MEASURING CUSTOMER SATISFACTION TOWARDS SERVICE QUALITY OF THE MATERNITY HOSPITAL IN HO CHI MINH CITY In Partial Fulfillment of the Requirements of the Degree of MASTER OF BUSINESS ADMINISTRATION In Marketing by Ms: NGUYEN THI THANH BINH ID: MBA03004 International University - Vietnam National University HCMC January 2013 MEASURING CUSTOMER SATISFACTION TOWARDS SERVICE QUALITY OF THE MATERNITY HOSPITAL IN HO CHI MINH CITY In Partial Fulfillment of the Requirements of the Degree of MASTER OF BUSINESS ADMINISTRATION In Marketing by MS: NGUYEN THI THANH BINH ID: MBA03004 International University - Vietnam National University HCMC January 2013 Under the guidance and approval of the committee, and approved by all its members, this thesis has been accepted in partial fulfillment of the requirements for the degree. Approved: ---------------------------------------------Chairperson --------------------------------------------Committee member ---------------------------------------------Committee member --------------------------------------------Committee member ---------------------------------------------Committee member --------------------------------------------Committee member Acknowledge Firstly, I especially want to thank my advisor, Doctor Nguyen Van Phuong, for his guidance during my research. His perpetual energy and enthusiasm in research had motivated all his advisees, including me. In addition, he was always accessible and willing to help his students with their research. I am myself showing my deepest thanks to Dr Ho Thanh Phong – Rector and Dr. Nguyen Quynh Mai – Dean and all of colleagues, friends and my classmates of MBA10 who support and create advantageous conditions for me to study and complete this thesis. Finally yet importantly, I would like to give my special thanks to my family whose patient love enabled me to finish this work. Ho Chi Minh /January 2013. Nguyen Thi Thanh Binh i Plagiarism Statements I would like to declare that, apart from the acknowledged references, this thesis either does not use language, ideas, or other original material from anyone; or has not previously submitted to any other educational and research programs or institutions. I fully understand that any writings in this thesis contradicted to the above statement will automatically lead to the rejection from the MBA program at the International University – Vietnam National University Ho Chi Minh City. ii Copyright Statement This copy of the thesis has supplied on condition that anyone who consults it understood to recognize that its copyright rests with its author and that no quotation from the thesis and no information derived from it may publish without the author’s prior consent. © Nguyen Thi Thanh Binh/ MBA03004/2010-2012 iii Table of Contents Chapter one – Introduction....................................................................................... 1 1. Introduction .......................................................................................................... 1 2. Research Problems ............................................................................................... 2 3. Research Objectives ............................................................................................. 2 4. Scope .................................................................................................................... 2 5. Implication of research ........................................................................................ 3 6. Research structure ............................................................................................... 3 Chapter Two – Literature Review............................................................................ 5 1. Definition of Service ............................................................................................ 5 2. Features of services .............................................................................................. 5 3. Service Quality..................................................................................................... 6 4. Service-quality model .......................................................................................... 7 5. Customer Satisfaction ........................................................................................ 11 6. The relationship between service quality and customer satisfaction ................. 12 7. Some empirical findings on service quality in maternity hospital ..................... 13 7.1. Dimensions of service quality ..................................................................... 15 7.2 Customer satisfaction with service quality of the maternity hospital ......... 15 8. Research Model ................................................................................................. 16 Chapter Three – Research Method ........................................................................ 19 1. The introduction about the maternity hospitals in Ho Chi Minh City. .............. 19 1.1 Tu Du hospital 19 1.2 Sai Gon International hospital 19 1.3 Hung Vuong hospital 20 1.4 University Medical Center hospital 20 iv 2. Scale ................................................................................................................... 21 2.1. Service Quality Scale. ............................................................................. 21 2.2 Scale of customer satisfaction. ................................................................. 23 3. Research Procedure ............................................................................................ 24 4. Sample Size ........................................................................................................ 25 5. Questionnaire Design ......................................................................................... 25 6. Analysis techniques ........................................................................................... 27 6.1. Descriptive Statistics ................................................................................... 27 6.2. Testing reliability of scale by Cronbach’s Alpha ....................................... 27 6.3. Exploratory Factors Analysis (EFA) .......................................................... 28 6.4. Multiple-Regression Analysis ..................................................................... 28 Chapter Four - Main Findings................................................................................ 29 1. Sample Description ........................................................................................... 29 1.1 Age description 29 1.2 Career description 30 1.3 Income description 30 2. Descriptive Statistics of KQCAH scale. ........................................................... 31 3. Assessment and Refinement of Scale. .............................................................. 35 3.1. Testing the reliability of service quality scale by Cronbach’s alpha .......... 36 3.2. Testing the reliability of customer satisfaction scale by Cronbach’s alpha. ........... 38 3.3. Assessment on Service Quality Scale using EFA analysis ......................... 43 3.4. Assessment of Customer Satisfaction Scale through EFA analysis ........... 43 3.5. Research Model Adjustment ....................................................................... 44 3.6. Testing the research model using ................................................................ 45 v 3.6.1. Correlation Matrix: .............................................................................. 46 3.6.2. Regression Analysis ............................................................................. 47 3.7. Comparison of customer satisfaction level between the maternity hospitals ....... 48 3.8. Discussion of results ................................................................................... 52 Chapter Five – Conclusion and Recommendation ............................................... 54 1. Conclusion ......................................................................................................... 54 2. Recommendations .............................................................................................. 54 3. Research Limitations ......................................................................................... 56 vi List of Tables Table 1: Dimensions quality ...................................................................................... 14 Table 2: Factors in study ........................................................................................... 18 Table 3: Coding variables in measurement scale ...................................................... 25 Table 4: Descriptive Statistics of Human and physical resources ............................. 31 Table 5: Descriptive Statistics of Efficiency and Continuty....................................... 32 Table 6: Descriptive Statistics of Facilities ............................................................... 33 Table 7: Descriptive Statistics of Information ........................................................... 33 Table 8: Descriptive Statistics of The hospital charges ............................................. 34 Table 9: Descriptive Statistics of First impression .................................................... 34 Table 10: Descriptive Statistics of Customer Satisfaction ......................................... 35 Table 11: Cronbach’s Alpha analysis of KQCAH scale ............................................ 38 Table 12: Cronbach’s Alpha analysis of customer satisfaction................................. 39 Table 13: Frequency of customer satisfaction .......................................................... 39 Table 14: KMO and Bartlett’s test about service quality ......................................... 40 Table 15: Rotated Component Matrixa ..................................................................... 42 Table 16: Total variance explained ........................................................................... 43 Table 17: Cronbach’s Alpha analysis of factors........................................................ 43 Table 18: Component matrix of customer satisfaction ............................................. 44 Table 19: KMO and Bartlett’s of customer satisfaction ............................................ 44 Table 20: KMO and Bartlett’s of new factors ............................................................ 46 Table 21: Model summary ......................................................................................... 46 Table 22: Coefficients ................................................................................................ 47 Table 23: Anova ......................................................................................................... 48 vii List of Figures Figure 1: Research Model .......................................................................................... 16 Figure 2: Adjusted Research Model ........................................................................... 17 Figure 3: Research process ........................................................................................ 24 Figure 4: Age description ........................................................................................... 29 Figure 5: Career description ...................................................................................... 30 Figure 6: Income description ..................................................................................... 30 Figure 7: Frequency of customer satisfaction ............................................................ 33 Figure 8: Adjusted research model after EFA analysis ............................................. 39 Figure 9: Comparison customer satisfaction level between the maternity hospitals . 44 Figure 10: Introduction of customers ......................................................................... 