An Empirical Study on Integration of Servqual and Kano Model for Measuring Service Quality of Hospitals in Ahmedabad

Ms. Nikita Patel ., Dr. Nishith Kumar H. Bhatt .


To survive in this competitive market and to achieve competitive advantage, hospital should continuously measure and improve their service quality which leads to patient satisfaction. Lot of research has been carried out to measure service quality through SERVQUAL or modified SERVQUAL scale. But Literature has explored that SERVQUAL cannot directly relate performance with satisfaction level because it assumes a linear relationship between customer satisfaction and service attribute performance. But the factors that cause dissatisfaction are different from the factors that cause satisfaction. Kano Model can be used to classify service quality attribute based on satisfaction level. This research paper will emphasis on integration of SERVQUAL and Kano model to measure service quality of Private Multispecialty Hospitals in Ahmedabad, Gujarat to find out the major areas for improvement as per the service quality is concerned. Research has identified high service quality gap for the dimensions reliability, responsiveness, assurance and empathy on the other hand tangibility shown least service quality gap. Service quality gap was observed in Must be service quality attributes that shown that hospitals are lacking in proving basic services too. To satisfy patients, Private Multispecialty Hospitals in Ahmedabad should focus more on improving service quality.


Hospital Service Quality, SERVQUAL, Kano Model

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Aagja, P. J., & Garg, R. (2010). Measuring perceived service quality for public hospitals (PubHosQual) in the India Context. International Journal of Pharmaceutical and Healthcare Marketing, 4 (1), 60-83.

Aaron A. Abuosi & Roger A. Atinga. (2013). Service quality in health care institutions: establishing the gaps for policy action. International Journal of Health Care Quality Assurance, 26 (5), 481-492.

Andaleeb, S. S. (2001). Service quality perception and patient satisfaction: a study of hospitals in a developing country. Social Science and Medicine, 52 (9), 1359-1370.

Bakar, C., Akgun, H. S., & Assaf, A. (2008). The Role of role expectations in patients’ hospital assessments: a Turkish university hospital example. International Journal of Health care Quality Assurance, 21 (5), 503-516.

Bedi,K.(2009). Production and Operations Management. New Delhi: Oxford University Press.

Berger, C., Blauth, R., Boger, D., Bolster, C., Burchill, G., DuMouchel, W., et al. (1993). Kano's method for understanding customer-defined quality. The centre for quality management Journal, 2 (4), 2-36.

Berry, L. L., & Bengdapudi, N. (2007). Health care: a fertile field for service research. Journal of Service Research, 10 (2), 111-122.

Bhattacharyya, S. K., & Rahman, Z. (2004). Capturing the customer’s voice, the centerpiece of strategy making: a case study in banking. European Business Review, 16 (2), 128-38.

Birdogan, B., Cigdem, S. B., Zuhal, C., & Ilker, M. A. (2009). An application of integrating SERQUAL and Kano's model into QFD for logistics services: A case study from Turkey. Asia Pacific Journal of Marketing and logistics, 21 (1), 106-126.

Brown, S. W., & Swartz, T. A. (1989). A gap analysis of professional service quality. Journal of Marketing, 53, 92-98.

Busacca, B., & Padula, G. (2005). Understanding the relationship between attribute performance and overall satisfaction: theory,measurment and implications. Marketing Intelligence and Planning , 23 (6), 543-61.

Butt, M. M., & Run, E. C. (2010). Private healthcare quality: Applying a SERVQUAL model. International Journal of Healthcare Quality Assurance, 23 (7), 658-673.

Buttle, F. (1996). SERVQUAL: review, critique and research agenda. European Journal of Marketing, 30 (1), 8-32.

Cardero-Ampiero, J., Darder, A., Santillana, J., Caloto, M. T., & Nocea, G. (2012). Evaluation of patients' and physician's expectation and attributes of Osteoarthritis treatment using Kano methodoly. Qual Life Res, 21, 1391-1404.

Chen, Y. H., & Su, C. T. (2006). A Kano-CKM model for customer knowledge discovery. Total Quality Management, 17 (5), 589-608.

Devlin, S. J., & Dong, H. K. (1994). Service Quality from Customer's Perspectives. Marketing Research, 6 (1), 5-13.

Duggirala, D., Rajendran, C., & Anantharaman, R. N. (2008). Patient perceived dimensions of total quality service in healthcare. Benchmarking: An International Journal, 15 (5), 560-583.

Emery, C. R., & Tian, R. G. (2002). Schoolwork as products, professors as customers: a practical teaching approach in business education. Journal of Education for Business, 78 (2), 97-102.

Fundin, A., & Nilsson, L. (2003). Using Kano's theory of attractive quality to better understand customer experience with e-services. Asian Journal on quality , 4 (2), 32-49.

Gustafsson, A. (1998). QFD – Va¨gen till no¨jdare kunder i teori och praktik (in Swedish), Studentlitteratur, Lund.

Headly, D. E., & Miller, S. J. (1993). Measuring service quality and its relationship to future consumer behavior. Journal of Healthcare Marketing, 13 (4), 32-40.

Herzberg, F., Bernard, M. and Snyderman, B. (1959). The Motivation to Work. Wiley, New York, NY.

Herzberg, F. (1966). Work and the Nature of Man. World Publishing Co., Cleveland, OH.

Hogstrom, C., Rosner, M., & Gustafsson, A. (2010). How to create attractive and unique customer experiences: An Application of Kano's theory of attractive quality to recreational tourism. Marketing Intelligence and Planning, 28 (4), 385-402.

Industries commisionerate, Government of Gujarat (2014). Healthcare. Gujarat: iNDEXTb.

