Periodicity.: January - February 2019
e-ISSN......: 2236-269X
MODELO PARA A FORMATAÇÃO DOS ARTIGOS A SEREM UTILIZADOS NO ENEGEP 2003

 AN EMPIRICAL STUDY ON AVAILABILITY OF RURAL HEALTH CARE SERVICES IN ZAROL VILLAGE AS PER THE INDIAN PUBLIC HEALTH STANDARDS

 

Anupam Mitra

TeamLease Skills University India

E-mail: anupam.mitra@teamleaseuniversity.ac.in

 

Shivangi Shukla

TeamLease Skills University India

E-mail: shivangi.s@teamleaseuniversity.ac.in

 

Submission: 25/04/2018

Revision: 10/05/2018

Accept: 15/06/2018

 

ABSTRACT

A study on availability of Health care services in Zarol village as per the Indian Public Health Standards has been undertaken with the main objective to find out the prevailing gap between expected health standards and actual Indian Public health standards. A sample of 80 respondents was undertaken for the survey. Data were collected through structured closed ended questionnaire using Non-probability convenience sampling method through personally interviewing the respondents. The Service Quality Dimensions were used to measure the Service Quality Assurance of Public Health care services. Research result reveals that means score of major service quality dimensions is relatively high indicating higher level of patient’s satisfaction from PHC of Zarol. Whereas the mean score of only personnel quality and safety measures having relatively low score indicating lower level of patient’s satisfaction.

Keywords: Quality Assurance, Service Quality Dimensions, Indian Public Health Standards, Public Health Care Services

1.     INTRODUCTION

            “Services are economic activities offered by one party to another. Often time-based, performances bring about desired results to recipients, objects or other assets for which purchasers have responsibility. In exchange for money, time and effort, service customers expect value from access to goods, labor, professional skills, facilities, networks and systems, but they do not take ownership of any of the physical elements involved” [1]

            As per the Planning Commission, a town with a most extreme populace of 15,000 is viewed as provincial in nature.

            The National Sample Survey Organization (NSSO) characterizes 'rural' as the area with a populace density of up to 400 for every square kilometer. Villages with clear reviewed limits yet no city board and at least 75% of male working populace engaged in agribusiness and associated exercises.

            Health care sector is playing a dynamic role for the overall health of our country. Despite the fact that there are such a large number of changes in the setting of Indian Rural Health Care Services yet with regards to country's overall health care scenario.

            Guidelines are a methods for depicting a level of value that the health care centers are relied upon to meet. A Primary Health Center fills in as the first port of call to a qualified specialist in the public health care division in provincial zones giving a scope of Curative, Promotive and preventive health care services. A PHC furnishing 24 hours services and with proper linkages, assumes a critical part of expanding institutional conveyances accordingly diminishing maternal mortality and infant mortality.

 

 

2.     RURAL HEALTHCARE SYSTEM IN INDIA

            The rural healthcare services framework in India has been created as a three level framework containing the following:

a)   The Community Health Center (CHC) - A 30 bed clinic/referral unit for 4 PHCs with authority administrations. (Rustic Health Statistics in India 2012)

b)   The Primary Heath care center (PHC) - A referral unit for 6 (4-6 bed) sub focuses staffed by a medical officer in charge and 14 paramedics. (RUSTIC HEALTH STATISTICS IN INDIA, 2012)

c)    3.The Sub Center-The most fringe purpose of contact between the Primary Healthcare system  and the community, staffed by 1 Health Worker-Female (HM-F)/Auxiliary Nurse Midwife (ANM) and 1 Health Worker-Male (HW-M) (RURAL HEALTH STATISTICS IN INDIA, 2012)

2.1.        Primary Health Centers (PHCs)

            PHC is the main contact point between village community and the Medical Officer. The PHCs were imagined to give an incorporated curative and preventive health care to the country populace with emphasis on preventive and primitive parts of medicinal services. The PHCs are set up and kept up by the State Governments under the Minimum Needs Program. PHC acts as a referral unit for 6 Sub Centers and has 4-6 beds for patients. The activities of PHC involve curative, Preventive, Promotive and family welfare services.