47 viii Abbreviation EFA: Exploratory Factors Analysis KQCAH: The Key Quality Characteristics Assessment for Hospitals KMO: Kaiser-Meyer-Olkin JCAHO: Joint Commission on Accreditation of Healthcare Organizations SERVQUAL: Service quality SPSS: Statistical Package for Social Sciences ix Abstract Service quality of the maternity hospital is been perceived as an important factor for customer satisfaction. The aim of this study is to analyze the customer satisfaction about service quality of the maternity hospital. Besides, it is to determine the hospital service quality from the pregnant women’s viewpoints and the relative importance of quality dimensions to improve better service quality for pregnant women and babies. This study was been conducted with 225 respondents who are pregnant women or women giving birth within 6 months in the maternity hospitals in Ho Chi Minh City in 2012. As a result, there are five (05) factors of service quality in the maternity hospitals impacting on customer satisfaction. Those are effectiveness and continuity; human and physical resources; the hospital charges; facilities and information. This research provides a framework to researchers know. The result may help the maternity hospitals to improve better service quality. Keywords: Customer satisfaction, service quality, maternity hospital, pregnant women. x xi Chapter one – Introduction 1. Introduction The hospital industry is one of the fastest growing industries today. Hospital managers have to understand the quality and the value of services offering to their consumers. The positive consequences of companies achieving high levels of customer satisfaction and service quality are well-documented (Rust & Zahorik, 1993; Zeithaml, Berry and Parasuraman, 1996). Indeed, service quality and customer satisfaction issues are very important as companies attempt to differentiate their services and compete effectively in the marketplace (Parasuraman, Zeithaml & Berry [PZB}, 1988; Brown & Swartz, 1989). A hospital is an institution of health care providing treatment with specialized staff and equipment, but not always providing for long-term patient stay. Today hospitals are centers of professional health care provided by physicians and nurses. The state, health organizations, health insurances or charities, including direct charitable donations usually provide financial support and other assistance to hospitals. There are several kinds of hospitals. Types of specialized hospitals include trauma centers, rehabilitation hospitals, children’s hospitals, seniors' (geriatric) hospitals, maternity hospitals and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital), certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth. Moreover, the hospitals are been developed in Vietnam. However, the author wants to focus the maternity hospital in Ho Chi Minh City because the author is a pregnant woman. The author also wants to know service quality of the maternity hospital in Ho Chi Minh City to choose hospital for giving birth next year. Therefore, the author wants to measure customer satisfaction and evaluates the service quality of the maternity 1 hospitals in Ho Chi Minh City. In addition, implications about study for the maternity hospitals to improve better service quality for pregnant women or women give birth whom will come in there. 2. Research problems Much of study and literature in marketing and management recognizes the importance of customer satisfaction. Therefore, it would be quite natural that such services would have an impact on the customer satisfaction. In this study, the author wants to focus service quality of the maternity hospitals. What do pregnant women want to have service quality of the maternity hospital in Ho Chi Minh City? How did the maternity hospitals take care for women giving birth? What do pregnant women expect service quality of the maternity hospitals? That is the reason for the author to choose this research topic: “MEASURING CUSTOMER SATISFACTION TOWARDS SERVICE QUALITY OF THE MATERNITY HOSPITALS IN HO CHI MINH CITY” 3. Research objective  Identify determinants of service quality of the maternity hospital in Ho Chi Minh City area.  Identify customer satisfaction towards service quality  Recommend some solutions for maternity hospitals to improve better service quality for pregnant women. 4. Scope The scope of present research includes measuring the quality services and evaluating customer satisfactions for the pregnant women or women gave birth within 6 months in the maternity hospital in Ho Chi Minh City. The total duration time for implementing this study is about 05 months (from August 2012 to January 2 2013); the data collection was been conducted in the maternity hospitals in Ho Chi Minh City area. 5. Implication of research Measuring the service quality and evaluating customer satisfactions for the pregnant women or women gave birth within 6 months in the maternity hospital in Ho Chi Minh City. Continuing to correct maternity hospitals to improve level of better quality services and caring for pregnant women and babies. 6. Research structure The structure of the thesis consist five chapters: Chapter 01: Introduction Chapter 1 introduces about service quality of the maternity hospital industry in Ho Chi Minh City. This part will include the reasons of this research and some existing problems need to have optimal solutions to solve. Chapter 02: Literature Review This chapter addresses the theories of service quality, customer satisfaction, factors that affect customer satisfaction. Chapter 03: Research model In this chapter, the report will describe in detail the methods and research design including data collection method, population approach. Besides, the measurement scale used in proposed model should be included as well. Chapter 04: Main Findings The previous chapter presented the research methodology. Following, this chapter will describe the characteristics of the sample, present the data analysis and discuss the findings of the research. 3 Chapter 05: Conclusions & Recommendations - Conclusion: Main results of this study. - Recommendations for maternity hospital to improve better service quality - Research Limitations 4 Chapter Two – Literature Review 1. Definition of Service Kotler and Keller (2010) define service as follows: “A service is any act or performance one party can offer to another that is essentially intangible and does not result in the ownership of anything” (page 386.) 2. Features of services Services have distinctive characteristics compared to common goods, includes intangibility, inseparability, variability and perishability (Kotler and Keller, 2010). - Intangibility: Services are intangible means that they cannot be touched, gripped, handled, looked at, smelled, tasted or heard. Thus, there is neither potential nor need for transport, storage or stocking of services. Furthermore, a service cannot be (re)sold or owned by somebody, neither can it be turned over from the service provider to the service consumer nor returned from the service consumer to the service provider. Solely, the service delivery can commissioned to a service provider who must generate and render the service at the distinct request of an authorized service consumer. - Inseparability: The service provider is indispensable for service delivery as he must promptly generate and render the service to the requesting service consumer. In many cases, the service delivery executed automatically but the service provider must preparatory assign resources and systems and actively keeps up appropriate service delivery readiness and capabilities. Additionally, the service consumer is inseparable from service delivery because he is involved in it from requesting it up to consuming the rendered benefits. 5 - Variability: Each service is unique. It is one-time generated, rendered and consumed and can never be exactly repeated as the point in time, location, circumstances, conditions, current configurations and/or assigned resources are different for the next delivery, even if the same service consumer requests the same service. Many services are been regarded as heterogeneous or lacking homogeneity and are typically modified for each service consumer or each new situation. - Perishability: Services cannot be stored and available at the time when it was been provided. Perishability can be a problem if the demand fluctuates. Each of these characteristics is retractable per se and their inevitable coincidence complicates the consistent service conception and makes service delivery a challenge in each case. Proper service marketing requires creative visualization to evoke effectively a concrete image in the service consumer's mind. From the service consumer's point of view, these characteristics make it difficult, or even impossible, to evaluate or compare services prior to experiencing the service delivery. 3. Service Quality Managing the quality of service is an interesting subject in Marketing. Until now, there have been many studies related to this topic, therefore, also have its definitions were given. However, no agreements are been made. From the standpoint of customers, the quality of service means a measure how well a delivered service matches customers’ expectation and satisfies their requirements (Lewis and Booms, 1983). Quality is one of important elements to service and physical goods, and criteria for consumers in distinguishing and selecting the provider among many competitors. For service industry, quality cannot estimate before. Therefore, it has 6 caused difficulty for both assessment of customers (in purchasing process) and providers (in after sales service.). 4. Service-quality model According to Gronroos (1984), the service quality experienced by a customer has two dimensions: Technical and Functional quality. In which Functional quality describes how the service is to deliver and technical quality describes what the customers received during a service delivery. The organization’s image works as a filter and can modify positively or negatively the customers’ perception of service quality. Gronroos (2007) emphasizes that the followings “Seven criteria of good perceived service quality” are the determinants that need to be considered when evaluating the service quality of any organization: professionalism and skills; attitudes and behavior; accessibility and flexibility; reliability and trustworthiness; service recovery; service scale; reputation and credibility. However, the above Seven criteria of good perceived service quality”, concepts have the similar characteristics to the Parasuraman el at (1985) “Ten determinants of service quality”. Based on this service-quality model, Parasuraman et. al., (1988) developed SERVQUAL (Service Quality) scale. This is a multi-item scale developed to assess customer perceptions of service quality in service and retail businesses (Parasuraman et. al., 1988). Parasuraman, in his initial paper, introduced the gaps model and established ten possible determinants of service quality (Parasuraman, 1985). Include: 1. Competence (Possession of the required skills and knowledge to perform the service: knowledge and skill of the contact personnel, knowledge and skill of the operational support personnel, research capability of the organization) 7 2. Courtesy (Politeness, respect, consideration and friendliness of the contact personnel: consideration for the customer's property, clean and neat appearance of public contact personnel) 3. Credibility (Trustworthiness, believability and honesty. It involves having the customer's best interest at heart: company name, company reputation, personal characteristics of the contact personnel) 4. Security (Freedom from danger, risk or doubt: physical safety, financial security, confidentiality) 5. Access (Approachability and ease of contact: Service is easily accessible, waiting time to receive service is not extensive, convenient hours of operation, convenient location of service facility) 6. Communication (Informing the customers in a language they can understand and listening to them. It may mean that the company has to adjust its language for different consumers: explaining the service itself, explaining how much the service will cost, explaining the trade-offs between service and cost, assuring the consumer that the problem will be handled) 7. Understanding/ knowing the customer (Making the effort to understand the customer's needs: understanding customer's specific needs, providing individualized attention, recognizing the customer) 8. Tangibles (Physical evidence of the service: appearance of physical facilities, tools and equipments used to provide the service, appearance of personnel and communication materials, other customers in the service facility) 9. Reliability (The ability to perform the promised service dependably and accurately: service is performed right at the first time, the company keeps its 8 promises in accuracy in billing, in keeping records correctly and in performing the services at the designated time) 10. Responsiveness (The willingness and/ or readiness of employees to help customers and to provide prompt service, timeliness of service: mailing a transaction slip immediately, setting up appointments quickly) The advantage of these models is able to cover all attributes of service. However, its weakness is that measurement is very complicated. Therefore, Victor Sower, JoAnn Duff, William Kilbourne, Gerald Kohers and Phyllis Jones (2001) developed KQCAH scale (The Key Quality Characteristics Assessment for Hospitals) and based on theoretical framework of the quality hospital service’s JCAHO (Joint Commission on