a predictive model of satisfaction of bangladeshi patients in two selected private hospitals in...
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A Predictive Model of Satisfaction of Bangladeshi Patients in Two selected Private Hospitals in Thailand”. AU Journal of Management, vol. 5, No. 2, July-December 2007: Assumption University, Thailand.TRANSCRIPT
A PREDICTIVE MODEL OF SATISFACTION OF BANGLADESHI PATIENTS IN TWO SELECTED PRIVATE
HOSPITALS IN THAILAND
By
Adnan NafisGraduate School of Business
Assumption University
Published in AU Journal of Management, vol. 5, No. 2, July-December 2007:
Assumption University, Thailand.
1
Introduction
In the healthcare industry, hospitals provide the same types of service, but they
do not provide the same quality of service (Youssef et al., 1996). Furthermore,
consumers today are more aware of alternatives on offer and rising standards of
service have increased their expectations. They are also becoming increasingly critical
of the quality of service they experience Patient satisfaction is an important indicator
of the quality of medical care and a major determinant in the choice of a care provider
in the future (Croucher,1991). Accurate and reliable survey information provides the
data basis for continuous quality improvement in the delivery of services. By meeting
the needs of the patient, the institution in turn will ultimately ensure its competitive
position (Curbow, 1986). The Bangladesh government allocates $500 million every
year in the health sector. While the efforts are in the right direction, the public health
sector is plagued by uneven demand and perceptions of poor quality. The private
health care sector (including unqualified providers) is the largest provider of health
care as about 70% of the patients seek medical care from this sector (World Bank,
2003). Absenteeism of health care providers has landed Bangladesh 2nd in the world’s
lowest ranking of countries facing doctor absenteeism in healthcare (World Bank,
2003). The Institute of Health Economics, University of Dhaka, estimates that
Bangladeshis spend approximately $300 million a year on foreign healthcare services
which was supported by the Bangladesh Medical Association-BMA President (World
Bank, 2003). At present, unreliable test results and wrong diagnosis and a general
perception of poor and unreliable services may explain why those who can afford it
have been seeking health care services in other countries. A large number of
Bangladeshi patients are forced to go to India, Thailand or Singapore for treatment.
One report suggests that 1200 patients travel abroad every day for treatments.
(Consumers Association of Bangladesh-CAB, 2003).
Thailand has secured a commanding position in the world health care arena.
Though it is a third world country, it has achieved the quality of the developed
countries. Foreigners flock to Thailand's private hospitals for a variety of reasons,
among them accessibility, cost and quality. The kingdom is one of the three countries
in the region cashing in on its ability to use cheap but highly skilled labor, affordable
hospital accommodation and specialist treatments. In 2003, 60% of Bumrungurd
Hospital’s (BH) revenues came from Thai nationals, with the remaining 40% from
international patients. Of the international patients, 60% were resident expatriates and
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40% were ‘health tourists’ who came from abroad. Surprisingly enough, Bangladeshi
patients make up the largest ‘health tourist’ geographic segment for BH
(www.thaistock.com). Bangladeshi patients in the two major private hospitals in 2005
were 32,417 and in 2006 were 27,813. Up to May 2007, approximately 15,195
Bangladeshi patients visited these two private hospitals.
Research Objectives
In the competitive market of health care, Thai hospitals need to understand the key
factors of Bangladeshi patient satisfaction which will enable them to achieve a
competitive advantage over Singaporean and Indian hospitals. In this study, the
researcher sought to construct a predictive model of satisfaction of Bangladeshi
Patients in two selected private hospitals in Thailand. In order to do that, the
researcher sought to identify the main dimensions of service quality of Thai private
hospitals affecting Bangladeshi patient satisfaction.
The objectives of the research are:
1. To identify the key service quality factors of Thai private hospitals that affect
Bangladeshi patients’ satisfaction.
2. To assess how Bangladeshi patients’ rate the service quality dimensions of
Thai private hospitals.