3.     LITERATURE REVIEW:

3.1.        Mosad Zineldin, (2006)

            Service quality is a multidimensional concept and in order to operationalize it many variables have to be considered. SERVQUAL is a widely used scale to measure different quality dimensions. Originally, as developed by Parasuraman, Zeithaml e Berry (1985), scale consisted ten dimensions used by the customer to Judge Company’s service, which were reduced into five major dimensions (CRONIN; TAYLOR, 1992): tangibles, reliability, responsiveness: assurance and empathy.

            The SERVQUAL constructs impact is used to measure service quality and to identify service quality gaps but not their root causes for which other approaches are needed (WISNIEWSKI; WISNIEWSKI, 2005).

            Some efforts have been invested to improve the methods. In this research we describe a study involving a new instrument and a new method that assures a reasonable level of relevance, validity and reliability, while being explicitly change oriented.

3.2.        Leo van der Reis Qian Xiao Grant Savage, (2007)

            To achieve the goal of a truly caring commonwealth, we must improve quality and safety in health care, increase access and utilization of technology, promote greater consumer involvement at all stages, restructure the medical malpractice system to reach all who may be injured by systemic errors, and develop sustainable financing less subject to the vagaries of state revenues.

            However, the access issue still remains a basic and important problem we have to confront. The rapidly evolving nature of the health care system presents both enhanced opportunities to address the access problem and new threats to the fragile health care system. However, with the efforts and resources of communities, providers, government, and others to create viable long-term solutions, a good tendency can be expected.

            For example, Senate Bill No. 738 – the Health Access and Affordability Act, a petition from the Committee on Health Care Financing – appears strongest in its objectives to offer full health care coverage that is universal and continuous, and is affordable to individuals and families (MOORE, 2005).

3.3.        Gyan Prakash, (2015)

            There are few relevant healthcare regulations and their enforcement is weak. Social regulation is at best weak and economic regulation is non-existent. Patients have poor role-awareness, do not appreciate their responsibilities and their rights are limited.

            Partnership and coordination among various health institutions are weak and managers in each institution are more concerned about their functions. Self-regulation among healthcare professionals is fragile and services are inefficient. The author contributes to the healthcare literature, first, by synthesizing the literature and identifying healthcare issues and challenges, and emphasizes regulation in molding healthcare service delivery.

            Broader experiences in the literature suggest that governments in emerging economies are yet to synergize technical and functional quality for an all-encompassing service delivery. These issues seem to be well resolved in developed economies; however, healthcare shattering, long waiting times and underlying payment mechanisms need attention.

3.4.        Hardeep Chahal Shivani Mehta, (2013)

            Theoretically, the study confirmed that all patient satisfaction dimensions are significant in assessing patient satisfaction which validate the existing findings of various researchers such as Raftopoulous (2005), Kang and James (2004), Chahal and Sharma (2004); Sardana (2003); Brady and Cronin (2001); Corbin et al. (2001); Newman et al. (1998); Gilson et al. (1994).

            Besides, model testing conducted also provides new insight to understand the relationship between patient satisfaction dimensions and loyalty. The study also contributes in the understanding of patient behavior and their medical needs in general, which can be used for increasing patient satisfaction in particular.

            It is also found that to retain patients and to improve relations with the patients; the medical staff must show concern and sympathy for the patients, which results in easy recovery, improved services, and above all, improved patient satisfaction and loyalty. The findings suggest that training programs on patient relationship management at least once a year, along with spiritual discourses should be considered and organized to inculcate the changes in the attitude and behavior of staff towards patients.

            The patient-staff interactions (physicians, nurses and supportive staff) and their impact on satisfaction and loyalty are significant to understand patients’ behavior and to improve the image of the hospital over competitors. Further, the patient-oriented approach will help the Indian health service provides in linking their technological and non-technological factors to the unserved needs of the patients which, in turn, will help in enhancing the degree of patient satisfaction.

            Strategies such as responding to patients’ enquiry promptly, bridging the communication gap between patients and medical personnel, becoming more friendly and understanding to the problems of patients, maintaining cleanliness in the units, both internally and externally, providing regular report regarding the patients’ progress without waiting for them to demand, providing a grievances system in the unit, conducting surveys to know about the attitude of the patients with regard to the employees, adopting patient-oriented policies and procedures, solving patient-related problems immediately and providing every type of essential facility should be implemented by the hospitals in India for improving and maintaining high patient satisfaction.