Accreditation of Healthcare Organizations) to measure hospital quality. The authors asserted that nine components of JCAHO are similar with the components of SERVQUAL and it is easier to understand. That the components of JCAHO completed SERVQUAL tools and chosen as the theoretical framework on the hospital quality. Using a combination of qualitative and quantitative research mythologies, Victor Sower, JoAnn Duff, William Kilbourne, Gerald Kohers and Phyllis Jones (2001) defined the components of hospital service quality and developed an instrument to measure patient satisfaction. The authors formed eight components to measure the quality of hospital services. Those are: (1) Respect and caring, (2) Effectiveness and continuity, (3) Appropriateness, (4) Information, (5) Efficiency, (6) Meals, (7) First impression, (8) Staff diversity. - Respect and caring: “with which services are provided. The degree to which the pregnant women/ women gave birth within 6 months or a 9 designee is involved in her-own care decisions and to which these providing services do so with sensitivity and respect for the pregnant women’s need, expectations, and women gave birth within 6 months differences. - Effectiveness: “with which tests, procedures, treatments and services are provided. The degree to which the care provided in the correct manner, given the current state of knowledge, to achieve the desired or projected outcome for the pregnant women or women gave birth within 6 months. - Continuity: “of the services provided to the pregnant women with respect to other services, practitioners, and providers and over time. The degree to which the care for the pregnant women are coordinated among practitioners, among organizations, and overtime” - Appropriateness: “of a specific test, procedure or service to meet the pregnant women’s needs. The degree to which the care provided is relevant to the pregnant women’s clinical needs, given the current state of knowledge” - Efficiency: ‘with which services are provided. The relationship between the outcomes (results of care) and the re-sources used to deliver pregnant women care” - Information: to help and contact with patients and the patient’s family. For examples: to provide quick information on the treatment, doctors and consultants that are available. - Meals: quality and efficiency of the supply of food such as taste food for pregnant women, on time and eat the hot food 10 - First impression: the reputation of the hospital; provide fast service; dedication and enthusiasm of the doctors and nurses in hospitals; beautiful design; clean; fully equipped for mothers and babies. - Staffs diversity: includes the variety of facial expressions, gender, they can speak many languages. Therefore, KQCAH has eight components to measure the quality of hospital services. KQCAH is a multi-item scale that can provide valid and reliable information to hospital administrators. A hospital company with multiple units will find KQCAH that a useful way to compare the quality among its own units. So, KQCAH scale selected for theoretical framework for this study. 5. Customer Satisfaction There is general agreement that: Satisfaction is a person’s feeling of pleasure or disappointment resulting from comparing a product’s perceived performance (or outcome) in relation to his or her expectations (Kotler, 2003). Based on this review, customer satisfaction is been defined as the result of a cognitive and affective evaluation, where some comparison standard is compared to the actually perceived performance. If the perceived performance is less than expected, customers will be dissatisfied. On the other hand, if the perceived performance exceeds expectations, customers will be satisfied. Otherwise, if the perceived expectations are been met with performance, customers are in an indifferent or neutral stage. Customer satisfaction is been defined as a customer’s overall evaluation of the performance of an offering to date. This overall satisfaction has a strong positive effect on customer loyalty intentions across a wide range of product and service categories (Gustafson, 2005). 11 It is been seen as a key performance indicator within business. In a competitive marketplace where businesses compete for customers, customer satisfaction is been considered as a key differentiator and increasingly has become a key element of business strategy. 6. The relationship between service quality and customer satisfaction Service quality and customer satisfaction are important concepts to academic researchers studying consumer and customer loyalty (Dawn, Amy & Kent, 1995). There has had research on service and generally, service quality and customer satisfaction are distinct definitions (Bitner, 1990; Boulding & et. al., 1993). The satisfaction of customer, is an overall concept, states their satisfaction when they buy service. While service quality is considered by service dimensions (Zeithaml & Bitner, 2000). According to Oliver (1993), service quality has affected to customer satisfaction. It shows that service quality, defined by many different factors, is a determinant of satisfaction. 7. Some empirical findings on service quality in maternity hospital 7.1. Dimensions of service quality Naresh K. et al. (2004) identified the antecedents of what the international consumer perceives as service “quality.” This paper aims to examine the differences in perception of service quality dimensions between developed and developing economies. Parasuraman et al. (1985) proposed a framework consisting of ten determinants or dimensions of service quality: reliability, access, and understanding of the customer, responsiveness, competence, courtesy, communication, credibility, security, and tangible considerations. 12 In addition, Parasuraman et al. (1988) developed five dimension of service quality that have been empirically tested (Table: Dimensions of quality) and incorporated into their SERVQUAL instrument. While a major step forward, these dimensions were developed and tested in industries quite different from the health care industry. Other studies have identified potential difficulties related to the SERVQUAL instrument. Among the criticisms are questions about predictive and convergent validity and unstable dimensionality. Chakrapani (1998) developed a simpler service quality model consisting of three dimensions (Table 1: Dimensions of quality). This model intended to be simpler and more generalized than are those with more dimensions. Simplicity and generalizability reduce the applicability of these dimensions to one specific type of organization. Coddington and Moore (1987) suggest that the top five factors that define quality for health care providers from a consumer’s perspective are (a) warmth, caring, and concern, (b) medical staff, (c) technology equipment, (d) specialization and scope of services available, and (e) outcome (Table 1: Dimensions of quality). The Joint Commission on Accreditation of Healthcare Organization (JCAHO) identifies nine quality dimensions for hospital (Table 1: Dimensions of quality). This list is been closely related to Coddington and Moore’s (1987) five factors and the SERVQUAL dimensions, but is more comprehensive. Since the JCAHO, dimensions encompass the SERVQUAL and Coddington and Moore (1987) dimensions and since they were been developed specifically for use in the hospital accreditation process, the nine JCAHO dimensions were selected as the theoretical framework of hospital service quality for this study. Therefore, the intent of this study is to develop a valid and reliable instrument based upon the JCAHO dimensions of hospital service quality. 13 Table 1: Dimensions of quality DIMENSIONS OF QUALITY Garvin’s Evans & Parasuraman Chakrapani’s Coddington’s JCAHO (1996) (1987) Lindsay’s et al.’s (1998) (1987) dimensions product (1999) service SERVQUAL dimensions dimensions dimensions dimensions (1988) dimensions Performance Time Tangibles Service/ Warmth/ Efficacy Features Timeline Reliability Product Caring/ Appropriateness Reliability Completeness Responsiveness Dependability/ Concern Efficiency Conformance Courtesy Assurance Support Medical staff Respect Durability Consistency Empathy Exceeding Technology- Caring Serviceability Accessibility & Expectations equipment Safety Aesthetics convenience Specialization Continuity Perceived Accuracy Services Effectiveness quality Responsiveness Available Timeliness Outcome Availability 7.2 Customer satisfaction with service quality of the maternity hospital According to Auckland (2008) researched “Maternity services consumer satisfaction survey report”, the present report outlines the result of the 2007 survey of 2,936 women using Maternity Services. The objectives of the survey were to measure satisfaction among women using Maternity Services during March and April 2007 and where possible to compare the levels of satisfaction (or percentage of those satisfied) to those recorded in the 2002 survey. There was a significant increase in the percentage of women returning home within 12 hours of the birth of their baby (from 8% in 2002 to 14% in the current survey). Across the board, irrespective of when they left hospital, 13% of women reported not feeling ready to leave hospital. When asked why they felt not ready to leave, the women mentioned needing more rest, feeling unwell, breast feeding issues, facility issues, 14 & baby needing special care, medical reasons, as well as feeling pressured to leave. The 2007 survey demonstrates some clear service changes since the 2002 survey, as well as highlighting some new information. Results about overall satisfaction with service of the maternity hospital as follows: Respondents asked to indicate how satisfaction they were with their maternity services. The response options given were: “I felt well looked after”; was satisfactory” and “I didn’t feel well looked after”. Results indicate that, across the board, more than three quarters of the 2,811 women (or 78%) felt “well looked after”, while another 18% said it was “satisfactory”. However, 107 women, representing 4%, “didn’t feel well looked after” In addition, through survey of Marketing & Families Newspaper in Vietnam about customer satisfaction in June 2008 on healthcare services and customer care of hospital with 77.75% of reviews are “good”, 21.6% of the reviews are “very good”. Also similar to asking your general assessment of how the hospital has 27.64% of the respondents answered “very good”, 71.95% answered “good”, 0.27% answered “average”. 15 8. Research Model This research model has eight factors to measure customer satisfaction about service quality of the maternity hospital. Principal components factor analysis with very-max rotation determined eight (08) dominant factors present in the data. Respect and Caring Effectiveness and continuity H1 H2 H3 Appropriateness H4 Information Efficiency H5 Customer satisfaction H6 First impression H7 Meals H8 Staff diversity Figure 1: Research Model However, the author only used six (06) factors to research for this study. Those are respect and caring, effectiveness and continuity, appropriateness, information, efficiency, first impression. Because the author had done pilot interview about eight factors but interviewees gave feedbacks that we should drop two (02) factors: meals and staff diversity. Their reason were meals which not server all hospitals in Ho Chi Minh area, only Sai Gon International hospital is to server meals on time for pregnant women. The others has a canteen in hospitals, if you want to 16 have a breakfast, dinner, lunch, you will order canteen for serving meals. In additions, staff diversity factor is also not to use in hospitals. For the international hospitals as Sai Gon international hospital or French – Vietnamese hospital have to recruit staff diversity to server foreigner patient. With two factors that only are been used for a hospital so that we cannot compare and design a questionnaire for all hospitals. Therefore, the author did not use “Meals” factor and “Staff diversity” factors in the maternity hospitals in Ho Chi Minh City. That is reason why the author only used six factors for this study as follows: Figure 2: Adjusted research model 17 This is table about factors which are been changed by names in study. Table 2: Factors in study Factors The first factors Names in study Human and physical resources 1 Respect and Caring 2 Effectiveness and continuity Effectiveness and continuity 3 Appropriateness Facilities 4 Information Information 5 Efficiency The hospital charges 6 First impression First impression (Doctors & staffs) Hypothesizes the adjusted model had redefined as follows: H1: There are positive relationship between human and physical resources (doctors & staffs) and customer satisfaction. H2: There are positive relationship