A HIERARCHICAL APPROACH TO PERCEIVED SERVICE QUALITY IN HOSPITAL OUTPATIENT SERVICES

The economic and business scenario of recent years has obliged firms to adapt continually in order to be able to offer a level of quality in their market offering to achieve customer satisfaction. This reality explains the academic interest in delimiting the correct definition and measurement of perceived service quality. However, a review of the literature shows the existence of notable discrepancies in its theoretical and operational treatment (Rust and Oliver, 1994), justifying their study in the present investigation.
Specifically, on the basis of the contribution by Brady and Cronin (2001), perceived service quality is approached conceptually and measured as a multidimensional and hierarchical construct of a reflective character in first and second order and formative in third order.

To corroborate the validity and reliability of the scale proposed we consider the healthcare service, specifically the outpatient service in five hospitals (three public and two private) of the Valencia Region (Spain). This distinction allows us to analyze the possible differences that may occur in the perception of the overall quality of the service, in the different principal dimensions forming it, and in the patient’s general satisfaction depending on the public or private ownership of the hospital.

To this end, the paper is structured showing first a brief introduction to the different nature of formative and reflective models. There follows an academic review of the definition and measurement of perceived service quality, which serves as a basis for its subsequent treatment as a multidimensional and hierarchical construct of a reflective and formative character. We next describe the methodology used in the study and set out the results obtained in the total sample of patients and in the two subsamples containing either publicly owned or privately owned hospitals. Finally, we present the conclusions of the study, its main limitations, and future lines of research.