Summer Training Report

On
CUSTOMER SATISFACTION FROM
HOSPITAL SERVICES: STUDY OF
FORTIS HOSPITAL

Submitted in partial fulfillment of the degree of

Master of Business Administration
Affiliated To
MAHARISHI DAYANAND UNIVERSITY

Submitted to: Submitted by:

The Controller of Examination BRIJ MOHAN
SHARMA
M.D.U. (Rohtak) 2k13-MRCE-MBA-

008

FARIDABAD (HARYANA)
Aug,2014

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 Declaration

I Brij Mohan, Roll No. 2k13-MRCE-MBA-008, a student of Masters of Business Administration

of 3rd semester, at Manav Rachna College of Engineering, Faridabad here by solemnly declare
that researched project titled “Customer Satisfaction from Hospital Services: Study of Fortis
Hospital”, is the outcome of my own research prepared by me and the same has not been
submitted to any university or institute of the award of any degree and diploma.

Faculty’s Signature Candidate‘s Signature

……………………….. …………………………..

(Signature of the Director/ Principal of the Institute)

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 PREFACE

With Immense pleasure and deep sense of sincerity, I have completed my Industrial training. It is
an essential requirement for each and every student to have some practical exposure towards real
world situations. A systematized practical experience to inculcate self confidence in a student so
that they can mentally prepare themselves for this competitive environment.

The Purpose of Training are:

1. Developing intellectual ability of student

2. Bring confidence
3. Developing skills
4. Modify Attitudes

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 Acknowledgement

I would like to express my profound gratitude to Ms. Nidhi Khera , (MANAGER) and Ms.
ASHRITA under whose guidance I was able to complete my summer training project and was
able to learn the various aspects of Customer Satisfaction apart from my project “Customer
Satisfaction from Hospital Services: Study of Fortis Hospital”.

Their guidance and inspiration helps me lot during prepare my project. Their cordial cooperation
also impresses me to furnish my project in good manner. I express my gratitude to all authorities
at FORTIS HOSPITAL, whose directions and valuable information greatly helped me in
preparing my project.

Thanks are all due to our faculty Mr. Amit Seth (Dean of industry interface), Mrs. Bindu
Aggarwal (HOD MBA DEPARTMENT) and Mrs. Meenakshi at MRCE members for their
motivation and teaching, which have enabled me to cross this milestone.

I acknowledge the great assistance and support of entire team of professionals who allowed me
to pursue this project, despite an already crowded and over loaded work schedule.

I would like to specially thank my family members without their support it was impossible to go
for the project.

Last but not least I must thank god.

(Brij Mohan)

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 TABLE OF CONTENT
S.NO TOPIC Page No.
1. Chapter 1 - COMPANY PROFILE (1-18)
 Introduction to the company 2-3
 Vision and Mission of the company 4
 Core values 4
 Executive Summary 5-6
 Objective of the study 7
 Scope of the study 8
 Literature review 9-18
2. Chapter 2 - Introduction to the topic (19-27)
 Fortis escorts hospital 20
 Services offered 20-22
 Customer expectations 22-23
 Customer satisfaction 23
 Measuring satisfaction 24-26
 Price and product chart 27
3. Chapter 3 - Research Methodology 28-29
 Research design 30
 Data collection 30
 Sample size and design 30
 Research period 30
 Finding and analysis 31-43
4. Chapter 3 - Conclusion and Suggestion (44-48)
 Conclusion 45
 Recommendation 46-47
 Limitation 48

Bibliography 49

Annexure
(Questionnaire)

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 CHAPTER – 1
COMPANY PROFILE

INTRODUCTION TO THE COMPANY

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Fortis Healthcare was established in 1996 by the promoters of Ranbaxy Laboratories, among the
world's top 10 generic companies, also India's largest Parma Company. Integral to the objective
of creating a world class healthcare system is the need to educate and train high Quality Medical
manpower in institutions that provide a nurturing and enabling environment. In pursuit of this
vision, Fortis Healthcare has very successfully achieved critical mass and credibility and is now
widely recognized as a Healthcare Institution of excellence in the delivery arena to offer superior
services to the community. Whilst continuing to grow and excel in Healthcare delivery Fortis
Healthcare is now putting additional effort to set up Institutions in Medical & Healthcare
Education which would include Doctors, Nurses, Technicians, Paramedics and Healthcare
Management personnel.

Fortis Hospital Mohali with Super-specialty in Heart was the first flagship hospital started in
2001. In a short period of last 6 years Fortis with a compliment of 13 hospitals, has achieved a
dominant position in the sector especially in north India. It is today the second largest healthcare
provider network in the country amongst the private sector players. Synonymous with the Fortis
hallmark of putting the patient at the centre of our endeavors in healthcare delivery, Fortis
proposes a very similar approach of putting the student at the centre of our thinking when it
comes to setting up our Medical & Healthcare Educational Institutions. The centricity of patient
and student will prevail at the same time as providing the highest stature to their doctors, nurses
and other manpower who work in our Institutions. With the acquisition of Escorts Heart Institute
& Research Centre in 2009, Fortis has the unique distinction of being amongst the world’s
largest cardiac care providers. With four large projects currently under execution and dialogue
with various state governments for setting up infrastructure for healthcare delivery and medical
& healthcare education, Fortis Group has emerged as the fastest growing healthcare delivery
organization of India. The foray in the arena of medical & healthcare education will fulfill the
quest to be an integrated healthcare delivery organization which has been contributed to patient
care on one end and out turn of doctors, dentists, nurses, technicians, Para-medics and healthcare
managers.

Fortis Group comprises of a host of other companies, which are primarily in order to associate
and allied with functions of the healthcare sector. Apart from Ranbaxy Laboratories Limited, the
flagship company of the Group, the other companies include: SRL Ranbaxy, India’s largest

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Laboratory Medicine Company with 18 laboratories and 550 collection centers across the entire
country; Religare Enterprises, amongst India’s largest financial services provider company;
Fortis Clinical Research Limited, Fortis Health world, which has recently launched a string of
retail health stores; Fortis Health staff which trains nurses for overseas placement; and Fortis
Medical University which is envisaged to encompass and roll out the educational foray in the
arena of medical & healthcare education.

Fortis Group over the last 6 years has emerged as the second largest health delivery company of
India with impeccable quality credentials. Synonymous to Fortis Group has been the patient
centricity, the hallmark of its existence which is now broadening its horizons by making a foray
in medical & healthcare education with a similar commitment to its key stakeholder – ‘the
student’. In line with its commitment, Fortis Group will continue to engage with the State of
Rajasthan to strengthen and expand the healthcare delivery network, improve the quality of
health services and augment medical & healthcare education infrastructure for teaching &
training of quality health manpower.

At Fortis Group it has been felt that a lot is being done for the people, who could afford
healthcare, but the unmet need of the underprivileged community is staring us in the face.
Consequently, each of the unit of Fortis Group embarked upon engagement with such sections of
society in urban slums and rural areas through various outreach programs to ensure and facilitate
delivery of quality health services at their doorstep. This has resulted in to creation of ‘Centre for
Community Initiatives (CCI)’ at Corporate to facilitate delivery of such endeavors in an
organized manner on one end and discharge an advisory role for various units along with co-
ordination & consolidation of the efforts on the other end.

Vision

“To create a world-class integrated healthcare delivery system in India, entailing the finest
medical skills combined with compassionate patient care.”