between effectiveness and continuity and customer satisfaction H3: There are positive relationship between facilities and customer satisfaction H4: There are positive relationship between information and customer satisfaction H5: There are positive relationship between the hospital charges and customer satisfaction H6: There are positive relationship between first impression and customer satisfaction 18 Chapter Three – Research Method 1. The introduction about the maternity hospitals in Ho Chi Minh City Nowadays, Ho Chi Minh City has many hospitals that serve the people. In particular, the maternity hospitals are also one important part of the hospitals and people can know as: 1.1 Tu Du hospital - 284 Cong Quynh, Dist 1, HCMC Tu Du Hospital was a specialist maternity hospital where was established in 1923. In 1937, it was been built maternity hospital with named Maternite Indochinoise (maternity hospital Indochina) by Professor Dr. George Cartoux (French) director. On April 8, 2004, the hospital was renamed the Tu Du Hospital with the total number of beds is 1,000. Today, Tu Du Hospital is been known as a leading hospital of obstetrics and gynecology of the country, and is the largest center gynecology in South. Tu Du Hospital is successful deployment of new achievements in the medical field as follows: implementation of ultrasound in obstetrics and gynecology, gynecological laparoscopic surgery (1990), established the Department of Rehabilitation infants (1996), successful implementation of the method of in vitro fertilization (1997), very preterm infant feeding method Kangaroo, genetics, etc. 1.2 Sai Gon international hospital – 63 Bui Thi Xuan, Dist 1, HCMC Saigon International Hospital was established and started construction in 1996 and in 2000 it was been operated. This is a private maternity hospital. Saigon International Hospital has modern equipment, full facilities, comfortable room, etc. Since the beginning of hospital’s establishment, board of directors have confirmed and defined the hospital that has to run well and effectiveness. Saigon International Hospital will share good services for communities and society. 19 1.3 Hung Vuong hospital – 128 Hong Bang, Dist 5, HCMC Hung Vuong hospital built in 1900, as a Maternity hospital. Hung Vuong Hospital has functions:  Providing the highest level of reproductive health treatment and care  Performing scientific research, focusing on Reproductive Health  International Collaboration  Training under- and post-graduate fellows from medical and nursing universities  Having the highest technical responsibility for 24 districts of HCMC Besides, it is one of the first BABY FRIENDLY Hospitals in Vietnam: approved since 1995 1.4 University Medical Center Hospital – 243 A Hoang Van Thu, Dist Tan Binh, HCMC University Medical Center Hospital established on March 31, 2002 based on the cooperation contract between Ho Chi Minh City University of Medicine and Mekong Obstetrics Hospital Limited Company. It is currently operating at 243A Hoang Van Thu Street, Ward 1, Tan Binh District, and Ho Chi Minh City. Now it has more than 200 beds, clinic, emergency room, labor room, laboratory, diagnostic imaging, operating room and recovery rooms are equipped with modern machinery. University Medical Center Hospital can perform the surgery in obstetrics, gynecology, and laparoscopic surgery. Along with a team of professors, doctors, industry experts specialized in Obstetrics, Gynecology, and Pediatric of hospital, they trained basic in Vietnam and abroad. University Medical Center Hospital is promoting the advantage of being a basis-leading specialist in the field of care for women of all age a comprehensive way. 20 2. Scale To measure customer satisfaction towards service quality of the maternity hospitals in Ho Chi Minh City, we follow previous studies as mentioned above to identify the scale of service quality and customer satisfaction. 2.1 Service quality scale The research applied the concept of rating things with numerical scores. This method gives us a number to express the level of satisfaction. Normally, scales of five (5-point Liker scale) used to indicate the extreme dissatisfaction and extreme satisfaction. The service quality model includes 30 observed variables adjusted for measuring six dimensions of service quality as follows: a. Human and physical resources (doctor & staff) - Employees respect the patient - Employees are friendly, polite when they respond patient's need - Employees are always willing to help the patient - Employees listen and solve quickly the complaining of patient - Employees ensure information confidentiality of patient b. Effectiveness and continuity - The patient can touch and talk easy with hospital’s employees - Hospital has simple procedure, quickly time for hospitalize - Employees tried to control the patient’s pain when they were hurt - Employees are well-trained with high competence - Patients were allowed to participate in their decisions and treatment - Patients were carefully instructed before leaving hospital 21 c. Facilities - The hospital has a quite space - Hospital employees look clean and are well-dressed - The hospital has modern equipment and technology - The hospital has clean room and tidy equipment - Equipment with utensils is full for mothers and newborn baby - The hospital has the necessary light d. Information - The patient don’t have to fill out so many forms of admission - Phone system for calling employees is ready and in good condition - The doctor informed the patient about the results of examination testing, treatment - The patient gets the doctor to provide information quickly e. The charges hospital - Hospital collects reasonable medical charges - The hospital charges is clear and easily to understand - Employees are available for their explaining about the hospital charges f. First impression - Hospital has reputation - Hospital is thoughtful of the patient - Hospital has modern equipment and facilities - The hospital has a lot of professional and good doctors - Hospital ‘s landscape is clean 22 - The patient feels comfortable to contact with hospital’s employees 2.2 Scale of customer satisfaction. Based on Perception-Based Customer Satisfaction Model of Athanassopoulos & Iliakopoulos (2003), scale of satisfaction has six observed variables, these are: - Do you satisfy with your maternity hospital? - Do you satisfy with human and physical resources in hospital? - Do you satisfy with effectiveness and continuity of hospital services? - Do you satisfy with the hospital charges? - Do you satisfy with facilities on service quality of hospital? - Do you satisfy with information on service quality of hospital? 23 3. Research procedure This is the research procedure that researcher has to do in order in this study. Problem statement Research question Literature review Research model Field research Methodology Questionnaire design Pilot test Questionnaire survey conducting Data processing and analysis Findings and recommendations Figure 3: Research process 24 4. Questionnaire design After reviewing theories and some empirical reports related to the research problem, the questionnaire was designed which included three parts as follows: Firstly, Part 01 includes common information about the maternity hospital, which pregnant women or women gave birth within 6 months in the maternity hospital in Ho Chi Minh City. Secondly, Part 02 includes service quality and their satisfaction about maternity hospital. Therefore, data from this part played an important role for whole research process. There are 36 observed items where 30 first observed variables used to measure the service quality based on KQCAH scale. The last part of questionnaire helped us to classify interviewed objectives as career, age and income. Table 3: Coding variables in measurement scale No. Code Description Human and physical resources (Doctors & Staff) 1. H1 Employees respect the patient 2. H2 Employees are friendly, polite when they respond patient's need 3. H3 Employees are always willing to help the patient 4. H4 Employees listen and solve quickly the complaining of patient 5. H5 Employees ensure information confidentiality of patient Effectiveness and continuity 6. E1 The patient can touch and talk easy with hospital’s employees 7. E2 Hospital has simple procedure, quickly time for hospitalize 8. E3 Employees tried to control the patient’s pain when they were hurt 9. E4 Employees are well-trained with high competence 10. E5 11. E6 Patients were allowed to participate in their decisions and treatment Patients were carefully instructed before leaving hospital Facilities 25 12. F1 The hospital has a quite space 13. F2 Hospital employees look clean and are well-dressed 14. F3 The hospital has modern equipment and technology 15. F4 The hospital has clean room and tidy equipment 16. F5 Equipment with utensils is full for mothers and newborn baby 17. F6 The hospital has the necessary light Information 18. I1 The patient don’t have to fill out so many forms of admission 19. I2 Phone system for calling employees is ready and in good condition 20. I3 The doctor informed the patient about the results of examination testing, treatment 21. I4 The patient gets the doctor to provide information quickly The hospital charges 22. T1 Hospital collects reasonable medical charges 23. T2 The hospital charges is clear and easily to understand Employees are available for their explaining about the hospital charges First impression 24. T3 25. FI1 Hospital has reputation 26. FI2 Hospital is thoughtful of the patient 27. FI3 Hospital has modern equipment and facilities 28. FI4 The hospital has a lot of professional and good doctors 29. FI5 Hospital's landscape is clean 30. FI6 The patient feels comfortable to contact with hospital’s employees. Customer satisfaction 31. S1 Do you satisfy with your maternity hospital? 32. S2 Do you satisfy with human and physical resources in hospital? 33. S3 Do you satisfy with effectiveness and continuity of hospital services? 34. S4 Do you satisfy with the hospital charges? 35. S5 Do you satisfy with facilities on service quality of hospital? 26 36. S6 Do you satisfy with information on service quality of hospital? 5. Sample size Firstly, we conducted a pilot test on 20 pregnant women and women giving birth within six (06) months. From their comments and suggestions, we completed the final questionnaire design. We distributed 250 questionnaires to potential respondents. We implemented the survey during one month and received 225 samples. After collecting data, we use the Statistical Package for Social Sciences (SPSS) version 16 to code and refine the database. 6. Analysis techniques 6.1 Descriptive statistics “Descriptive statistics are used by researchers to summarize and "describe" data found during research. Typically, researchers deal with lots of data and descriptive statistics provide a way for the researchers to summarize the main properties of a large group of data into just a few numbers. This lets the researcher show what the data are without tons and tons of numbers. Some examples of descriptive statistics are frequency distributions, measures of center (i.e., mean, median, and mode), range, and standard deviation. 6.2 Testing reliability of scale by Cronbach’s Alpha Cronbach's α (alpha) is a coefficient of reliability. It is been commonly used as a measure of the internal consistency or reliability of a psychometric test score for a sample of examinees (Cronbach, 1951). A reliability coefficient is from 0.7 to 0.8 considered acceptability in most of social science application. Besides, the item-total correlation coefficient of variable, which is less than 0.30, will be been rejected. 27 Many researchers found that the scale has 0.8 – 1.0 of reliability coefficient is a good one. 6.3 Exploratory Factors Analysis (EFA) After data collection was completed, descriptive statistics were been initially conducted to provide an overview of the sample. Secondly, the reliability tests and exploratory factor analysis (EFA) were been applied to analyze the data and conduct a primary test of the validity and reliability of the instrument. The purpose of this test is to assess the scales used to measure the constructs, i.e. to refine the measures; the refinement is been based on reliability and dimensionality. “Consider the accordance of EFA: KMO coefficient (Kaiser-Meyer-Olkin) is a criterion for evaluating the accordance of the data for EFA. The EFA is appropriate when 0.5 ≤ KMO ≤1” (Hoang et al., 2005). “A value of 0 indicates that the sum of partial of correlations is large relative to the sum of correlations, indicating diffusion in the pattern of correlations (hence, factor analysis is likely to be inappropriate). A value close to 1 indicates that patterns of correlations are relatively compact and so factor analysis should yield distinct and reliable factors” (Andy Field, 2009) The criteria to determine the number of factors are been extracted: all extraction factors must have Eigenvalue > 1. This standard is widely accepted as the basic for adding or removing any factor (Kaiser, 1960, Rummell, 1970 – extract from Hoang et al., 2008). 