Public Perception Of Service Quality On Public Healthcare Sector In Kerala
Keywords:
Kerala, Health Sector, Health Policy, Public Involvement, Performance service quality in government Hospitals
Abstract
The public health sector in Kerala stands out as a peculiar and exemplary model within India, setting high standards for the healthcare system. Kerala's commitment to healthcare is reflected in its exceptional performance in various health indicators, surpassing the national average. The focus on primary healthcare and preventive measures has resulted in remarkable outcomes, ensuring that healthcare services reach even the most remote areas. The comprehensive network of primary healthcare centers, coupled with the presence of well-equipped secondary and tertiary care centers, ensures people have access to quality healthcare at all levels. The government of Kerala has been initiating various health supporting schemes from time to time in order to improve infrastructure, enhance quality, and provide financial protection for critical illnesses. Furthermore, the state's emphasis on education and high literacy rates has contributed to a skilled healthcare workforce that upholds the highest standards of patient care. Exhibiting a commitment to accessibility, quality, and the overall well-being of its population, Kerala's public health sector serves as a shining example for the rest of the country. The public healthcare system in Kerala has been widely acclaimed for its achievements and serves as a model for other states and countries. The paper investigates how the policy of the state government and the involvement of public service quality influences the performance of Government Hospitals in Kerala.
References
1. Akhila Johnson (2019). An evaluation of primary health care system in Kerala https://www. researchgate.net/publication/360473401.
2. G. Ajai Krishnan, Athira K. Nair (2021) Primary Health-Care Innovations with Superior Allusion to Family Health Centers: Indian Journal of Community Medicine. March 1, 2021, IP: 117.222.146.11.
3. Margo Stevenson Rowan (2007). Integrating Public Health and Primary Care: HEALTHCARE POLICY Vol.3 No.1, 2007.
4. Choi, K. S., Lee, H., Kim, C., & Lee, S. (2005). The service quality dimensions and patient satisfaction relationships in South Korea: comparisons across gender, age and types of service. Journal of Services Marketing, 19(3), 140–149.
5. Donabedian, A.(2005). Evaluating the Quality of Medical Care. The Milbank Quarterly, 83(4), 691–729.
6. Lim, P. C. & Tang, N. K. H. (2000). A study of patients’ expectations and satisfaction in Singapore hospitals. International Journal of Health Care Quality Assurance, 13(7), 290 - 299.
7. Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2017). Multivariate Data Analysis. India: Pearson India Education Services Pvt. Ltd.
8. Church, J., Saunders, D., Wanke, M., Pong, R., Spooner, C., and Dorgan, M. (2002), ‘Citizen participation in health decision-making: past experience and future prospects’, Journal of Public Health Policy, 23:12-32.
9. Tobias Hainz and HL (2016). Collective agency and the concept of ‘public’ in public involvement: A Practice-Oriented Analysis, VMC Medical ethics Article-I, 2016, 6 January 2016, 1-14.
10. Subitha Lakshminarayanan (2011). Role of government in public health: Current scenario in India and future scope, Journal of Family and Community Medicine, Vol 18, Issue 1, 26-30.
11. Nunnally, J. C. (1978). Psychometric Theory, (2nd ed.). New York: McGraw-Hill.
12. Kerlinger, F. N. (1999). Foundations of Behavioral Research (2nd ed.). New York: Holt Rinehart and Winston, Inc.
13. Liu, Y. & Li, H. (2010). Mobile internet diffusion in China: an empirical study. Industrial Management and Data Systems, 110(3), 309-24.
14. Campbell, D. T. & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychology Bulletin, 53, 81-105.
15. Claes Fornell & David F. Larcker. (1981). Evaluating Structural Equation Models with Unobservable Variables and Measurement Error. Journal of Marketing Research, 18(1), 39-50. doi: 10.2307/3151312.
16. Hair, J. F., Anderson, R. E., Tatham, R. L. & Black, W. C. (1998). Multivariate Data Analysis. Englewood Cliffs, NJ: Prentice-Hall.
17. Mulaik, S. A., James, L. R., Van Altine, J., Bennett, N., Lind, S. & Stilwell, C. D. (1989). Evaluation of goodness-of-fit indices for structural equation models. Psychological Bulletin, 105, 430-45.
18. Bentler P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238–246. doi: 10.1037/0033-2909.107.2.238.
19. Marsh H. W., Balla J. R., & McDonald R. P. (1988). Goodness-of-fit indexes in confirmatory factor analysis: the effect of sample size. Psychological Bulletin, 103, 391–410. doi: 10.1037/0033-2909.103.3.391.
