |
|
Male |
40 |
3.4500 |
1.37654 |
|
|
|
|
Personnel
quality |
Female |
40 |
2.8050 |
1.38896 |
-.403 |
.688 |
|
Male |
40 |
2.6800 |
1.38401 |
|
|
|
|
Clinical Care |
Female |
40 |
3.7833 |
1.26885 |
.839 |
.404 |
|
Male |
40 |
3.5333 |
1.39351 |
|
|
|
|
Administrative
procedures |
Female |
40 |
3.5750 |
1.30959 |
.217 |
.828 |
|
Male |
40 |
3.5083 |
1.43021 |
|
|
|
|
Safety
measures |
Female |
40 |
2.2125 |
1.45834 |
.483 |
.630 |
|
Male |
40 |
2.3750 |
1.54733 |
|
|
|
|
Image |
Female |
40 |
3.6833 |
1.16929 |
.647 |
.519 |
|
Male |
40 |
3.8583 |
1.24696 |
|
|
|
|
Trustworthiness |
Female |
40 |
3.1167 |
1.35569 |
-.250 |
.803 |
|
Male |
40 |
3.0417 |
1.32516 |
|
|
|
|
Social
Responsibility |
Female |
40 |
3.0469 |
.60227 |
-.665 |
.508 |
|
Male |
40 |
3.1438 |
.69715 |
|
|
Female
respondents gave highest rate to Image as it has highest mean of 3.6833 and
they gave lowest rate to safety measure as it is having lowest mean of 2.2125.
For male respondents Image is having highest mean of 3.8583 and safety measures
are having lowest mean of 2.3750.
All
the p values are >0.05 so they are not statistically significant at 95% confidence
interval so Null hypothesis (H01) cannot be rejected so there is no significant
difference between dimensions of Service Quality and Gender
5.1.3. ANOVA
Test
H02:
mean of various dimensions of service quality does not have
significance difference across (or between) age groups.
Table 5: ANOVA test for service quality of patient satisfaction between
age groups
|
|
<25 |
25 to 35 |
36 to 45 |
>=46 |
Total |
F |
p-value |
|
Infrastructure |
8a 1.19±0.26b |
30 2.92±0.86 |
17 4.05±0.39 |
25 4.82±.25 |
80 3.58±1.27 |
99.15 |
<0.001 |
|
Personnel quality |
8 1±0.00 |
30 1.69±0.52 |
17 2.92±0.58 |
25 4.44±0.55 |
80 2.74±1.38 |
161.41 |
<0.001 |
|
Clinical care |
8 1.17±0.18 |
30 2.88±0.84 |
17 4.25±0.22 |
25 4.99±0.07 |
80 3.66±1.33 |
138.11 |
<0.001 |
|
Administrative procedures |
8 1.13±0.17 |
30 2.70±0.89 |
17 4.16±0.24 |
25 4.91±0.25 |
80 3.54±1.36 |
118.98 |
<0.001 |
|
Safety measures |
8 1±0.00 |
30 1.17±0.36 |
17 2.03±0.28 |
25 4.24±1.01 |
80 2.29±1.50 |
126.73 |
<0.01 |
|
Image |
8 1.38±0.45 |
30 3.18±0.79 |
17 4.24±0.23 |
25 4.93±0.14 |
80 |
115.21 |
<0.01 |
|
Trustworthiness |
8 1±0.00 |
30 2.17±0.69 |
17 3.51±0.53 |
25 4.55±0.47 |
80 3.08±1.33 |
124.47 |
<0.01 |
|
Social Responsibility |
8 2.58±0.81 |
30 2.73±0.52 |
17 3.11±0.39 |
25 3.69±0.38 |
80 3.09±0.65 |
20.79 |
<0.01 |
a: number
of cases. b: mean±SD
For the age group of
below 25 years, highest mean representing highest rate by respondents i.e.
2.5181 for Social Responsibility & lowest mean of 1 for safety measures,
Trustworthiness & personnel quality. For the age group of 25 to 35 years
highest mean was 3.1778 for Image and lowest mean of 1.1667 for safety
measures. For the age group of 36 to 45 years, highest mean of 4.2549 for
Clinical care & lowest mean of 2.0294 for safety measures.
For the age group of above 46 years, highest mean of
4.9867 for Clinical care & lowest mean of 3.69 for Social Responsibility.
All the p values are
statistically significant at 95% confidence level as all p values are < 0.05
so there is a significant difference between various dimensions of service
quality and age groups. So Null hypothesis (H02) can be rejected.
5.1.4. ANOVA
test for service quality of patient satisfaction between qualification of
respondents
H03: mean of
various dimensions of service quality does not have significance difference
across qualification.
