NORTH SOUTH UNIVERSITY

Department of Master of Business Administration

Course Name: Business Statistics (BUS-511)

Topic:

Statistical study of investigation Cost & services Vs Patients Satisfaction in a Private

Hospital

SUBMITTED TO -

Dr. Kais Zaman, PhD

SUBMITTED BY -

Student Name Student ID

Salman Nusrat 1715184660
Shamim Ehsan 1715242660
Md. Nur Imam Mehedi 1835138060
Rafid Habib 1835164060
Shafiun Fahad Bayezid 1835188060
Acknowledgement

We would like to express our deepest gratitude to our advisor professor, Dr. Kais Zaman. Because of his

guidance, support, and patient through this journey we have learnt endless things regarding statistics.

We would like to express our gratitude towards the people who took part in the surveys for their kind co-

operation and encouragement which helped us in completion of this project.

Last but not least, we would like to thank our friends and class mates for their continuous help and

encouragement.
TABLE OF CONTENTS

ABSTRACT........................................................................................................................

BACKGROUND……………………………………………………………………………………

INTRODUCTION..............................................................................................................

OBJECTIVES.....................................................................................................................

DATA COLLECTION PROCEDURES............................................................................

MAIN VARIABLES...........................................................................................................

METHODOLOGY.............................................................................................................

RESEARCH QUESTION...................................................................................................

QUESTIONNAIRE FOR THE VARIABLE “COST”.......................................................

QUESTIONNAIRE FOR THE VARIABLE “AVAILABILITY”.....................................

QUESTIONNAIRE FOR THE VARIABLE “SERVICE”.................................................

QUESTIONNAIRE FOR THE VARIABLE “LOYALTY” ………………………………………….

HYPOTHESIS TESTING..................................................................................................

CONCLUSION...................................................................................................................

REFERENCE......................................................................................................................
Abstract

Patient satisfaction is the most important measure of service quality in health care industry. But it is a

matter of irony that Patients satisfaction factor seems to have been largely ignored by health care

managers in developing countries. Patients’ voice must begin to play a greater role in the design of health

care service delivery processes in the developing countries where it needs to be followed more cautiously

than the developed countries. Patient’s satisfaction largely depends on multiple independent factors like

cost, services, availability of treatment, loyalty towards the patients etc. It should go without saying that

customers are the lifeblood of all organizations, yet few companies seem fully capable of matching their

performances to the needs of their customers, either in quality, efficiency or personal service. And for a

hospital their patients are their customers. We have to recognize that improving quality to our customers

is not a matter of choice. This study is, therefore, patient-centered and identifies the cost and service

quality factors that are important to patients; it also examines their links to patient satisfaction in the

context of Dhaka City in Bangladesh. The present study is made to find out that, how far the Cost

oriented service quality dimensions impact on the patient satisfaction. A questionnaire was developed and

a total of 60 patients in 3 different hospitals participated. Evaluations were obtained from patients on

dimensions of perceived Diagnostics service quality including tangible, reliability, responsiveness,

assurances, empathy, and communication. In the case of personal characteristics, there were a significant

difference among the age and educational groups, while no significant difference between gender, marital

status and professional groups. Outcome of the study is too beneficial to policy makers, researchers,

academicians and planners of the concern area.

Keywords: Customer satisfaction; Cost and service Oriented Diagnostics, Service quality; Personal

characteristics; Health services.

Background
Introduction

Patient satisfaction is an important and commonly used indicator for measuring the quality in health care.

Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects

the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a

proxy but a very effective indicator to measure the success of doctors and hospitals.

The concept of patient satisfaction is not new. Patients are one of the main stakeholders among the ever-

expansive modern world of medicine. Patient satisfaction forms an essential component of many policy

level decisions. Changes in patient care trends have been seen in developing countries recently. Patient

Satisfaction is a complex, multidirectional issue that needs to be approached from several different

angles.

This study attempts to identify the factors that influence patients’ satisfaction with health care services,

and examines their service experiences with public and private medicals in Bangladesh. A better

understanding of the determinants of patient satisfaction in regards of cost & services with the different

types of hospitals should help policy- and decision-makers adopt and implement effective measures to

improve health care services in the country.

Objective of the Study

The main objective of the study is to investigate the relationship between hospital investigation cost &

service quality with patients satisfaction. The specific objectives are;

1. To identify the relationship between cost of diagnostics test and patients satisfaction in the private

hospitals in Dhaka, Bangladesh.

2. To identify the relationship between service quality of diagnostics test and patients satisfaction in the

private hospitals in Dhaka, Bangladesh.

