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In the Kingdom of Saudi Arabia, the health sector, like other sectors, is under full
control of Ministry of health (MOH), although there are also allowed functioning of private
sector hospitals. The Government of Saudi Arabia keeps allocating sufficient funds for the
promotion of the healthcare sector and also encourages the private sector operators to
enhance the healthcare opportunities and flourish service of humanity in this sector in the
Kingdom. Private hospitals will carry on performing an even more vital and key role within
the Kingdom. There are certain diseases which are specifically related to lifestyle of the
(cardiovascular) and kidney (dialyses) and these have generated new prospects for expansion
and the private sector is progressively projected to be a key role player and contributor of
main providers for these sections. (Colliers International, (2012) Kingdom of Saudi Arabia:
As far as the deliverance of healthcare in the Kingdom of Saudi Arabia and around
provider become progressively more multifaceted. Inclinations, advancements and day to day
resolutions to meet modern challenges in the era of quality, standardisation and excellence.
Owing to well-built development essentials coupled with the growing population and
In the light of prospective needs and in order to maintain quality in healthcare sector,
the current set-up is covered by various insurance companies and almost 25 companies listed
on the Saudi Stock Exchange and are hence driven by cost versus quality. Unless a fixed
regulation is initiated to supervise pricing, healthcare affording and quality of care in private
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hospitals will persist to suffer lower profit margins and collection holds up which will
International, 2012, Haya Al- Fozan, in her cross-sectional descriptive design study
conducted in 2013, observed that overall mean satisfaction score was 4.45 out of 5. This data
was collected through questionnaire and 302 participants were patients and family caregivers
of National Guards hospitals across the Kingdom. The high level of satisfaction was reported
by the participants in the domain of respecting religion & culture, maintaining privacy and
On the other hand, the least satisfactory areas identified by the participants in her
study were: instructions at the time of discharge from the hospital and keep informing
patients family with various conditions and changes in patients condition during treatment
professionalism. In her conclusion of the study, she concludes in these words: This reflected
that the Saudi Nurses are able to deliver culturally appropriate high quality care sharing the
Discussing cultural aspect of nursing quality in KSA, Almutairi and McCarthy (2012)
in their study A multicultural nursing workforce and cultural perspectives in Saudi Arabia:
An overview observe that Saudi hospitals are multicultural in their composition as around
67% of nurses are expatriates who need to enhance their cultural competence in order to
this scenario, a lack of knowledge of Saudi culture among nurses can lead to cultural conflicts
and misunderstanding of some of the behaviours and practices of the indigenous Saudi
people (Almutairi and McCarthy (2012). Concluding their study, they remarked that better
comprehension of Saudi culture and religious practices during health care delivery by
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expatriate nurses can assist them in building a strong affiliating relationship with their
patients and this will also help in maintain quality care by avoiding impending cultural
Generally, service quality has been elaborated as the net difference between clients
assumptions with reference to standard of service expected and the actual level of it offered
1988). In some earlier studies, service quality has been alluded to as the degree to which an
administration lives up to clients' needs or desires (Lewis and Mitchell, 1990; Dotchin and
relative inadequacy or prevalence of the service (Zeithaml, Berry, and Parasuraman, 1990).
Parasuraman et al. (1988), in their study, evaluated five extents of service quality (Viz.
(c) Assurance-learning and affability of representatives and their capacity to pass on trust and
certainty;
(d) Reliability-capacity to play out the guaranteed service constantly and precisely; and
Gap 1: The distinction between service perspective of what clients expect and what clients
truly do anticipate.
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Gap 2: The contrast between service observations and service quality details - the
standardised gap.
Gap 3: The result of functional vagueness and divergence, poor employee-job fit and poor
technology-job fit, unfortunate managerial power systems, lack of supposed control and
deficiency of teamwork.
