10120140502001

International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online),

Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME

1

SATISFACTION LEVEL OF IPD PATIENTS WITH MEDICAL SERVICES

Dr. Satpal Singh1, Dr. Shipra Jain(PT)

2

1Assistant Professor, Department of Management Studies, D.C.R.U.S.T. Murthal, Sonepat

2Masters of Hospital Administration, D.C.R.U.S.T. Murthal, Sonepat

ABSTRACT

SUBJECT This dissertation report presents the methodology and result of patient experiences and

satisfaction about medical care in In-patient department of NKS Hospital.

OBJECTIVES The objective of study was to determine the level of patient satisfaction about medical care

services provided at NKS hospital through the use of patient satisfaction questionnaire.

METHODOLOGY The Patient satisfaction questionnaire was allowed to fill up by the 50 randomly selected

patients from the IPD at NKS Hospital.

DATA COLLECTION

Data were collected through patient satisfaction questionnaire.

DATA ANALYSIS For the purpose of data analysis one has used the Microsoft Excel.

RESULT Results are expressed through the findings of the tables and graphs. The result suggests that

although patient level of satisfaction was different for different aspect of medical care services,

mostly patients were satisfied with the service and service providers. We are able to determine how

the level of satisfaction is an important indicator of patient’s experiences to medical services.

RECOMMENDATIONS With these results, one can manifest the level of patient satisfaction for determining the

quality of care given in IPD and develop strategies to improve the patient care. Since this study

shows the satisfaction level slightly above the average in the IPD of NKS Hospital so in future a

INTERNATIONAL JOURNAL OF MANAGEMENT (IJM)

ISSN 0976-6502 (Print)

ISSN 0976-6510 (Online)

Volume 5, Issue 2, February (2014), pp. 01-09 © IAEME: www.iaeme.com/ijm.asp

Journal Impact Factor (2013): 6.9071 (Calculated by GISI) www.jifactor.com

IJM © I A E M E



2

study can be conducted on OPD to check the level of satisfaction and relate the satisfaction level

with the IPD.

INTRODUCTION

The statement of problem identifies the gap in knowledge pertaining to the patient

satisfaction as it directly relates to perception of caring nursing behaviors. In addition, the problem

statement provides the researchers with a clear direction for the development of the research purpose.

In addition, the authors make a clear case that additional research is warranted, especially with the

extension of nursing in our country. In the literature review, the authors cite several studies

describing caring knowledge in nursing, but the lack of true evidence regarding caring consequences.

The purpose of this study was firstly to analyze the possibility of characterizing the patient’s

responses typologically, taking into account patient evaluations of medical care; and secondly, to

identify the particular healthcare dimensions that determine a patient's satisfaction or dissatisfaction.

Understanding patient satisfaction with the healthcare provided by family doctors is, first and

foremost, essential for improving the quality of medical care.

There are basically three reasons why patient satisfaction is viewed as an important tool for

measuring aspect of care. Firstly, there is convincing evidence that satisfaction is an important

outcome measure. It may be a predictor of whether patients follow their recommended treatments,

and is related to whether patients re-attend for treatment and change their provider of health care.

Secondly, patient satisfaction is an increasingly useful measure in assessing consultations and

patterns of communication. Thirdly, patient feedback is used systematically to choose between

alternative methods of organizing or providing health care.

PATIENT SATISFACTION AS MEASURE OF HEALTHCARE

� An important outcome measure.

� Useful in assessing consultations and patterns of communication.

� Used systematically, feedback enables choice between alternatives in

� Organising or providing healthcare.

REVIEW OF LITERATURE

Doris C. Vahey (2004 February) studied that high levels of nurse burnout could adversely

affect patient satisfaction. This study examines the effect of the nurse work environment on nurse

burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction

with their nursing care. They conducted cross-sectional surveys of nurses (N = 820) and patients (N

= 621) from 40 units in 20 urban hospitals across the United States. Nurse surveys included measures

of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse

outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were

interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient

Satisfaction Scale (LOPSS).

This research concluded that improvements in nurses' work environments in hospitals have

the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and

increase patients' satisfaction with their care.

Mair F, Whitten P.( 2000 June) did a research into patient satisfaction with teleconsultation,

specifically clinical consultations between healthcare providers and patients involving real time

interactive video.Methodological deficiencies (low sample sizes, context, and study designs) of the

published research limit the generalisability of the findings. The studies suggest that teleconsultation



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is acceptable to patients in a variety of circumstances, but issues relating to patient satisfaction

require further exploration from the perspective of both clients and providers.