3. To identify any other independent/dependent variables which can affect the satisfaction level of the

patients while doing a investigation test

4. To identify the degree of patients satisfaction among in different private hospitals in Dhaka,

Bangladesh.

5. To identify the differences between cost & service quality among different hospital Dhaka,

Bangladesh.

Data Collection Procedures

The nature of our study needs different sample types and more or less moderate sample size. So we have

visited three private hospitals and collect their diagnostics rate chart. After that we prepared a set of

questionnaire with 10 questions related to the satisfaction level of the patients. We have prepared the

questionnaire based on 4 different independent variables (Cost, Service, Availability and Loyalty). We

identify that these factors can be related with the patient’s satisfaction level. We randomly selected 20

patients each hospital which will be total sample size of 60 persons. We asked the same questions to all the

patients from all 3 hospitals. We can measure the satisfaction level of patients among different hospitals.

Based on these questions we can find the we can measure if there is any relationship between cost & services

with the satisfaction of the patients

Main Variables

Investigation Cost: Treatment cost is the most important thing which a patient considers while going for

an investigation test. It is one of the most critical independent variables that may affect patients' desire

and influences patients' satisfaction level.

Availability: all kind of investigation related instruments are available or not, which are fully automated

or not for accurate diagnostic results. And also all types of emergency services like 24/7 diagnostics, 24/7

report delivery etc. are available or not. These types of factors define the level of patients’ treatment

accessibility.

Service: I n health care industry service is the most important factor. The prices of investigation tests

are almost same across different hospitals of the same kind. But the difference creator factor is the

service. So the service provider’s dedication, sympathy and understanding of patients’ issues and

needs can significantly impact the satisfaction of the patients.

Loyalty: Loyalty means providing the full possible service based on the ability of a hospital has. It

indicates the guaranteed benefit constantly and precisely. Concept of loyalty is also lessened when

there is no proper investigation or the generating investigation report is faulty.

Research Methods:

For this research study we have followed two types of research procedures:

1. Primary research

2. Secondary research

For our primary research, we conducted in-depth interviews of Patients separately. We went

through natural survey or observational experiment where we observed patients closely to identify

the problems they had to face when confronting the hospitals. We also surveyed of how the

pathology staffs treat the patients. Hence, we designed a questionnaire with various types of questions so

as to get a range of useful data which helped us to provide with answers of our research questions. For

this reason, we have selected three hospitals to conduct our research works.

For our secondary research, we planned to use the resources of the library and the web – books and

articles, standard reference sources and databases, government documents, NGO data, media and

academic web-sites and any other forms of supplementary materials, etc.

Research Questionnaire and the Outcomes:

In the research questionnaire we designed the questions in a way that it covers all the aspects of the

patients through which a patient can be affected. We designed the questions into 4 different independent

variables which are also connected both the patients and hospital investigation department. So we can see

if there is any relationship of these 4 independent variables to the dependent variable patient satisfaction.

Questionnaire for Variable “Cost”:

Q. Are you satisfied with the price structure of the different investigations of this hospital?

Ans: Yes / No

Response from Nightingale Medical College & Hospital Patient s’:

Cost of Investigation

Yes No

Q.1 6 14

Total 6 14
 Percentage 30% 70%

Cost
Yes No

30%

70%

Interpretation: 30% patients of Nightingale Hospital are satisfied and 70% patients are not satisfied

with the Investigation cost oriented service.

Response from Asian Medical College & Hospital Patients’:

Cost of Investigation
 Yes No

Q. 1 9 11

Total 9 11

Percentage 45% 55%

 Cost
yes No

45%

55%

Interpretation: 45% patients of Asiyan Hospital are satisfied and 55 % patients are not satisfied with the

treatment cost.

Response from East West Medical College & Hospital Patients’:

Cost of Investigation

Yes No

Q. 1 4 16

Total 4 16

Percentage 20% 80%

 Cost
Yes No

20%

80%

Interpretation: 20% patients of East West Hospital are satisfied and 80 % patients are not satisfied

with the treatment cost.

Questionnaire for Variable “Availability”:

Q1. Does this hospital have all types of investigation test equipment according to your desire test?

Ans: Yes / No

Q2. Does this hospital have the facility of provide pathological tests 24/7?

Ans: Yes / No

Q3. Does this hospital have the facility of collecting the test reports 24/7?

Ans: Yes / No

Response from Nightingale Medical College & Hospital Patient s’:

Availability

Yes No

Q. 1 16 4

Q. 2 15 5

Q. 3 17 3

Total 48 12

Percentage 80% 20%

 Availability
Yes No
20%

80%

Interpretation: 80% patients of Nightingale Hospital are satisfied and 20 % patients are not satisfied
with the availability of duty doctor, Emergency situation, ambulance and medical equipment.