The research focused on rating all the dimensions of service quality
(Reliability, responsiveness, assurance, tangibles, communication, empathy, process
features, cost, access, billing services, and treatment outcomes) of two selected Thai
private hospitals by Bangladeshi patients to identify the key factors of a predictive
model of their (patient) satisfaction.
Literature Review
The SERVQUAL instrument has been empirically evaluated in the hospital
environment and has been shown to be a reliable and valid instrument in that setting
(Babakus and Manggold, 1992). Other studies of Health care quality measurement
(Canel and Fletcher,2001; Lam, 1997; Donthu, 1991; Sohail, 2003) have also used
SERVQUAL. Despite controversies regarding the validity and reliability of
SERVQUAL (Teas, 1994; Newman, 2001), the application of SERVQUAL, with or
without modification, can be found in healthcare. The extent of modification or
addition to the SERVQUAL dimensions varies from researcher to researcher. In
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Bangladesh, few studies were done to evaluate quality and patient satisfaction.
SERVQUAL were used in all of them. The SERVQUAL framework was refined for
the Bangladeshi context by Andaleeb (2000a, 2001,2007). Mittal and Baldasare
(1996) agreed that attributes of a service or product affect the position of an
organization in terms of overall satisfaction. They also mentioned that different
attributes of a product / service might influence overall satisfaction differently
depending on their salience. In the health care context, the consumer – the patient –
participates in the production of the service, and therefore performance and quality
can be affected by patient actions, moods and cooperativeness (Zeithaml, 1981). The
idea that perceived service quality results from a comparison of expectations with
perceptions of performance would seem to imply that perceived quality equates with
satisfaction. That is, if a customer is satisfied then there is quality of service.
Hypotheses 1:
Ho: Reliability of Thai private health care providers has no impact on Bangladeshi
patients’ satisfaction
Ha: Reliability of Thai private health care providers has an impact on Bangladeshi
patients’ satisfaction.
Reliability refers to a providers’ ability to perform the promised service
dependably and accurately. For instance, in Bangladesh, reliability of the provider is
often perceived as low for various reasons, such as the accusation that doctors
recommend unnecessary medical tests, there is an irregular supply of drugs at the
hospital premises, supervision of patients by care providers is irregular, and
specialists are unavailable. Perceptions of reliability are also attenuated when doctors
do not provide correct treatment the first time.
Hypotheses 2
Ho: Responsiveness of Thai private health care providers has no impact on
Bangladeshi patients’ satisfaction.
Ha: Responsiveness of Thai private health care providers has an impact on
Bangladeshi patients’ satisfaction.
Patients expect hospital staff to respond promptly when needed. They also
expect the required equipment to be available, functional and able to provide quick
diagnoses of diseases.
Hypotheses 3:
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Ho: Assurance from Thai private health care providers has no impact on Bangladeshi
patients’ satisfaction.
Ha: Assurance from Thai private health care providers has an impact Bangladeshi
patients’ satisfaction.
Knowledge, skill and courtesy of the doctors and nurses can provide a sense of
assurance that they have the patient’s best interest in mind and that they will deliver
services with integrity, fairness and beneficence. For a service that is largely credence
based (Zeithaml and Bitner 2000), where customers are unable to evaluate the quality
of the services after purchase and consumption, the sense of assurance that is
engendered can greatly influence patient satisfaction. In the health care system,
assurance is embodied in service providers who correctly interpret laboratory reports,
diagnose the disease competently, provide appropriate explanations to queries, and
generate a sense of safety.
Hypotheses 4:
Ho: Physical appearance (tangibility) of the Thai private hospitals has no impact on
Bangladeshi patients’ satisfaction.
Ha: Physical appearance (tangibility) of the Thai private hospitals has an impact on
Bangladeshi patients’ satisfaction.