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 Mission

“To make quality healthcare services widely available to the community at large.”

Core values

Vision: Imbibe and share the vision.

 Integrity: Lead through honesty and integrity.

 Respect: Earn respect
 Trust: Gain patient trust.
 Understanding: Commit to compassion, care and understanding.
 Own: Own quality excellence.
 Uphold: Uphold innovation and continuous improvement.
 Share: Develop and share success.

EXECUTIVE SUMMARY

The modern age can be called as the “Age of Consumers”. In today’s cut-throat competition the
consumer is considered as the king. Many policies of various organizations are aimed at keeping
the consumer happy and satisfied. It is very important for every single organization to keep its

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consumers satisfied in order to maintain its competitiveness in the market. Not only does this
help the organization to maintain the size of its share in the market, it might even help it to
increase the size of its share. It might also be instrumental in increasing the overall market size.
This helps in increasing the overall profitability of the organization. It also helps the long-term
survival prospects of the organization. Consumers when viewed on the macro level exhibit
similar traits. However, when they take a closer look and come down to the micro level, we find
that the consumers vary as in comparison to one another on one aspect or the other based on a
variety of attributes (Kotler, 2003).

This project covered the brief understanding about the private hospital industry
surrounding the Delhi area, I have collected the primary data from the Fortis hospital
which is one of the best hospital in Delhi and NCR, as the growing concern about the health
in the Delhi and NCR region also to understand whether the Fortis hospital has targeted
the market right or not, I have concluded this project with the proper recommendation has
been made to that, which help another research to do some research assuming of that.

. They currently have a network of 12 hospitals primarily in north India, 15 satellite and heart
command centres in hospitals across the country and one heart command centre in Afghanistan.
Fortis is committed to delivering quality healthcare services to our patients in modern facilities
using advanced technology and our teams of doctors, nurses and other healthcare professionals,
who follow international protocols. Most of their hospitals are multi-specialty hospitals, which
provide secondary and tertiary healthcare to patients. Some of our multi-specialty hospitals also
include super-specialty “centres of excellence” providing quaternary healthcare to patients in key
specialty areas such as cardiac care, orthopaedic, neurosciences, oncology, renal care,
gastroenterology and mother and child care. In addition, two of their hospitals, Escorts Heart
Institute & Research Centre at New Delhi (“EHIRC”) and Escorts Heart Centre at Raipur
(“EHCR”), focus primarily on patients, with EHIRC serving as a super-specialty “centre of
excellence” for care. We also operate Fortis La Femme, a “boutique” style hospital that focuses
on women’s health and maternity care.

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 OBJECTIVE OF STUDY:

 To measuring the satisfaction level of patients’ in Fortis Hospital.

 To study patients’ expectations towards facility or service provided by hospital

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 To study perceptions from the hospital services.

 To study measuring their satisfaction level from the hospital services. For both the first
and second objective of study i.e. the customers’ expectations and their perceptions of
hospital services.

SCOPE OF THE STUDY

 In the present business scenario of cut throat competition, customer satisfaction has
become the prime concern of every single kind of industry.
 Companies are increasingly becoming the customer focused.

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  Companies can win customers and surge ahead of competitors by meeting and satisfying
the needs of the customers. World over businesses have realized that marketing is not the
only factor in attracting and retaining customers.

LITERATURE REVIEW
Many studies have been conducted on the customer satisfaction. An attempt has been made to
present in brief, a review of literature on customer satisfaction in general as well as on the
customer satisfaction from hospital services.

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Priscilla et al (1983) proposed a cognitive model to assess the dynamic aspect of consumer
satisfaction/ dissatisfaction in consecutive purchase behavior. They found that satisfaction has a
significant role in mediating intentions and actual behavior for five product classes that were
analyzed in the context of a three- stage longitudinal field study. They found that repurchases of
a given brand is affected by lagged intention, whereas switching behavior is more sensitive to
dissatisfaction with brand consumption.

David and Wilton(1988) have extended consumer satisfaction literature by theoretically and
empirically examining the effect of perceived performance using a model first proposed by
Churchill and Surprenant, investigating how attractive conceptualizations of comparison
standards and disconfirm capture the satisfaction formation process and exploring possible
multiple comparison processes in satisfaction formation. They suggest that perceived
performance exerts direct significant influence on satisfaction in addition to those influences
from expected performance and subjective disconfirm.

Saha (1988) made an attempt to investigate the interrelationships between job-satisfaction, life
satisfaction, life satisfaction-over-time and health. The relationship among these four variables
and biographical variables were also examined. The study was conducted over the nurses in
Nigeria. The data was collected from the full time employees only because statements about job
satisfaction and other variables are different when supplied by retirees, part-time nurses.

Bolton and Drew (1991) proposed a model of how customers with prior experiences and
expectations assessed service levels, overall service quality and service value. They applied the
model to residential customers of local telephone services. Their study explored how customers
integrate their perceptions of a service to form an overall evaluation of that service. They
developed a multistage model of determinants of perceived service quality and service value.
The model described how customers expectations, perceptions of current performance and
disconfirmation experiences affected their satisfaction or dissatisfaction with a service, which in
turn affected their assessment of service quality and value.

Boulding et al (1993) stated that the service quality relates to the retention of customers at
aggregate level. The author has offered a conceptual model of the impact of service quality on
particular behavior that signal whether customers remain with of defect from a company. The

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results of the study show strong evidence of their being influenced by service quality. The
findings also reveal difference in the nature of the service quality.

Aurora and Malhotra (1997) had done a comparative analysis of the satisfaction level of
customer of public and private sector Hospitals, in order to help the Hospital management to
formulate marketing strategies to lure customers towards them and hence increase customer
base.

Grewal et al had expanded and integrated prior price perceived value models within the context
of price comparison advertising. More specifically, the conceptual model explicates the effects of
advertised selling and reference prices on buyers’ internet reference prices, perceptions of
quality, acquisition value, transaction value, and purchase and search intentions. Two
experimental studies test the conceptual model. The results across these two studies, both
individually and combined, support the hypothesis that buyers’ internal reference prices are
influenced by both advertised selling and reference price as well as buyers’ perception of product
quality. The authors also find that effect of advertised selling price on buyers’ acquisition value
was mediated by their perceptions of transaction value. In addition, effects of perceived
transaction value on buyers, behavioral intentions were mediated by their acquisition value
perceptions.

Voss (1998) had examined the rule of price, performance and expectations to determine
satisfaction in service exchange. When price and performance are consistent, expectations have
an assimilation effect on performance and satisfaction judgments; when price and performance
are inconsistent, expectations have no effect on performance and satisfaction judgments. To
examine these issues authors develop a contingency model that they estimate using data from a
multimedia experimental design. The results generally support contingency framework and
provide empirical support for normative guidelines that call for creating realistic performance
expectations and offering money-back service guarantees.

Garbarino and Johnson (1999) analyze that the relationships of satisfaction, trust and
commitment to component satisfaction attitudes and future intentions for the customers of a New
York off-Broadway repertory theater company. For the relational customers ( individual ticket
buyers and occasional subscribers), overall satisfaction is the primary mediating construct

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between the component attitudes and future intentions and for the high relational customers
(consistent subscribers), trust and commitment, rather than satisfaction, are the mediators
between component attitudes and future intentions.

