NEW TOPIC ADOPTION AND VARIOUS TECH CHARGES AND CUSTOMER PREFERENCE IN HOSPITAL NEED FOR THE STUDY:

Many policies of various organizations are aimed at keeping the consumer happy and satisfied. It is very important for each and every organization to keep its 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 vie ed on the macro level e!hibit similar traits. "o ever do n to the micro level, hen hen

e take a closer look and come

e find that the consumers vary as compared to one another on one

aspect or the other based on a variety of attributes #$otler, %&&'(. In the present business scenario of cutthroat competition, customer satisfaction has become the prime concern of each and every kind of industry. Companies are increasingly becoming customer focused. Companies can in customers and surge ahead of competitors by

meeting and satisfying the needs of the customers. )orld over businesses have realized that marketing is not the only factor in attracting and retaining customers. *ther ma+or factors responsible for the same are satisfaction through service ,uality and value. -ven the best marketing companies in the orld fail to sell products and services that fail

to satisfy the customers. needs. /o customer satisfaction is the key ord in today.s fiercely competitive business environment.

REVIEW OF LITERATURE: Many studies have been conducted on the customer satisfaction. 0n attempt has been made to present in brief, a revie of literature on customer satisfaction in general as ell as on

the customer satisfaction from hospital services. 1riscilla et al #234'( proposed a cognitive model to assess the dynamic aspect of consumer satisfaction5 dissatisfaction in consecutive purchase behavior. They found that satisfaction have a significant role in mediating intentions and actual behavior for five product classes that ere analyzed in the conte!t of a three- stage longitudinal field

study. They found that repurchases of a given brand is affected by lagged intention hereas s itching behavior is more sensitive to dissatisfaction consumption. 6avid and )ilton#2344( have e!tended consumer satisfaction literature by theoretically and empirically e!amining the effect of perceived performance using a model first proposed by Churchill and /urprenant, investigating ho attractive conceptualizations of comparison standards and disconfirmation capture the satisfaction formation process and e!ploring possible multiple comparison processes in satisfaction formation. They suggest that perceived performance e!erts direct significant influence on satisfaction in addition to those influences from e!pected performance and sub+ective disconfirmation. ith brand

/aha #2344( made an attempt to investigate the interrelationships bet een +ob-satisfaction, life satisfaction, life satisfaction-over-time and health. The relationship among these four variables and biographical variables over the nurses in Nigeria. The data ere also e!amined. The study as conducted

as collected from the full time employees only hen

because statements about +ob satisfaction and other variables are different supplied by retirees, part-time nurses. 7olton and 6re #2332( proposed a model of ho customers

ith prior e!periences and

e!pectations assessed service levels, overall service ,uality and service value. They applied the model to residential customers of local telephone services. Their study e!plored ho 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 ,uality and service value. The model described ho customers

e!pectations, perceptions of current performance and disconfirmation e!periences affected their satisfaction or dissatisfaction assessment of service ,uality and value. 7oulding et al #233'( stated that the service ,uality relates to the retention of customers at aggregate level. The author has offered a conceptual model of the impact of service ,uality on particular behavior that signal hether customers remain ith of defect ith a service, hich in turn affected their

from a company. The results of the study sho

strong evidence of their being

influenced by service ,uality. The findings also reveal difference in the nature of the service ,uality.

0urora and Malhotra #2338( had done a comparative analysis of the satisfaction level of customer of public and private sector banks, in order to help the bank management to formulate marketing strategies to lure customers to ards them and hence increase customer base. 9re al et al had e!panded and integrated prior price perceived value models ithin the conte!t

of price comparison advertising. More specifically, the conceptual model e!plicates the effects of advertised selling and reference prices on buyers. internet reference prices, perceptions of ,uality, ac,uisition value, transaction value, and purchase and search intentions. T o e!perimental studies test the conceptual model. The results across these t o studies, both individually and combined, support the hypothesis that buyers. internal reference prices are influenced by both advertised selling and reference price as ell as buyers. perception of product ,uality. The authors also find as mediated by

that effect of advertised selling price on buyers. ac,uisition value

their perceptions of transaction value. In addition, effects of perceived transaction value on buyers, behavioral intentions perceptions. ere mediated by their ac,uisition value