Sitzia J. (1999 Aug) did this study to assess the properties of validity and reliability of

instruments used to assess satisfaction in a broad sample of health service user satisfaction studies,

and to assess the level of awareness of these issues among study authors.

With few exceptions, the study instruments in this sample demonstrated little evidence of reliability

or validity. Moreover, study authors exhibited a poor understanding of the importance of these

properties in the assessment of satisfaction. Researchers must be aware that this is poor research

practice, and that lack of a reliable and valid assessment instrument casts doubt on the credibility of

satisfaction findings.

Sitzia J, Wood N.( 1998 Aug) conducted the research to examine the quality of response rate

reporting and to identify methodological factors influencing response rates in published patient

satisfaction studies.Patient satisfaction studies generally show poor awareness of the importance of

methodological issues relevant to response rate. Far more attention to this aspect is needed if findings

in this field are to be accepted as valid and useful.

Khayat K, Salter B.(1994 May) A survey was undertaken to investigate the use of a patient

satisfaction survey and whether aspects of patient satisfaction varied according to sociodemographic

characteristics such as age, sex, social class, housing tenure and length of time in education.Surveys

and analyses of this kind, if conducted for a single practice, can form the basis of a marketing

strategy aimed at optimizing list size, list composition, and service quality. Satisfaction surveys can

be readily incorporated into medical audit and financial management.

Ann Kutney-Lee, Matthew D. McHugh (2009 June)Patient satisfaction is receiving greater

attention as a result of the rise in pay-for-performance (P4P) and the public release of data from the

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This paper

examines the relationship between nursing and patient satisfaction across 430 hospitals. The nurse

work environment was significantly related to all HCAHPS patient satisfaction measures.

Additionally, patient-to-nurse workloads were significantly associated with patients’ ratings and

recommendation of the hospital to others, and with their satisfaction with the receipt of discharge

information. Improving nurses’ work environments, including nurse staffing, may improve the

patient experience and quality of care.

R Baker and M Whitfield(1992 June) conducted the researchto establish the validity of two

patient satisfaction questionnaires (surgery satisfaction questionnaire and consultation satisfaction

questionnaire developed for use in general practice. Both questionnaires classified patients in groups

1 and 2 according to the construct of satisfaction; thus the difference in median scores for every

component of satisfaction in each questionnaire was significant and occurred in the direction

predicted by the construct. Each questionnaire also discriminated between patients grouped

according to their assessed level of continuity of care. They concluded that SSQ and CSQ are valid

measures of satisfaction for these types of patients.

D C Morrell and M O Roland(1986 March) An experiment was carried out in which patients

who were seeking appointments for a consultation in a general practice in south London attended

consulting sessions booked at 5, 7.5, or 10 minute intervals. The particular session that the patient

attended was determined non-systematically. The clinical content of the consultation was recorded

on an encounter sheet and on audio-tape. At the end of each consultation patients were invited to

complete a questionnaire designed to measure satisfaction with the consultation. The stress

engendered in doctors carrying out surgery sessions booked at different intervals of time was also

measured. At surgery sessions booked at 5 minute intervals, compared with 7.5 and 10 minute

intervals, the doctors spent less time with the patients and identified fewer problems, and the patients

were less satisfied with the consultation. Blood pressure was recorded twice as often in surgery

sessions that were booked at 10 minute intervals compared with those booked at 5 minute intervals.



4

There was no evidence that patients who attended sessions booked at shorter intervals

received more prescriptions, were investigated or referred more often to hospital specialists, or

returned more often for further consultations within four weeks. There was no evidence that the

doctors experienced more stress in dealing with consultations that were booked at 5 minute intervals

than at consultations booked at 7.5 and 10 minute intervals, though they complained of shortage of

time more often in surgery sessions that were booked at shorter intervals.

Vinagre, M. H. and Neves, J. (2008)."The influence of service quality and patients' emotions

on satisfaction." International Journal of Health Care Quality Assurance 21(1): 87-103. PURPOSE:

The purpose of this research is to develop and empirically test a model to examine the major factors

affecting patients' satisfaction that depict and estimate the relationships between service quality,

patient's emotions, expectations and involvement. DESIGN/METHODOLOGY/APPROACH: The

approach was tested using structural equation modeling, with a sample of 317 patients from six

Portuguese public healthcare centres, using a revised SERVQUAL scale for service quality

evaluation and an adapted DESII scale for assessing patient emotions. FINDINGS: The scales used

to evaluate service quality and emotional experience appears valid. The results support process

complexity that leads to health service satisfaction, which involves diverse phenomena within the

cognitive and emotional domain, revealing that all the predictors have a significant effect on

satisfaction. RESEARCH LIMITATIONS/IMPLICATIONS: The emotions inventory, although

showing good internal consistency, might be enlarged to other typologies in further research--needed

to confirm these findings. PRACTICAL IMPLICATIONS: Patient's satisfaction mechanisms are

important for improving service quality. ORIGINALITY/VALUE: The research shows empirical

evidence about the effect of both patient's emotions and service quality on satisfaction with

healthcare services. Findings also provide a model that includes valid and reliable measures

Watrous, J. and Hobson, A. (1994)."A systems approach to gathering and analyzing patient

and family complaints and suggestions." Journal for Healthcare Quality 16(6): 14-6.

