Patient Satisfaction in the Peruvian Health Services: Validation and Application of the HEALTHQUAL Scale
Abstract
:1. Introduction
1.1. Quality of the Services in Hospital Management
1.2. Public–Private Associations (PPPs) as an Organization Model in Health
1.3. The HEALTHQUAL Scale, Dimensions, and Items
1.4. Research Model and Hypothesis
1.4.1. Healthcare Personnel Dimension (HP)
- H1: The better the performance of healthcare personnel, the greater the efficiency in healthcare; and
- H2: The better the performance of healthcare personnel, the greater loyalty of users to the healthcare service.
1.4.2. Nonhealthcare Personnel Dimension (NHP)
- H3: The better the performance of nonhealthcare personnel, the greater the efficiency in healthcare; and
- H4: The better the performance of nonhealthcare personnel, the greater loyalty of the user to the healthcare services.
1.4.3. Facilities, Equipment, and Tangible Dimension (FET)
- H5: The better the conditions of the facilities, equipment, and tangibles, the greater the efficiency in healthcare; and
- H6: The better the conditions of the facilities, equipment, and tangibles, the greater the loyalty of the user to the healthcare service.
1.4.4. Relationship Between Efficiency (EFI) and Loyalty (L)
- H7: The greater the efficiency of the healthcare service provided, the greater the patient’s loyalty to that healthcare service.
- H1: Healthcare personnel positively impact efficiency;
- H2: Healthcare personnel positively impact loyalty;
- H3: Nonhealthcare personnel positively impact efficiency;
- H4: Nonhealthcare personnel positively impact loyalty;
- H5: Facilities, equipment, and tangibles positively impact efficiency;
- H6: Facilities, equipment and tangibles positively impact loyalty; and
- H7: Efficiency positively impacts loyalty.
2. Materials and Methods
2.1. Measurement Instrument
2.2. Variables
2.3. Application of the Questionnaire
2.4. Data Processing and Analysis
3. Results
3.1. Global Model
3.2. Measurement Model
3.3. Structural Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Age | Hospital 1 1 | Hospital 2 2 | Total | ||
---|---|---|---|---|---|
Male | Female | Male | Female | ||
18–34 | 16 | 16 | 17 | 18 | 67 |
35–54 | 25 | 24 | 25 | 27 | 101 |
55–74 | 16 | 18 | 12 | 14 | 60 |
+75 | 6 | 7 | 5 | 4 | 22 |
Total | 128 | 122 | 250 |
Indicator | |
---|---|
SRMR 1 | |
Saturated Model | 0.0643 |
Estimated Model | 0.0643 |
Construct/Indicator | Factor Loadings | Composite Reliability | AVE 1 | ρA 2 | |
---|---|---|---|---|---|
Healthcare Personnel (HP) | 0.952 | 0.667 | 0.947 | ||
HP1 | The professionalism of the healthcare personnel is very high | 0.7574 *** | |||
HP2 | The kindness and courtesy of the healthcare personnel is very high | 0.7497 *** | |||
HP3 | Confidence in the healthcare personnel is very high | 0.8000 *** | |||
HP 4 | The healthcare personnel provide a highly personalized service | 0.7828 *** | |||
HP5 | Communication with the healthcare personnel is very good | 0.8387 *** | |||
HP6 | Individualized care of the healthcare personnel to the problems of the patient is very good | 0.8623 *** | |||
HP7 | The interest of the healthcare personnel in attending to the patient’s problems is very high | 0.8733 *** | |||
HP8 | The concern of the healthcare personnel to understand the problems of the patient is very high | 0.8514 *** | |||
HP9 | The prestige of the medical staff is very good | 0.8554 *** | |||
HP10 | Doctors explain in detail the diagnoses and treatment of a disease | 0.7858 *** | |||
Nonhealthcare personnel (NHP) | 0.957 | 0.848 | 0.941 | ||
NHP1 | The professionalism of the non-healthcare personnel is very high | 0.9034 *** | |||
NHP2 | The kindness and courtesy of the nonhealthcare personnel is very good | 0.9250 *** | |||
NHP3 | Individualized care of the nonhealthcare personnel to the problems of the patient is very good | 0.9335 *** | |||
NHP4 | The interest of the nonhealthcare personnel in attending to the patient’s problems is very high | 0.9221 *** | |||
Facilities, equipment, and tangibles (FET) | 0.894 | 0.585 | 0.865 | ||
FET1 | The cleanliness of the facilities is very high | 0.6434 *** | |||
FET2 | The equipment of the healthcare center is very good | 0.7434 *** | |||
FET3 | The accessibility of the healthcare center is very good | 0.8034 *** | |||
