Health Care Quality in Greek NHS Hospitals: No one knows better than patients

Purpose: Healthcare organizations operating in the public sector are experiencing increasingly low trust on the part of the patients in terms of the quality of care provided. Today people hoping to receive high service quality tend to prefer private hospitals or even travel abroad. Thus, National Health System Hospitals are undergoing pressure from governments and the general public to improve their quality and compete effectively. With this in mind, the purpose of this paper is fourfold. First, to identify the relevant service quality dimensions used by Greek patients to evaluate service quality. Second, to assess patients’ perceptions and expectations related to the quality provided by public hospitals. Third, to investigate how closely patients’ perceptions and expectations of service quality match. Fourth, to determine the relative importance of quality dimensions in influencing patients’ overall quality perceptions. Methodology: Empirical research is used to determine patients’ perceptions and expectations of service quality in NHS hospitals located in North Greece. In this study SERVQUAL instrument was used to measure the service quality. The SERVQUAL questionnaire included an expectations’ and a perceptions’ section, each consisting of 26 statements. In addition, the questionnaire contained i) an extra section relating to demographics (e.g. age, gender, education) and ii) an overall question on the impression of quality of service provided. Due to the recognized instability of the dimensionality of SERVQUAL, it was considered necessary to test this instrument for its usefulness in the Greek hospital environment. Questionnaires were distributed and explained to the patients in the hospital wards on the day they were discharged from the hospital. One hundred and thirty seven (137) satisfactorily completed questionnaires were collected. Findings: The analysis revealed that patients perceived receiving a rather satisfactory level of health care quality across all SERVQUAL dimensions. However, the results of this study showed that a gap exists between the rating which patients assign to expectations and to perception statements. In fact, expectations exceed perceptions of the provided service quality, suggesting that there is room for quality improvement initiatives. Finally, despite the criticism of the SERVQUAL instrument, in the present study it proved to be a useful tool (in terms of its validity and reliability) for 11th QMOD Conference. Quality Management and Organizational Development Attaining Sustainability From Organizational Excellence to Sustainable Excellence; 20-22 August; 2008 in Helsingborg; Sweden 457 measuring quality in the health care sector. Additionally, SERVQUAL can be considered as a flexible tool since it allows modification to incorporate the idiosyncrasies of specific industry or/and national context. Originality/value of paper: This paper sheds light on a poorly researched field in the Greek context. The results clearly establish the areas where quality improvements are more demanding. Further, it provides directions for hospital managers and policymakers to develop strategies which will meet patients’ expectations of service quality, restore patients' trust in public hospitals and increase thus their competitiveness. Finally, it gives support to the view that, although difficult, service quality in the health sector can be measured and consequently be monitored systematically in order to narrow previously identified gaps and take corrective actions when necessary.