20. Cole D. A. (1987). Utility of confirmatory factor analysis in test validation research. Journal of Consulting and Clinical Psychology, 55(4), 584–594. doi: 10.1037/0022-006X.55.4.584.
21. Kline R. B. (1998). Principles and practice of structural equation modeling. NY: Guilford Press.
22. Marsh H. W., & Hocevar D. (1985). Application of confirmatory factor analysis to the study ofMarsh and Hocevar (1985)
23. MacKinnon D. P., Warsi G., & H. Dwyer, James. (1995). A simulation study of mediated effect measures. Multivariate behavioral research, 30, 41. doi: 10.1207/s15327906mbr3001_3.
24. Andy Field. (2009). Discovering Statistics Using SPSS (3rd ed.). New Delhi: Sage Publications India Pvt. Ltd.
25. Ranjit Kumar. (2009). Research Methodology – A step by step guide for beginners (2nd ed.). New Delhi: Dorling Kindersley India Pvt. Ltd.
26. Bagozzi, R. P. & Yi, Y. (1988). On the evaluation of structural equation models. Academy of Marketing Science, 16, 76-94.
27. Rick C. Farr & Paul R. Timm. (2004). Business Research: An Informal Guide. New Delhi: Viva Books Private Limited.
28. Crimp M. & Wright L. T. (1995). The marketing research process (4th ed.). London: Prentice Hall.
29. Eurobarometer qualitative study on patient involvement in healthcare. European Commission website; 2012. https://ec.europa.eu/eip/ageing/library/eurobarometer-qualitative-study-patient-involvement-healthcare _ en
30. Fulop N, Ramsay A. How organizations contribute to improving the quality of healthcare. BMJ 2019;365: l1773. doi: 10.1136/ bmj.l1773.
31. Scholtes B, Breinbauer M, Rinnenburger M. et al. Hospital practices for the implementation of patient partnership in a multi-national European region. Eur J Public Health 2020;31(1):73–9. doi: 10.1093/eurpub/ckaa 153 .
32. Rozenblum R, Lisby M, Hockey PM, et al. The patient satisfaction chasm: the gap between hospital management and frontline clinicians. BMJ Qual af 2013;22:242–50. doi: 10.1136/bmjqs- 2012- 001045 .
33. Batalden P. Getting more health from healthcare: quality improvement must acknowledge patient coproduction . an essay by Paul Batalden. BMJ 2018;362: k3617. doi: 10.1136/bmj.k3617 .
34. Measuring what matters: The patient-reported indicator surveys. Patientreported indicators for assessing health system performance. [Status Report]. The OECD Health Committee website. http://www.oecd.org/health/health-systems/Measuring-what-matters-the-Patient-Reported
35. Indicator- Surveys.pdf. Accessed November 1, 202.Groene O, Sunol R, Klazinga NS, et al. Involvement of patients or their representatives in quality management functions in EU hospitals: implementation and impact on patient-centred care strategies. Int J Qual Health Care 2014;26(S1):81–91. doi: 10.1093/intqhc/ mzu022 .
36. Panikar PGK, Soman CR. Health Status of Kerala, the Paradox of Economic Backwardness and Health Development. Trivandrum: Centre for Development Studies, 1984: 39.
37. Azarudeen, Mohamed & Mohan Kumar, Buvnesh Kumar &Logaraj, M. & Ramraj, Balaji. (2019). A study on impact of training programme on knowledge of maternal health care among ASHA workers in a tribal population of Tamil Nadu. International Journal of Community Medicine and Public Health. 6. 1147. 10.18203 / 2394-6040.ijcmph20190601
38. Pal, Jayita& Roy, Suvendu & Nandi, Swagata & Satapathy, Sankalpa. (2019). Assessment of knowledge and practices of ASHA workers related to maternal-child health and their performance affecting factors: A mixed method study in Deganga block, North 24 parganas district, West Bengal, India. International Journal of Research in Medical Sciences. 7. 3672. 10.18203/2320-6012.ijrms20194291.
39. Pandave HT, Pandave TK. Primary health care system in India: Evolution and challenges. Int J. Health System Disaster Management 2013;1:125-8.
40. British Columbia Health Communities, Ministry of Health. Resource guide for local government. Vancouver, BC, Canada: MoH, 2013. ment in Nigeria: a case study of Ibadan South West Local Government. Int J Health Care Res. 2020;5:327–337.
41. Varatharajan D, Thankappan R, Jayapalan S. Assessing the performance of primary health centers under decentralized government in Kerala, India. Health Policy Plan 2004;19(1):41–5.