Physical evidence that the hospital will provide satisfactory services is very
important to patient satisfaction judgments. Generally, good appearance (tangibility)
of the physical facilities, equipment, personnel and written materials create positive
impressions. A clean and organized appearance of a hospital, its staff, its premises,
restrooms, equipment, wards and beds can influence patients’ impressions about the
hospital.
Hypotheses 5:
Ho: The quality of communication perceived by the Bangladeshi patient has no
impact on Bangladeshi patients’ satisfaction.
Ha: The quality of communication perceived by the Bangladeshi patient has
an impact on Bangladeshi patients’ satisfaction.
Communication is also vital for patient satisfaction. If a patient feels alienated,
uninformed or uncertain about her health status and outcomes, it may affect the
healing process. When questions of concern can be readily discussed and when
patients are consulted regarding the type of care they will be receiving, it can alleviate
their feelings of uncertainty. Also, when the nature of the treatment is clearly
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explained, patients’ awareness is heightened and they are better sensitized to expected
outcomes. Appropriate communication and good rapport can, thus, help convey
important information to influence patient satisfaction. In particular, patients expect
doctors and nurses to communicate clearly and in a friendly manner regarding
laboratory and other test results, diagnoses, prescriptions, health regimens, etc.
Similarly, nurses are expected to understand patient problems and to communicate
them to the doctor properly.
Hypotheses 6:
Ho: Empathy received from Thai private health care providers has no impact on
Bangladeshi patients’ satisfaction.
Ha: Empathy received from Thai Hospitals has an impact on Bangladeshi patients’
satisfaction.
Health care providers’ empathy and understanding of patients’ problems and
needs can greatly influence patient satisfaction. Patients desire doctors to be attentive
and understanding towards them. Similarly patients expect nurses to provide personal
care and mental support to them. This reflects service providers’ empathy.
Hypotheses 7:
Ho: The process features of Thai hospitals have no impact on Bangladeshi patients’
satisfaction.
Ha: The process features of Thai hospitals have impact on Bangladeshi patients’
satisfaction
Process features refer to an orderly management of the overall health care
service process. This constitutes patients’ expectation that doctors will maintain
proper visiting schedules and that there will be structured visiting hours for relatives,
friends, etc. Updated patient records and standard patient release procedures also
facilitate patient care. Process features in Thai healthcare includes the interpreters,
who guide the Bangladeshi patients through the whole process of getting treatment.
Hypotheses 8:
Ho: The perceived overall cost of Thai Hospitals has no impact on Bangladeshi
patients’ satisfaction.
Ha: The perceived overall cost of Thai Hospitals has an impact on Bangladeshi
Patients’ satisfaction.
In addition to service factors, perceived treatment cost is another factor that
patients may perceive as excessive. In the more affluent western world, Schlossberg
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(1990) and Wong (1990) suggest that health care consumers have become much more
sensitive to costs, despite health insurance coverage. Andaleeb (2001,2001) and Hasin
et al.,(2001), used cost in the SERVQUAL dimensions. Wong (1990) also predicts
that consumers will shop for the best value. In the developing world, especially
Bangladesh, cost is a perennial concern among those seeking health care service,
given their low earnings. Such costs include consultation fees, laboratory test charges,
travel, drugs and accommodation.
Hypotheses 9:
Ho: The Bangladeshi patients’ access to Thai private hospitals has no impact on
Bangladeshi patients’ satisfaction.
Ha: The Bangladeshi patients’ access to the Thai private Hospitals has an impact on
Bangladeshi patients’ satisfaction.
Availability of doctors, nurses and hospital beds round the clock is of concern
to patients in defining the level of access they have to health care. In Bangladesh
hospital beds and cabins are hard to avail. Most of the hospitals have to deal with over
capacity. To access a foreign hospital, visa processing matters and arranging for
accommodation and food are major concerns; patients usually prefer countries with
minimum hassle in this regard. Therefore, it is hypothesized that when a hospital has
easy physical access, where doctors, nurses, beds/cabins, etc. are available and when
visa processing is simple, patients will be more satisfied.