Sharma and Chahal (1999) had done a study of patient satisfaction in outdoor services of private
health care facilities. They had done a survey to understand the extent of patient satisfaction with
diagnostic services. They have constructed a special instrument for measuring patient
satisfaction. The instrument captures the behavior of doctors and medical assistants, quality of
administration, and atmospherics. The role of graphic characters like gender, occupation,
education, and income is also considered. Based on their findings, they also suggested strategic
actions for meeting the needs of the patients of private health care sector more effectively. In
their study provided suggestions like becoming more friendly and understanding to the problems
of patients, maintaining cleanliness in the units, both internally and externally, providing regular
report regarding the patients’ progress without waiting for them to demand, conducting surveys
to know about the attitude of the patients with regard to the employees and adopting patient-
oriented policies and procedures.

Simester et al (2000) have studied that multinational firm uses sophisticated, state-of-the-art
methods to design and implement customer satisfaction improvement programs in the United
States and Spain. Their experiments reveals a complex and surprising picture that highlights
implementation issues, a construct of residual satisfaction not captured by customer needs and
the managerial need for combining nonequivalent controls and nonequivalent dependent
variables.

Ofir and Simonson (2001) in their study found that customer evaluations of quality and
satisfaction are critical inputs in development of marketing strategies. Given the increasingly
common practice of asking such evaluations, buyers of products and services often know in
advance that they subsequently has been asked to provide their evaluations. In a series of field
and laboratory studies, the authors demonstrate that expecting to evaluate leads to less favorable
quality and satisfaction evaluations and reduces customer’s willingness to purchase and
recommend the evaluated services. The negative bias of expected evaluations is observed when
actual quality is either low or high, and it persist even when buyers are told explicitly to consider
both the positive and negative aspects.

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Dholakia and Morwitz (2002) have examined the scope and persistence of the effect of
measuring satisfaction on consumer behavior over time. In an experiment conducted in a
financial services setting, they found that measuring satisfaction changes one-time purchase
behavior, changes relational customer behaviors and results in effects that increase for months
afterward and persist even a year later. Their results raised questions concerning the design,
interpretation and ethics in the conduct of applied marketing research studies.

Sharma and Chahal (2003) stated that due to increased awareness among the people patient
satisfaction had become very important for the hospitals. The authors examined the factors
related to patient satisfaction in government outpatient services in India. They said that there are
four basic components which had impact on the patient satisfaction namely, behavior of doctors,
behavior of medical assistants, quality of atmosphere, and quality of administration. They also
provided strategic actions necessary for meeting the needs of the patients of the government
health care sector in developing countries.

Folkes and Patrick (2003) in their study showed converging evidence of a positivity effect in
customers’ perceptions about service providers. When the customer has little experience with the
service, positive information about a single employee leads to perception that the firm’s other
service providers are positive to a greater extent than negative information leads to perception
that the firm’s other service providers are similarly negative. Four studies were conducted that
varied in the amount of information about the service provider, the firm, and the service. The
positivity effect was supported despite differences across studies in methods as well as measures.

Vernoer (2003) had investigated the different effects of customer relationship perceptions and
relationship marketing instruments on customer retention and customer share development over
time. Customer relationship perceptions are considered evaluations of relationship strength and a
supplier’s offerings, and customer share development is the change in customer share between
two periods. The results show that affective commitment and loyalty programs that provide
economic incentives positively affect both customer retention and customer share development,
whereas direct mailings influence customer share development. However, the effect of these
variables is rather small. The results also indicate that firms can use the same strategies to affect
customer satisfaction that can have impact on both customer retention and customer share
development.

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Anderson et al (2004) developed a theoretical framework that specifies how customer
satisfaction affects future customer behavior and, in turn, the level, timing, and risk of future
cash flows. Empirically, they find a positive association between customer satisfaction and
shareholder value. They also find significant variation across industries and firms.

Reinartz et al (2004) in their study of Customer Relationship Management Process had stated
that it is very important for maintaining healthy relations with the customers in order to provide
them satisfaction. In their study, they (1) conceptualize a construct of the CRM process and its
dimensions, (2) operationalize and validate the construct, and (3) empirically investigate the
organizational performance consequences of implementing the CRM processes. Their research
questions are addressed in two cross-sectional studies across four different industries and three
countries. The key outcome is a theoretically sound CRM process measure that outlines three
key stages: initiation, maintenance, and termination.

Homburg et al (2009) conducted two experimental studies (a lab experiment and a study
involving a real usage experience over time) which reveal the existence of a strong, positive
impact of customer satisfaction on willingness to pay and they provide support for a nonlinear,
functional structure based on disappointment theory. In addition, the second examines dynamic
aspects of the relationship and provides evidence for the stronger impact of cumulative
satisfaction rather than of transaction-specific satisfaction on willingness to pay.

Mithas et al (2009) evaluates the effect of customer relationship management (CRM) on

customer knowledge and customer satisfaction. They analyze archival data of a cross-section of
U.S firms which shows that the use of CRM applications is positively associated with improved
customer knowledge and improved customer satisfaction. They also found that gains in customer
knowledge are enhanced when firms share their customer related information with their supply
chain partners.

Gustafson et al (2009) in their study of telecommunications services examine the effect of

customer satisfaction, affective commitment, and calculative commitment on retention and the
potential for situational conditions to moderate the satisfaction-retention relationship. Their
results support consistent effects of customer satisfaction, calculative commitment and prior-
churn on retention.

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Gruca and Rego (2009) strengthen the chain of effects that link customer satisfaction to
shareholder value by establishing the link between satisfaction and two characteristics of future
cash flows that determine the value of the firm to shareholders: growth and stability. By using
the longitudinal American Customer Satisfaction index and COMPUSTAT data and hierarchical
Bayesian estimation they found that satisfaction creates shareholder value by increasing future
cash flow growth and reducing its variability. They also test the stability of findings across
several firm and industry characteristics and assess the robustness of the results using multi-
measure and multi-method estimation

Thompson (2009) in his study had shown that consumers often misjudge their health
risks owing to a number of well-documented cognitive biases. These studies assume that
consumers have trust in the expert systems that culturally define safe and risky behaviors’.
Consequently, this research stream does not address choice situations where consumers have
reflexive doubts toward prevailing expert risk assessments and gravitate toward alternative
model of risk reductions. This study explores how dissident health risk perceptions are culturally
constructed in the natural childbirth community, internalized by consumers as a compelling
structure of feeling, and enacted through choices that intentionally run counter to orthodox
medical risk management norms. Hospital industry is an important component of the value
chain in Indian Hospital industry rendering services and recognized as Hospital delivery segment
of the Hospital industry, which is growing at an annual rate of 14%. The size of the Indian
Hospital industry is estimated at Rs. 1,717 billion in 2007. It is estimated to grow by 2012 to Rs.
3,163 billion at 13% CAGR. The private sector accounts for nearly 80% of the Hospital market,
while public expenditure accounts for 20%. The country had 1 5,393 (2009) hospitals, which had
8.75 lakh hospital beds. According to the WHO report, India needs to add 80,000 hospital beds
each year for the next five years to meet the demands of its growing population. Newfound
prosperity of many Indian households is spurring demand for high-quality medical care,
transforming the Hospital delivery sector into a profitable industry. Medial tourism is changing
the face of traditional Hospital industry in India. India’s excellence in the field of modern
medicine and its ancient methods of physical and spiritual wellbeing make it the most favorable
destination for good health and peaceful living. India’s cost advantage and explosive growth of
private hospitals, equipped with latest technology and skilled Hospital professionals has made it
a preferred destination for Hospital Services. According to Ministry of Commerce and Industry,

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Indian Hospital Services that was valued at US$350 million in 2010, is estimated to grow into a
US$2 billion industry by 2012.