42. Charnes, A., Cooper, W. W., & Rhodes, E. (1978). Measuring the efficiency of decision making units. European Journal of Operational Research, 2(6), 429–444.
43. Kannan, K. P., Thankappan, K. R., Ramankutty, V., & Aravindan, K. P. (1991). Health and Development in Rural Kerala: A study of the linkages between socioeconomic status and health status. Palakkad: Integrated Rural Technology Centre.
44. Chilingerian, J. A. (1995). Evaluating physician efficiency in hospitals: A multivariate analysis of best practices. European Journal of Operational Research, 80(3), 548–574.
2. G. Ajai Krishnan, Athira K. Nair (2021) Primary Health-Care Innovations with Superior Allusion to Family Health Centers: Indian Journal of Community Medicine. March 1, 2021, IP: 117.222.146.11.
3. Margo Stevenson Rowan (2007). Integrating Public Health and Primary Care: HEALTHCARE POLICY Vol.3 No.1, 2007.
4. Choi, K. S., Lee, H., Kim, C., & Lee, S. (2005). The service quality dimensions and patient satisfaction relationships in South Korea: comparisons across gender, age and types of service. Journal of Services Marketing, 19(3), 140–149.
5. Donabedian, A.(2005). Evaluating the Quality of Medical Care. The Milbank Quarterly, 83(4), 691–729.
6. Lim, P. C. & Tang, N. K. H. (2000). A study of patients’ expectations and satisfaction in Singapore hospitals. International Journal of Health Care Quality Assurance, 13(7), 290 - 299.
7. Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2017). Multivariate Data Analysis. India: Pearson India Education Services Pvt. Ltd.
8. Church, J., Saunders, D., Wanke, M., Pong, R., Spooner, C., and Dorgan, M. (2002), ‘Citizen participation in health decision-making: past experience and future prospects’, Journal of Public Health Policy, 23:12-32.
9. Tobias Hainz and HL (2016). Collective agency and the concept of ‘public’ in public involvement: A Practice-Oriented Analysis, VMC Medical ethics Article-I, 2016, 6 January 2016, 1-14.
10. Subitha Lakshminarayanan (2011). Role of government in public health: Current scenario in India and future scope, Journal of Family and Community Medicine, Vol 18, Issue 1, 26-30.
11. Nunnally, J. C. (1978). Psychometric Theory, (2nd ed.). New York: McGraw-Hill.
12. Kerlinger, F. N. (1999). Foundations of Behavioral Research (2nd ed.). New York: Holt Rinehart and Winston, Inc.
13. Liu, Y. & Li, H. (2010). Mobile internet diffusion in China: an empirical study. Industrial Management and Data Systems, 110(3), 309-24.
14. Campbell, D. T. & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychology Bulletin, 53, 81-105.
15. Claes Fornell & David F. Larcker. (1981). Evaluating Structural Equation Models with Unobservable Variables and Measurement Error. Journal of Marketing Research, 18(1), 39-50. doi: 10.2307/3151312.
16. Hair, J. F., Anderson, R. E., Tatham, R. L. & Black, W. C. (1998). Multivariate Data Analysis. Englewood Cliffs, NJ: Prentice-Hall.
17. Mulaik, S. A., James, L. R., Van Altine, J., Bennett, N., Lind, S. & Stilwell, C. D. (1989). Evaluation of goodness-of-fit indices for structural equation models. Psychological Bulletin, 105, 430-45.
18. Bentler P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238–246. doi: 10.1037/0033-2909.107.2.238.
19. Marsh H. W., Balla J. R., & McDonald R. P. (1988). Goodness-of-fit indexes in confirmatory factor analysis: the effect of sample size. Psychological Bulletin, 103, 391–410. doi: 10.1037/0033-2909.103.3.391.
20. Cole D. A. (1987). Utility of confirmatory factor analysis in test validation research. Journal of Consulting and Clinical Psychology, 55(4), 584–594. doi: 10.1037/0022-006X.55.4.584.
21. Kline R. B. (1998). Principles and practice of structural equation modeling. NY: Guilford Press.
22. Marsh H. W., & Hocevar D. (1985). Application of confirmatory factor analysis to the study ofMarsh and Hocevar (1985)
23. MacKinnon D. P., Warsi G., & H. Dwyer, James. (1995). A simulation study of mediated effect measures. Multivariate behavioral research, 30, 41. doi: 10.1207/s15327906mbr3001_3.
24. Andy Field. (2009). Discovering Statistics Using SPSS (3rd ed.). New Delhi: Sage Publications India Pvt. Ltd.
25. Ranjit Kumar. (2009). Research Methodology – A step by step guide for beginners (2nd ed.). New Delhi: Dorling Kindersley India Pvt. Ltd.
