Measuring gaps in healthcare quality using SERVQUAL model: challenges and opportunities in developing countries.

Purpose: The purpose of this paper is to gauge the health-care services from a patient's perspective in five private hospitals in the Syrian capital Damascus. Design/methodology/approach: The five dimensions-SERVQUAL model (tangibility, empathy, assurance, reliability and responsiveness) was implemented to measure the gap between patient's perception and expectation in health-care service quality. Findings: The SERVQUAL tool proved to be reliable and valid in assessing service quality in Syrian health-care setting. The assessment of the service quality from a patient's perspective shows that all SERVQUAL dimensions were negative except for tangible element that scored (+0.57) gap. Based on patient's expectation, empathy scored the highest score with (4.37), followed by responsiveness (4.17), reliability (3.90), tangibility (3.82) and assurance (3.45). The widest negative gaps among the 22 SERVQUAL items were related to listening skills of hospital staffs (−1.52) and for spending enough time with patient (−1.81). This study indicated that tangible dimension plays a significant role in balancing the deficiency in other service quality dimensions. In addition, communication skills of medical and paramedical staff should be improved to ameliorate patient's perception about health-care services. Research limitations/implications: This study provides valuable insights into the patient's perception, but the feedback from hospital staffs (doctor, nurses) and hospital's senior managers also considered potential rich information sources. This survey is conducted in the capital, and future research should include replication of this study in the other 13 Syrian governorates before generalizing the findings of this research. Practical implications: Hospital administrator could use SERVQUAL model to improve their operational performance as well as to benchmark their behavior against other competitors in the health-care market in Damascus. This paper provides valuable information to policymakers and top hospital management to understand patient-centered care and to improve health-care system in Syria. Besides, this research provides a marketing insight to realize what patient expects and how she/he assesses the care service. Originality/value: To the author's knowledge, this is one of very few studies conducted to assess service quality in private health-care sector in Damascus. The main contribution of this study is providing the empirical evidence that the five dimensions-SERVQUAL scale proved to be reliable and valid instrument for measuring and analyzing health-care service quality in Syria. [ABSTRACT FROM AUTHOR]