:oss #2334( had e!amined the rule of price, performance and e!pectations to determine satisfaction in service e!change. )hen price and performance are consistent, e!pectations have an assimilation effect on performance and satisfaction +udgments; hen price and performance are inconsistent, e!pectations have no effect on performance and satisfaction +udgments. To e!amine these issues authors develop a contingency model that they estimate using data from a multimedia e!perimental design. The results generally support contingency frame ork and provide empirical support for normative guidelines that call for creating realistic performance e!pectations and offering money-back service guarantees. 9arbarino and <ohnson #2333( analyze that the relationships of satisfaction, trust and commitment to component satisfaction attitudes and future intentions for the customers of a Ne =ork off-7road ay repertory theater company. >or the relational

customers # individual ticket buyers and occasional subscribers(, overall satisfaction is the primary mediating construct bet een the component attitudes and future intentions and for the high relational customers #consistent subscribers(, trust and commitment, rather than satisfaction, are the mediators bet een component attitudes and future intentions.

/harma and Chahal #2333( had done a study of patient satisfaction in outdoor services of private health care facilities. They had done a survey to understand the e!tent of patient satisfaction ith diagnostic services. They have constructed a special instrument for

measuring patient satisfaction. The instrument captures the behaviour of doctors and medical assistants, ,uality of administration, and atmospherics. The role of graphic characters like gender, occupation, education, and income is also considered. 7ased on their findings, they also suggested strategic actions for meeting the needs of the Customer of private health care sector more effectively. In their study provided suggestions like becoming more friendly and understanding to the problems of Customer, maintaining cleanliness in the units, both internally and e!ternally, providing regular report regarding the Customer. progress ithout aiting for them to

demand, conducting surveys to kno about the attitude of the Customer ith regard to the employees and adopting patient-oriented policies and procedures. /imester et al #%&&&( have studied that multinational firm uses sophisticated, state-of-the-art methods to design and implement customer satisfaction improvement programs in the ?nited /tates and /pain. Their e!periments reveals a comple! and surprising picture that highlights implementation issues, a construct of residual satisfaction not captured by customer needs and the managerial need for combining none,uivalent controls and none,uivalent dependent variables.

*fir and /imonson #%&&2( in their study found that customer evaluations of ,uality and satisfaction are critical inputs in development of marketing strategies. 9iven the increasingly common practice of asking such evaluations, buyers of products and services often kno in advance that they subse,uently ill be asked to provide their

evaluations. In a series of field and laboratory studies, the authors demonstrate that e!pecting to evaluate leads to less favorable ,uality and satisfaction evaluations and reduces customer.s illingness to purchase and recommend the evaluated services.

The negative bias of e!pected evaluations is observed hen actual ,uality is either lo or high, and it persist even positive and negative aspects. 6holakia and Mor itz #%&&%( have e!amined the scope and persistence of the effect of measuring satisfaction on consumer behavior over time. In an e!periment 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 after ard and persist even a year later. Their results raised ,uestions concerning the design, interpretation and ethics in the conduct of applied marketing research studies. hen buyers are told e!plicitly to consider both the

/harma and Chahal #%&&'( stated that due to increased a areness among the people patient satisfaction had become very important for the hospitals. The authors e!amined the factors related to patient satisfaction in government outpatient services in India. They said that there are four basic components hich had impact on the patient satisfaction

namely, behaviour of doctors, behaviour of medical assistants, ,uality of atmosphere, and ,uality of administration. They also provided strategic actions necessary for meeting the needs of the Customer of the government health care sector in developing countries. >olkes and 1atrick #%&&'( in their study sho ed converging evidence of a postivity effect in customers. perceptions about service providers. )hen the customer has little e!perience ith the service, positive information about a single employee leads to

perception that the firm.s other service providers are positive to a greater e!tent than negative information leads to perception that the firm.s other service providers are similarly negative. >our studies ere conducted that varied in the amount of

information about the service provider, the firm, and the service. The positivity effect as supported despite differences across studies in methods as ell as measures.