26. Bagozzi, R. P. & Yi, Y. (1988). On the evaluation of structural equation models. Academy of Marketing Science, 16, 76-94.
27. Rick C. Farr & Paul R. Timm. (2004). Business Research: An Informal Guide. New Delhi: Viva Books Private Limited.
28. Crimp M. & Wright L. T. (1995). The marketing research process (4th ed.). London: Prentice Hall.
29. Eurobarometer qualitative study on patient involvement in healthcare. European Commission website; 2012. https://ec.europa.eu/eip/ageing/library/eurobarometer-qualitative-study-patient-involvement-healthcare _ en
30. Fulop N, Ramsay A. How organizations contribute to improving the quality of healthcare. BMJ 2019;365: l1773. doi: 10.1136/ bmj.l1773.
31. Scholtes B, Breinbauer M, Rinnenburger M. et al. Hospital practices for the implementation of patient partnership in a multi-national European region. Eur J Public Health 2020;31(1):73–9. doi: 10.1093/eurpub/ckaa 153 .
32. Rozenblum R, Lisby M, Hockey PM, et al. The patient satisfaction chasm: the gap between hospital management and frontline clinicians. BMJ Qual af 2013;22:242–50. doi: 10.1136/bmjqs- 2012- 001045 .
33. Batalden P. Getting more health from healthcare: quality improvement must acknowledge patient coproduction . an essay by Paul Batalden. BMJ 2018;362: k3617. doi: 10.1136/bmj.k3617 .
34. Measuring what matters: The patient-reported indicator surveys. Patientreported indicators for assessing health system performance. [Status Report]. The OECD Health Committee website. http://www.oecd.org/health/health-systems/Measuring-what-matters-the-Patient-Reported
35. Indicator- Surveys.pdf. Accessed November 1, 202.Groene O, Sunol R, Klazinga NS, et al. Involvement of patients or their representatives in quality management functions in EU hospitals: implementation and impact on patient-centred care strategies. Int J Qual Health Care 2014;26(S1):81–91. doi: 10.1093/intqhc/ mzu022 .
36. Panikar PGK, Soman CR. Health Status of Kerala, the Paradox of Economic Backwardness and Health Development. Trivandrum: Centre for Development Studies, 1984: 39.
37. Azarudeen, Mohamed & Mohan Kumar, Buvnesh Kumar &Logaraj, M. & Ramraj, Balaji. (2019). A study on impact of training programme on knowledge of maternal health care among ASHA workers in a tribal population of Tamil Nadu. International Journal of Community Medicine and Public Health. 6. 1147. 10.18203 / 2394-6040.ijcmph20190601
38. Pal, Jayita& Roy, Suvendu & Nandi, Swagata & Satapathy, Sankalpa. (2019). Assessment of knowledge and practices of ASHA workers related to maternal-child health and their performance affecting factors: A mixed method study in Deganga block, North 24 parganas district, West Bengal, India. International Journal of Research in Medical Sciences. 7. 3672. 10.18203/2320-6012.ijrms20194291.
39. Pandave HT, Pandave TK. Primary health care system in India: Evolution and challenges. Int J. Health System Disaster Management 2013;1:125-8.
40. British Columbia Health Communities, Ministry of Health. Resource guide for local government. Vancouver, BC, Canada: MoH, 2013. ment in Nigeria: a case study of Ibadan South West Local Government. Int J Health Care Res. 2020;5:327–337.
41. Varatharajan D, Thankappan R, Jayapalan S. Assessing the performance of primary health centers under decentralized government in Kerala, India. Health Policy Plan 2004;19(1):41–5.
42. Charnes, A., Cooper, W. W., & Rhodes, E. (1978). Measuring the efficiency of decision making units. European Journal of Operational Research, 2(6), 429–444.
43. Kannan, K. P., Thankappan, K. R., Ramankutty, V., & Aravindan, K. P. (1991). Health and Development in Rural Kerala: A study of the linkages between socioeconomic status and health status. Palakkad: Integrated Rural Technology Centre.
44. Chilingerian, J. A. (1995). Evaluating physician efficiency in hospitals: A multivariate analysis of best practices. European Journal of Operational Research, 80(3), 548–574.
Published
2024-09-09
How to Cite
R. P. Rajesh, Dr. M. C. Balagurubaran, & Dr. J. Rajan. (2024). Public Perception Of Service Quality On Public Healthcare Sector In Kerala. Revista Electronica De Veterinaria, 25(1S), 729 - 733. https://doi.org/10.69980/redvet.v25i1S.845
Section
Articles