6.4 Multiple – Regression Analysis On the purpose of find out the weighted score of each service quality’s dimensions on total customer satisfaction, this research used multiple-regression as efficient analysis tool. It also helps to reject inappropriate variables from original model and rebuild new ones. 28 Chapter Four - Main Findings 1. Sample Description There were totally 225 hard copies of questionnaires delivered and received directly from respondents at hospitals. We summarize demographic characteristics of the database: 1.1 Age description With 225 questionnaires, the largest group of respondents (39.1%) were aged 26 to 30 years. The next largest group of respondents (37.3%) were aged 31 to 35 years. Smaller groups of respondents were aged 35 to 40 years (20%) and 20 to 25 years (3.6%). Figure 4: Age description 29 1.2 Career description Most of the respondents in this survey are officers in Ho Chi Minh city with 83.1%. Figure 5: Career description 1.3 Income description Figure 6: Income description 30 In this figure, the highest income is 43.1% with income over 7 million to 10 million VND. Next, there is 29.3% of income over 10 million VND and only 5.8% of income under 4 million VND. 2. Descriptive Statistics Descriptive statistics for each measurement item are reported in Tables below including minimum, maximum, mean and standard deviation. Table 4: Descriptive Statistics of Human and physical resources Descriptive Statistics Code Item label N Min Max H1 Employees respect the patient Employees are friendly, polite when they respond patient's need Employees are always willing to help the patient Employees listen and solve quickly the complaining of patient Employees ensure information confidentiality of patient Valid N (listwise) Average 225 1.0 5.0 Std Deviation 3.422 .863 225 1.0 5.0 3.378 .815 225 1.0 5.0 3.404 .819 225 1.0 5.0 3.204 .792 225 1.0 5.0 3.547 .865 H2 H3 H4 H5 Mean 225 3.391 We can see that the average Mean value in table 4 is 3.391. Comparing with five (5) – maximum value, this average point is just above the average. Employees respect the patient. They are friendly, polite and they are always willing to help the patient. It means that pregnant women are also satisfied with human and physical resources in the maternity hospital. 31 Table 5: Descriptive Statistics of Effectiveness and continuity Descriptive Statistics Code E1 E2 E3 E4 E5 E6 Item label The patient can touch and talk easy with hospital’s employees Hospital has simple procedure, quickly time for hospitalize Employees tried to control the patient’s pain when they were hurt Employees are well-trained with high competence Patients were allowed to participate in their decisions and treatment Patients were carefully instructed before leaving hospital Valid N (listwise) Average N Min Max Mean 225 1.0 5.0 3.182 225 1.0 5.0 3.431 225 1.0 5.0 3.382 225 1.0 5.0 3.809 225 1.0 5.0 3.467 Std Deviation 0.875 0.919 0.889 0.787 0.850 225 1.0 5.0 3.689 0.854 225 3.493 We can see that the average Mean value in table 5 is 3.493. Comparing with five (5) – maximum value, this average point is just above the average. In this description, employees are well trained with high competence are highest (mean = 3.809). In general, pregnant women are satisfied with effectiveness and continuity. 32 Table 6: Descriptive Statistics of Facilities Descriptive Statistics Mean Std Deviation 1.0 5.0 3.2578 1.059 225 1.0 5.0 3.6978 225 1.0 5.0 225 1.0 5.0 3.5822 225 1.0 5.0 3.6578 225 1.0 5.0 3.7333 Code Item label N Min F1 The hospital has a quite space Hospital employees look clean and are well-dressed The hospital has modern equipment and technology The hospital has clean room and tidy equipment Equipment with utensils is full for mothers and newborn baby The hospital has the necessary light Valid N (listwise) Average 225 F2 F3 F4 F5 F6 Max 3.88 0.800 0.761 0.878 0.868 0.779 225 3.635 We can see that the average Mean value in table 6 is 3.635. Comparing with five (5) – maximum value, this average point is not very high but overall most of pregnant women are satisfied with facilities. For examples: the hospital has a quite space, clean room, full equipment for mothers and new baby … Table 7: Descriptive Statistics of Information Descriptive Statistics Code I1 I2 I3 I4 Item label The patient don’t have to fill out so many forms of admission Phone system for calling employees is ready and in good condition The doctor informed the patient about the results of examination testing, treatment The patient gets the doctor to provide information quickly Valid N (listwise) Average N Min Max Mean 225 1.0 5.0 3.4622 225 1.0 5.0 3.3378 Std Deviation 0.945 0.941 225 1.0 5.0 3.6578 0.734 225 1.0 5.0 3.5289 0.738 225 3.497 33 We can see that the average Mean value in table 7 is 3.497. Comparing with five (5) – maximum value, this average point is just above the average. It means that pregnant women are also satisfied with information of the maternity hospital. Table 8: Descriptive Statistics of The hospital charges Descriptive Statistics Code T1 T2 T3 Item label N Hospital collects reasonable medical charges The hospital charges is clear and easily to understand Employees are available for their explaining about the hospital charges Valid N (listwise) Average Min Max Mean 225 1.0 5.0 3.5244 225 1.0 5.0 3.8533 225 1.0 5.0 3.5289 Std Deviation 0.866 0.682 0.785 225 3.636 The average Mean value in table 8 is 3.636. Comparing with five (5) – maximum value, this average point is rather high. It means that overall most of pregnant women are satisfied with the hospital charges. Because the hospital charges are reasonable, clear, easily to understand and employees are available for their explaining. Table 9: Descriptive Statistics of First impression Descriptive Statistics Code FI1 FI2 FI3 FI4 FI5 FI6 Item label Hospital has reputation Hospital is thoughtful of the patient Hospital has modern equipment and facilities The hospital has a lot of professional and good doctors Hospital's landscape is clean The patient feels comfortable to N Min Mean Std Deviation 225 1.00 5.00 4.0711 0.728 225 1.00 5.00 3.5067 225 1.00 5.00 3.6667 225 1.00 5.00 3.9556 225 225 1.00 5.00 3.4489 1.00 5.00 3.3644 Max 0.768 0.773 0.817 0.828 0.797 34 contact with hospital’s employees 225 Valid N (listwise) Average 3.669 We can see that the average Mean value in table 9 is 3.669. Comparing with five (5) – maximum value, this average point is rather high and it is the highest average point of factors. It means that overall most of pregnant women will have impression about hospital when they come in there. Table 10: Descriptive Statistics of Customer Satisfaction Descriptive Statistics Code S1 S2 S3 S4 S5 S6 Do you satisfy with your maternity hospital? Do you satisfy with human and physical resources in hospital? Do you satisfy with effectiveness and continuity of hospital services? Do you satisfy with the hospital charges? Do you satisfy with facilities on service quality of hospital? Do you satisfy with information on service quality of hospital? Valid N (listwise) Average N Min Max Mean Std Deviation 225 1.0 5.0 3.6578 0.752 225 1.0 5.0 3.3511 0.805 225 1.0 5.0 3.6000 0.707 225 1.0 5.0 3.5422 0.801 225 1.0 5.0 3.4756 0.732 225 1.0 5.0 3.5467 0.687 225 3.5289 In this part, my thesis has six items, which was been used for measuring customer satisfaction towards service quality of the maternity hospital in Ho Chi Minh City. We can see that the average Mean value in table 10 is 3.5289. Comparing with five (5) – maximum value, this average point is also high, it means that overall most of pregnant women are satisfied with service quality of the maternity hospital. 3. Assessment and refinement of scale 35 3.1 Testing the reliability of service quality scale by Cronbach’s alpha Table 11: Cronbach’s Alpha analysis of KQCAH scale Scale Cronbach's Corrected Squared Observed Scale Mean if Variance if Alpha if Item-Total Multiple variable Item Deleted Item Item Correlation Correlation Deleted Deleted Human and physical resources variable group: Alpha = .861 H1 13.5333 7.018 .729 .632 .818 H2 13.5778 6.959 .807 .714 .798 H3 13.5511 6.972 .799 .672 .800 H4 13.7511 7.447 .699 .566 .827 H5 13.4089 8.350 3.99 .163 .901 Effectiveness and continuity variable group: Alpha = .819 E1 17.7778 10.415 .498 .339 .809 E2 17.5289 9.313 .684 .494 .767 E3 17.5778 9.575 .659 .455 .773 E4 17.1511 11.040 .446 .266 .817 E5 17.4933 10.260 .553 .322 .797 E6 17.2711 9.815 .665 .465 .773 Facilities variable group: Alpha = .841 F1 18.5511 9.775 .612 .487 .822 F2 18.1111 10.680 .694 .515 .802 F3 17.9289 11.682 .517 .359 .834 F4 18.2267 10.185 .713 .525 .796 F5 18.1511 10.798 .596 .398 .820 F6 18.0756 11.151 .613 .383 .817 Information variable group: Alpha = .793 I1 10.5244 4.295 .480 .245 .812 I2 10.6489 3.791 .652 .430 .718 I3 10.3289 4.400 .691 .562 .708 I4 10.4578 4.508 .642 .527 .729 The hospital charges variable group: Alpha = .718 T1 7.3822 1.719 .459 .267 .742 T2 7.0533 1.801 .682 .473 .782 T3 7.3778 1.825 .505 .355 .668 First impression variable group: Alpha = .741 FI1 17.9422 7.617 .386 .566 .729 FI2 18.5067 6.849 .562 .470 .681 FI3 18.3467 6.692 .602 .381 .669 FI4 18.0578 7.635 .310 .576 .752 FI5 18.5644 6.926 .479 .528 .705 FI6 18.6489 6.791 .548 .558 .684 36 The above table showed the reliable level of service quality scale. Firstly, human and physical resources group included five (05) observed items; those are H1, H2, H3, H4 and H5. All of them had accepted due to corrected item-total correlation coefficient greater 0.3. Besides, Cronbach’s alpha was rather high to 0.86 (> 0.7), therefore, human and physical resources’ component scale value reliable and could be used for next analysis step. Secondly, the study continued to consider the observed variable group Effectiveness and continuity. This component had six (06) variables in total. The corrected item-total correlation coefficients are greater than 0.3 and Alpha = 0.82 (> 0.7). It showed that this component scale was reliable for factor analysis. Thirdly, the observed group - Facilities has six (06) variables and Cronbach’s alpha coefficient = 0.84 (> 0.7). Therefore, the scale value was reliability. Next, the variable group was Information with four (04) variables and Cronbach’s alpha coefficient = 0.79 (> 0.7). With five variable groups of service quality, the hospital charges had Alpha coefficient = 0.72 (> 0.7). Because of that, this group would continue into next analysis step. Finally, first impression group also has six (06) variables and Cronbach’s alpha coefficient = 0.74 (> 0.7). Therefore, there were no reasons to reject these variables for factor analysis later. In general, the Cronbach’s Alpha coefficients of service quality’s components were greater than 0.7. It proved that this was a good scale. Thus, this study was been continued with exploratory factor analysis as data reduction method. 37 3.2 Testing the reliability of customer satisfaction scale by Cronbach’s alpha. Table 12: Cronbach’s Alpha analysis of customer satisfaction Reliability Statistics Cronbach's Alpha N of Items .855 6 Item-Total Statistics Scale Mean if Scale Variance Item Deleted if Item Deleted Corrected Item-Total Correlation Cronbach's Alpha if Item Deleted S1 17.5156 8.349 .645 .831 S2 17.8222 8.031 .665 .827 S3 17.5733 8.299 .716 .819 S4 17.6311 9.011 .429 .872 S5 17.6978 8.203 .710 .819 S6 17.6267 8.333 .734 .816 The scale of customer satisfaction includes six (06) observed items. Cronbach’s alpha was also rather high (0.855). Additionally, the corrected item total correlation coefficient of each variable was also greater than 0.3. So, the results indicates that the initial measurement set is correctly designed. The six items representative to this dimension are closely related.. In addition, table 6 showed that percentage of customer satisfaction about service quality of the maternity hospitals in Ho Chi Minh City. 38 Table 13: Frequency of customer satisfaction Customer satisfaction Percent Valid Percent 2.00 0.89 0.89 9.00 76.00 115.00 23.00 225.00 4.00 33.78 51.11 10.22 100.00 4.00 33.78 51.11 10.22 100.00 Frequency Valid 1 2 3 4 5 Total Cumulative Percent 0.90 4.90 37.78 89.78 100.00 Figure 7: Frequency of customer satisfaction From the above results, we can see about customer satisfaction rate in the concentrated sample at the satisfaction (Mode = 4, Mean = 3.66). There are 23 customers that corresponding with 10.22% is strongly satisfied. Besides, only two (02) customers with 0.89% are strongly dissatisfied about service quality of hospital. 