Gap 4: The contrast between service oriented observations and service related quality details
Gap 5: The contrast between what clients expect from administration and what they really
get, desires are comprised of past understanding, informal exchange and needs of clients
estimation is on the premise of two arrangements of articulations in gatherings as per the five
In the light of these gaps, patients get different services of therapeutic care and judge
the nature of services afforded to them (Choi et al., 2004). The service quality has two
measurements: (a) a specialized measurement i.e., what service has been provided and (b) a
procedure/practical measurement i.e., how the service has been provided (Grnroos 2000).
The first one related quantitatively and the other one is related qualitatively. Parasuraman, et
al (1988) recommended a broadly utilized model known as SERVQUAL for assessing the
prevalence of the service quality. In the SERVQUAL model, Parasuraman et. al.
distinguished the gap between the recognition and desire of purchasers on the premise of five
physical assets to quantify buyer fulfillment in the light of service quality (Parasuraman A.,
Berry L,1988).
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As regards to service quality, patient satisfaction studies are utilised to look at the
nature of the service quality offered by the healthcare providers (Lin and Kelly 1995). Much
confirmation has been recorded for the service quality to fulfillment interface in various
marketing (Brady and Robertson 2001; Gotlieb, Grewal, and Brown 1994; Rust and Oliver
1994; Andaleeb 2001). The Consumer Assessment of Healthcare Providers and Systems
(CAHPS) is one of the instruments connected for measuring service quality in the field of
healthcare. As indicated by Agency for Healthcare Research and Quality (2009), CAHPS is a
between the patient and healthcare service professionals. CAHPS concentrates on surveying
the genuine experience of patients during healthcare process instead of measuring patients'
observation. According to the CAHPS philosophy, patients are inquired as to whether they
SERVQUAL Model
is connected to the ideas of observations and desires (Parasuraman et al., 1985, 1988; Lewis
and Mitchell, 1990). Clients' impression of service quality emerges from a correlation of their
before-service expectations and what level of service they actually receive. The service will
sufficient, if it parallels the desires; the service will be classed as terrible, poor or lacking, if it
doesn't meet expectations at all or quite opposite to expectations (Vzquez et al., 2001).
In light of this viewpoint, Parasuraman et al. (1988) built up a scale for measuring
service quality, which is generally known as SERVQUAL. This scale operationalizes service
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quality by ascertaining the distinction amongst desires and discernments, assessing both in
connection to the 22 things that speak to five service quality measurements known as
studies directed in different service settings, social settings and geographic areas like the
nature of service offered by a hospital or a clinic (Babakus and Mangold, 1989), a CPA firm
(Bojanic, 1991), a dental school/clinic, business college or placement institute, and intense
care clinic (Carman, 1990), pesticide control business, cleaning, and fast food (Cronin and
Taylor, 1992), banks and financial institutions (Cronin and Taylor, 1992; Spreng and Singh,
1993; Sharma and Mehta, 2004) and mega malls and departmental stores (Finn and Lamb,
1991).
All these studies do not conform to the element structure proposed by Parasuraman et
al. (1988). The universality or inclusiveness of the scale and its measurements has always
been debatable and likely to face criticism (Lapierre et al., 1996) and it is proposed that this
scale requires customization to the particular service segment in which they are implemented.
In the time of globalization, rivalry has turned into a key issue in a wide range of industry and
also in public service sector. Literature review of past studies concluded in the field proposes
that there are two significant points that must be considered while evaluating service quality
which are: a) patient satisfaction and b) perceived service quality. Both these should be
measured together for the solidity of a health care organization in a competitive atmosphere.
Researchers in this field have recommended distinctive models and strategies for measuring
persistent satisfaction considering service quality as one of the precursors. Distinctive literary
works sum up and declare that SERVQUAL is a famous model for measuring service quality.
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circumstances (Rohini and Mahadevappa, 2006). Parasuraman et.al. (1988), in their
affirmation, physical assets and compassion on the premise of which clients' desires and
observations are measured. They clarified all the previously mentioned measurements with
the assistance of twenty two proclamations that have been distinguished as qualities making
those five measurements (Parasuraman et. al., 1988, Bhattacherjee, 2010). Babakus and
Mangold (1992) distinguished SERVQUAL as a solid and legitimate model in the clinical
set-up.
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