:ernoer #%&&'( 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 bet een t o periods. The results sho that affective

commitment and loyalty programs that provide economic incentives positively affect both customer retention and customer share development, hereas direct mailings

influence customer share development. "o ever, 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. 0nderson et al #%&&@( developed a theoretical frame ork that specifies ho customer

satisfaction affects future customer behaviour and, in turn, the level, timing, and risk of future cash flo s. -mpirically, they find a positive association bet een customer satisfaction and shareholder value. They also find significant variation across industries and firms.

Aeinartz et al #%&&@( in their study of Customer Aelationship Management 1rocess had stated that it is very important for maintaining healthy relations ith the customers in order

to provide them satisfaction. In their study, they #2( conceptualize a construct of the CAM process and its dimensions, #%( operationalize and validate the construct, and #'( empirically investigate the organizational performance conse,uences of implementing the CAM processes. Their research ,uestions are addressed in t o cross-sectional studies across four different industries and three countries. The key outcome is a theoretically sound CAM process measure that outlines three key stagesB initiation, maintenance, and termination. "omburg et al #%&&C( conducted t o e!perimental studies #a lab e!periment and a study involving a real usage e!perience over time( positive impact of customer satisfaction on hich reveal the e!istence of a strong, illingness to pay and they provide

support for a nonlinear, functional structure based on disappointment theory. In addition, the second e!amines dynamic aspects of the relationship and provides evidence for the stronger impact of cumulative satisfaction rather than of transactionspecific satisfaction on illingness to pay. Mithas et al #%&&C( evaluates the effect of customer relationship management #CAM( on customer kno ledge and customer satisfaction. They analyze archival data of a crosssection of ?./ firms associated hich sho s that the use of CAM applications is positively

ith improved customer kno ledge and improved customer satisfaction. hen firms share

They also found that gains in customer kno ledge are enhanced their customer related information ith their supply chain partners.

9ustafsson et al #%&&C( in their study of telecommunications services e!amine the effect of customer satisfaction, affective commitment, and calculative commitment on retention and the potential for situational conditions to moderate the satisfactionretention relationship. Their results support consistent effects of customer satisfaction, calculative commitment and prior-churn on retention. 9ruca and Aego #%&&C( strengthen the chain of effects that link customer satisfaction to shareholder value by establishing the link bet een satisfaction and t o characteristics of future cash flo s that determine the value of the firm to shareholdersB gro th and stability. 7y using the longitudinal 0merican Customer /atisfaction inde! and C*M1?/T0T data and hierarchical 7ayesian estimation they found that satisfaction creates shareholder value by increasing future cash flo gro th 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 multimeasure and multi-method estimation

Thompson #%&&C( in his study had sho n that consumers often mis+udge their health risks o ing to a number of ell-documented cognitive biases. These studies assume

that consumers have trust in the e!pert systems that culturally define safe and risky behaviours. Conse,uently, this research stream does not address choice situations here consumers have refle!ive doubts to ard prevailing e!pert risk assessments and gravitate to ard alternative model of risk reductions. This study e!plores ho 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 orthodo! medical risk management norms. OBJECTIVES: The current study is focused on e!amining the various factors related to Customer 1reference ith the follo ing specific ob+ectivesB 2. To study the customer e!pectations from hospital services in Chennai. %. To study the customer perception of hospital services. '. To study the degree of satisfaction of customers from hospital services.