Response from Asiyan Medical College & Hospital Patient s’:

Availability

Yes No

Q. 1 12 8

Q. 2 13 7

Q. 3 11 9

Total 36 24

Percentage 60% 40%

 Availability
Yes No

40%

60%

Interpretation: 60% patients of Asiyan Medical College & Hospital are satisfied and 40 % patients
are not satisfied with the availability of duty doctor, Emergency situation, ambulance and medical
equipment.

Response from East West Medical College & Hospital Patients’:

Availability

Yes No

Q. 1 15 5

Q. 2 13 7

Q. 3 14 6

Total 42 18

Percentage 70% 30%

 Availability
Yes No
30%

70%

Interpretation: 70% patients of East West are satisfied and 30 % patients are not satisfied with the
availability of duty doctor, Emergency situation, ambulance and medical equipment.

Questionnaire for Variable “Service”:

Q1. Do you have to wait for a short time while going for an investigation test?

Ans: Agree / Strongly Agree / Neutral / Disagree Strongly / Disagree

Q2. Do the staffs of the hospital are friendly and helpful?

Ans: Agree / Strongly Agree / Neutral / Disagree Strongly / Disagree

Q3. Do you always get all kinds of assistants while you go for a test from the pathological staffs?

Ans: Agree / Strongly Agree / Neutral / Disagree Strongly / Disagree

Response from Nightingale Medical College & Hospital Patient s’:

Service

Strongly Agree Neutral Disagree Strongly

Agree Disagree

Q. 1 3 10 3 0 4

Q. 2 5 11 3 0 1

Q. 3 4 9 6 0 1

Total 12 30 12 0 6

Percentage 20% 50% 20% 0% 10%

Service
Strongly Agree Agree Neutral
Disagree Strongly Disagree

10% 20%
20%

50%
 Interpretation:

20% patients strongly agree those statements.

50% patients agree those statements.

20% patients are neutral with those statements.

0% patients disagree with those statements.

10% patients strongly disagree with those statements.

Calculation Of Service: (Strongly Agree) =20; (Agree) =50. So total (Strongly Agree + Agree) =
70%

Response from Asiyan Medical College & Hospital Patient s’ :

Service

Strongly Strongly
Agree Neutral Disagree
Agree Disagree

Q. 1 4 11 3 0 2

Q. 2 5 11 3 0 1

Q. 3 6 10 2 0 2

Total 15 32 8 0 5

25% 53.34% 13.33% 0% 8.33%

Percentage
 Service
Strongly Agree Agree Neutral
Disagree Strongly Disagree
8% 25%
13%

53%

Interpretation:

25% patients strongly agree those statements.

53.34% patients agree those statements.

13.33% patients are neutral with those statements.

0% patients disagree with those statements.

8.33% patients strongly disagree with those statements.

Calculation of Service:(Strongly Agree) =25, (Agree) = 53.34. So total (Strongly Agree

+Agree) = 78.34
 Response from East West Medical College & Hospital Patient s’:

Service

Strongly Strongly
Agree Neutral Disagree
Agree Disagree

Q. 1 3 10 3 0 4

Q. 2 1 12 6 0 1

Q. 3 5 10 5 0 0

Total 9 32 14 0 5

Percentage 15% 53.34% 23.33% 0% 8.33%

Service
Strongly Agree Agree Neutral
Disagree Strongly Disagree
8%
15%
23%

53%
 15% patients strongly agree those statements.

53.34% patients agree those statements.

23.33% patients are neutral with those statements.

0% patients disagree with those statements.

8.33% patients strongly disagree with those statements.

Calculation of Service:(Strongly Agree) =15 (Agree) = 53.34. So total (Strongly Agree +

Agree) = 68.34

Questionnaire for Variable “Loyalty”:

Q1. Do you think Staffs of this hospital are loyal towards their work and patients?

Ans: Agree / Strongly Agree / Neutral / Disagree Strongly / Disagree

Response from Nightingale Medical College & Hospital Patient s’:

Loyalty

Strongly Strongly
Agree Neutral Disagree
Agree Disagree

Q. 1 3 10 3 0 4

Q.2 4 8 5 0 3

Total 7 18 8 0 7

Percentage 17.5% 45% 20% 0% 17.5%

 Loyalty
Strongly Agree Agree Neutral
Disagree Strongly Disagree
18% 18%

20%

45%

17.5% patients strongly agree those statements.

45% patients agree those statements.