4.     RELEVANCE OF THE STUDY

            The fundamental issue hidden for rural health care is because of health issues or poor health services, the work efficiency of provincial people is at great hazard. It has been seen in a few villages that, the accessibility and nature of health care services are in the extremely poor state regardless of immense consumption and endeavors from the government.

            Along these lines, there are such a significant number of issues have turned out; this research will unquestionably yield the constructive results on the said issues to Government and to the village individuals

            Due to non-accessibility to Public Health care and low quality of medicinal services benefits, a major share of individuals in India swing to the nearby local private health center as their first decision of care. In any case, private medicinal services are costly, regularly unregulated and variable in quality.

            Other than being temperamental for the unskilled, it is additionally not affordable by lower income groups. The key difficulties in the public health care services are low nature of care, poor responsibility, lack of awareness, and restricted access to facilities.

            Individuals in rural zones confront some unique medical problems than individuals who live in towns and urban areas. Getting health care services can be an issue when individuals live in a remote zone. They won't not have the capacity to get to a healing center rapidly in a crisis. They additionally might not have any desire to venture out long separations to get normal registration and screenings. Rural areas mostly have fewer specialists and dental practitioners, and certain experts won't be available at all

           

In rural areas health care services are mainly provided by:

a)   Government / government sponsored health centers or hospitals.

b)   A charitable trust run health centers or hospitals.

c)    Private practitioners.

4.1.        Objectives:

            To analyze the actual scenario of Rural Health Care Services in Zarol village and to measure the satisfaction level of patients

4.2.        Research methodology

Research Design is a framework or blue print for conducting the marketing research project. It specifies the details of the procedures necessary for obtaining the information needed to structure and solve marketing research problems. For this study, we used survey method by personally interviewing respondents through closed ended questionnaire

4.2.1.   Scope of the Study

            The scope of study is Zarol village in the state of Gujarat.

4.2.2.   About Zarol:

            Zarol is a village situated in Nadiad Taluka of Kheda district, Gujarat with total 293 families residing. The Zarol village has a population of 1379 of which 707 are males while 672 are females as per Population Census 2011. [2]

4.2.3.   The sample

            The actual user of specific service will constitute the sample of the study. Sample of 80 respondents has taken for the survey.

4.2.4.   Statistical Analysis

            For Data analysis, various statistical tests were used such as, Frequency distribution, Cronbach’s alpha for checking reliability, Mean, Standard Deviation as Descriptive Statistics, and Independent Sample T-test for equality of means and Analysis of Variance (ANOVA). 

            Quantitative research methods were used to measure availability of health care services by applying above mentioned statistical tests.

4.2.5.   Interview Script

Name

 

 

 

 

 

Gender

Male

Female

 

 

 

Age group

Below 25

25 to 35

36 to 45

46 or above

 

Qualification

Illiterate

SSC

HSC

Bachelors

Masters

Marital status

Single

Married(Not having kids)

Married (Having kids)

Divorced

 

Village

 

 

 

 

 

Table 1: Factors and Satisfaction

FACTORS

 

SD

D

N

A

SA

A.     

Infrastructure

This Health Care Centre is always well-ventilated with natural lights

 

 

 

 

 

 

There is always a minimal noise pollution in Health Centre

 

 

 

 

 

 

There is a prevalent security available in the Centre

 

 

 

 

 

 

Required basic medicines are always available on time

 

 

 

 

 

 

Doctors are always available when needed

 

 

 

 

 

 

Food quality is always good at Health Centre

 

 

 

 

 

 

All basic medical equipment are in working condition

 

 

 

 

 

 

Good housekeeping facilities are always available (eg. Pillows, buckets, mugs, dressing material etc.)

 

 

 

 

 

 

Overall,  You are satisfied by infrastructure of health Centre you visited

 

 

 

 

 

B.     