Hypotheses 10:
Ho: The billing services of Thai Private Hospitals have no impact on Bangladeshi
Patient satisfaction.
Ha: The billing services of Thai Private Hospitals have an impact on Bangladeshi
Patient satisfaction
Making or sending out of bills or invoices. Hughes (1991) used billing
services in his attribute based model to measure patient satisfaction. For Bangladeshi
patients it is an important factor. In most hospitals, billing services are crude and
some times insensitive. In most hospitals, the billing services cause a lot of tension.
So, billing services have a big impact on Bangladeshi patient satisfaction.
Hypotheses 11:
Ho: Treatment outcome of Thai Private Hospitals has no impact on Bangladeshi
patient satisfaction.
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Ha: Treatment outcome of Thai Private Hospitals has an impact on Bangladeshi
patient satisfaction.
Results or impact of medical care. Treatment outcome is an important factor
for patient satisfaction. In hospital’s view outcome is defined by “hard” data such as
length of stay or mortality. From the patients point of view, if they do not feel cured
in their mind, indeed they have not been cured. Hughes (1991) used it to measure
patient satisfaction. For Bangladeshi patients it is an important factor.
Methodology
Questionnaire design
The questionnaire is patterned on previous studies, i.e, “Patient satisfaction
with Bangladeshi Health services” (Andaleeb, 2007); “Quality of services research in
hospitals in Malaysia” (Sadiq, 2003). The questionnaire was modified to
accommodate the suggestions of the Marketing Director of Bumrungrad Hospital and
Marketing Director of Bangkok Hospital. Malhotra (2004) indicated a value of at least
0.6 is considered satisfactory. The reliability measured in this research is as follows:
Reliability 0.726, Responsiveness 0.704, Assurance 0.795, Tangibles 0.858,
Communication 0.803, Empathy 0.794, Process features 0.675, Cost 0.758, Access
0.653, Billing services 0.838, Treatment outcome 0.812.
Data collection
The researcher obtained authorization letters from the two hospitals to
distribute self-administered questionnaire to collect data for the research. The
researcher distributed the questionnaires at the cashier’s section in both the hospitals
and was there to collect them back. Help was given to those patients who had
problems in the interpretation of the questionnaire. Moreover, the respondents were
informed that this participation was entirely voluntary, and had anonymity and
confidentiality
Sampling method
Bangladeshi patients in the two major private hospitals in 2005 were 32,417
and in 2006 were 27,813. Up to May 2007, approximately 15,195 Bangladeshi
patients visited these two private hospitals. Thus, the target population is
approximately 30,000. Therefore, according to Anderson (1996), the researcher
choose 5% points of error (or 95% level of confidence), the sample size is 381.
However, in order to be sure of collecting at least 381 valid questionnaires with
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correct and complete answers, the researcher distributed 400 questionnaires among
patients in the two private hospitals. Equal numbers of questionnaires were distributed
in both the hospitals.
Analysis
To measure the levels of Bangladeshi patient satisfaction with the dimensions of
service quality, the researcher had to calculate the means of all service quality
dimensions. From the statistical data in Table 1, the researcher found that the
Bangladeshi patients were satisfied most with assurance (strongly satisfied) followed
by tangibles (strongly satisfied), communication (strongly satisfied),
reliability(satisfied), billing services (satisfied), process features(satisfied), treatment
outcome ( satisfied), access ( satisfied), responsiveness(satisfied), empathy (satisfied).
They were neither satisfied nor dissatisfied with cost (neutral).