39 3.3 Assessment on Service Quality Scale using EFA analysis After assessing the reliability of scale by Cronbach’s alpha, the present study continued with factor analysis. In this analysis, extraction method used, that was, Principal component with varimax rotation. Table 14: KMO and Bartlett’s test about service quality KMO and Bartlett's Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy Bartlett's Test of Sphericity Approx.Chi-Square df Sig 0.927 4203.742 435 0.000 The service quality scale included six (06) main constructs and measured 30 observed variables. These variables met the allowed standard of reliability. Exploratory Factors Analysis would re-assess the variability among observed variables by each constructs. KMO and Bartlett’s test in EFA analysis measured the sampling adequacy. With KMO coefficient was rather high (0.927 > 0, 5) with significant of 0,000 showed that EFA analysis was appropriate. With Principal component and Varimax rotation method, factor analysis had extracted six factors from 30 observed variables. Then, by rejecting inappropriate variables one by one, which had factor loadings coefficients less than 0.5 in model, we had the final rotated component matrix table after 03 times for extracting as follows: 40 Table 15: Rotated Component Matrixa No. Variable 1 2 3 4 5 6 7 8 9 10 11 H2 H3 H4 H1 FI1 FI4 T1 T2 I3 I4 I2 12 13 14 15 16 F3 F2 F5 FI5 FI6 Rotated Component Matrixa Component Human and physical Effectiveness resources and Facilities Information (Doctor & continuity Staff) 0.84 0.83 0.83 0.77 0.87 0.86 0.71 0.70 0.77 0.75 0.66 0.74 0.70 0.68 The hospital charges 0.81 0.68 Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. a. Rotation converged in 5 iterations. After factor analysis, the service quality of hospital scale based on KQCAH model included 16 observed variables. From original six components of hospital service, they were been regrouped and renamed as follows: - Group 1: H1, H2, H3, H4 - Human and physical resources (Doctors & Staffs) - Group 2: T1, T2, FI1, FI4 - Effectiveness and continuity - Group 3: I2, I3, I4 - Facilities 41 - Group 4: F2, F3, F5 - Information - Group 5: FI5, FI6 - The hospital charges With total extracted variance of 74.713% (>50%), it indicated that five factors were explained by 74.713% of data variability. These variables satisfied requirements of convergent and discriminant validity due to factor loadings greater than 0.5 and cross loadings (variable loads on multiple factor) differed by more than 0.3. Table 16: Total variance explained Total Variance Explained Component Initial Eigenvalues % Cumulative Total Variance % 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 6.294 2.734 1.239 0.990 0.697 0.658 0.563 0.470 0.418 0.396 0.345 0.308 0.264 0.243 0.197 39.335 17.089 7.744 6.190 4.355 4.109 3.520 2.940 2.615 2.475 2.155 1.927 1.647 1.521 1.229 39.335 56.424 64.168 70.358 74.713 78.822 82.342 85.282 87.897 90.372 92.527 94.454 96.101 97.622 98.850 16 0.184 1.150 100.000 Extraction Sum of Squared Loadings % Cumulative Total Variance % Rotation Sums of Squared Loadings % Cumulative Total Variance % 6.294 2.734 1.239 0.990 0.697 3.283 2.773 2.413 1.933 1.552 39.335 17.089 7.744 6.190 4.355 39.335 56.424 64.168 70.358 74.713 20.516 17.334 15.080 12.082 9.701 Extraction Method: Principle Component Analysis This new scale considered as reliable one after computing reliability of each group had had Alpha coefficients bigger 0.8. 42 20.516 37.850 52.930 65.012 74.713 Table 17: Cronbach’s Alpha analysis of factors Item-Total Statistics Scale mean if item Deleted H1 H2 H3 H4 T1 T2 FI1 FI4 I2 I3 I4 F2 F3 F5 FI5 FI6 Scale Variance if item Deleted 53.9644 54.0089 53.9822 54.1822 53.8622 53.5333 53.3156 53.4311 54.0489 53.7289 53.8578 53.6889 53.5067 53.7289 53.9378 54.0222 51.695 51.58 51.276 52.864 56.968 53.946 56.396 56.309 51.868 52.306 52.364 52.501 52.956 52.466 52.335 51.513 Corrected Item-Total Correlation 0.603 0.656 0.680 0.558 0.169 0.550 0.274 0.240 0.529 0.667 0.657 0.585 0.577 0.534 0.576 0.680 Squared Multiple Correlation Cronbach's Alpha if Item Deleted 0.652 0.728 0.711 0.607 0.387 0.534 0.605 0.594 0.498 0.614 0.576 0.473 0.452 0.376 0.575 0.636 0.872 0.870 0.868 0.874 0.890 0.874 0.884 0.887 0.875 0.870 0.870 0.873 0.873 0.875 0.873 0.869 3.4 Assessment of Customer Satisfaction Scale through EFA analysis The scale of customer satisfaction involved six (06) observed variables. After testing Cronbach’s alpha, this scale met the reliable level. EFA analysis was been used to test the convergence of observed variables. Table 18: Component Matrix of customer satisfaction Component Matrix Component 1 S1 0.752 S2 0.797 S3 0.819 S4 0.553 S5 0.827 S6 0.840 Extraction Method: Principal Component Analysis a. 1 components extracted 43 With Extraction method – Principle Component Analysis and rotation technique, factor analysis extracted one (01) factor only which had factor loadings coefficient from 0.55 to 0.84. Besides, KMO and Bartlett’s test in EFA analysis measured the sampling adequacy. With KMO coefficient of customer satisfaction was rather high (0.829 > 0. 5) with significant of 0.000 showed that EFA analysis was appropriate. Table 19: KMO and Bartlett’s test of customer satisfaction KMO and Bartlett's Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy. Bartlett's Test of Sphericity Approx. Chi-Square df Sig. .829 625.788 15 .000 3.5 Research Model Adjustment According to EFA analysis above, the components of service quality changed from six (06) into five (05) factors and the number of observed variables reduced from 30 into 16 explanatory variables. Therefore, the initial research model should been adjusted. The new research model of hospital service quality also would have 05 constructs included: human and physical resources, effectiveness and continuity, facilities, information and the hospital charges. 44 Human and physical resources (Staffs) H1’ H5’ H2’ The hospital charges Effectiveness and continuity Customer Satisfaction H4’ Information H3’ Facilities Figure 8: Adjusted research model after EFA analysis Hypothesis of adjusted model had redefined as follows: H1’: There are positive relationship between human and physical resources (doctors & staffs) and customer satisfaction. H2’: There are positive relationship between effectiveness and continuity and customer satisfaction H3’: There are positive relationship between facilities and customer satisfaction H4’: There are positive relationship between information and customer satisfaction H5’: There are positive relationship between the hospital charges and customer satisfaction 45 3.6 Testing the research model using 3.6.1. Correlation Matrix: The first step of multiple regression analysis process, that is, considering the linear correlation between observed variables. This has normally done with the aim to pre-test the relationship between the dependent variable and independent variables, and between independent variables before running the regression model. Table 20: KMO and Bartlett’s test of new factors KMO and Bartlett's Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy. Bartlett's Test of Sphericity .878 Approx. Chi-Square 1996.378 Df 120 Sig. .000 With KMO and Bartlett’s test after running regression model, this value was to be greater than 0.8. According to Keiser a KMO measure of 0.9 - 1.0 is marvelous, 0.8 - 0.9 meritorious, 0.7 - 0.8 middling, 0.6 - 0.7 mediocre, 0.5-0.6 miserable, (Marcus J.Schmidt, Svend Hollense, 2006). Therefore, the factor analysis is suitable for this data set. 3.6.2. Regression Analysis: Regression models: Customer satisfaction = β0 + β1 (Staff) +β2 (Effectiveness and continuity) + β3 (Facilities) +β4 (Information) + β5 (The hospital charges) + error Table 21: Model summary Model Summary Model R R Square Adjusted R Square Std. Error of the Estimate Change Statistics R Square Change F Change df1 df2 0.829a 0.688 0.681 0.565 0.688 96.490 1 5 219 a. Predictors: (Constant), Human and physical resources, Effectiveness and continuity, Facilities, Information, The hospital charges Sig.F Change 0.000 46 R-square is the percentage of variance in the dependent variable explained by the collection of independent variables. R-square measures the proportion of the variation in the dependent variable that was been explained by variations in the independent variable. The adjusted R square coefficient =0.681 showed that there was 68.1% .of variance of dependent variable could be explained by independent variables. In other word, 68.1% of variability about customer satisfaction explained by the linear relationship with Human and physical resources (Doctors & Staff); Effectiveness and continuity; Facilities; Information; The hospital charges. Besides, the Significant F value was so small (.000), therefore we could conclude that the regression model was appropriate with set of data. Table 22: Coefficients Coefficientsa Model Unstandardize Standardized Coefficients Cofficients B 1 (Constant) Std.Erro r -1.675 .038 physical .404 .038 Effectiveness and continuity .451 Facilities t Sig. Beta .000 .000 .404 10.691 .000 .038 .451 11.942 .000 .348 .038 .348 9.223 .000 Information .246 .038 .246 6.525 .000 The hospital charges .374 .038 .374 9.894 .000 Human and resources a.Dependent Variable: Customer Satisfaction Equation model has evaluated and verified the suitability of the model. The independent variables were been predicted well for customer satisfaction. Exposure levels were been arranged in descending levels as follows: effectiveness and continuity, human and physical resources, the hospital charges, facilities and information. Thus, 47 - Human and physical resources have a significant to impact on customer satisfaction (β1 = 0.404, t = 10.691, sig. = 0.000). - Effectiveness and continuity have a significant to impact on customer satisfaction (β2 = 0.451, t = 11.942, sig. = 0.000). - Facilities have a significant to impact on customer satisfaction (β3 = 0.348, t = 9.223, sig. = 0.000). - Information have a significant to impact on customer satisfaction (β4 = 0.246, t = 6.525, sig. = 0.000). - The hospital charges have a significant to impact on customer satisfaction (β5 = 0.374, t = 9.894, sig. = 0.000). The beta coefficients had positive signal reflected that factors, in regression model, were directly proportional to the satisfaction of customer. Which one is 5%, all variables accepted (sig.< 0.05) therefore they would be affected on customer satisfaction. Table 23: Anova ANOVAb Model 1 Sum of Squares 154.06 df Mean Square F Sig. 5.00 30.81 96.49 0.00 Residual 69.94 219.00 0.32 Total 224.00 224.00 Regression a. Predictors: (Constant), Human and physical resources, Effectiveness and continuity, Facilities, Information, The hospital charges b. Dependent Variable: Customer satisfaction 48 3.7. Comparison of customer satisfaction level between the maternity hospitals Figure 9: Comparison customer satisfaction level between the maternity hospitals 49 As the chart above, Tu Du hospital has strongly satisfied with 4% about service quality of maternity hospital. Next, University Medical Center hospital – branch 4 with 2.67%, Hung Vuong hospital with 1.78%, Sai gon international hospital with 1.33% and the others with 0.44%. Although Tu Du hospital also has evaluated with dissatisfy about service quality (3.56%) but the pregnant women or women gave birth baby still believe in this hospital because Tu Du hospital was one of the best famous hospitals in Vietnam with the professional doctors. Besides, the charges hospital of Tu Du is always cheaper than hospitals so Tu Du hospital gains the advantage of the highest satisfaction on the service quality of maternity hospital in Ho Chi Minh City. University Medical Center hospital – branch 4 also has evaluated with high satisfaction behind Tu Du hospital. However, the charges hospital in there is rather expensive and there no use the state’s health insurance card so that is one disadvantage of hospital. However, the pregnant women or women gave birth still evaluate good service quality about facilities, human and physical resources, effectiveness and continuity. Although the hospital charges of this hospital is higher price than Tu Du hospital but it is still cheaper than Sai Gon international hospital. Moreover, pregnant women or women gave birth can be assured about service quality of this hospital. Hung Vuong hospital is the third rank after Tu Du hospital and University Medical Center hospital – branch 4 about service quality of the maternity hospital (1.78%). Customers can use the state’s health insurance card for giving birth baby in there, reducing the charges hospital. However, two hospitals always overload the pregnant women or women prepare to have new baby. Therefore, the quality of service would not be responded well to customers. 