Purpose -The purpose of this paper is to develop and empirically validate a multidimensional scale for measuring healthcare service quality (HCSQ), based on modified Brady and Cronin's hierarchical service quality model. The study also investigated HCSQ and its ability to predict important service outcomes through two different models. In the first model, direct effects of service quality dimensions, namely physical environment quality (comprising ambient condition, social factor and tangibles), interaction quality (comprising attitude and behaviour, expertise and process quality) and outcome quality (comprising waiting time, patient satisfaction and loyalty) on image are measured. In the second model, direct effects of physical environment quality (comprising ambient condition, social factor and tangibles), interaction quality (comprising attitude and behaviour, expertise and process quality) on service quality through outcome quality (comprising waiting time, patient satisfaction and loyalty) are measured. Design/methodology/approach -Data were collected from 400 indoor patients of five departments', namely general medicine, surgery, pediatrics, orthopedics and gynecology and ENT of a tertiary public hospital of North India using stratified sampling. Findings -The study supports both the models for measuring HCSQ. Structural equational modelling is used to test the hypotheses relating to direct and indirect effects in the two models.Research limitations/implications -The major limitations of the study include selection of only inpatients and use of non-financial performance measures. Originality/value -The paper contributes to the development of multiple dimensional holistical service quality models in the healthcare sector.

The purpose of this article is to evaluate service quality and service performance relationship in the health-care sector using respective developed multidimensional scales. Data were collected from 400 inpatient respondents, using stratified sampling method from five departments, namely general medicine, surgery, pediatrics, orthopedics, gynecology, and ENT of a tertiary hospital (North India). The results confirm significant relationship among subdimensions of physical environment quality and interaction quality (service quality) and four service performance measures, namely waiting time, patient satisfaction, patient loyalty, and image in public hospitals.

This study provides conceptual as well as empirical investigation of consumer perceived value (CPV) and consumer loyalty (CL) measures in the healthcare sector. It also offers an insight regarding the role of CPV in influencing CL. The data were collected from 515 hospitalised patients of 2 tertiary hospitals, namely the Government Medical College and Hospital (public) and Acharya Shri Chander College of Medical Sciences and Hospital (private) sector operating in Jammu, North India, from July 2009 to October 2009. Exploratory factor analysis and confirmatory factor analysis were used to analyse CPV and CL. The results suggest that CPV is a function of acquisition value, transaction value, efficiency value, aesthetic value, social interaction value, and self-gratification value. Similarly, CL is related to preference loyalty (i.e., using provider again for same services, using provider again for different services), recommending provider to others, price indifference loyalty, and dissatisfaction response. The study underscores significant dimensions of consumer value and CL and validates the relationship between value and loyalty in healthcare service sector. The CPV and CL instruments include important aspects of patients' perceptions of healthcare services. The scales are psychometrically adequate and are recommended for evaluating patients' experiences of the quality of healthcare services. The study is limited theoretically to assessing the relationship between CPV and CL. Their relationships with other measures, such as consumer experiences, quality, satisfaction, service dominant logic, and image, need to be assessed in further works.

PurposeThe purpose of this paper is to analyze the dimensionality of the consumer perceived value (CPV) concept, development of a CPV scale and its measurement in the Indian healthcare sector.Design/methodology/approachThe data on consumer perceived value are gathered from 515 inpatients. The scale development is performed through exploratory factor analysis, reliability and validity analysis, and confirmatory analysis.FindingsCPV scale in healthcare sector is a multidimensional scale represented by 27 items spread over six dimensions that are significant for consumer value measurement. The dimensions include acquisition value (AV), transaction value (TV), efficiency value (EV), aesthetic value (ESV), social interaction value (SI) and self gratification value (SG).Research limitations/implicationsThe study is theoretically limited to value and its antecedents. Research work on relationship of consumer perceived value with service quality, customer relationship management, internal marketing orientation, external marketing orientation and financial performance need to be pursued further for richer insight into the inter‐related service marketing concepts. The study is limited to indoor patients only and the perceptions of employees and other stakeholders are important to understand their overall affect on CPV.Originality/valueThe study has unique value to the healthcare literature, both from theoretical and managerial perspectives. The study produced a standardized scale of consumer perceived value which can be used in both public and private healthcare sectors. It incorporates valuation of functional and affective aspects, and provides overall quantification of the value perceived by Indian healthcare consumers.

PurposeThis paper aims to examine the three dynamics of customer relationship management (CRM), namely, service quality (SQ), customer satisfaction (CS) and customer loyalty (CL) (long‐term relationship) in the healthcare sector. It specifically investigates the effects of physical environment quality (PEQ) and interaction quality (IQ) and significant components of SQ on outcome SQ dimensions, namely, CS and CL.Design/methodology/approachA total of 400 indoor patients from departments such as, general medicine, pediatrics, general surgery, gynecology, ENT and orthopedics were selected using proportionate stratified random sampling from May‐August 2007. Personal contact approach was used for contacting the respondents. Data validity and reliability were duly assessed using exploratory factor analysis. The data were then analyzed using structural equation modeling through AMOS.FindingsBased on data analysis, the direct effect of CRM dynamics, i.e. PEQ and IQ on SQ and their ultimate effect on CS and CL is found to be significant. However, the model fit values came out poor as p (CMIN) (0.000), CMIN/DF (2,605.41), RMSEA (0.263), NFI (0.076), RFI (−0.066), IFI (0.078), TLI (−0.069) and CFI (0.074).Research limitations/implicationsThe cross‐sectional research design of the study does not offer nearly the same insight into the dynamics of CR as a longitudinal design study. The study analysed overall CS and CL as the major focus of the study was on the PEQ and IQ to understand impact of SQ on CRM outcomes and has ignored some antecedents that could help and explain customer perception more concretely. Further future studies could consider broader organization image typologies and measures in understanding CRM dynamics such as organizational excellence and customer value. This could become the future agenda for the upcoming studies.Practical implicationsPEQ needs to be improved by focusing on cleanliness of wards and toilets, peaceful atmosphere, supportive and additional facilities, clean drinking water, clean beddings, special services to the needy. IQ hospitals should organize training programmes to inculcate better attitudinal and behavioural skills to understand patients, giving them proper care, listening to and answering their queries. For better process quality, hospitals need to focus on effective administration functioning. The study concludes that there is need to improve CRM dynamics (PEQ and IQ) in the public healthcare to accomplish CRM objectives (CS and CL).Originality/valueThis study provides some important insights for CRM theory and practice. An understanding of SQ, CS and loyalty dynamics is a first step toward effective service management and the retention of customers in the long term. Three‐way interactions between the main effects of SQ, CS and loyalty yield additional insight into the relative importance of physical environment and IQ in customers' decision to be loyal, and that can provide a pave way for accomplishing CRM objectives.