Personnel quality

Behavior of hospital staff is always courteous with you

 

 

 

 

 

 

 

Nurses always care for you deeply

 

 

 

 

 

 

Doctors are regularly visiting their ward rounds

 

 

 

 

 

 

Doctors  who are diagnosing are fully skilled

 

 

 

 

 

 

Overall, You are satisfied by staff behavior

 

 

 

 

 

C

Clinical Care

You always get proper medical counselling by doctors at the time of your discharge

 

 

 

 

 

 

Post treatment explanation is given by doctors thoroughly

 

 

 

 

 

 

Information about unexpected complications is given to you properly

 

 

 

 

 

 

Overall, you are satisfied by clinical care

 

 

 

 

 

D

Administrative procedures

You have to wait longer in Health Centre

 

 

 

 

 

 

Clear information about hospital rules and regulations is always given 

 

 

 

 

 

 

Admission procedure to Health Centre is very simple

 

 

 

 

 

 

Overall, you are satisfied by administrative procedures

 

 

 

 

 

E.

 Safety measures

PHC staff is always wearing the hygienic gloves

 

 

 

 

 

 

 

PHC environment is infection free

 

 

 

 

 

 

Overall, you are satisfied by safety measures

 

 

 

 

 

F.  Image

Ethics are always followed by this Health Centre

 

 

 

 

 

 

According to you, this Health Care Centre has good reputation

 

 

 

 

 

 

You are always treated honestly 

 

 

 

 

 

 

overall, you are satisfied by goodwill of your Health Centre

 

 

 

 

 

G. Trustworthiness

You have full confidence in the doctors who treated you

 

 

 

 

 

 

Health care Centre is always delivering the promised services

 

 

 

 

 

 

Privacy and confidentiality of information is always being carried by health care Centre

 

 

 

 

 

 

Overall, you are satisfied by  trustworthiness of your Health Centre

 

 

 

 

 

H.

Social Responsibility

This Health care Centre is organizing free check ups during epidemic cases

 

 

 

 

 

 

This Service provider is arranging medical camps for needy people

 

 

 

 

 

SD=Strongly Disagree  D= Disagree N=Neutral  A=Agree SA=Strongly Agree

Period of this Interview- 1 month (March 2018)  

            Profile of the interviewees: Demographic information on 80 respondents who participated in an interview was obtained from Zarol village. Of the 80, 40 (50%) were male and remaining 40 (50%) were female. Equal division between masculine and feminine was intentional so that by using independent sample T-test, we can analyze and compare the means and find out if there is any significant difference between various dimensions of service quality and gender.

Figure 1: Age Group Wise Distribution

Figure 2: Qualitication wise distribution

Figure 3: Social Status Wise Distribution

4.3.        Constructed Hypothesis for the study

·        H01: mean of various dimensions of service quality does not have significance difference across (or between) gender groups

·        H02: mean of various dimensions of service quality does not have significance difference across (or between) age groups.

·        H03: mean of various dimensions of service quality does not have significance difference across qualification

·        H04: mean of various dimensions of service quality does not have significance difference across marital status

Figure 4: Main Thrust of the paper

5.     RESULTS AND DISCUSSION

5.1.        Demographic Factors

            Cronbach’s alpha, α (or coefficient alpha), developed by Lee Cronbach in 1951, measure reliability or internal consistency. ‘Reliability’ is how well a test measures what it should. Cronbach’s alpha tests to see if multiple-question Likert scale surveys are reliable. These questions measure latent variables — hidden or unobservable variables those are very difficult to measure in real life. Cronbach’s alpha will justify if the test which have designed is accurately measuring the variable of interest. [3]

            We have used Cronbach’s Alpha in this study to analyze that the service quality dimensions used to measure availability of health care services are reliable or not. High reliability means it measures availability of health care services and low reliability means it measures something else (possibly nothing at all)

5.1.1.   Following table shows Cronbach’s Coefficient (Alpha) values for ensuring scale validity for the given study:

Table 2: Reliability Statistics for Service quality dimensions

Sr.

No.

