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Abstract The service quality measurement scale (SERVQUAL) has been widely used in research to measure quality of service. The aim of this paper is to demonstrate the use of SERVQUAL for measuring patients) perceptions of health care quality in Hong Kong. The paper also examines the validity, reliability and predictive validity of SERVQUAL and analyzes its applicability to the health care sector in Hong Kong. The results indicate that SERVQUAL appears to be a consistent and reliable scale to measure health care service quality. However, the proposed five dimensions of SERVQUAL are not confirmed. The results also indicate that perceived health care service performance generally falls short of expectations except in the physical elements of service quality. Timely, professional and competent services are what patients expect from health care providers.
Introduction
During the past decade, concern for service quality reached unprecedented levels. The present `quality revolution' has been fired by exacerbated competition and many companies have now accepted the challenge of improving service quality. In the health care sector, the past few years have witnessed an increasing concern regarding the quality of primary health care in Hong Kong. The health care service can be broken down into two quality dimensions: technical quality and functional quality (Donabedian, 1980; Gronroos, 1984). Technical quality in the health care sector is defined primarily on the basis of the technical accuracy of the medical diagnoses and procedures or the conformance to professional specifications. Functional quality refers to the manner in which the health care service is delivered to the patients. Quality, from the professionals' perspective, is technical and has been operationalized in terms of three constructs: structure, process and outcome (Donabedian, 1980). Structure pertains to whether the health care providers have the knowledge, skill and resources to diagnose and treat the patients' health condition properly. Process concerns whether diagnostic and therapeutic interventions are applied appropriately. Outcome reflects whether professional and technical resource inputs produce the expected effect.
Research has shown that technical quality falls short of being a truly useful measure for describing how patients evaluate the quality of a medical service encounter (Bowers et al., 1994). Although technical quality has high priority with patients, most patients do not have the knowledge to evaluate effectively the quality of...