50 Sai Gon International hospital is a modern hospital where has more equipment, good room, good service, etc. However, the hospital charges are too high price for customers. If customers have income over 10 million, they will ready to go to this hospital. Moreover, this hospital will refuse pregnant women whom have bad problems during pregnancy and they will move to Tu Du hospital or Hung Vuong hospital for treatment. This shows that Sai Gon international hospital has no professional in treatment because this hospital is afraid of affecting to hospital’s reputation. Therefore, Sai Gon International hospital is not overloaded and has more room for serving in case of easily pregnant women. Here are four hospitals where customers want to come for taking care babies and pregnant women. Every hospital has different strengths and weaknesses but all hospitals are always to serve patients. Nowadays, there are private hospitals where expanded and developed to serve customers, for examples: Vu Anh international hospital, An Sinh hospital, Hanh Phuc hospital …These hospitals have just established after the public hospitals but they have known about good service for customer satisfaction. So based on factors in this study, the hospital should be considered and improved about their service quality to customers. Besides, customer satisfaction about service quality of the maternity hospital will also affect and influence to introduce the other customers. Here is figure 10 of introduction to the maternity hospital when customer feels satisfy. 51 Figure 10: Introduction of customer 3.8 Discussion of results The data have been collected using KQCAH scale from 225 samples to measure service quality of the maternity hospital in Ho Chi Minh City. Besides, five (05) factors of service quality in the maternity hospital have affected customer satisfaction. In addition, effectiveness and continuity (β2 = 0.451), next to human and physical resources (β1 = 0.404), the hospital charges (β5 = 0.374), facilities (β3 = 0.348) and information (β4 = 0.246). Moreover, customer satisfaction rate in the concentrated sample at the satisfaction (Mode = 4, Mean = 3.66). There are 23 customers that corresponding with 10.22% is strongly satisfied. The important practical implications of my thesis is that it brings information about the measurement of customer satisfaction and human and physical resources, the hospital charges, facilities and information, and also the relationships between them. In addition, the research findings help the maternity hospitals that improve better the quality of service with more improvement and effectiveness. As the results, this research provides evidence to confirm that human and physical resources, the hospital charges, facilities and information are been positively related to customer 52 satisfaction. Moreover, customer satisfaction towards the quality of service is a valuable tool for the maternity hospital and assesses their service effectiveness. And based on those factors in this study, the maternity hospitals should improve in order of priority as effectiveness and continuity, human and physical resources, the hospital charges, facilities and information. For examples: firstly effectiveness and continuity: when customers have a problem, they normally believe that this hospital could solve it. Therefore, doctors should show sincere interest in solving the problem to help them to reduce their worry. Secondly, human and physical resources can quickly analyze the pregnant women and do the right things for the recovery of the pregnant women and babies. They are always worried regarding their needs and wants. Thus, human and physical resources should have enough knowledge and customer’s relationship to answer customer’s questions. Next, the hospital charges are also a problem, which customers want to know. Now, a few public hospitals use the State’s health insurance card to reduce cost for patients. Thus, the private hospitals or public hospitals should have policy for using this card. This is also a good condition to use State’s health insurance card for payment and develop insurance department in society. Besides, customers expect that hospital should neat and clean, for examples: clean the floor every day, supply new clothes for patients, change blanket, pillow, etc… The hospital has modern equipment, full clothes for mothers and babies, comfortable room, etc... That is also an advantage to towards the quality of service. Finally, about information, the hospital employees should inform the customer regarding their exact problems and when services will be performed. Otherwise customers get tension, worries and beget lack of confidence. So the timing should be informed to the customer regarding the service of the customer. 53 Chapter Five – Conclusion and Recommendation 1. Conclusion This thesis studies on “Measuring customer satisfaction towards service quality of the maternity hospitals in Ho Chi Minh City”. The results have identified and evaluated the determinants effecting on customer satisfaction. This thesis also has an important significance for the maternity hospital so that they can understand more clearly about pregnant women demands. Besides the maternity hospital would have a strategy to solve this problem to improve the quality of service. The study identified five factors of the maternity hospitals in Ho Chi Minh area. The findings of the study reveal that the pregnant women, women giving birth within 6 months in the maternity hospitals and their customer satisfaction want to have a good service quality. As the results of this research, service quality of the maternity hospital, which has good, serving attitude of human and physical resources, effectiveness and continuity, the hospital charges, facilities, information and caring for pregnant women and babies, will make the customer feel more satisfied, safe and want to continue for using that maternity hospital. 2. Recommendations: To gain benefit and maintain the sustainable development, the maternity hospitals have suitable plan to improve better service quality. To achieve this, the hospitals must make the customer feel satisfy to use the service and recommend to others. In the current situation, measuring of patient satisfaction is becoming important in the health care organization. The maternity hospitals in particular and the general hospital should consider both perspectives: quality and cost. Maternal 54 satisfaction measurement can help us to discover what people think about our hospital, allowing us to take the appropriate steps to keep customers. Thus, some of the ideas improve the service quality of the maternity hospital as follows: firstly, there is always a suggestion box and a hot line 24/24 for customer requesting in everywhere in hospital. Employees should supply quickly information about treatment of customer to reduce their anxiety. There is a customer service department to answer or explain the pregnant women’s information. Besides, this department can help them in maternal problem such as treatment, pregnancy care, pregnancy consultant, babies’ health care, and women after giving birth. Information is necessary to contact between the maternity hospital and pregnant women. Secondly, hospital should build and invest for good infrastructure to serve the pregnant women and babies. More customers want to have a comfortable private room with full facilities and they can spend a lot of money for that service. That is why new hospitals have more advantages to attract customers by comfortable facilities. However, increased cost mainly comes from initial investment in new equipment and computer software, large number of labor hours needed to run the system, and initial staff training cost. Thirdly, the maternity hospital should use to widen the state’s health insurance card for customer to reduce treatment cost. Next, the maternity hospital has training classes for employees to satisfy customers. Besides, the hospitals must create favorable conditions for leaders; key staffs that complete their learning in the country and foreign management. The maternity hospitals have policy about good salary level or bonus level to encourage and motivate employees. In addition, hospital needs invest in equipment, application new diagnostic and treatment techniques for professional managing. This is also increasing effectiveness and continuity in hospital. 55 In general, the hospital has good service system, including improved customer satisfaction, improved information system, and improved facilities (room, clothes for mother and baby, light, etc.)…Besides, if the hospital can serve food for customer on time, the hospital will have advantage about service system because now there is only Sai Gon International hospital for serving food. With human and physical resources, effectiveness and continuity, the hospital charges, facilities, information and caring for pregnant women and babies, will make the customer feel more satisfied. Therefore, the hospital must have a strategy for improving better service quality. 3. Research Limitations: Similar to other studies, this study also has its own limitations. There were some limitations in research process as follows:  This research just carried out in Ho Chi Minh area from August 2012 to January 2013.  Opinions expressed by the pregnant women or women gave birth in different the maternity hospitals were not considered separately. The above limitations are suggestions for next research order to have more comprehensive and better evaluation on customer satisfaction for the maternity hospitals in general in Vietnam. 56 References Auckland – Health service consumer research (2008), “Maternity Services Consumer Satisfaction Survey Report” – http://www.nzdoctor.co.nz/media/6422/maternity-services-consumer-survey-report2007.pdf Aaron K. 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Delivering Quality Service: Balancing Customer Perceptions and Expectations, New York: The Free Press, 256 pp. 58 Lewis, R.C. & Booms, B.H. (1983) The marketing aspects of service quality. In: L. BERRY et al. (Eds), Emerging Perspectives on Services Marketing (New York, AMA). Oliver, Richard L. (1997), Satisfaction: A Behavioural Perspective on the Consumer, New York: McGraw Hill. Schroeder, Roger G., (2003), “Operations Management: Contemporary concepts and Cases, “2nd Ed., McGraw Hill/Irwin Victor Sower, JoAnn Duffy, William Kilbourne, Gerald Kohers & Phyllis Jones, (2001), “The Dimensions of Service Quality for Hospitals: Development and - Use of the KQCAH Scale,” Health Care Management Review, 26 (2), 47-59. Vanessa A. Theurer - UTAH STATE UNIVERSITY Logan, Utah (2011), “Improving Patient Satisfaction in a Hospital Foodservice System Using Low-Cost Interventions: Determining Whether a Room Service System is the Next Step” Tabachnick, B. G., & Fidel, L. S. (1996), “Using multivariate statistics,” NY: Harpers Collins And the following web links: http://www.jcaho.org http://www.bvdaihoc.com.vn/bv/news.asp?bvdh.umc=Tinmoi&action=23 http://tudu.com.vn/ http://sihospital.com.vn/ http://hungvuong.com.vn http://www.alleydog.com/glossary/definition.php?term=Descriptive%20Statistics#i xzz25M0SEx7X (Descriptive Statistics) 59 Appendix Appendix 1: Cronbach’s Alpha analysis of KQCAH scale Scale Corrected Squared Cronbach's Observed Scale Mean if Variance if Item-Total Multiple Alpha if Item variable Item Deleted Item Correlation Correlation Deleted Deleted Human and physical resources variable group: Alpha = .861 H1 13.5333 7.018 .729 .632 .818 H2 13.5778 6.959 .807 .714 .798 H3 13.5511 6.972 .799 .672 .800 H4 13.7511 7.447 .699 .566 .827 H5 13.4089 8.350 3.99 .163 .901 Effectiveness and continuity variable group: Alpha = .819 E1 17.7778 10.415 .498 .339 .809 E2 17.5289 9.313 .684 .494 .767 E3 17.5778 9.575 .659 .455 .773 E4 17.1511 11.040 .446 .266 .817 E5 17.4933 10.260 .553 .322 .797 E6 17.2711 9.815 .665 .465 .773 Facilities variable group: Alpha = .841 F1 18.5511 9.775 .612 .487 .822 F2 18.1111 10.680 .694 .515 .802 F3 17.9289 11.682 .517 .359 .834 F4 18.2267 10.185 .713 .525 .796 F5 18.1511 10.798 .596 .398 .820 F6 18.0756 11.151 .613 .383 .817 Information variable group: Alpha = .793 I1 10.5244 4.295 .480 .245 .812 I2 10.6489 3.791 .652 .430 .718 I3 10.3289 4.400 .691 .562 .708 I4 10.4578 4.508 .642 .527 .729 The hospital charges variable group: Alpha = .718 T1 7.3822 1.719 .459 .267 .742 T2 7.0533 1.801 .682 .473 .782 T3 7.3778 1.825 .505 .355 .668 First impression variable group: Alpha = .741 FI1 17.9422 7.617 .386 .566 .729 FI2 18.5067 6.849 .562 .470 .681 FI3 18.3467 6.692 .602 .381 .669 FI4 18.0578 7.635 .310 .576 .752 FI5 18.5644 6.926 .479 .528 .705 FI6 18.6489 6.791 .548 .558 .684 60 Appendix 2: Descriptive Statistics of KQCAH scale Descriptive Statistics N Minimum Maximum Mean Std. Deviation H1 225 1.00 5.00 3.4222 .86316 H2 225 1.00 5.00 3.3778 .81528 H3 225 1.00 5.00 3.4044 .81885 H4 225 1.00 5.00 3.2044 .79225 H5 225 1.00 5.00 3.5467 .86541 E1 225 1.00 5.00 3.1822 .87507 E2 225 1.00 5.00 3.4311 .91900 E3 225 1.00 5.00 3.3822 .88924 E4 225 1.00 5.00 3.8089 .78712 E5 225 1.00 5.00 3.4667 .85042 E6 225 1.00 5.00 3.6889 .83512 F1 225 1.00 5.00 3.2578 1.05866 F2 225 1.00 5.00 3.6978 .80025 F3 225 1.00 5.00 3.8800 .76111 F4 225 1.00 5.00 3.5822 .87813 F5 225 1.00 5.00 3.6578 .86770 F6 225 1.00 5.00 3.7333 .77919 I1 225 1.00 5.00 3.4622 .94474 I2 225 1.00 5.00 3.3378 .94096 I3 225 1.00 5.00 3.6578 .73390 I4 225 1.00 5.00 3.5289 .73819 T1 225 1.00 5.00 3.5244 .86632 T2 225 1.00 5.00 3.8533 .68191 T3 225 1.00 5.00 3.5289 .78508 FI1 225 1.00 5.00 4.0711 .72845 FI2 225 1.00 5.00 3.5067 .76835 FI3 225 1.00 5.00 3.6667 .77344 FI4 225 1.00 5.00 3.9556 .81710 FI5 225 1.00 5.00 3.4489 .82825 FI6 225 1.00 5.00 3.3644 .79652 Valid N (listwise) 225 61 Appendix 3: Descriptive Statistics of customer satisfaction scale Descriptive Statistics Code S1 S2 S3 S4 S5 S6 N Do you satisfy with your maternity hospital? Do you satisfy with human and physical resources in hospital? Do you satisfy with effectiveness and continuity of hospital services? Do you satisfy with the hospital charges? Do you satisfy with facilities on service quality of hospital? Do you satisfy with information on service quality of hospital? Valid N (listwise) Average Min Max Std Deviation Mean 225 1.0 5.0 3.6578 225 1.0 5.0 3.3511 225 1.0 5.0 3.6000 0.752 0.805 0.707 225 1.0 5.0 3.5422 225 1.0 5.0 3.4756 225 1.0 5.0 3.5467 0.801 0.732 0.687 225 3.5289 Appendix 4: Cronbach’s Alpha analysis of customer satisfaction scale Scale Observed Mean if Scale Variance variable Item if Item Deleted Deleted Corrected Squared Cronbach's Item-Total Multiple Alpha if Item Correlation Correlation Deleted Customer satisfaction variable group: Alpha = .855 S1 17.5156 8.349 .645 .441 .813 S2 17.8222 8.031 .665 .552 .827 S3 17.5733 8.299 .716 .541 .819 S4 17.6311 9.011 .429 .274 .872 S5 17.6978 8.203 .710 .612 .819 S6 17.6267 8.333 .734 .617 .816 62 Appendix 5: Regression Analysis Model Summary Std. Error of the Model R R Square Adjusted R Square Estimate .829a 1 .688 .681 .565 a. Predictors: (Constant), Human and physical resources, Effectiveness and continuity, Facilities, Information, The hospital charges Coefficients Model Unstandardize Standardized Coefficients Cofficients B 1 (Constant) Std.Error -1.675 .038 .404 .038 .451 continuity t Sig. Beta .000 .000 .404 10.691 .000 .038 .451 11.942 .000 .348 .038 .348 9.223 .000 Facilities .246 .038 .246 6.525 .000 Information .374 .038 .374 9.894 .000 Human and physical resources Effectiveness and The hospital charges a.Dependent Variable: Customer Satisfaction ANOVAb Sum of Model df Mean Square F Sig. Squares Regression 1 Residual Total 154.06 5.00 30.81 69.94 219.00 0.32 224.00 224 96.49 .000a a. Predictors: (Constant), Human and physical resources, Effectiveness and continuity, Facilities, Information, The hospital charges b. Dependent Variable: Customer satisfaction 63 Appendix 6: Questionnaire Questionnaire Hello! My name is Nguyen Thi Thanh Binh, a member of MBA10 class, International University-VNU. Now, I am doing my thesis with the name of topic “MEASURING CUSTOMER SATISFACTION TOWARDS SERVICE QUALITY OF MATERNITY HOSPITAL IN HO CHI MINH CITY”. Please help me to fill up the below questionnaire. Information are given is confidential and will only be used for academic purpose. Your cooperation in providing true information and honest views is been appreciated. Part 01 Q1. Have you ever come to maternity hospital in HCMC? Yes No (If No, stop; If Yes: continue Q.2) Q2. Which maternity hospital will you think first to visit there? (Please choose the only one) 1.Tu Du hospital 2.Hung Vuong hospital 3.Sai Gon international hospital 4.University Medical Center hospital – branch 4 5.The others Part 2 Q3. Based on the questionnaire below, please let us know about human and physical resources that your assessment on service quality of maternity hospital you chose in Q2 in part 1. 1. Strongly dissatisfied 2. Dissatisfy 3. Normal 4. Satisfy 5. Strongly satisfied Item 1 2 3 4 5 Employees respect the patient Employees are friendly, polite when they respond patient's 64 need Employees are always willing to help the patient Employees listen and solve quickly the complaining of patient Employees ensure information confidentiality of patient Q4. Based on the questionnaire below, please let us know about the coordination between departments that your assessment on service quality of maternity hospital you chose in Q.2. 1. Strongly dissatisfied 2. Dissatisfy 3. Normal 4. Satisfy 5. Strongly satisfied The patient can touch and talk easy with hospital’s employees Hospital has simple procedure, quickly time for hospitalize Employees tried to control the patient’s pain when they were hurt Employees are well-trained with high competence Patients were allowed to participate in their decisions and treatment Patients were carefully instructed before leaving hospital Q5. Based on the questionnaire below, please let us know about facilities that your assessment on service quality of maternity hospital you chose in Q2. 1. Strongly dissatisfied 2. Dissatisfy 3. Normal 4. Satisfy 5. Strongly satisfied The hospital has a quite space Hospital employees look clean and are well-dressed The hospital has modern equipment and technology The hospital has clean room and tidy equipment Equipment with utensils is full for mothers and newborn baby The hospital has the necessary light Q6. Based on the questionnaire below, please let us know about information that your assessment on service quality of maternity hospital you chose in Q2. 1. Strongly dissatisfied 2. Dissatisfy 3. Normal 4. Satisfy 5. Strongly satisfied The patient don’t have to fill out so many forms of admission 65 Phone system for calling employees is ready and in good condition The doctor informed the patient about the results of examination testing, treatment The patient gets the doctor to provide information quickly Q7. Based on the questionnaire below, please let us know about the hospital charges that your assessment on service quality of maternity hospital you chose in Q2. 1. Strongly dissatisfied 2. Dissatisfy 3. Normal 4. Satisfy 5. Strongly satisfied Hospital collects reasonable medical charges The hospital charges is clear and easily to understand Employees are available for their explaining about the hospital charges Q8. Based on the questionnaire below, please let us know about first impression that your assessment on service quality of maternity hospital you chose in Q2. 1. Strongly dissatisfied 2. Dissatisfy 3. Normal 4. Satisfy 5. Strongly satisfied Hospital has reputation Hospital is thoughtful of the patient Hospital has modern equipment and facilities The hospital has a lot of professional and good doctors Hospital's landscape is clean The patient feels comfortable to contact with hospital’s employees. Q9. Based on the questionnaire below, please let us know about totally service quality that your assessment on service quality of maternity hospital you chose in Q2 1. Strongly dissatisfied 2. Dissatisfy 3. Normal 4. Satisfy 5. Strongly satisfied Do you satisfy with your maternity hospital? Do you satisfy with human and physical resources in hospital? Do you satisfy with effectiveness and continuity of hospital services? Do you satisfy with the hospital charges? Do you satisfy with facilities on service quality of hospital? Do you satisfy with information on service quality of hospital? 66 Q10. You are willing to introduce service quality of your maternity hospital to others or not. 1. Never introduce 2. Normal 3. May be 4. Ready 5. Quite ready Part 3 1. Name: 2. Address: 3. Phone number: 4. Email: 5. Ages: 1. From 20 to 25 2.From 26 to 30 3.From 31 to 35 4.From 36 to 40 6. Occupation Housewife Worker Officer Others 7. How much is your income? Under 4 million VND From 4 million – 7 million Over 7 million – 10 million Over 10 million Thank you for your cooperation! 67 [...]... women want to have service quality of the maternity hospital in Ho Chi Minh City? How did the maternity hospitals take care for women giving birth? What do pregnant women expect service quality of the maternity hospitals? That is the reason for the author to choose this research topic: MEASURING CUSTOMER SATISFACTION TOWARDS SERVICE QUALITY OF THE MATERNITY HOSPITALS IN HO CHI MINH CITY 3 Research... Chi Minh City because the author is a pregnant woman The author also wants to know service quality of the maternity hospital in Ho Chi Minh City to choose hospital for giving birth next year Therefore, the author wants to measure customer satisfaction and evaluates the service quality of the maternity 1 hospitals in Ho Chi Minh City In addition, implications about study for the maternity hospitals... months in the maternity hospital in Ho Chi Minh City Continuing to correct maternity hospitals to improve level of better quality services and caring for pregnant women and babies 6 Research structure The structure of the thesis consist five chapters: Chapter 01: Introduction Chapter 1 introduces about service quality of the maternity hospital industry in Ho Chi Minh City This part will include the reasons... Research Method 1 The introduction about the maternity hospitals in Ho Chi Minh City Nowadays, Ho Chi Minh City has many hospitals that serve the people In particular, the maternity hospitals are also one important part of the hospitals and people can know as: 1.1 Tu Du hospital - 284 Cong Quynh, Dist 1, HCMC Tu Du Hospital was a specialist maternity hospital where was established in 1923 In 1937, it... objective  Identify determinants of service quality of the maternity hospital in Ho Chi Minh City area  Identify customer satisfaction towards service quality  Recommend some solutions for maternity hospitals to improve better service quality for pregnant women 4 Scope The scope of present research includes measuring the quality services and evaluating customer satisfactions for the pregnant women or... within 6 months in the maternity hospital in Ho Chi Minh City The total duration time for implementing this study is about 05 months (from August 2012 to January 2 2013); the data collection was been conducted in the maternity hospitals in Ho Chi Minh City area 5 Implication of research Measuring the service quality and evaluating customer satisfactions for the pregnant women or women gave birth within... Customer satisfaction, service quality, maternity hospital, pregnant women x xi Chapter one – Introduction 1 Introduction The hospital industry is one of the fastest growing industries today Hospital managers have to understand the quality and the value of services offering to their consumers The positive consequences of companies achieving high levels of customer satisfaction and service quality are... service quality of the maternity hospital Besides, it is to determine the hospital service quality from the pregnant women’s viewpoints and the relative importance of quality dimensions to improve better service quality for pregnant women and babies This study was been conducted with 225 respondents who are pregnant women or women giving birth within 6 months in the maternity hospitals in Ho Chi Minh. .. hospitals, children’s hospitals, seniors' (geriatric) hospitals, maternity hospitals and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital) , certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth Moreover, the hospitals are been developed in Vietnam However, the author wants to focus the maternity hospital in Ho Chi Minh. .. built maternity hospital with named Maternite Indochinoise (maternity hospital Indochina) by Professor Dr George Cartoux (French) director On April 8, 2004, the hospital was renamed the Tu Du Hospital with the total number of beds is 1,000 Today, Tu Du Hospital is been known as a leading hospital of obstetrics and gynecology of the country, and is the largest center gynecology in South Tu Du Hospital .. .MEASURING CUSTOMER SATISFACTION TOWARDS SERVICE QUALITY OF THE MATERNITY HOSPITAL IN HO CHI MINH CITY In Partial Fulfillment of the Requirements of the Degree of MASTER OF BUSINESS ADMINISTRATION... topic: MEASURING CUSTOMER SATISFACTION TOWARDS SERVICE QUALITY OF THE MATERNITY HOSPITALS IN HO CHI MINH CITY Research objective  Identify determinants of service quality of the maternity hospital. .. Vietnam However, the author wants to focus the maternity hospital in Ho Chi Minh City because the author is a pregnant woman The author also wants to know service quality of the maternity hospital in