Dimensions

Cronbach's Alpha

No. of

Items

1

Infrastructure

.890

2

2

Personnel quality

.981

5

3

Clinical Care

.951

3

4

Administrative procedures

.968

3

5

Safety measures

.980

2

6

Image

.958

3

7

Trustworthiness

.958

3

8

Social Responsibility

.519

8

Table 3: Descriptive Statistics

Descriptive Statistics

 

N

Minimum

Maximum

Mean

Std. Deviation

Infrastructure

80

1.00

5.00

3.5813

1.26902

Personnel quality

80

1.00

5.00

2.7425

1.37912

Clinical Care

80

1.00

5.00

3.6583

1.33014

Administrative procedures

80

1.00

5.00

3.5417

1.36294

Safety measures

80

1.00

5.00

2.2937

1.49618

Image

80

1.00

5.00

3.7708

1.20430

Trustworthiness

80

1.00

5.00

3.0792

1.33254

Social Responsibility

80

1.13

4.38

3.0953

.64914

Valid N (list wise)

80

 

 

 

 

            Means scores of Infrastructure, Clinical care, administrative procedures, Image, trustworthiness, social responsibility are relatively high indicating a higher level of patient’s satisfaction from PHC of Zarol. Whereas personnel quality and safety measures are having relatively low score indicating a lower level of patient’s satisfaction.

5.1.2.   T- Test

            H01: mean of various dimensions of service quality does not have significance difference across (or between) gender groups

Table 4: T – Test for service quality of patient satisfaction between female and male 

 

Gender

N

Mean

Std. Deviation

T

P-value

Infrastructure

Female

40

3.7125

1.15408

.924

.358

Male

40

3.4500

1.37654

 

 

Personnel quality

Female

40

2.8050

1.38896

-.403

.688

Male

40

2.6800

1.38401

 

 

Clinical Care

Female

40

3.7833

1.26885

.839

.404

Male

40

3.5333

1.39351

 

 

Administrative procedures

Female

40

3.5750

1.30959

.217

.828

Male

40

3.5083

1.43021

 

 

Safety measures

Female

40

2.2125

1.45834

.483

.630

Male

40

2.3750

1.54733

 

 

Image

Female

40

3.6833

1.16929

.647

.519

Male

40

3.8583

1.24696

 

 

Trustworthiness

Female

40

3.1167

1.35569

-.250

.803

Male

40

3.0417

1.32516

 

 

Social Responsibility

Female

40

3.0469

.60227

-.665

.508

Male

40

3.1438

.69715

 

 

            Female respondents gave highest rate to Image as it has highest mean of 3.6833 and they gave lowest rate to safety measure as it is having lowest mean of 2.2125. For male respondents Image is having highest mean of 3.8583 and safety measures are having lowest mean of 2.3750.

            All the p values are >0.05 so they are not statistically significant at 95% confidence interval so Null hypothesis (H01) cannot be rejected so there is no significant difference between dimensions of Service Quality and Gender

5.1.3.   ANOVA Test

            H02: mean of various dimensions of service quality does not have significance difference across (or between) age groups.

Table 5: ANOVA test for service quality of patient satisfaction between age groups

 

<25

25 to 35

36 to 45

>=46

Total

F

p-value

Infrastructure

8a

1.19±0.26b

30

2.92±0.86

 

17

4.05±0.39

25

4.82±.25

80

3.58±1.27

99.15

<0.001

Personnel quality

8

1±0.00

30

1.69±0.52

17

2.92±0.58

25

4.44±0.55

80

2.74±1.38

161.41

<0.001

Clinical care

8

1.17±0.18

30

2.88±0.84

17

4.25±0.22

25

4.99±0.07

80

3.66±1.33

138.11

<0.001

Administrative procedures

8

1.13±0.17

30

2.70±0.89

17

4.16±0.24

 

25

4.91±0.25

80

3.54±1.36

118.98

<0.001

Safety measures

8

1±0.00

30

1.17±0.36

17

2.03±0.28

25

4.24±1.01

80

2.29±1.50

126.73

<0.01

Image

8

1.38±0.45

30

3.18±0.79

17

4.24±0.23

25

4.93±0.14

80

115.21

<0.01

Trustworthiness

8

1±0.00

30

2.17±0.69

17

3.51±0.53

25

4.55±0.47

80

3.08±1.33

124.47

<0.01

Social Responsibility

8

2.58±0.81

30

2.73±0.52

17

3.11±0.39

25

3.69±0.38

80

3.09±0.65

20.79

<0.01

a: number of cases. b: mean±SD

For the age group of below 25 years, highest mean representing highest rate by respondents i.e. 2.5181 for Social Responsibility & lowest mean of 1 for safety measures, Trustworthiness & personnel quality. For the age group of 25 to 35 years highest mean was 3.1778 for Image and lowest mean of 1.1667 for safety measures. For the age group of 36 to 45 years, highest mean of 4.2549 for Clinical care & lowest mean of 2.0294 for safety measures.