RESEARCH METHODOLOGY: This study describes the research methodology of the study. It includes the Aesearch >rame ork, /ample design and selection, Collection of 6ata, Aesearch vehicle and Methods for analysis of data. It also points out the limitations of present study. To study consumers. e!pectations, perception and their satisfaction level it e!amine the follo ing aspects as re,uired to

#i( #ii( #iii( #iv( #v( #vi( #vii( #viii( #i!( #!( #!i( #!ii(

Customer e!pectations from the behavior of the doctors, Customer. e!pectations from the behavior of the medical assistants, Customer. e!pectations from the ,uality of administration of hospitals, Customer. e!pectations from the services provided by the hospitals, Customer. perceptions for the behavior of the doctors, Customer. perceptions for the behavior of the medical assistants, Customer. perceptions for the ,uality of administration of hospitals, Customer. perceptions for the services provided by the hospitals, Customer. satisfaction level for the behavior of the doctors, Customer. satisfaction level for the behavior of the medical assistants, Customer. satisfaction level for the ,uality of administration of hospitals and Customer. satisfaction level for the services provided by the hospitals,

RESEARCH FRAMEWORK The present study is based on e!plorative and descriptive research design ith the

ob+ective of measuring the satisfaction level of Customer. of five ma+or private hospitals in Chennai. The study uses both primary and secondary information. 0s it is clear from the ob+ectives of the study, the study as divided into three parts i.e.

Customer. e!pectations, perceptions from the hospital services and then measuring their satisfaction level from the hospital services. >or both the first and second ob+ective of study i.e. the customers. e!pectations and their perceptions of hospital services, primary data as collected through a structured ,uestionnaire. Then to meet ere used on the information

the third ob+ective of the study proper statistical tools collected for the first t o ob+ectives of the study.

SAMPLE DESIGN AND SELECTION 1opulation and /ampleB In vie of the fact that this as a one person survey to be completed as restricted to only those hospitals hich ithin limited ere located

resources the present study

in Chennai. The population of this study comprised of the indoor Customer only. >ive ma+or private hospitals in Chennai ere selected namelyB 0pollo Medical College and "ospital M9A Medical College and "ospital /AM Medical College and "ospital Miot "ospital 7ala+i "ospital Selectio o! Re"#o $e t" >rom these hospitals primary data respondents as collected from the respondents. The

ere either the Customer themselves or their relatives. >or sample as follo ed. 0t the first stage, sample ards and private ards ards in the hospital.

selection, a multistage sampling procedure units consisted of total number of general 2&D of the general ards and 2&D private,

ere selected randomly. Then from

each selected general private

ard ' to C Customer

ere chosen and from each selected as collected through a pre-

ard one patient

as chosen. The information

designed, structured ,uestionnaire. 0 sample of 4& respondents selected from these hospitals on the basis of their convenience for the first ob+ective and the second ob+ective. To suggest solutions to the problems observed during the survey is done through secondary data.

TableB /ampling 1lan SELECTION OF WARDS "*/1IT0E #0( T*T0E 9-NA0E )0A6 / /-E-CT6 9 N A 0 E ) 0 A 6 / #2&D *> 0 ( 01*EE* M9A /AM Miot 7ala+i T*T0E F C 28 %F 2F 8& 2 2 % ' % 3 82 @F 34 F4 8F 'C3 8 C 2& 8 24 @8 #7(T*T0E 1AI :0 T) 0A 6/ /-E-CT-6 1 A I : 0 T ) 0 A 6 / #2&D *> 0(

SELECTION OF RESPONDENTS:

"*/1IT0E

A-/1*N6-NT >A*M 9-N-A0E )0A6 #' T* C >A*M -0C"(

A-/1*N6-NT/ >A*M 1AI:0 T)0A6 #2 >A*M -0C"( 8G2H8 CG2HC 2&G2H2& 8G2H8 4G2H4 '8

T*T0E A-/1*N6-NT/

01*EE* M9A /AM Miot 7ala+i T*T0E

2GCHC 2GCHC %GCH2& %GC I 2G'H2' %GCH2& @'

