Assessment of Service Quality in the Outpatient Department of Public Hospitals in Yangon, Myanmar

Abstract

Services are intangible in nature and difficult to assess as compared to the products. Measuring the quality of intangible service products has become a great challenge for managers and technical staffs in the health services industry. In Myanmar, the network of hospitals and health centers provides preventive and curative services ranging from primary to tertiary care. The service quality of public hospitals can be affected due to an imbalance between supply and demand resulting in the decline of customer satisfaction level. The assessment of patients’ expectation and perception would be necessary for policymakers and government officials to reform and rebuild the operating system and service quality in public hospitals. Therefore, this research aims to assess service quality in the outpatient department of public hospitals in Yangon, Myanmar. The study employed the SERVQUAL framework, comprising five dimensions – namely tangible, reliability, responsiveness, assurance, and empathy – to evaluate the quality of services provided in the outpatient department of public hospitals in Yangon, Myanmar. After developing a questionnaire relevant to Myanmar culture, the data collection was collected from the Yangon region because this is the most crowded and has the highest population among the 15 states and regions. So, the 806 patients were asked from the outpatient department (OPD) of the hospitals of 18 primary, 2 secondary and 6 tertiary curative care levels. Based on data collection, the scores between the perception and expectation on service quality dimensions showed positive scores in all dimensions. The mean perception score exceeded the mean expectation score and it could explain that the patients were satisfied with perceived service quality. Moreover, the result showed that residence was significantly related to the tangible, reliability, responsiveness and empathy dimensions. The monthly income was significantly related to the reliability and responsiveness dimensions. The marital status was significantly related to the assurance dimension. The results emphasize the importance of understanding the local context and demographic characteristics when designing interventions or improvements in healthcare services. Understanding the underlying factors contributing to these variations could provide valuable insights for healthcare providers to enhance their service quality based on the specific needs of different patient groups. To validate the association between the observed and the latent variables, the measurement model was assessed by the first-order and second-order confirmatory factor analyses. Based on the fit indices, the second-order confirmatory factor model did not adequately represent the data. Therefore, it could not confirm the hypothesized two-factor model of service quality, where service expectation and perception were higher-order factors encompassing the individual five dimensions of service quality. Due to the diverse nature of service industries and the complexities inherent in healthcare services, it is needed to emphasize the importance of tailoring the SERVQUAL scale to each sector's specific needs, cultural context and national context.

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