            For the age group of above 46 years, highest mean of 4.9867 for Clinical care & lowest mean of 3.69 for Social Responsibility.

All the p values are statistically significant at 95% confidence level as all p values are < 0.05 so there is a significant difference between various dimensions of service quality and age groups. So Null hypothesis (H02) can be rejected.

5.1.4.   ANOVA test for service quality of patient satisfaction between qualification of respondents

            H03: mean of various dimensions of service quality does not have significance difference across qualification.

Table 6: ANOVA test for service quality of patient satisfaction between qualification of respondents

 

Illiterate

SSC

HSC

Graduation

Post-Graduation

Total

F

p-value

Infrastructure

15a

4.77±0.37b

21

4.02±0.98

 

26

3.50±1.05

11

2.27±.1.15

7

2.07±0.93

80

3.58±1.27

16.817

<0.001

Personnel quality

15

4.19±0.84

21

3.1524± 1.33

26

2.44±1.16

11

1.51±0.62

7

1.49±0.71

80

2.74±1.38

14.29

<0.001

Clinical care

15

4.87±0.37

21

4.17±0.98

26

3.58±1.12

11

2.12±1.18

7

2.24±0.98

80

3.66±1.33

17.65

<0.001

Administrative procedures

15

4.82±0.35

 

21

4.02±1.08

26

3.41±1.19

11

2.15±1.21

7

2.05±0.87

80

3.54±1.36

15.60

<0.001

Safety measures

15

4.033±1.33

21

2.67±1.50

26

1.79±1.02

11

1.14±0.38

7

1.14±0.38

80

2.29±1.49

15.124

<0.001

Image

15

4.82±0.42

21

4.23±0.78

26

3.74±0.99

11

2.27±1.25

7

2.57±0.79

80

3.77±1.20

17.89

<0.001

Trustworthiness

15

4.42±0.68

21

3.48±1.16

26

2.88±1.11

11

1.79±0.96

7

1.76±0.89

80

3.08±1.33

14.78

<0.001

Social Responsibility

15

3.58±0.45

21

3.29±0.55

26

3.07±0.48

11

2.53±0.65

7

2.45±0.79

80

3.09±0.65

8.94

<0.001

a: number of cases. b: mean±SD

            For the Illiterate group, highest mean of 4.8667 for Clinical Care & lowest mean of 3.5750 for Social Responsibility. For the SSC group, highest mean of 4.2381 for Image and lowest mean of 2.6667 for safety measures. For HSC group, highest mean of 3.7436 for Image and lowest mean of 1.7885 for safety measures. For Graduation group, highest mean of 2.5341 for Social Responsibility and lowest mean of 1.1364 for safety measures. For Post-graduation group, highest mean of 2.5714 for Image and lowest mean of 1.1429 for safety measures.

            All the p values are statistically significant at 95% confidence level as all p values are < 0.05 so there is a significant difference between various dimensions of service quality and qualification groups. So Null hypothesis (H03) can be rejected.

 

5.1.5.   ANOVA test for service quality of patient satisfaction between marital status of respondents

            H04: mean of various dimensions of service quality does not have significance difference across marital status

Table 7: ANOVA test for service quality of patient satisfaction between marital status of respondents

 

Single

Married(not having kids)

Married (having kids)