Table 1- Descriptive Statistics of Bangladeshi patients’ satisfaction with each service quality dimensions
Service dimensions Mean Std. Deviation Nreliability 4.0923 .60962 390responsive 3.7667 .64487 390assurance 4.3697 .47779 390tangible 4.2248 .51834 390communication 4.2009 .62267 390empathy 3.6850 .58462 390process 3.9987 .48565 390cost 3.0790 .68575 390access 3.8564 .53738 390billing 4.0615 .46751 390outcome 3.9936 .60786 390
To identify the overall level of satisfaction of Bangladeshi patients with the
service quality of Thai private hospitals, the researcher used descriptive statistics to
compute the means of overall satisfaction of Bangladeshi patient satisfaction. As per
the results shown in table 5.11, the mean score is 3.8882, which belongs in the range
of 3.41-4.20. Hence, according to Anderson et al. (2002), the researcher can conclude
that the Bangladeshi patients who received treatment at the two private hospitals
during the time of survey were satisfied with the overall service quality of the two
private hospitals. According to the survey, there were 333 “satisfied” and 53 “very
satisfied” Bangladeshi patients that accounted for nearly 86.2% of respondents. Three
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patients were neutral in their opinion, that is 0.8%. Only 1 patient was “dissatisfied”,
that is 0.3%.
Table 2- Regression analysisM
odel
Unstandardized Coefficients
Standardized Coefficients
t Sig.
Collinearity Statistics
B Std. Error Beta Tolerance VIF1 (Constant) .721 .152 4.747 .000
reliability .073 .026 .130 2.803 .005 .354 2.824
responsive .058 .018 .110 3.301 .001 .687 1.456
assurance .019 .035 .027 .547 .585 .320 3.129
tangible .076 .028 .116 2.724 .007 .426 2.349
communication .060 .032 .110 1.856 .064 .219 4.567
empathy .074 .028 .128 2.650 .008 .328 3.045
process .138 .023 .197 5.963 .000 .701 1.427
cost .087 .023 .176 3.770 .000 .353 2.834
access .104 .026 .164 3.963 .000 .447 2.236
billing .078 .025 .107 3.092 .002 .634 1.578
outcome .046 .027 .082 1.727 .085 .336 2.979
ValidityThe model is a valid one to explain Bangladeshi patient satisfaction. The R
value is 0.843 and R2 is 71.1%. The Durbin Watson value is 1.506. Value between 1
and 3 is good (Durbin & Watson, 1951). The model has no multicollinearity and
singularity. Tolerance statistic shows that all the values are greater than 0.2. If the
value is above 0.1 then it is acceptable, although above 0.2 is better (Field, 2005).
Variance Inflation Factor (VIF) values are less than 10. VIF values should be less
than 10 (Field, A., 2005).
Equation:Y = a + b1X1+ b2X2+ b3X3 + b4X4+ b5X5+ b6X6 +b7X7+ b8X8+ b9X9 +b10X10+ b11X11
Where Y= Bangladeshi Patient satisfaction (Dependent variable)
X1 = Reliability (Independent Variable); X2 = Responsiveness (Independent
Variable); X3 = Assurance (Independent Variable); X4= Tangibility (Independent
Variable); X5 = Communication (Independent Variable); X6 = Empathy
(Independent Variable); X7 = Process features (Independent Variable) ; X8 =
Cost (Independent Variable); X9 = Access (Independent Variable); X10 = Billing
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services (Independent Variable); X11 = Treatment outcome (Independent
Variable)
Y= 0.721+.073 X1+ .058X2+ .019X3 + .076X4+ .060X5+ .074X6 +.138X7+ .087X8+
.104X9 +.078X10+ .046X11
From the table-2, it can be observed that Bangladeshi Patient satisfaction have
high positive relationships with treatment outcome, responsive, billing, process,
tangible, assurance, access, reliability, cost, empathy, communication as R is equal to
0.843 which is close to “1= strong relationship”. Moreover, Bangladeshi patient
satisfaction was explained by all Independent variables equal to 71.1% (R2 = 0.711).
From the F-test, the Alternative hypothesis can be accepted, which means that at least
one of independent variables (outcome, responsive, billing, process, tangible,
assurance, access, reliability, cost, empathy, communication) has influence on
Patient(Bangladeshi) satisfaction (F = 84.342, Sig. = 0.000) at 0.05 confidence levels.