20% patients are neutral with those statements.

0% patients disagree with those statements.

17.5% patients strongly disagree with those statements.

Calculation of Loyalty: (Strongly Agree) =17.5%, (Agree)= 45% So total (Strongly Agree +
Agree) = 62.5%
 Response from Asiyan Medical College & Hospital Patient s’:

Loyalty

Strongly Strongly
Agree Neutral Disagree
Agree Disagree

Q. 1 5 5 6 0 4

Q. 2 6 4 8 0 2

Total 11 9 14 0 6

Percentage 27.5% 22.5% 35% 0 15%

Loyalty
Strongly Agree Agree Neutral
Disagree Strongly Disagree
13% 28%

36%

23%
 27.5% patients strongly agree those statements.

22.5% patients agree those statements.

35% patients are neutral with those statements.

0% patients disagree with those statements.

15% patients strongly disagree with those statements.

Calculation of Loyalty: (Strongly Agree) =27.5%, (Agree) = 22.5. So Total (Strongly Agree
+ Agree) = 50%

Response from East West Medical College & Hospital Patient s’:

Loyalty

Strongly Agree Neutral Disagre Strongly

Agree e Disagree

Q. 1 3 10 3 0 4

Q. 2 4 9 5 0 2

Total 7 19 8 0 6

Percentage 17.5% 47.5% 20% 0% 15%

 Loyalty
Strongly Agree Agree Neutral
Disagree Strongly Disagree
18%
15%

20%

48%

17.5% patients strongly agree those statements.

47.5% patients agree those statements.

20% patients are neutral with those statements.

0% patients disagree with those statements.

15% patients strongly disagree with those statements.

Calculation of Loyalty: (Strongly Agree) =17.5%, (Agree) = 47.5. So Total (Strongly Agree +
Agree) = 65%
 Patients Satisfaction level:

Cos Availabilit Servic Loyalt Averag

t y e y e
Nightingal 30 80 70 62.5 60.6
e
Asiyan 45 60 78.34 50 58.3
East West 25 70 68.34 65 57.08
100 210 216.68 177.5

Interpretation:

In this table we ignore all those people who were not satisfied and neutral. Cause our main
concern is to find out the people who are satisfied.

Nightingale Medical College Hospital:

So far we observed that 30% of patients are satisfied with the cost, 80% are
satisfied with the availability, 70% are satisfied with the service and 62.5 % are satisfied
with the loyalty.

It shows that the satisfaction level of service is high but the cost of investigation also very
high that’s why

Satisfaction level goes down. So cost should be reasonable.

Asiyan Medical College Hospital:

So far we observed that 45% of patients are satisfied with the cost, 60% are satisfied
with the availability, 78.34 % are satisfied with the service and 50% are satisfied with the
loyalty.

Cost of investigation is moderate.

 East West Medical College Hospital:

So far, we observed that 20% of patients are satisfied with the cost, 70% are
satisfied with the availability, 68.34% are satisfied with the service and 65% are satisfied
with the loyalty.

Cost of investigation is very high.

Cost Availability Service Loyalty Average

Nightingale 30 38 32 35 33.75

45 28 36 28 34.25
Ashiyan

25 34 32 37 32
East West

100 100% 100% 100%

Comparison of Satisfaction Level of Three Hospitals:

This table shows the proportion of all the variables for three hospitals

Cost
Nightingale Ashiyan East West
25% 30%

45%

Interpretation:

Considering the cost of three hospitals, we found 30%, 45% and 25% patients are
satisfied with the cost of Nightingale, Asiyan and East West hospital respectively. So
here we see patients are highly satisfied with the cost of Ashiyan hospital.
 Availability

38 28 34

Nightingale Ashiyan East West

Interpretation:

Considering the availability of three hospitals, we found 38%, 28% and 34% patients are
satisfied with the cost of Nightingale, Ashiyan and East West hospital respectively. So
here we see patients are highly satisfied with the availability of Nightingale Medical
college hospital.
 Service
36

32 32

Nightingale Ashiyan East West

Interpretation:

Considering the service of three hospitals, we found 32%, 36% and 32% patients are
satisfied with the cost of oriented service Nightingale, Ashiyan and East West hospital
respectively. So here we see patients are highly satisfied with the service of Ashiyan
hospital
 Loyalty

35 37
28

Nightingale Ashiyan East West

Interpretation:

Considering the loyalty of three hospitals, we found 35%, 28% and 37% patients are satisfied
with the cost of Nightingale, Ashiyan and East West hospital respectively. So here we see
patients are highly satisfied with the loyalty of East West hospital.
 Satisfaction Level