Total

F

p-value

Infrastructure

6

1.17±0.26

3

1.17±0.29

71

3.89±0.98

80

3.58±1.27

33.43

<0.001

Personnel quality

6

1±0.00

3

1±0.00

71

2.96±1.31

80

2.74±1.38

9.92

<0.001

Clinical care

6

1.11±0.17

3

1.44±0.19

71

3.97±1.06

80

3.66±1.33

29.30

<0.001

Administrative procedures

6

1.06±0.14

3

1.44±0.19

71

3.84±1.13

80

3.54±1.36

24.18

<0.001

Safety measures

6

1±0.00

3

1±0.00

71

2.46±1.51

80

2.29±1.49

4.09

<0.001

Image

6

1.28±0.44

3

1.78±0.38

71

4.07±0.91

80

3.77±1.20

36.02

<0.001

Trustworthiness

6

1±0.00

3

1±0.00

71

3.34±1.17

80

3.08±1.33

17.50

<0.001

Social Responsibility

6

2.52±0.92

 

3

2.58±0.47

71

3.17±0.60

80

3.09±0.65

3.98

<0.001

            For the single group of respondents, highest mean of 2.5208 for Social Responsibility & lowest mean of 1 for Personnel quality, Trustworthiness, safety measures. For Married (Not having kids group), highest mean of 2.5833 for Social Responsibility and lowest mean of 1 for personnel quality, Trustworthiness, safety measures. For married (having kids group), highest mean for Image i.e. 4.0657 and lowest mean of 2.4577 for safety measures.

            All the p values are statistically significant at 95% confidence level as all p values are < 0.05 so there is a significant difference between various dimensions of service quality and marital status groups. So Null hypothesis (H04) can be rejected.

6.     MANAGERIAL IMPLICATIONS:

1.    Primary Health Centre must organize basic tutorial for rural people at their level of understanding

2.    Staff of government hospital must be given training of how to behave with customers.

3.    Doctors of Government hospitals must be given enough salary package to avoid certain issues

4.    Government hospital of rural area should also progress towards Digitalized direction.

5.    Enough amenities should be developed for waiting room patients.

7.     CONCLUSION:

            This study focuses on availability of Health Care Services in Zarol village as per the Indian Public Health Standards. From our research findings we can say that for H01all the p values were >0.05 so they are not statistically significant at 95% confidence interval so Null hypothesis (H01) cannot be rejected so there is no significant difference between dimensions of Service Quality and Gender.

            For H02, All the p values are statistically significant at 95% confidence level as all p values are < 0.05 so there is a significant difference between various dimensions of service quality and age groups. So Null hypothesis (H02) can be rejected.

            For H03 all p values are < 0.05 so there is a significant difference between various dimensions of service quality and qualification groups. So Null hypothesis (H03) can be rejected.

            For H04 All the p values are < 0.05 so there is a significant difference between various dimensions of service quality and marital status groups. So Null hypothesis (H04) can be rejected.

            We also faced certain limitations during our study like because of time constraint limited sample size was taken, as this survey is for remote area, Google survey form didn’t work so a questionnaire was redrafted in regional language hence it took longer for field survey. Research scholar can further carry this research to map the real changes in the context of the health status of the remote area.

REFERENCES:

AMERICAN ACADEMY OF FAMILY PHYSICIANS (2015) Rural Practice, Keeping Physicians In. Retrieved October 7, 2015, from AAFP.org.

AKIN, J.; HUTCHISON, P. (1999) Health Care Facility Choice and the Phenomenon of Bypassing, Health Policy and Planning, n. 14, p. 135-151.

BABAKUS, E.; MANGOLD, W. G. (1989) Adapting the SERVQUAL scale to health care environment: an empirical assessment. In: BLOOM, P. (eds), AMA Educators Proceedings. Chicago, IL: American Marketing Association

BATES, L.; HANCOCK, L.; PETERKIN, D. (2001) A little encouragement: health services and domestic violence", International Journal of Health Care Quality Assurance, v. 14, n. 2 p. 49-56

BRADY, M. K.; CRONIN JR., J. (2001) Some new thoughts on conceptualizing perceived service quality: a hierarchical approach, Journal of Marketing, v. 65, July, p. 34-49

CALNAN, M. (1988a) Lay Evaluation of Medicine and Medical Practice: Report of a Pilot Study, International Journal of Health Service, n. 18, p. 311-322.

CALNAN, M. W. (1998b) The Patient’s Perspective, International Journal of Technology Assessment of Health Care, n. 14, p. 24-34.