The above background initiated need for a comprehensive Industry Insight on Hospital industry.
Overview of the hospital industry in India with a brief preamble of global Hospital and hospital
industry is discussed in the beginning along with its classification according to its objective,
ownership and system of medicine. Application of technology, growth drivers, issues and
challenges, regulatory environment and most importantly quality control and accreditation are
discussed in total 10 chapters. The report has been useful for various international investors
interested in hospital industry in India, entrepreneurs for setting up hospitals or hospitals in
expansion mode, other components.

Of a value chain in Hospital contemplating to enter Hospital delivery, Hospitalizing sector and
students enrolled in Hospital management. India perhaps is one of the most attractive
destinations for the Hospital and medical businesses. Indian Hospital industry size is over US$23
billion and growing at 18% per annum. The increase in lifestyle diseases, phenomenal growth in
an income levels, 300 million strong middle class, increase in educational levels, and increase in
government, private & insurance driven spending are the key reasons of growth of the Indian
Hospital industry.

Large number of foreign and Indian private Hospital, pharmaceutical, biotechnology, clinical
research, diagnostic and other medical companies are increasing their investments and expanding
operations. Several international medical equipment and services companies are focusing on
India’s strategy. Large groups of companies from U.S., U.K., Canada, Italy, Japan, and Australia
have recently visited India to strengthen their presence in India or explore new opportunities.
Public Private Sector opportunities are increasing.

Business opportunities for the international companies are there in Clinical Research,
Pharmaceuticals & Food Supplements, Biotechnology, Hospitals for Tertiary & Secondary Care,
Clinical Laboratories, Imaging, Diagnostic Centers, Pharmacy Chains, Telemedicine, Mobile and
Home Care, Biotechnology, Training & Education Opportunities, Knowledge & Business
Process Outsourcing (Medical Writing, Pharmacovigilance, Insurance, Hospital Processes and
other areas), Hospital Information Technology, Hospital Services, Medical Equipment,

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Instrumentation, Consumables, Specialized Consulting Services, Hospital Administration &
Management, Hospital Placement Services (Nursing and other trained staff), Quality
Accreditations/Certifications, Specialized Marketing & Promotions and Medical
Publications/Medical Writing.

Medians has extensive experience in providing India entry strategy and support services to the
large number of foreign companies, and have experience at the top management level with both
Indian and foreign Hospital companies. Medians offers a wide range of business strategy, market
entry services and on ground support, developing new business opportunities, competitor
strategies, qualitative & quantitative market research, partner search, arranging visit programs
and focused business missions, working with federal and state governments on developing new
Public Private Partnership opportunities, legal and regulatory affairs, advice, identify and
negotiate a real estate for offices or facilities, providing information on suppliers, recruitment
and training, providing temporary office and secretarial support, booking of hotels & transport,
accompanying to business meetings and several other services which would be extremely useful
and save your time and resources. The rate of growth of the health care industry in India is
moving ahead neck to neck with the pharmaceutical industry and the software industry of the
country. Much has been said and done in the health care sector for bringing about improvement.
Till date, approximately 12% of the scope offered by the health care industry in India has been
tapped. The health care industry in India is reckoned to be the engine of the economy in the years
to come. Health care industry in India is worth $17 billion and is anticipated to grow by 13%
every year. The health care sector encompasses health care instruments, health care in the retail
market, hospitals enrolled to the hospital networks etc.

Health care industry in India and the GDP or gross domestic product: Expenses incurred by the
Indian Government on health care is the highest amongst developing countries. India's expenses
on health care sector comprise 5.25% of the GDP. Chances are that the health care market could
experience a hike and attain a figure ranging $53 to $73 billion five years henceforth. This in
turn will reflect an increase in the gross domestic product to 6.2% GDP. The health care industry
in India earns revenues accounting for 5.2% of gross domestic product. Employment
opportunities are provided to as many as 4 million people in the health care segment or other
related sectors catering to the health care industry in India in some way or the other. Owing to

21
the vast differences in medical expenses in western countries and that of India, India has become
one of the favorites for health care treatments.

Due to the progressive nature of the health care sector in India, several foreign companies are
intending to invest in the country. Hospital Infrastructure India (HII), to be held from 7 – 9
December 2010 at the Bombay Exhibition Centre in Mumbai, is organized by IIR Exhibitions
India. It is part of Informal Plc., a leading international organizer of exhibitions and conferences,
with experience in organizing some of the world’s largest medical events including Arab Health
and Hospital Build series. HII aims to provide exhibitors with a world class professional
exhibition experience here in India.

Leading hospitals such as Fortis, Hinduja, Hiranandani and Lilavati hospitals have partnered and
fully supported the event. HII 2010 has also received strong support from the key trade
associations including Biomedical Engineering Society of India (BESEI), Federation of Hospital
Administrations (FHA), Indian Society of Hospital Waste Management (ISHWM), Indian
Association of Structural Engineers (IASE), The American Academy of Hospital Interior
Designers (AAHID), the Indian Institute of Architects (IIA), The American Academy of Hospital
Interior Designers (AAHID) and National Accreditation Board for Hospitals & Hospital
Providers (NABH).

The event has also garnered participation & interest from important Indian and international
companies including Chempharm, L&T, Schneider, GMP India, HKS & TAHPI covering the
entire gamut of hospital infrastructure, design, IT, planning and equipment. Country
representations at this stage include US, UK, Canada, Korea, Taiwan and Australia.

“Fortis are delighted with the support from key associations, industry players and the foremost
authorities from the Hospital sector from India and abroad. India has urgent requirements to
upgrade its hospital infrastructure as well as build new hospitals to meet the growing demand. To
achieve this, access is needed to a broad range of products, services and technologies. HII is
designed to be a key link in facilitating that objective,” said Guru Prasad, Group Exhibitions
Director of IIR Exhibitions India. The industry support reinforces the need in India for a platform
for Hospital Infrastructure industry which has been ideal for the convergence of the latest

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technology and business opportunities in this realm. Dr. Vivek Desai of one of India’s leading
Hospital consultancy firm HOSMAC confirms the industry feelings towards this event, “Hospital
Infrastructure India has been the perfect platform for all diverse players in the Hospital industry
to showcase their products and services. Entrepreneurs and health providers has been find this a
unique destination to network and connect for future growth”. HOSMAC has been the
knowledge partner for HII 2010. The 3 day exhibition has been complemented by a series of
seminars, workshops and an international technical conference. The conference has been covered
vital issues connected to hospital infrastructure such as design and construction of green
hospitals, latest trends in specialty & facility design as well as project financing options aimed to
provide hospital professionals with an opportunity to learn about the newest trends and
technologies and its applicability in the region. With our global expertise, support from key
associations & industry coupled with positive industry trends, HII has all the right ingredients to
become the industry platform for India’s Hospital industry. Rising costs, expanding market
demand, and increasing customer dissatisfaction will characterize Hospital in this decade and
help redefine the roles of patients, providers and payers. Simply put, Hospital organizations face
a growing imbalance of supply and demand. On the demand side is a large population of aging
patients in deteriorating health who demand more services, pharmaceuticals, and medical
breakthroughs. The supply side, however, is hampered by a shrinking pool of investment capital,
a shortage of willing caregivers, and aging physical plants straining under the current volume of
patients.