Most medical facilities' leaders are concerned with satisfying the patients who use their

healthcare organization. Whereas many facilities have identified specific individuals whose job it is

to hear patient complaints, the authors promote the view that all staff members play important roles

in patient advocacy. Management's role is to determine how to collect and analyze the complaints

and suggestions voiced by patients throughout their healthcare experience. This article presents one

method.

Wensing, M. and Elwyn, G. (2002)."Research on patients' views in the evaluation and

improvement of quality of care." Quality & Safety in Health Care 11(2): 153-7.

The identification of methods for assessing the views of patients on health care has only

developed over the last decade or so. The use of patients' views to improve healthcare delivery

requires valid and reliable measurement methods. Four approaches are recognised: inclusion of

patients' views in the information to those seeking health care, identification of patient preferences in

episodes of care, patient feedback on delivery of health care, and patients' views in decision making

on healthcare systems. Outcome measures for the evaluation of the use of patients' views should

reflect the aims in terms of processes or outcomes of care, including possible negative consequences.

Rigorous methodologies for the evaluation of methods have yet to be implemented.

VanderVeen, L. and Ritz, M. (1996). "Customer satisfaction: a practical approach for

hospitals." Journal for Healthcare Quality 18(2): 10-5. A California hospital developed a program to

better serve and satisfy its customers. This article details the hospital's plan to implement the

program with the collection and use of data to measure success, promote

staff accountability, and, ultimately, demonstrate improved customer satisfaction as measured by

fewer complaints. The various activities initiated to promote staff education and recognize

employees also are briefly addressed.



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Turnbull, J. E. and Luther, K. M. (1996). "Patient satisfaction report paves way to improved

care." QRC Advisor 13(1): 1-7. In this article, the second in a two-part series, we show how a data-

driven clinical model was implemented to improve care using patient satisfaction reports. Last

month, we outlined the essential components of a data-driven clinical model and summarized two

research paradigms that provide the theoretical foundation

for such a model.

Trumble, S. C., O'Brien, M. L., O'Brien, M. and Hartwig, B. (2006). "Communication skills

training for doctors increases patient satisfaction." Clinical Governance 11(4): 299-307.

Purpose - The purpose of this paper is to examine changes in patients' satisfaction after their doctor

has participated in a brief educational intervention on medico legal risk management.

Design/methodology/approach - Questionnaire completed by ambulatory patients, measuring

satisfaction with their doctor's communication skills before and three months after the doctor

participated in a three hour workshop on medico legal risk management. 75 obstetrician/

gynecologists (O&Gs) and 99 general practitioners (GPs) were each rated by 60 of their patients

following a consultation in their clinical rooms. Findings - Patient satisfaction as evidenced by

change to "complete satisfaction" with doctor's communication skills and overall satisfaction with

the clinical encounter. Practical implications - Participants had high initial patient satisfaction ratings

and these were found to have improved across all parameters three months after the educational

intervention. Originality/value - The educational intervention was successful in improving doctors'

communication skills as evidenced by enhanced patient satisfaction in all key areas, including those

most frequently associated with patient complaint, litigation and adverse outcome.

Triolo, P. K., Hansen, P., Kazzaz, Y., Chung, H. and Dobbs, S. (2002). "Improving patient

satisfaction through multidisciplinary performance improvement teams" Journal of Nursing

Administration 32(9): 448-54. Hospitals today are challenged by high patient census, rising acuity,

and workforce issues that can result in a serious decline in overall patient satisfaction. This article

discusses how one hospital tackled the issue of declining patient satisfaction scores on five

"troubled" patient care units through a performance improvement strategy that included MD-RN

partnerships, co-mentoring, and unit staff development and involvement in the problem-solving

process. The result was a steady improvement in patient satisfaction over a 6-month period.

METHODOLOGY

STUDY DESIGN A survey was conducted on 50 randomly selected populations in the In-Patient Department of

NKS Hospital. Patient Satisfaction Questionnaire was used as tool for collecting data from the

randomly selected sample. The questionnaire was allowed to be filled up by individual subject in

order to prevent any kind of bias.