FET4 | The appearance and presence of the healthcare personnel is very good | 0.8435 *** | |||
FET5 | The appearance and presence of the non-healthcare personnel is very good | 0.8051 *** | |||
FET6 | There is clear signage for each department in the hospital | 0.7335 *** | |||
Efficiency (EFI) | 0.919 | 0.507 | 0.906 | ||
EFI1 | The hospital provides many facilities to arrange a medical appointment | 0.7402 *** | |||
EFI2 | The level of bureaucracy is minimal (very low) | 0.7282 *** | |||
EFI3 | The waiting time in the healthcare center before entering a medical consultation is adequate | 0.6685 *** | |||
EFI4 | The hospital provides a very good computerized service | 0.6844 *** | |||
EFI5 | The speed of ancillary testing is very high | 0.7036 *** | |||
EFI6 | Complaint resolution is very fast and satisfactory | 0.7796 *** | |||
EFI7 | The time spent focusing on the care of each patient is adequate | 0.7330 *** | |||
EFI8 | The hours of the healthcare center are very wide and adequate | 0.6492 *** | |||
EFI9 | Medical expenses are reasonable | 0.6465 *** | |||
EFI10 | The existence of improvement in the medical condition as a result of the efforts and treatment by medical personnel is very high | 0.7512 *** | |||
EFI11 | The occurrence of side effects when patients take their medicines is very low | 0.7382 *** | |||
Loyalty (L) | 0.945 | 0.852 | 0.913 | ||
L1 | The patient is treated again in this hospital | 0.9169 *** | |||
L2 | The patient recommends this hospital to his friends and family | 0.9432 *** | |||
L3 | Visiting the hospital again for its effectiveness in organization and service | 0.9081 *** |
Heterotrait–Monotrait Ratio (HTMT) | |||||
---|---|---|---|---|---|
HP | NHP | FET | EFI | L | |
HP | |||||
NHP | 0.63 | ||||
FET | 0.679 | 0.593 | |||
EFI | 0.73 | 0.661 | 0.756 | ||
L | 0.697 | 0.588 | 0.626 | 0.785 | |
Fornell–Larcker Criterion | |||||
HP | NHP | FET | EFI | L | |
HP | 0.817 | ||||
NHP | 0.613 | 0.921 | |||
FET | 0.672 | 0.531 | 0.765 | ||
EFI | 0.682 | 0.613 | 0.672 | 0.712 | |
L | 0.65 | 0.546 | 0.566 | 0.72 | 0.923 |
Construct | HP | NHP | FET | EFI | L |
---|---|---|---|---|---|
HP | 1.907 | 2.184 | |||
NHP | 1.655 | 1.792 | |||
FET | 1.726 | 2.02 | |||
EFI | 2.504 | ||||
L |
Hypothesis | Suggested Effect | Path Coefficient | Confidence Interval 99% | Student’s t | p-Value |
---|---|---|---|---|---|
H1: HP -> EFI | + | 0.3331 *** | [0.2410; 0.4223] | 6.0374 | 0.0000 |
H2: HP -> L | + | 0.2525 *** | [0.1039; 0.4118] | 2.7147 | 0.0033 |
H3: NHP -> EFI | + | 0.2338 *** | [0.1547; 0.3252] | 4.4977 | 0.0000 |
H4: NHP -> L | + | 0.0856 | [−0.0566; 0.2069] | 1.0763 | 0.1409 |
H5: FET -> EFI | + | 0.3428 *** | [0.2545; 0.4314] | 6.3340 | 0.0000 |
H6: FET -> L | + | 0.0595 | [−0.0555; 0.1763] | 0.8476 | 0.1983 |
H7: EFI -> L | + | 0.4550 *** | [0.3345; 0.5904] | 5.9320 | 0.0000 |
Construct | R2 | Q2 | f2 | Direct Effect | Correlation | Variance Explained |
---|---|---|---|---|---|---|
EFI | 0.6007 | 0.2792 | ||||
H1: HP | 0.1457 | 0.3331 | 0.682 | 22.70% | ||
H3: NHP | 0.0827 | 0.2338 | 0.6131 | 14.30% | ||
H5: FET | 0.1705 | 0.3428 | 0.6715 | 23.00% | ||
L | 0.572 | 0.4529 | ||||
H2: HP | 0.0682 | 0.2525 | 0.6501 | 16.40% | ||
H4: NHP | 0.0096 | 0.0856 | 0.5457 | 4.70% | ||
H6: FET | 0.0041 | 0.0595 | 0.5656 | 3.40% | ||
H7: EFI | 0.1932 | 0.455 | 0.7197 | 32.70% |
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Share and Cite
Barrios-Ipenza, F.; Calvo-Mora, A.; Velicia-Martín, F.; Criado-García, F.; Leal-Millán, A. Patient Satisfaction in the Peruvian Health Services: Validation and Application of the HEALTHQUAL Scale. Int. J. Environ. Res. Public Health 2020, 17, 5111. https://doi.org/10.3390/ijerph17145111
Barrios-Ipenza F, Calvo-Mora A, Velicia-Martín F, Criado-García F, Leal-Millán A. Patient Satisfaction in the Peruvian Health Services: Validation and Application of the HEALTHQUAL Scale. International Journal of Environmental Research and Public Health. 2020; 17(14):5111. https://doi.org/10.3390/ijerph17145111
Chicago/Turabian StyleBarrios-Ipenza, Fernando, Arturo Calvo-Mora, Félix Velicia-Martín, Fernando Criado-García, and Antonio Leal-Millán. 2020. "Patient Satisfaction in the Peruvian Health Services: Validation and Application of the HEALTHQUAL Scale" International Journal of Environmental Research and Public Health 17, no. 14: 5111. https://doi.org/10.3390/ijerph17145111