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 CHAPTER-II
INTRODUCTION TO THE TOPIC

FORTIS ESCORTS HOSPITAL, (FEH)

FEH is the first amongst the proposed multi super specialty hospitals to be set up in Rajasthan,
with the mission to bring quality medical care at doorstep. It is envisaged that FEHJ will form
the integral part of the Medical & Healthcare Education Hub proposed in Jaipur (land for which
is going to be shortly allotted).

FEH would position itself as a “Multi Super-Specialty” Hospital with focus on super specialties
of Cardiac Sciences, Neurosciences, Renal Sciences and GI Diseases besides the complete range
of multi-specialty services in all the disciplines.

24
FEH will establish itself as an institution that provides world - class healthcare with a high focus
on medical excellence, compassionate patient care and health education on preventive measures.

Services offered
The Multi Specialty services include -

 Anesthesia
 Critical Care
 Dental
 Cosmetic & Plastic Surgery
 Dermatology
 Diabetes & Endocrinology
 Dietetics
 ENT
 General Surgery
 Gynecology & Obstetrics
 Internal Medicine
 Ophthalmology
 Orthopedics & Joint Replacement
 Pediatrics & Neonatology

 Physiotherapy and Preventive Health Check

 Psychiatry
 Pulmonary Medicine
 Radiology

The Super Specialty services includes

 Cardiac Sciences
 Neurosciences
 Renal Sciences
 GI Diseases(Gastro-Intestinal)
25
The 24 hour services provided by FEHJ include

 Ambulance
 Dialysis
 Emergency
 Laboratory
 Pharmacy
 Radiology
FEHJ also does Community Outreach programmes which are an initiative to fulfill their
corporate social responsibility towards the society.

Team FEHJ organizes

 Free Outstation OPDs

 Free Cardiac & Multi-Specialty Camps
 Public Awareness Lectures
 Continuous Medical Education Programs for Medical Fraternity
Whether the buyer is satisfied after purchase depends on the product’s performance in relation to
the buyer’s expectations. In general, satisfaction is a person’s feelings of pleasure or
disappointment resulting from comparing a product’s perceived performance in relation to his or
her expectations. If the performance falls short of expectations, the customer is dissatisfied. If the
performance matches the expectations, the customer is satisfied. If the performance exceeds
expectations, the customer is highly satisfied or delighted.

The link between customer satisfaction and customer loyalty is not proportional. Suppose
customer satisfaction is rated on a scale from one to five. At a very low level of customer
satisfaction (level one), customers are likely to abandon the company and even bad mouth it. At
levels two to four customers are fairly satisfied but still find it easy to switch when a better offer
comes along. At level five, the customer is very likely to repurchase and even spread good word
out of mouth about the company. High satisfaction creates an emotional bond with the brand or
company, not just a rational preference.

26
 CUSTOMER EXPECTATIONS
How do buyers form their expectations? From past buying experiences, friends’ and associates’
advice, and marketers’ and competitors’ information and promises. If marketers raise
expectations too high, the buyer is likely to be disappointed. However, if the company sets
expectations too low, it won’t attract enough customers. Some of today’s most successful
companies are raising expectations and delivering performances to match. These companies are
aiming for TCS- total customer satisfaction.

A customers’ decision to be loyal or to defect is the sum of many small encounters with the
company. The key to generating high customer loyalty is to deliver high customer value. So a
company must design a competitively superior value proposition aimed at a specific market
segment, backed by a superior value-delivery system.

The value proposition consists of the whole cluster of benefits the company
promises to deliver; it is more than the core positioning of the offering. Whether the promise is
kept depends on the company’s ability to manage its value delivery system. The value delivery
system includes all the experiences the customer will have on the way to obtaining and using the
offering.

Customer satisfaction
It is a feeling of pleasure or disappointment on the offers perceived performance in relation to
buyers’ expectations. Expectation is defined as what the customer wants/requires from the
product/service and perceived performance is the perception of the customer about the
product/service i.e. evaluation of the product/service after using it. So perception is what the
customer actually receives/gets from the product/service. The evaluation is done by comparing
the expectations with the perceived performance of the product/service. Therefore customer
satisfaction is a function of perceived performance and customer expectations. Customers who
are just satisfied find it easy to switch over when a better offer comes than those who are highly

27
satisfied. For customer focused companies satisfaction is both a goal as well as a marketing tool.
What a consumer thinks about the product or services offered by a firm can have a marked effect
on the purchase of its products or services. So one of the tasks before the management is to know
what the consumer expect and what they are getting in return.

Satisfaction is a judgment that a product or service feature, or the product or service itself,
provided (or is providing) a pleasurable level of consumption-related fulfillment, including levels
of under- or over fulfillment. The expectations-disconfirmation paradigm provides the most
popular explanation of consumer satisfaction. However, and as is occasionally noted, if a
customer experiences disconfirmation after consuming a product, future expectations regarding
the product should be revised toward the performance perceived by the customer. If expectations
do not change in the face of disconfirmation, the implication would be that the customer did not
learn from their consumption experience (Oliver, 1997).

MEASURING SATISFACTION

Although the customer oriented companies seek to create high customer satisfaction that is not is
main goal. If the company increases customer satisfaction by lowering its price or increasing its
services, the result may be lower profits. The company might be able to increase its profitability
by means other than increased satisfaction. Also, company has many stakeholders, including
employees, dealers, suppliers, and stockholders. Spending more to increase customer satisfaction
might diverts funds from increasing the satisfaction of other partners. Ultimately, the
company must operate on the philosophy that it is trying to deliver a high level of customer
satisfaction subject to delivering acceptable levels of satisfaction to the other stakeholders,
given its total resources.

Table describes four methods companies use to track and measuring customer satisfaction:

28
Complaint and suggestion A customer-centered organization makes it easy for
system customers to register suggestion and complaints.

Customer Satisfaction Surveys Responsive companies measure customer

satisfaction directly by conducting periodic surveys.
While collecting customer satisfaction data, it is also
useful to ask additional questions to measures
repurchase intention and to measure the likelihood
or willingness to recommend the brand to others.

Ghost Shopping Companies can hire people to pose as potential

buyers to report on strong and weak points
experienced in buying company’s and competitors’
products.

Lost Customer Analysis Companies should contact customers who have

stopped buying or who have switched to another
supplier to learn why this happened.

The measurement of customer satisfaction has become very important for the health care sector
also. The concept of customer satisfaction has encouraged the adoption of a marketing culture in
the health care sector in both developed and developing countries. As large numbers of hospitals
are opening up and the people are becoming more aware and conscious of health, great
competition has emerged in this industry. So to retain their patients hospitals have to provide
better facilities/services to its customers. Various factors that can affect the patients’ satisfaction
include behavior of doctors, availability of specialized doctors, behavior of medical assistants,
quality of administration, quality of atmosphere, availability of modern facilities etc.