Nightingale

32% 34%

Ashiyan

East West

34%

Interpretation:

Considering three hospitals, we found 33.75%, 34.25% and 32% patients are satisfied
with the Nightingale, Ashiyan and East West hospital respectively. So here we see
patients are highly satisfied with Ashiyan hospital.
 Chi Squire Test

Cos Availabilit
Service
Hospital t y Loyalty
Nightingal
30 80 70
e 62.5
Asiyan 45 60 78.34 50
East West 25 70 68.34 65
100 210 216.68 177.5

Observed value

Hospital Cost Availability Service Loyalty Total

Nightingale 30 80 70 62.5 242.5
Asiyan 45 60 78.34 50 233.34
East West 25 70 68.34 65 228.34
Total 100 210 216.68 177.5 704.18

Expected Value
Hospital
Total
 Cost Availability Service Loyalty
Nightingal
e
34.44 72.32 74.62 61.13 242.5
Asiyan 33.14 69.58 71.79 58.81 233.34
East West 32.42 68.10 70.26 57.55 228.34
Total 100 210 216.68 177.5 704.18

Chi- Square Score

Cos Availabilit Servic Loyalt

Tota
Hospital t y e y l
Nightingal 0.57 0.82 0.29 0.03 1.71
e
4.24 1.32 0.60 1.32 7.48
Asiyan
1.70 0.05 0.05 0.96 2.76
East West
Grand 11.9
Total 5

Chi-Square test: -
Step 1:

Ho: Patients satisfaction level doesn’t depend on the Investigation test cost and service

H1: Patients satisfaction level depends on the Investigation test cost and service

Step 2:

Significance level α=0.05

Step 3:

Test Statistics Chi-Square distribution

Step 4:

DF= (Number of rows – 1) * (Number of columns – 1)

= (3 – 1) * (4 - 1) = 6

so, at α=0.05 and DF=6 the critical value of chi-square= 12.59

Reject Ho if Chi-Cal> Chi-Crit

Step 5:

Calculative value of chi-square:

(Observed Value−Expected Value)²

X 2 =∑ ❑
Expected Value

Chi-Cal (X²) = 11.95

Since we found Chi-Cal< Chi Crit. So we do not reject Ho.

So we can conclude our statistical study that the satisfaction level of the patents does not

depend on the investigation test cost and service of a hospital pathology department.
Conclusion:

We contend that improving medical care in Bangladesh requires attention to service features that
are regularly rated by patients. These features include doctors, nurses, tangibles, process features,
cost, services etc. However, additional organizational and extra-organizational issues that play a
vital role must also be addressed to improve the health care system. However the outcome that
we have described from three medical from 60 patients are not reflect the decision of the
majority of the patients. Additional study may incorporate more numbers of private medical and
different variable analysis. Also the public and private medical both from urban and rural area
can be observed under the assessment to get the more accurate answers. The review will have the
capacity to highlight the significance of medicinal services quality as patient fulfillment
indicators by ensuring the proper services along with cost management. It can be used to assess
other healthcare practices from patient perspectives and to ensure minimum charges on the
service availability. This thorough analysis will have vital implications for policy makers.

Reference:

 Nightingale Hospital

 Asiyan Hospital

 East West Hospital

 https://docs.google.com/forms/d/1MpNIjrB01guiKdLKAkbX5PEeGRM0Q0qSF

Xm8dY4tbh4/edit
Appendix:

Bus 511 (Study questionnaire)

* Required

1. Age *

2. Occupation *

3. Are you satisfied with the price price structure of the different investigations of this
hospital? (cost related) *
Mark only one oval.

Yes No

Moderately satisfied

4. Does this hospital have all types of investigation test equipment you need? (Availability
related) *
Mark only one oval.

Yes

No

5. Does this hospital have the facility of provide pathological tests 24/7? (Availability related)
*
Mark only one oval.

Yes

No

6. Does this hospital have the facility of collecting the test reports 24/7? (Availability related) *
Mark only one oval.

Yes
 No

7. Do you have to wait for a long time while going for an investigation test? (service related) *
Mark only one oval.

Yes No

Sometimes

Rarely

8. Do the staffs of the hospital are friendly and helpful? (Service related) *
Mark only one oval.

Yes No

Moderate

Indifferent

9. Do you always get all kinds of assistants while you go for a test from the pathological
staffs? (Service related) *
Mark only one oval.

Yes No

Sometimes

May be

10. Do you think Staffs of this hospital are loyal towards their work and patients? (Loyalty
related) *
Mark only one oval.

Yes No

Moderate

Sometimes

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