2% 2& %& %& 24 4&

In this

ay data

as collected from 4& respondents that comprise of the indoor Customer

themselves or their attendants. DATA COLLECTION: 7efore an attempt research as made to collect the information from the sample, the desk

as conducted to see the literature and other library material available on the ere revie ed to have a through kno ledge before

sub+ect. :arious studies considering ho

to collect the information from the respondents. 0fter having the as prepared to obtain ans er

background kno ledge a structured ,uestionnaire

pertinent to the ob+ectives of the study. >or the purpose of the study, eighty indoor Customer ere selected and intervie ed from the five private hospitals. /econdary data as also collected from various books, +ournals, magazines etc. ANALYSIS OF DATA:

The data 5 information contained in the ,uestionnaire table

ere first transferred to master as then

hich facilitated tabulation of data in desired form. The collected data

grouped into tables and analyzed using various statistical tools like mean scores. *ther statistical tool used includes T-test for measuring hether there is significant

difference bet een the mean scores of attributes i.e. bet een e!pectations and perceptions of a factor. Aeaction of the respondents to ards the different factors given as studied using a structured, non-disguised and ell-defined ,uestionnaire designed for the Customer or their attendants. The ,uestionnaire contained rating ,uestions. -ach factor as rated over a scale of 2 to 3 i.e. likert scale as used. The respondents hat they had

ere asked to rate the factors according to perceived from the hospital services. Mean score

hat they e!pect and

as calculated for the ,uestions asked on a 3-point scale. In case of 3-point scale here the respondents ere asked to indicate their degree of importance5unimportance

for e!pectations and degree of bad5good for the perceptions, scores from 2to 3. >re,uencies ere multiplied ith their respective

ere assigned

eights and aggregate

values found out. Mean score as calculated using the formulaB Mean /core H #J)ifn(5n i H 2 to 3 n H 4& )here, )i H )eight attached for degree of importance5unimportance and good5bad. fn H 0ssociated fre,uency n H Number of respondents

T-test

as used to see

hether there is significant difference bet een the means of a factor for

the t o data samples at CD level of significance. T-test as used because the both the data samples ere collected from the same selected individuals. >irst the data as

collected from a patient for his e!pectations from the various factors taken for the study and then from same patient data is collected for his perceptions for the hospital services. /imilarly, the data t o samples as collected from the other Customer. /o, the data in as collected from the same

as dependent as data in one sample

individual as in other sample.

LIMITATIONS OF THE STUDY 0ny study based on consumer survey through a pre-designed ,uestionnaire suffers from the basic limitation of the possibility of difference bet een hat is the truth, no matter ho hat is recorded and

carefully the ,uestionnaire has been designed and

field investigation has been conducted. This is because the consumers may not deliberately report their true preferences and even if they ant to do so, there are

bound to be differences o ing to problems in filters of communication process. The error has been tried to be minimized by conducting intervie s personally yet there is no full proof ay of obviating the possibility of error creeping in. /o, the study suffers from some limitations also. 0s such generalizing the results, the follo ing limitations of the study should be taken into the account. 0s the study as to be completed in a short time, the time factor acted as a considerable limit on the scope and the e!tensiveness of the study. The information provided by respondents may not be fully accurate due to unavoidable biases. The lack of corporation sho n by the respondents, because of this optimum number of responds not collected, so the sample as to be shortened. REFERENCES: 0urora / and Malhotra M #2338( Customer satisfactionB 0 comparative analysis of the satisfaction level of customer of public and private sector banks. Decision %@B 2&3-'&. 0nderson - ), >ornell C and Mazvancheryl / $ #%&&@( Customer satisfaction and shareholder value. J Mktg F4B 28%-4C. 7olton A and 6re < " #2332( 0 multistage model of customer.s assements of service

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