Jane´, A. C., & Domı´nguez, S. M. (2003). Citizens' role in health care services: satisfaction behavior: Kano's model,Part 1. Quality Management in Health Care , 12 (1), 64-71.

Kano, N. (2001). Life cycle and creation of attractive quality. 4th International QMOD (Quality Management and Organisational Development) Conference, Linko¨ping University, Linko¨ping.

Kano, N., Seraku, N., Takahashi, F. & Tsjui, S. (1984). Attractive quality and must-be quality. Hinshitsu, Vol. 14 No. 2, pp. 147-56.

Kara, A., Lonial, S., Tarim, M., & Zaim, S. (2005). A Paradox of service quality in Turkey. European Business Review, 17 (1), 5- 20.

Karassavidou, E., Glaveli, N., & Papadopoulos, C. T. (2009). Quality in NHS Hospitals: no one knows better than patients. Measuring Business Excellence, 13 (1), 34-46.

Kilbourne, W. E., Duffy, M., Giarchi, G., & Duffy, J. A. (2004). The applicability of SERVQUAL in cross national measurements of Health care Quality. Journal of Service marketing, 18 (7), 524-533.

Lilja, J., & Wiklund, H. (2006). Obstacles to the creation of attractive quality. The TQM Magazine , 18 (1), 55-66.

Lim, P. C., & Tang, N. (2000). A study of patients' expectation and satisfaction in Singapore hospitals. International Journal of Health care Quality Assurance, 13 (7), 290-299.

Ludwig-Beymer, p., Ryan, C. J., Johnson, N. J., Hennessy, K. A., Gattuso, M. C., Epsom, R., et al. Using patient perceptions to improve quality care. Journal of Nursing Care Quality, 7 (2), 42-51.

Marchand, M., & Schroyen, F. (2005). Can a mixed health care system be desirable on equity grounds?. Scandinavian Journal of Economics , 107 (1), 1-23.

Matzler, K., & Hinterhuber, H. H. (1998). How to make product development projects more successful by integrating Kano's model of customer satisfaction in to quality function deployment. Technovation , 18 (1), 25-38.

Matzler, K., Hinterhuber, H. H., Bailom, F., & Sauerwein, E. (1996). How to delight your customers. Journal of Product and Brand Management, 5 (2), 6-18.

Momani, A., Al-Hawari, T., Al-Shebami, H., & Al-Araildah, O. (2014). Classifying and Ranking Healthcare Quality Attributes Using integrated Kano-Fuzzy Analytical Hierarchy process. Engineering Management Research, 3 (1), 68-88.

Narang, R. (2010). Measuring perceived quality of health care services in India. International Journal of Health Care Quality Assurance, 23 (2), 171-186.

O'Connor, S. J., Trinh, H. Q., & Shewchuk, R. M. (2000). Perceptual gaps in understanding patient expectation for health care service quality. Health care management Review, 25 (2), 7-23.

Olgun K.,Ceylan A., & İbrahim T. D.(2014) . The Impact of Service Quality Dimensions on Patient Satisfaction, Repurchase Intentions and Word-of-Mouth Communication in the Public Healthcare Industry. 2nd International Conference on Strategic Innovative Marketing, 148, 161 – 169.

Pai, Y. P., & Chary, S. T. (2013). Dimensions of hospital service quality: a critical review. International Journal of Health Care Quality Assurance, 26 (4), 308-340.

Parasuraman, A., Zeithaml, V., & Berry, L. (1985). A Conceptual model of service quality and its implications for future research. Journal of Marketing , 49 (1), 41-50.

Parasuraman, A., Zeithaml, V., & Berry, L. (1988). SERVQUAL: a multi item scale for measuring customer perception of service quality. Journal of Retailing, 64 (1), 12-37.

Pawitra, T. A., & Tan, K. C. (2003). Tourist satisfaction in Singapore- a perspective from Indonesian perspective. European Journal of Innovation Management, 13 (5), 399-411.

Ramsaran-Fowdar, R. (2008). The relative importance of service dimensions in a healthcare settings. International Journal of Healthcare Quality Assurance, 21 (1), 104-124.

Rao, K. D., Peters, D. H., & Bandeen-Rochen, K. (2006). Towards patient centered health services in India- a scale to measure patient perception of quality. International Journal for Quality in Health Care, 18 (6), 414-421.

Rohini, R., & Mahadevappa, B. (2006). Service Quality in Bangalore hospitals- an empirical study. Journal of Service Research, 6 (1), 59-85.

Shen, X. X., Tan, K. C., & Xie, M. (2000). Benchmarking in QFD for Quality improvement. An International Journal , 7 (4), 282-291.

Sohail, M. S. (2003). Service quality in hospitals: more favorable than you might think. Managing Service Quality, 13 (3), 197-207.

Sulisworo, D., Elizabeth, N., & Maniquiz, F. (2012). Integrating Kano’s Model and SERVQUAL to Improve Healthcare service quality. IC-GWBT, 130-144.

Tan, K. C., & Pawitra, T. A. (2001). Integrating SERVQUAL and Kano's model into QFD for service excellence development. Managing Service quality, 11 (6), 418-430.

Tan, K. C., Xie, M., & Shen, X. X. (1999). Development of innovative products using Kano's model and quality function deployment. International Journal of Innovation Management, 3 (3), 271-86.

Ting, S. C., & Chen, C. N. (2002). The asymmetrical and non-linear effects of store quality attributes on customer satisfaction. Total Quality Management , 13 (4), 547-69.

Witell, L., & Lofgren, M. (2007). Classification of quality attributes. Managing Service Quality, 17 (1), 54-73.


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