SAMPLE DESIGN Fifty patients were randomly selected from the Indoor Department of NKS hospital. All were

receiving treatment for their underlying medical condition.

DATA COLLECTION For present study, primary data are collected by personal interviews, observation and a set of

questionnaire to be filled by Patients/Attendants. A number of questions concerning to various

factors associated with Medical Care in I.P.D. Department are framed with a view to assess the

level of satisfaction in admitted patients and these questions are in proper sequence. Most of the

questions are of multiple choices and close ended type and filled by using survey method



6

PROCEDURE Each subject was allowed to fill the Patient Satisfaction Questionnaire in the standard way.

Prior to filling of questionnaire clear instruction was given regarding the allocation of answers.

OBJECTIVE OF STUDY � To determine the level of patient satisfaction in the IPD of NKS Hospital. Its purpose is to

analyze the level of patient satisfaction about the medical services.

� To determine what factors are most likely to influence satisfaction with inpatient medical

care.

� To explore the extent to which satisfaction is a meaningful indicator of patients’ experience

of healthcare services.

DATA ANALYSIS & INTERPRETATION

Among 50 randomly selected patients, all completed the questionnaire with a response rate of

100%. All the results were analysed by using Patients Satisfaction Questionnaire through the use of

tables, graphs

TABLE NO.1 SR.

NO.

QUESTION ASKED FROM PATIENTS S.A A. N.O. D. S.D. TOTAL

PTS.

1 Doctor’s explain the reasons for medical tests 2 9 22 13 4 50

2 Doctor’s consultation room is well equipped to provide

comprehensive medical care….

5 16 11 15 3 50

3 Perfectness of medical care 9 19 8 8 6 50

4 Sometimes doctors make me wonder if their diagnosis is correct 0 9 22 13 6 50

5 Cost of medical care is affordable financially 15 17 9 7 2 50

6 Doctor’s examine patients carefully to check everything when

treating

3 9 28 6 4 50

7 Patients have to pay more for medical care than they can afford 2 5 17 17 9 50

8 Availability of medical specialists on patient’s need 15 23 2 6 4 50

9 Waiting time is too long for emergency treatment 0 5 6 23 16 50

10 Doctors act too businesslike and impersonal toward patients 0 6 9 22 13 50

11 Doctors are friendly and courteous towards patients 17 24 7 2 0 50

12 Sometimes healthcare professionals hurry too much when they treat

patients.

13 6 5 19 17 50

13 Is it hard to get an appointment for medical care on patient’s need

and right away

0 0 3 28 19 50

14 dissatisfaction with some things & departments while getting the

medical care

9 8 10 14 9 50

15 Patients get medical care & immediate attention of healthcare

professionals whenever patients need it

11 27 5 7 0 50

S.D. - STRONGLY DISAGREE, D - DISAGREE, N.O. - NO OPINION, A - AGREE, S.A. -

STRONGLY AGREE

International Journal of Management (IJM), ISSN 0976

Volume 5, Issue 2, February (2014),

Graph 1: SHOWING THE SATISFACTION LEVEL AMONG PATIENTS IN I.P.D.

DEPARTMENT

From the data analysis from above table and graph, the following result is concluded

� The level of patient satisfaction is low in

hospital.

� The level of satisfaction is average for the availability of medical facilities.

� The level of satisfaction is high for perfectness of medical care in NKS Hospital.

� The level of patient satisfaction is below average in NKS Hospital.

� The level of satisfaction for the cost of medical services is high in NKS Hospital.

� The level of patient satisfaction was average for alertness of medical practitioners in NKS

Hospital.

� The patients level of satisfaction for affordability of treatment is average in NKS Hospital.

� The level of satisfaction is high for accessibility of medical services in NKS Hospital.

� The level of satisfaction is high for waiting time to get emergency medical services in NKS

Hospital.

� The level of satisfaction for attitude of medical professional is hi

� The level of satisfaction is high for

Hospital.

� The level of satisfaction is high for time spent with doctors in NKS Hospital.

� The level of patient satisfaction is low for conveni

9

16

19

9

1722

11

8

22

9

13 15 8

13

7

4 36 6

2

1 2 3 4 5

PATIENT SATISFACTION IN I.P.D. DEPARTMENT

STRONGLY AGREE AGREE

International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976

(2014), pp. 01-09 © IAEME

7

SATISFACTION LEVEL AMONG PATIENTS IN I.P.D.

GRAPH 1

From the data analysis from above table and graph, the following result is concluded

The level of patient satisfaction is low in doctor’s explanations for medical test in NKS

evel of satisfaction is average for the availability of medical facilities.

