SERV-India instrument for measuring service quality in healthcare: development and pilot testing

The aim of the present study was to develop a viable instrument for measuring service quality (SQ) in the healthcare sector, including a new pool of factors identified that largely influence service quality primarily in the Indian healthcare sector (SERV-INDIA).

An item pool was created by utilizing the SERVQUAL questionnaire as a generic model and an expert panel evaluated the items to assess the content validity index and ratio. The reliability, including internal consistency and reproducibility, was examined via Cronbach's alpha coefficient and the Pearson's r correlation. In addition, a known-group validity test was performed to evaluate how well the questionnaire discriminates the service quality satisfaction index between patients' expectations and patients' perceptions and among individuals who are receiving treatment under cash and insurance both public and private during present hospitalization. Also construct validity was performed using Confirmatory factor analysis (CFA).

A total of one hundred and three participants were studied for pilot testing. The mean age group of the participants was 30-40 years; almost 50% had studied until high school in the context of formal education. Overall, 7% of the participants were low, 19% were marginal, and 70% had an adequate service quality satisfaction index. The internal consistency, as measured by Cronbach's alpha, was found to be 0.956 for Part 1 and 0.965 for Part 2 of the questionnaire. For known-group validity, participants who took treatment under cash during hospitalization had significantly higher satisfaction scores (P < 0.001) than patients with insurance, both public and private. In addition to this, the association between service quality satisfaction scores and Sifarish was also significant (P < 0.001). The CFA demonstrated acceptable fit on multiple indices for both parts of the questionnaire (CFI = 0.876 & 0.804 and SRMR = 0.036 & 0.065).

SERV-INDIA is a valid and reliable measure of service quality in the healthcare sector, with newly introduced significant indicators like Mode of payment including Baksheesh and Sifarish.