As grew the competition, so grew the trend of providing better facilities to the customers by the
hospitals. In last few years, a plethora of hospitals have mushroomed in and around the city.
These hospitals are advertising heavily about the specialized treatments provided by these
hospitals. There are various hospitals that provide specialized treatments for various diseases.
Because of neck to neck competition between hospitals customers run to these hospitals for

29
specialized treatments. Interestingly all hospitals claim to have a high success rate. They claim to
provide the best treatment and other essential facilities at reasonable cost and in easy way to their
customers. But how much of this is true and how many of their claims are myth is not known to
vast majority of customers.

As competition is increasing, the hospitals are making their best efforts to provide quality health
care services to its customers. They have begun practicing a patient satisfaction strategy
comprising consumer-oriented plans, policies and practices to genuinely meet the needs of
customers. Also, with increased awareness and high expectations of the customers’ hospitals
have to provide them better facilities. Patients have begun to demand high quality of services i.e.
a consumer oriented approach.

These days patients have become more aware about their rights so they want they should be
better facilities like responding to their queries promptly, friendly environment, understanding
their problems, availability of specialized doctors, maintaining cleanliness, regular repots etc. i.e.
providing them every type of essential facilities.

So, if the hospitals want that their customers must be satisfied, they have to provide not only
better treatment but other facilities also. The current study is focused on examining the various
factors related to patient satisfaction with the following specific objectives:

1. To study the customer expectations from hospital services.

2. To study the customer perception of hospital services.

3. To study the degree of satisfaction of customers from hospital services

30
PRICE AND P RODUCT CHART

31
 CHAPTER-III
RESEARCH METHODOLOGY

Research Methodology
32
 Research methodology may be understood as a science of studying how research is done
scientifically. In it we study the various steps that are generally adopted by a researcher in
studying the research problem along with logic behind them. Following are the steps and
techniques which were used by me.

 The design of this research is exploratory research

 We will use of qualitative research method in order to gather students perception in

subject matter

 Quantitative research method is gather data will be integrated in numbers and percentages

 The methodology of our study has various steps listed below-

 Formulating the research problem

 Extensive literature review

 Developing the objective

 Preparing the research design including sample design.

 Collecting the data

 Analysis the data

 Interpretation of data

 Preparation of report

RESEARCH DESIGN

33
The data collected is Primary data and Secondary data, which is both quantitative and qualitative
data, which was further analyzed in order to draw conclusions and suggestions.

DATA COLLECTION

 Collection of Data from the foot fall at the OPD in the primary

SAMPLE SIZE AND DESIGN:

A multistage sampling procedure was taken based on convenience. The actual consumers were
contacted based on random sampling.

RESEARCH PERIOD:
Research work is carried for 8 weeks.

Secondary Data: To suggest solutions to the problems observed during the survey will be
done through secondary data.

Primary Data: Primary data has been collected from the respondents. The respondents will
be either the patients themselves or their relatives. For sample selection, a multistage sampling
procedure will be followed. The information will collect through a structured questionnaire.

Tools Used: Excel

Sampling Method: For sample selection, a multistage sampling procedure has been
followed. At the first stage, sample units consisted of the total number of general wards and
private wards in the hospital.

Sample size: 20 patients & their relatives from General Wards & 15 patients & their
relatives from Private Wards

Target Audience: Patients & Doctors of Fortis Hospital

FINDING AND ANALYSIS

34
Q1- Expectations of Patients from the Behavior of Doctors
Attributes Expectations
(Mean Value)
Availability 8.98
Knowledge 8.94
Handling of Queries 8.51
Cooperation 8.53
Politeness 8.71
Impartial attitude 8.39
Examination Comfort 8.79
Thorough Check-Up 8.98
Empathy 7.31
Individual Consideration 6.70
Experience 8.64
Average 8.46

9
8
7
6
5
4
3
2
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It is clear that the mean scores for the attributes availability of doctors, knowledge of doctors, thorough
check-up and examination comfort are 8.98, 8.93, 8.98 and 8.78 which show that patients consider these
attributes very important. So, their expectation level for these attributes is very high. Mean scores for the
attributes politeness, experience, cooperation, handling of queries and impartial attitude are 8.71, 8.64,
8.54, 8.51 and 8.39 respectively also shows that patients also consider these attributes very important. So,
a doctor must try to fulfill these expectations in an efficient manner.

Q2 - Expectations of Patients from the Behavior of Medical Assistants

35
 Attributes Expectations
(Mean Value)
Availability 9
Knowledge 8.56
Cooperation 8.65
Politeness 8.79
Impartial attitude 8.49
Maintenance of Record 8.71
Handling of Queries 8.44
Experience 7.45
Dress 6.9
Average 8.33

Chart Title
Average Availability
10% 11%
Dress
8% Knowledge
10%
Experience
9%
Cooperation
10%

Handling of Queries
10%
Politeness
11%
Maintenance of Record
10% Impartial attitude
10%

Mean score for the attribute availability of medical assistants is 9, which means all the patients
had given rating 9 to this attribute i.e. they consider this factor very important and their level of
expectations for this attributes are very high. Politeness, maintenance of records and cooperation
with patients are given the mean scores as 8.79, 8.71 and 8.65 respectively which means that
patients also consider these factors very important.

Q3-Expectations of Patients from the Quality of Administrations

36
 Attributes Expectations

(Mean Value)

Convenient Office Hours 6.53

Check Up Procedure 8.85

Over Crowding 8.26

Welcome Your Ideas 7.31

Fee 7.10

Grievances Handling System 8.45

Billing Procedure 8.78

Check Out Procedure 8.78

Behavior of Clerical Staff 8.89

Behavior of Security Staff 8.85

Average 8.17

Chart Title
Average Convenient Office Hours
9% 7%
Behavior of Security Staff Check Up Procedure
10% 10%

Over Crowding
9%
Behavior of Clerical Staff
10%

Welcome Your Ideas

Fee 8%
Check Out Procedure 8%
10%
Billing Procedure Grievances Handling System
10% 9%

37
Q4- Expectations of Patients from the Services/ Facilities provided by
the hospitals
Attributes Expectations

(Mean Value)

Proper Sitting Arrangements 8.98

Bedding Arrangements 9

Staff Appearance 6.55

Natural Light 8.36

Dust Boxes 9

Flies & Mosquitoes 9

Outer & Inner Appearance 7.44

Parking 8.71

Well Equipped Units 8.33

Marking On Walls 8.07

Eating Places 8.69

Average 8.37

Chart Title
Series1

8.98 9 8.360000000000
9 9 7.44 8.71 8.33 8.07 8.69 8.37
6.55 01

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Q5- Perceptions of Patients for the Behavior of Doctors

38
 Attributes Perceptions

(Mean Value)

Availability 7.78

Knowledge 7.11

Handling of Queries 6.60

Cooperation 6.75

Politeness 6.86

Impartial attitude 7.46

Examination Comfort 7.76

Thorough Check-Up 7.88

Empathy 5.85

Individual Consideration 6.10

Experience 6.80

Average 6.99

Average Availability
8% 9%
Experience Knowledge
8% 8%

Individual Consideration
7% Handling of Queries
8%

Empathy
7% Cooperation
8%
Thorough Check-Up
9% Politeness
8%
Examination Comfort Impartial attitude
9% 9%

39
Q6- Perceptions of Patients for the Behavior of Medical Assistants

Attributes Perceptions

(Mean Value)