The level of satisfaction is high for perfectness of medical care in NKS Hospital.

The level of patient satisfaction is below average in NKS Hospital.

the cost of medical services is high in NKS Hospital.

The level of patient satisfaction was average for alertness of medical practitioners in NKS

The patients level of satisfaction for affordability of treatment is average in NKS Hospital.

evel of satisfaction is high for accessibility of medical services in NKS Hospital.

The level of satisfaction is high for waiting time to get emergency medical services in NKS

The level of satisfaction for attitude of medical professional is high for NKS hospital.

The level of satisfaction is high for behaviour of medical professional towards them in NKS

The level of satisfaction is high for time spent with doctors in NKS Hospital.

The level of patient satisfaction is low for convenience to get service in NKS Hospital.

9

5

23

5 6

24

6

0

28

17

2

6

9

7

5

3

6

17

6

23

22

2

19

28

4

9

4

1613

0

1719

6 7 8 9 10 11 12 13


AGREE NO OPINION DISAGREE STRONGLY DISAGREE

6502(Print), ISSN 0976 - 6510(Online),

SATISFACTION LEVEL AMONG PATIENTS IN I.P.D.

From the data analysis from above table and graph, the following result is concluded:

explanations for medical test in NKS

The level of satisfaction is high for perfectness of medical care in NKS Hospital.

the cost of medical services is high in NKS Hospital.

The level of patient satisfaction was average for alertness of medical practitioners in NKS

The patients level of satisfaction for affordability of treatment is average in NKS Hospital.

evel of satisfaction is high for accessibility of medical services in NKS Hospital.

The level of satisfaction is high for waiting time to get emergency medical services in NKS

gh for NKS hospital.

of medical professional towards them in NKS

The level of satisfaction is high for time spent with doctors in NKS Hospital.

ence to get service in NKS Hospital.

8

27

10

5

14

79

0

14 15


STRONGLY DISAGREE



8

� The level of satisfaction is high for dissatisfaction related to some medical services in NKS

Hospital.

� The level of satisfaction is high for opening hours in NKS Hospital.

CONCLUSION

Initially, researchers focused on patient satisfaction as an intermediate condition in order to

reach desirable clinical outcomes such as patient compliance with recommended treatment.

Gradually, patient satisfaction was shifted to a final outcome for evaluating and improving health

and care services. So, the goal of the study was to conduct a patient’s satisfaction survey to

determine the patient’s level of satisfaction in different aspect of medical care & to explore the extent

to which satisfaction is meaningful indicator of patient’s experience of healthcare services. This

study was conducted by an analysis of primary data from the NKS Hospital, New Delhi, INDIA. The

database contained patient responses to self-administered satisfaction questionnaires and information

about medical care services characteristics. The result suggests that although patient level of

satisfaction was different for different aspect of medical care services, mostly patients were satisfied

with the service and service providers. We are able to determine how the level of satisfaction is an

important indicator of patient’s experiences to medical services.

RECOMMENDATIONS

In comparable settings, if care providers wish to improve the quality of health services from a

patients’ perspective, they should give priority to provide reasons and explanation for the treatment

and medical test to the patients and family members. Further studies are recommended to discover

complementary predictors in formation of overall satisfaction. Since this study shows the satisfaction

level slightly above the average in the IPD of NKSHospital so in future a study can be conducted on

OPD to check the level of satisfaction and relate the satisfaction level with the IPD.

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Management (IJARM), Volume 5, Issue 1, 2014, pp. 42 - 52”. ISSN Print: 0976 – 6324,

ISSN Online: 0976 – 6332.

18. Dr. Satpal Singh and Dr. Seema, “Medical Record Department: An Analytical Study”

International Journal of Management (IJM), Volume 5, Issue 1, 2014, pp. 14 - 22,

ISSN Print: 0976-6502, ISSN Online: 0976-6510.

19. Dr. Satpal Singh and Dr. Sahil, “Study on Medical Tourism Global Competition in

Healthcare and a Study on Satisfaction Level Among Foreign Patient’s”, International

Journal of Marketing & Human Resource Management (IJMHRM), Volume 5, Issue 1, 2014,

pp. 9 - 21, ISSN Print: 0976 – 6421, ISSN Online: 0976- 643X.

20. Dr. Satpal Singh and Dr. Pankaj, “Health Care Quality Assurance: Emergency Department of

a Tertiary Care Hospital”, International Journal of Advanced Research in Management

(IJARM), Volume 5, Issue 1, 2014, pp. 31 - 41”. ISSN Print: 0976 – 6324, ISSN Online:

0976 – 6332.

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