Impact of the service quality dimensions:
From the beta value from Table 2, it can be observed that, process features have
the greater impact on patient satisfaction, beta value is equal 0.197; followed by Cost,
beta value is equal 0.176; access, beta value equal 0.164; reliability, beta value equal
0.130; empathy, beta value equal 0.128; tangible, beta value equal 0.116;
responsiveness, beta value equal 0.110; billing services, beta value equal at 0.107.
Hence, based on the beta values the dimensions can be ranked as: 1. Process features;
2. Cost 3. Access 4. Reliability 5. Empathy 6. Tangible 7. Responsiveness 8. Billing
services.
Discussion and conclusion
The research was conducted to construct a predictive model of satisfaction of
Bangladeshi patients in two selected private hospitals in Thailand. In order to do that,
the research focused on identifying the key service quality dimensions that affect
patient satisfaction and assess how Bangladeshi patients’ rate the service quality
dimensions of two selected private hospitals in Thailand. The study constructed a
model and revealed that 8 dimensions of the service quality of two selected Thai
private hospitals including reliability, responsiveness, tangibles, empathy, process
features, cost, access and billing services have positive impact on the patient
(Bangladeshi) satisfaction. Assurance, communication and treatment outcome have no
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impact on patient (Bangladeshi) satisfaction. As the study revealed, process feature
has the strongest impact on Bangladeshi patient satisfaction. The beta value is equal to
0.197. Bangladeshi patients travel to Thailand for better treatment and they go to
private hospital for better services and care. The study indicated that the Bangladeshi
patients were satisfied with process feature as the mean score is 3.9987. As the
process feature includes the willingness of the admission staff of helping and
providing information, the survey participants included the service of the interpreters.
The interpreters generally assist the patients with the process feature. The Bangladeshi
patients perceived them as part of the staff. So, the performance of the interpreters
impacts the satisfaction. The better the performance of the interpreters, the higher the
satisfaction will be. That is for, 1 standard deviation of process feature increase will
result in 0.197 standard deviation increase of satisfaction if all other variables are
constant. According to the study, cost has the second strongest impact on satisfaction.
The beta value is equal to 0.176. The study indicated that the Bangladeshi patients
were neither satisfied nor dissatisfied with cost as the mean was 3.0790. The mean of
“Cost of medicine” is 2.07, which falls in the range of dissatisfaction. The cost of
medicine is affecting the cost factor with satisfaction level. The study revealed that
access has strong impact on Bangladeshi patient satisfaction as beta value is equal to
0.164. The mean value is 3.8564, hence it falls in the “satisfied” range. Access
includes the operating hour of the hospital and telephone inquiry service. On
Saturdays and Sundays the hospital does not operate in full capacity. Some of the
patients traveling to Thailand on Fridays face some problems. Telephone inquiries are
some times concern for decrease in satisfaction. These features clearly impacts
satisfaction. The study revealed that empathy has a positive impact on the satisfaction
as the beta value equals to 0.128. That is for, 1 standard deviation of empathy increase
will result in 0.128 standard deviation increase of satisfaction if all other variables are
constant. The mean value is 3.6850. The nurses create some language barriers.
Empathy includes the nurses understanding the patients’ problems; the mean score is
2.96, that is “neutral”. Communication, more specifically the language barrier impacts
the satisfaction level. Interestingly, communication, treatment outcome and assurance
had no impact on patient satisfaction. The study indicated that the mean of
communication is 4.2009. Bangladeshi patients were strongly satisfied with
communication. The mean of treatment outcome was 3.9936, indicating “satisfaction”
.Assurance falls in the range of “strongly satisfied” as the mean was 4.3697.