Availability 7.89

Knowledge 6.46

Cooperation 6.71

Politeness 6.88

Impartial attitude 7.04

Maintenance of Record 7.99

Handling of Queries 6.10

Experience 6.35

Dress 9.00

Average 7.16

Availability Knowledge Cooperation Politeness

Impartial attitude Maintenance of Record Handling of Queries Experience
Dress Average

10% 11%

13% 9%

9%
9%

9% 10%

11% 10%

40
Q7-Perceptions of Patients for the Quality of Administration

Attributes Perceptions

(Mean Value)

Convenient Office Hours 8.26

Check Up Procedure 6.35

Over Crowding 7.95

Welcome Your Ideas 6.23

Fee 5.48

Grievances Handling System 6.01

Billing Procedure 7.66

Check Out Procedure 7.80

Behavior of Clerical Staff 7.15

Behavior of Security Staff 8.48

Average 7.14

41
 Series1
8.26 7.95 8.48
7.66 7.8
7.15 7.14
6.35 6.23 6.01
5.48

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Hou edu wdi Ide yste e du e du l St y St era
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Q8- Perceptions of Patients for the Services/ Facilities provided by the

hospitals

Attributes Perceptions(Mean Value)

Proper Sitting Arrangements 8.54

Bedding Arrangements 8.66

Staff Appearance 7.66

Natural Light 7.24

Dust Boxes 8.55

Flies & Mosquitoes 8.43

Outer & Inner Appearance 7.41

Parking 8.05

Well Equipped Units 7.09

Marking On Walls 7.78

Eating Places 8.43

Average 7.99

42
 Series1

8.54 8.66 7.66 7.24 8.55 8.43 7.41 8.05 7.09 7.78 8.43 7.99

ts nts nce ght xes oes nce ing ts alls ces age
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Q9- Satisfaction Level of the Patients for the Behavior of Doctors

Attributes Expectations Perceptions Difference T-value

(Mean Value) (Mean Value)

Availability 8.99 7.78 1.21 6.48*

Knowledge 8.98 7.11 1.83 7.11*

Handling of Queries 8.51 6.60 1.91 8.41*

Cooperation 8.54 6.75 1.79 10.01*

Politeness 8.71 6.86 1.85 10.05*

Impartial attitude 8.39 7.46 0.93 5.48*

Examination Comfort 8.79 7.76 1.03 7.92*

Thorough Check-Up 8.98 7.88 1.10 9.25*

Empathy 7.31 5.85 1.46 5.93*

43
Individual Consideration 6.98 6.10 0.88 5.04*

Experience 8.64 6.80 1.84 8.31*

*there is significant difference at 5% level of significance (t-critical =1.66)

The shows that difference between the mean values of expectations and perceptions for the
attributes handling of queries, politeness, experience, knowledge, cooperation and empathy are
1.91, 1.85, 1.84, 1.82, 1.79 and 1.46 respectively. The t-values for these attributes at 5% level of
significance show that there is significant difference in the mean values of expectations and
perceptions for these attributes. For the attributes availability, thorough check up and
examination comfort differences between there mean values for expectations and perceptions are
1.21, 1.1 and 1.02 respectively. There corresponding t-values indicates this is a significant
difference. 0.93 And 0.88 are the differences for the impartial attitude and individual
consideration respectively and t-values for these attributes also shows that there is significant
difference between the means scores of expectation and perceptions. So, it is clear that highest
difference is for the handling of queries and lowest for the attribute individual consideration.

Q 10- Satisfaction Level of the Patients from the Behavior of Medical

Assistants
Attributes Expectations Perceptions Difference T-value

(Mean Value) (Mean Value)

Availability 9.00 7.89 1.11 5.90*

Knowledge 8.56 6.46 2.10 8.98*

Cooperation 8.65 6.71 1.94 9.43*

Politeness 8.79 6.89 1.91 9.93*

Impartial attitude 8.49 7.04 1.45 5.93*

44
Maintenance of Record 8.71 7.99 0.73 4.94*

Handling of Queries 8.44 6.10 2.34 11.11*

Experience 7.45 6.35 1.10 3.99*

Dress 6.90 9.00 -2.10 -13.23*

*there is significant difference at 5% level of significance (t-critical =1.66)

It is clear from the table4.3.2 that difference between the mean values for expectations and
perceptions are highest for the attribute handling of queries which is 2.34 and its corresponding t-
value is very large and it shows that this difference between the values is significant. This means
that patients had not received what they have expected from this particular attribute. Differences
for the knowledge, cooperation and politeness are 2.1, 1.94 and 1.91 respectively and their
respective t-values indicate that these differences are quiet significant which means that
perceptions of these attributes are less than the expectation of patients’ from these attributes.
1.45, 1.11 and 1.10 are the differences between the mean scores of expectations and perceptions
for the attributes impartial attitude, availability and experience respectively and t-values
corresponding to these attributes are larger than the t-critical at 5% level of significance. This
means that differences are significant. The difference for the attribute maintenance of record is
0.73 and t-value for it shows that difference is quiet significant i.e. patients’ perception about this
factor is lower than their expectations. Dress has the difference -2.1, which shows that patients’
perception for this attribute is higher than their expectations.

Q 11- Satisfaction Level of the Patients for the Quality of

Administration

Attributes Expectations Perceptions Difference T-value

(Mean Value) (Mean Value)

Convenient Office 6.53 8.26 -1.74 -7.27*

45
Hours

Check Up Procedure 8.85 6.35 2.50 9.84*

Over Crowding 8.26 7.95 0.31 1.92*

Welcome Your Ideas 7.31 6.23 1.08 4.99*

Fee 7.10 5.48 1.62 4.49*

Grievances Handling 8.45 6.01 11.19*

System 2.44

Billing Procedure 8.78 7.66 1.11 7.47*

Check Out Procedure 8.78 7.80 0.98 7.08*

Behavior of Clerical 8.89 7.15 7.88*

Staff 1.74

Behavior of Security 8.85 8.48 3.10*

Staff 0.38

*there is significant difference at 5% level of significance (t-critical =1.66)

This table shows that differences between the mean values of expectations and perceptions for
the check up procedure and grievances handling system are 2.50 and 2.44 respectively which are
quiet big differences. So we can say that expectations of patients’ from these attributes are higher
than their perceptions.

Q12 - Satisfaction Level of the Patients for the Services and Facilities
Provided by the Hospitals
Attributes Expectations Perceptions Difference T-value

(Mean Value) (Mean Value)

Proper Sitting 8.98 8.54 0.44 5.04*

46
Arrangements

Bedding 9.00 8.66 4.48*

Arrangements 0.34

Staff Appearance 6.55 7.66 -1.11 -4.44*

Natural Light 8.36 7.24 1.13 4.52*

Dust Boxes 9.00 8.55 0.45 5.07*

Flies & Mosquitoes 9.00 8.43 0.58 6.13*

Outer & Inner 7.44 7.41 0.10

Appearance 0.03

Parking 8.71 8.05 0.66 3.80*

Well Equipped Units 8.33 7.09 1.24 5.63*

Marking On Walls 8.08 7.78 0.30 1.56

Eating Places 8.69 8.43 0.26 2.70*

*there is significant difference at 5% level of significance (t-critical =1.66)