Table 6: ANOVA test for service quality of patient satisfaction between
qualification of respondents
|
|
Illiterate |
SSC |
HSC |
Graduation |
Post-Graduation |
Total |
F |
p-value |
|
Infrastructure |
15a 4.77±0.37b |
21 4.02±0.98 |
26 3.50±1.05 |
11 2.27±.1.15 |
7 2.07±0.93 |
80 3.58±1.27 |
16.817 |
<0.001 |
|
Personnel quality |
15 4.19±0.84 |
21 3.1524±
1.33 |
26 2.44±1.16 |
11 1.51±0.62 |
7 1.49±0.71 |
80 2.74±1.38 |
14.29 |
<0.001 |
|
Clinical care |
15 4.87±0.37 |
21 4.17±0.98 |
26 3.58±1.12 |
11 2.12±1.18 |
7 2.24±0.98 |
80 3.66±1.33 |
17.65 |
<0.001 |
|
Administrative procedures |
15 4.82±0.35 |
21 4.02±1.08 |
26 3.41±1.19 |
11 2.15±1.21 |
7 2.05±0.87 |
80 3.54±1.36 |
15.60 |
<0.001 |
|
Safety measures |
15 4.033±1.33 |
21 2.67±1.50 |
26 1.79±1.02 |
11 1.14±0.38 |
7 1.14±0.38 |
80 2.29±1.49 |
15.124 |
<0.001 |
|
Image |
15 4.82±0.42 |
21 4.23±0.78 |
26 3.74±0.99 |
11 2.27±1.25 |
7 2.57±0.79 |
80 3.77±1.20 |
17.89 |
<0.001 |
|
Trustworthiness |
15 4.42±0.68 |
21 3.48±1.16 |
26 2.88±1.11 |
11 1.79±0.96 |
7 1.76±0.89 |
80 3.08±1.33 |
14.78 |
<0.001 |
|
Social Responsibility |
15 3.58±0.45 |
21 3.29±0.55 |
26 3.07±0.48 |
11 2.53±0.65 |
7 2.45±0.79 |
80 3.09±0.65 |
8.94 |
<0.001 |
a: number of cases.
b: mean±SD
For the Illiterate group, highest mean of 4.8667 for Clinical
Care & lowest mean of 3.5750 for Social Responsibility. For the SSC group,
highest mean of 4.2381 for Image and lowest mean of 2.6667 for safety measures.
For HSC group, highest mean of 3.7436 for Image and lowest mean of 1.7885 for
safety measures. For Graduation group, highest mean of 2.5341 for Social
Responsibility and lowest mean of 1.1364 for safety measures. For
Post-graduation group, highest mean of 2.5714 for Image and lowest mean of
1.1429 for safety measures.
All the p values are statistically significant at 95%
confidence level as all p values are < 0.05 so there is a significant
difference between various dimensions of service quality and qualification
groups. So Null hypothesis (H03) can be rejected.
5.1.5. ANOVA
test for service quality of patient satisfaction between marital status of
respondents
H04: mean of
various dimensions of service quality does not have significance difference
across marital status
Table 7: ANOVA test for service quality of patient satisfaction between
marital status of respondents
|
|
Single |
Married(not
having kids) |
Married (having
kids) |
Total |
F |
p-value |
|
Infrastructure |
6 1.17±0.26 |
3 1.17±0.29 |
71 3.89±0.98 |
80 3.58±1.27 |
33.43 |
<0.001 |
|
Personnel quality |
6 1±0.00 |
3 1±0.00 |
71 2.96±1.31 |
80 2.74±1.38 |
9.92 |
<0.001 |
|
Clinical care |
6 1.11±0.17 |
3 1.44±0.19 |
71 3.97±1.06 |
80 3.66±1.33 |
29.30 |
<0.001 |
|
Administrative procedures |
6 1.06±0.14 |
3 1.44±0.19 |
71 3.84±1.13 |
80 3.54±1.36 |
24.18 |
<0.001 |
|
Safety measures |
6 1±0.00 |
3 1±0.00 |
71 2.46±1.51 |
80 2.29±1.49 |
4.09 |
<0.001 |
|
Image |
6 1.28±0.44 |
3 1.78±0.38 |
71 4.07±0.91 |
80 3.77±1.20 |
36.02 |
<0.001 |
|
Trustworthiness |
6 1±0.00 |
3 1±0.00 |
71 3.34±1.17 |
80 3.08±1.33 |
17.50 |
<0.001 |
|
Social Responsibility |
6 2.52±0.92 |
3 2.58±0.47 |
71 3.17±0.60 |
80 3.09±0.65 |
3.98 |
<0.001 |
For the single group of
respondents, highest mean of 2.5208 for Social Responsibility & lowest mean
of 1 for Personnel quality, Trustworthiness, safety measures. For Married (Not
having kids group), highest mean of 2.5833 for Social Responsibility and lowest
mean of 1 for personnel quality, Trustworthiness, safety measures. For married
(having kids group), highest mean for Image i.e. 4.0657 and lowest mean of
2.4577 for safety measures.
All the p values are statistically significant at 95%
confidence level as all p values are < 0.05 so there is a significant
difference between various dimensions of service quality and marital status
groups. So Null hypothesis (H04) can be rejected.
6. MANAGERIAL IMPLICATIONS:
1. Primary Health Centre must organize basic tutorial for rural people at
their level of understanding
2. Staff of government hospital must be given training of how to behave
with customers.
3. Doctors of Government hospitals must be given enough salary package to
avoid certain issues
4. Government hospital of rural area should also progress towards
Digitalized direction.
5. Enough amenities should be developed for waiting room patients.
7. CONCLUSION:
This study focuses on availability of Health Care Services in
Zarol village as per the Indian Public Health Standards. From our research
findings we can say that for H01all the p values were >0.05 so they are not
statistically significant at 95% confidence interval so Null hypothesis (H01)
cannot be rejected so there is no significant difference between dimensions of
Service Quality and Gender.
For H02, All the p values are statistically significant
at 95% confidence level as all p values are < 0.05 so there is a significant
difference between various dimensions of service quality and age groups. So
Null hypothesis (H02) can be rejected.
For H03 all p values are < 0.05 so there is a
significant difference between various dimensions of service quality and
qualification groups. So Null hypothesis (H03) can be rejected.
For H04 All the p values are < 0.05 so there is a
significant difference between various dimensions of service quality and
marital status groups. So Null hypothesis (H04) can be rejected.
We also faced certain limitations during our study like
because of time constraint limited sample size was taken, as this survey is for
remote area, Google survey form didn’t work so a questionnaire was redrafted in
regional language hence it took longer for field survey. Research scholar can
further carry this research to map the real changes in the context of the
health status of the remote area.
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