CECIL G SHEPS CENTER FOR HEALTH SERVICES RESEARCH 725 Airport Road Campus Box 7590 University of North Carolina Chapel Hill, NC 27599-7590

CHAHAL, H.; SHARMA, R. D. (2004) Managing health care service quality in a primary health care centre, Metamorphosis, v. 3, n. 2, p. 112-31

CORBIN, C. L.; KELLEY, S. W.; SCHWARTZ, R. W. (2001) Concepts in service marketing for healthcare professionals, The American Journal of Surgery, v. 181, p. 1-7

CRONIN, J.; TAYLOR, S. (1992) Measuring Service Quality: A Reexamination and Extension, Journal of Marketing, v. 56, n. 3, p. 55-68.

DONGRE, Y.; MAHADEVAPPA, B.; ROHINI, R. (2010) Building access to healthcare in rural India: possibility and feasibility of low-cost medicine, International Journal of Pharmaceutical and Healthcare Marketing, v. 4, n. 4, p. 396-407

GHOSH, M. (2014) Measuring patient satisfaction, Leadership in Health Services, v. 27, n. 3, p. 240-254

GILSON, I.; ALILO, M.; HEGGENHOUGEN, K. (1994) Community satisfaction with primary health care services: an evaluation undertaken in the Morogoro Region of Tanazania, Social Science and Medicine, v. 39, p. 767-80

JAYESH, P.; GARG, A. R. (2010) Measuring perceived service quality for public hospitals (PubHosQual) in the Indian context, International Journal of Pharmaceutical and Healthcare Marketing, v. 4, n. 1 p. 60-83

KANG, G.-D.; JAMES, J. (2004) Service quality dimensions: an examination of Grönroos’s service quality model, Managing Service Quality: An International Journal, v. 14, n. 4, p.266-277, https://doi.org/10.1108/09604520410546806

KOTHARI, C. R.; GARG, G. (2014) Research Methodology-Methods & Techniques, New Age Publications

MOORE, J. (2005) Is Higher Education Ready for Transformative Learning? A Question Explored in the Study of Sustainability. Journal of Transformative Education, v. 3, p. 76-91.

NEWMAN, R. D. (1998) Satisfaction with outpatient health care services in Manica Province, Mozambique, Health Policy and Planning, v. 13, n. 2, p. 174-80

PARASURAMAN, A.; ZEITHAML, V. A.; BERRY, L. L. (1988) Servqual: A multiple-item scale for measuring consumer perception of service quality, Journal of retailing, v. 64, n. 1, p. 12.

PRAKASH, G. (2015) Steering healthcare service delivery: a regulatory perspective, International Journal of Health Care Quality Assurance, v. 28, n. 2 p. 173-192

RAFTOPOULOS,  V.  (2005)  A  Grounded  Theory  for  Patients´Satisfaction  with Quality of Hospital Care. ICUs and Nursing Wen Journal, n. 22, p. 1-15.

RURAL HEALTH INFORMATION HUB (2016) Social Determinants of Health. Retrieved June 8, 2016.

SARDANA, G. D. (2003) Performance grading of hospitals: a conceptual framework, Productivity, v. 44, n. 3, p. 450-65.

WISNIEWSKI, M.; WISNIEWSKI, H. (2005) Measuring service quality in a hospital colposcopy clinic, International Journal of Health Care Quality Assurance, v. 18 n. 3, p.217-228, https://doi.org/10.1108/09526860510594776

ZINELDIN, M. (2006) The quality of health care and patient satisfaction, International Journal of Health Care Quality Assurance, v. 19, n. 1, p. 60-92.



[1] Adapted from a definition by Christopher Lovelock (identified anonymously as Expert 6, Table II, p.112) in Bo Edvardsson, Anders Gustafsson, Inger Roos, “Service Portraits in Service Research: A Critical Review”, International Journal of Service Industry Management, 16, No.1,2005, 107-121.

 

[2] http://www.census2011.co.in/data/village/517602-zarol-gujarat.html

[3] Mohsen Tavakol and Reg Dennick. Making Sense of Cronbach’s Alpha. International Journal of Medical Education. 2011; 2:53-55 Editorial

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