This table shows that largest differences between expectations and perceptions are 1.24 and 1.12
for the attributes well equipped units and natural light respectively among all the other attributes.
This means that expectations of patients are higher than their perceptions for these attributes.
0.66, 0.58, 0.45 and 0.44 are the differences for the parking, flies & mosquitoes, dust boxes and
proper sitting arrangements respectively. The attributes bedding arrangements, marking on walls
and eating places have small differences of 0.34, 0.30 and 0.26 respectively between the mean
values of expectations and perceptions. For inner and outer appearance the difference is .025
which is very small and it can be concluded that patients’ perception and expectation for this
attribute are approximately same. But attribute staff appearance has negative value which is -
1.11 and it is true to say that patients’ expectations are lower for this attribute than their
perceptions

47
 CHAPTER-IV
CONCLUSION AND SUGGESTIONS

48
 CONCLUSION
 Fortis continuously strive to improve the quality of healthcare services provided by their
hospitals, while at the same time improving our financial results. Below are the key
strategies which are employing to achieve these goals: Continue to grow with a flexible
expansion program.
 They intend to utilize our existing experience in building, operating and acquiring
hospitals to continue our high rate of growth.
 Expand into new regions. They believe the growing affluence, sophistication and
awareness about healthcare services of patients throughout India will lead to higher
demand for our healthcare services
 Focus on high-growth segments of the healthcare market. The growth in the Indian
economy, together with an increase in purchasing power, an increase in awareness about
health and healthcare and an increase in lifestyle-related diseases such as heart disease,
has created a new and expanding group of patients.
 Attract and retain prominent, skilled doctors. The skill level of a hospital’s doctors is key
to its success. We believe that hiring surgeons and other physicians who have established
reputations for clinical excellence in their communities is key to the successful
implementation of our strategy to acquire, develop and operate hospitals
 Maximize efficiencies across our hospitals through greater integration and better supply
chain management. They continue to strive to maximize efficiencies across our hospitals
and are in the process of integrating the Escorts hospitals and our existing network of
hospitals. The integration will enable us to adopt the best practices from the Escorts

49
 hospitals across our existing network, as well as install the best practices from our
existing hospitals across the Escorts hospitals
 There is largest differences between expectations and perceptions are for the attributes
well equipped units and natural light respectively among all the other attributes. This
means that expectations of patients are higher than their perceptions for their attributes.

RECOMMENDATION
1. Expectation level is very high and nearly same for almost all the factors i.e. for behavior
of the doctors, behavior of medical assistants, quality of administration, service and
facilities provided.

2. Mean score for the expectations from all the four factors is 8.30 which is very high on the
scale 9.

3. Under behavior of doctors attribute availability and thorough check up has the highest
score 8.98 and empathy and individual consideration have 7.31 and 6.70 respectively.

4. Attribute convenient office hours has lowest expectation score of 6.53 and behavior of
clerical staff has the highest 8.89 among all the attributes of factor quality of
administration.

5. Bedding arrangements, dust boxes and flies and mosquitoes has score 9 for expectations
for these attributes of factor services provided by the hospitals.

6. Overall mean score for perceptions of patients’ about the four factor is 7.31 which is
considered good on the scale of 9.

50
 7. Empathy with score 5.85 has the minimum score and thorough check up with score 7.89
has highest score among all the attributes of factor behavior of doctors.

8. Perception about the dress of medical assistant is very good with score 9 and handling of
queries is lowest with score 6.1.

9. Fee has the lowest level of perception and behavior of security staff has the highest level
of perception.

10. Perceptions of patients’ about the attributes of factor services/facilities provided by the
hospitals are almost good.

11. The largest difference between expectations and perceptions is 1.91 for attribute handling
of queries and lowest for individual consideration 0.88 under factor behavior of doctors.

12. For behavior of medical assistants the largest difference is for the attribute handling of
queries and lowest for maintenance of record. Also dress has negative difference which
means perceptions are larger than expectations.

13. Attribute convenient office hours of factor quality of administration is negative, largest
difference is for the attribute check up procedure and lowest for behavior of security
staff.

Outer & inner appearance has the lowest difference 0.025 and well equipped units have the
highest 1.24.

51
 LIMITATIONS
 This project covered the Fortis Hospital aspects of study

 This project has been covered Delhi as a region as the duration of the project only 8
weeks. So I have to collect and finish this data within the time

52
 BIBLIOGRAPHY
 Anderson E W, Fornell C and Mazvancheryl S K (2004) Customer satisfaction
and shareholder value. J Mktg 68: 172-85.
 Bolton R and Drew J H (1991) A multistage model of customer’s assesments of
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ANNEXURE
54
 Questionnaire
Mark the rating between 1 to 9
Q1- Expectations of Patients from the Behavior of Doctors
Attributes Expectation

Rate b/w 1 to 9

Availability

Knowledge

Handling of Queries

Cooperation

Politeness

Impartial attitude

55
 Examination Comfort

Thorough Check-Up

Empathy

Individual Consideration

Experience

Q2- Expectations of Patients from the Behavior of Medical Assistants

Attributes Expectations

Rate b/w 1 to 9

Availability

Knowledge

Cooperation

Politeness

Impartial attitude

Maintenance of Record

Handling of Queries

Experience

Dress

56
Q3- Expectations of Patients from the Quality of Administrations
Attributes Expectations

Rate b/w 1 to 9

Convenient Office Hours

Check Up Procedure

Over Crowding

Welcome Your Ideas

Fee

Grievances Handling System

Billing Procedure

Check Out Procedure

Behavior of Clerical Staff

Behavior of Security Staff

Q4- Expectations of Patients from the Services/ Facilities provided by

the hospitals

Attributes Expectations
Rate b/w 1 to 9

Proper Sitting Arrangements

Bedding Arrangements

Staff Appearance

Natural Light

57
 Dust Boxes

Flies & Mosquitoes

Outer & Inner Appearance

Parking

Well Equipped Units

Marking On Walls

Eating Places

Q5- Perceptions of Patients for the Behavior of Doctors

Attributes Perceptions

Rate b/w 1 to 9

Availability

Knowledge

Handling of Queries

Cooperation

Politeness

Impartial attitude

Examination Comfort

Thorough Check-Up

Empathy

58
 Individual Consideration

Experience

Q6- Perceptions of Patients for the Behavior of Medical Assistants

Attributes Perceptions

Rate b/w 1 to 9

Availability

Knowledge

Cooperation

Politeness

Impartial attitude

Maintenance of Record

Handling of Queries

Experience

Dress

Q7- Perceptions of Patients for the Quality of Administration

Attributes Perceptions

Rate b/w 1 to 9

Convenient Office Hours

Check Up Procedure

59
 Over Crowding

Welcome Your Ideas

Fee

Grievances Handling System

Billing Procedure

Check Out Procedure

Behavior of Clerical Staff

Behavior of Security Staff

Q8-Perceptions of Patients for the Services/ Facilities provided by the

hospitals

Attributes Perceptions

Rate b/w 1 to 9

Proper Sitting Arrangements

Bedding Arrangements

Staff Appearance

Natural Light

Dust Boxes

Flies & Mosquitoes

Outer & Inner Appearance

Parking

60
 Well Equipped Units

Marking On Walls

Eating Places

Q9-Satisfaction Level of the Patients for the Behavior of Doctors

Q10- Satisfaction Level of the Patients from the Behavior of Medical
Assistants
Q11- Satisfaction Level of the Patients for the Quality of Administration
Q12- Satisfaction Level of the Patients for the Services and Facilities
Provided by the Hospitals

61
62