Assessing Quality of In-Patient Care and Patients's Expectations Using A SERVQUAL Approach in A Tertiary Care Hospital in India


  • Diwakar R SRM Medical College Hospital & Research Centre, SRM Institute of Science & Technology, Tamil Nadu, India
  • Jegan Joseph SRM Medical College Hospital & Research Centre, SRM Institute of Science & Technology, Tamil Nadu, India
  • Logaraj M SRM Medical College Hospital & Research Centre, SRM Institute of Science & Technology, Tamil Nadu, India
  • Kaveri Palanisamy SRM Medical College Hospital & Research Centre, SRM Institute of Science & Technology, Tamil Nadu, India
  • Manoj Punniyamurthy Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Tamil Nadu, India



SERVQUAL, service quality, perception, dimension


Background: Patient satisfaction is a key indicator of healthcare service quality and has implications for the growth and success of healthcare organizations. However, there is often a gap between patients’ expectations and perceptions of service quality, which can vary depending on various sociodemographic factors. This study aimed to assess the expectations, perceptions and service quality gap in a tertiary care hospital using SERVQUAL model.

Materials and Methods: A cross-sectional study was conducted among 120 adult inpatients using a semi-structured questionnaire based on the five dimensions of the SERVQUAL model. The quality gap was calculated as the difference between perception and expectation scores.

Results: The study found a significant negative quality gap across all five dimensions, with the largest gaps observed in reliability and responsiveness. The study also revealed that gender, age, and education influenced patients’ perception of service quality, while type of specialty, residence, monthly income, and occupation did not have a significant effect.

Conclusion: The study highlighted the need for improving the service quality in the tertiary care hospital, especially in terms of reliability and responsiveness. The study also suggested that healthcare managers and providers should consider the diverse expectations and needs of patients based on their sociodemographic characteristics.


Rivers PA, Glover SH. Health care competition, strategic mission, and patient satisfaction: research model and propositions. Journal of health organization and management. 2008 Oct 31;22(6):627-41. Doi: PMid:19579575 PMCid:PMC2865678

Harrison A. Structural change in hospitals: the implications for research. Journal of Health Services Research & Policy. 1996 Jan;1(1):44-50. Doi: PMid:10180845

Wong E, Mavondo F, Fisher J. Patient feedback to improve quality of patient-centred care in public hospitals: a systematic review of the evidence. BMC health services research. 2020 Dec;20:1-7. Doi: PMid:32527314 PMCid:PMC7291559

Sadigh SM: Service quality in hospitals: more favourable than you might think. Manag ServQual 2003, 13(3):197-206. Doi:

Kumah E, Osei-Kesse F, Anaba C. Understanding and using patient experience feedback to improve health care quality: systematic review and framework development. Journal of Patient-Centered Research and Reviews. 2017;4(1):24. Doi: PMid:31413967 PMCid:PMC6664367

Raposo ML, Alves HM, Duarte PA. Dimensions of service quality and satisfaction in healthcare: a patient's satisfaction index. Service Business. 2009 Mar;3:85-100. Doi:

Wolf JA, Niederhauser V, Marshburn D, LaVela SL. Reexamining "Defining Patient Experience": the human experience in healthcare. Patient Experience Journal. 2021;8(1):16-29. Doi:

El-Haddad C, Hegazi I, Hu W. Understanding patient expectations of health care: a qualitative study. Journal of patient experience. 2020 Dec;7(6):1724-31. Doi: PMid:33457636 PMCid:PMC7786689

A'aqoulah A, Kuyini AB, Albalas S. Exploring the gap between patients' expectations and perceptions of healthcare service quality. Patient preference and adherence. 2022 May 23:1295-305. Doi: PMid:35645558 PMCid:PMC9138681

Greene SM, Tuzzio L, Cherkin D. A framework for making patient-centered care front and center. The Permanente Journal. 2012;16(3):49. Doi: PMid:23012599 PMCid:PMC3442762

Parasuraman A, Zeithaml VA, Berry L: A Conceptual model of service quality and its implications for future research. J Mark 1985, 49:41-50. Doi:

Parasuraman A, Zeithaml VA, Berry LL: SERVQUAL: a multiple-item scale for measuring consumer perceptions of service quality. J Retail 1988, 64(1):12-40.

Berry LL, Parasuraman A, Zeitham! VA: Ten Lessons for Improving Service Quality. Marketing Science Institute Report; 1993:93-104.

Arora P, Narula S. Linkages between service quality, customer satisfaction and customer loyalty: A literature review. IUP Journal of Marketing Management. 2018 Nov 1;17(4):30.

Saha S, Bhattacharya J. Analyzing the blood bank service quality from Indian blood donors' perspective: An empirical evidence. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2019 Jan;44(1):58. Doi: PMid:30983716 PMCid:PMC6437788

Jonkisz A, Karniej P, Krasowska D. SERVQUAL method as an "old new" tool for improving the quality of medical services: A literature review. International journal of environmental research and public health. 2021 Oct 13;18(20):10758. Doi: PMid:34682499 PMCid:PMC8535625

Pekkaya M, Pulat İmamoğlu Ö, Koca H. Evaluation of healthcare service quality via Servqual scale: An application on a hospital. International Journal of Healthcare Management. 2019 Oct 2;12(4):340-7. Doi:

Jonkisz A, Karniej P, Krasowska D. The servqual method as an assessment tool of the quality of medical services in selected asian countries. International journal of environmental research and public health. 2022 Jun 26;19(13):7831. Doi: PMid:35805492 PMCid:PMC9266116

Aghamolaei T, Eftekhaari TE, Rafati S, Kahnouji K, Ahangari S, Shahrzad ME, Kahnouji A, Hoseini SH. Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients' perspective. BMC health services research. 2014 Dec;14:1-5. Doi: PMid:25064475 PMCid:PMC4115484

Zarei A, Arab M, Froushani AR, Rashidian A, Ghazi Tabatabaei SM. Service quality of private hospitals: The Iranian Patients' perspective. BMC health services research. 2012 Dec;12:1-7. Doi: PMid:22299830 PMCid:PMC3306759

Al‐Borie HM, Sheikh Damanhouri AM. Patients' satisfaction of service quality in Saudi hospitals: a SERVQUAL analysis. International journal of health care quality assurance. 2013 Jan 4;26(1):20-30. Doi: PMid:23534103

Lee D, Kim KK. Assessing healthcare service quality: a comparative study of patient treatment types. International Journal of Quality Innovation. 2017 Dec;3(1):1-5. Doi:

Singh P, Sidhu AS. Measuring Patient's Expectations and Realisations Using SERVQUAL: A Review of Oncology Services in Punjab, India. Asian Pacific Journal of Cancer Prevention: APJCP. 2023;24(10):3327. Doi: PMid:37898835 PMCid:PMC10770694

Ferreira DC, Vieira I, Pedro MI, Caldas P, Varela M. Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. InHealthcare 2023 Feb 21 (Vol. 11, No. 5, p. 639). MDPI. Doi: PMid:36900644 PMCid:PMC10001171




How to Cite

Diwakar R, Joseph J, M L, Palanisamy K, Punniyamurthy M. Assessing Quality of In-Patient Care and Patients’s Expectations Using A SERVQUAL Approach in A Tertiary Care Hospital in India. Natl J Community Med [Internet]. 2024 Jul. 1 [cited 2024 Jul. 21];15(07):566-71. Available from:



Original Research Articles