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Bangladeshi patients are attracted to Thai private hospitals because of doctors, so
assurance does not have an impact. Most of the Bangladeshi patients come to
Thailand after initial treatments in Bangladesh. Treatment outcome is attained so they
come as most of the patients surveyed are not first timers. They are frequent patients
of the Thai private hospitals. Communication covers the doctors’ performance so
satisfaction is not affected as the patients are regular.
Recommendations
The study suggests that the managers of Thai private hospitals should pay
adequate attention to the service quality dimensions which will increase the
satisfaction of Bangladeshi patient, eventually increasing the number of Bangladeshi
patients. The Bangladeshi patients perceive the Bangladeshi interpreters as part of the
staff. The current workforce should be monitored as the interpreters are linked with
the process feature and the overall service of the hospital. The interpreters handle the
communication between Bangladeshi patients and hospital personnel. They guide the
patients though all the steps of treatment. The nurses, pharmacy and billing section
are weak in communication. Without the interpreters, there will be a communication
gap and misunderstanding which will eventually reduce the satisfaction and result in
loss of patients. If the interpreters are not active, the Bangladeshi patients will not get
the full extent of service provided by the hospital. Their performance will impact the
overall performance. Their negligence may result in losing valuable patients for the
hospital. The job description of the interpreters can be modified. Their job currently is
only limited to interpretation but the patients perceive them as an important part of the
hospital service. The interpreter work force should be more trained, efficient and
professional. An evaluation of the current workforce should be done. If necessary the
hospitals should hire more professional and efficient workforce. Otherwise they can
re-evaluate the current workforce and increase their efficiency. The Bangladeshi
interpreter workforce should be young, energetic, efficient and sympathetic. Lack of
empathy and efficiency will reflect poorly on the hospital. The price of medication is
perceived as very costly even in comparison to other places in Thai market. The
hospitals can look into the matter. They can offer promotions to give discounts for
medicines to the frequent visitors or collaborate with Bangladeshi sponsors to offer
discounts. In collaboration with Bangladeshi service providers such as mobile
companies, banks and airlines, the hospitals can offer discounted rates on medicines
The Bangladesh offices should make the patients aware that Saturdays and Sundays
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are weekends unlike Bangladesh where Thursdays and Fridays are weekends. They
should inform the patients to arrange their traveling plans to avail the services in week
days and avoid the unnecessary discomfort of visiting the hospitals on weekends. The
Bangladesh office should inform the patients of the cost in advance to reduce
confusion. In general, cost of medical tests and medicine cost should be informed in
advance. So, the patients can be mentally ready. Increase in advertising budgets for
this purpose would be a good solution. Though some of the hospitals have multi
lingual telephone service, the efficiency should be increased. The hospitals can
outsource this service. Otherwise, they can increase they service quality by hiring
more efficient workforce. The hospitals should increase the comfort of the waiting
rooms. The waiting area seats can be made more comfortable, may be the color of the
room can be modified to increase the patients’ comfort. Relaxing music may be
played to reduce the tension of the patients. By consulting human behavior
psychiatrists the waiting rooms can be rearranged to increase the physical and mental
comfort of the patients. Nurses pose some problems related to empathy factor. So,
their English proficiency can be increased. New recruitments can screened for that. If
the interpreters are increased they can solve this problem. More interpreters or more
active workforce can solve the problem.
Limitations of the Study The study has some limitations. Firstly, only two private hospitals in Bangkok
were targeted. Secondly, only Bangladeshi patients visiting the two hospitals were
targeted. Thirdly, only outpatients are targeted. The results may not be representative
for inpatients in the hospitals or generalizable to all the Bangladeshi patients in other
Thai private hospitals. Fourthly, the study is being conducted from September 2007 to
October, 2007. In this case, it becomes a limitation of this study in that the findings
can not be generalized for the Bangladeshi patients visiting around the year. Despite
these limitations, the researcher believes this study could provide some valuable
insights to Bangladeshi patient satisfaction with Thai private hospitals and hopefully
such limitations could encourage further studies.
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