• Rejikumar G Department of Management, Amrita Vishwa Vidyapeetham, Kochi Campus, Kochi, Kerala.
  • Archana Ks Department of Management, Amrita Vishwa Vidyapeetham, Kochi Campus, Kochi, Kerala.


Objectives: The objective of this study was to examine the formation of wellness perceptions and satisfaction from antecedents that explain various attributes regarding service quality perceptions about doctors by patients. The topic is of contemporary relevance as health-care firms are reengineering their competencies to deliver personalized health services to for unmatched experience to develop long-term relationships with patients.

Methods: Responses from 280 patients about service quality attributes of doctors, wellness perceptions, and their satisfaction are collected using a structured questionnaire. An exploratory factor analysis was performed using SPSS. 20 to identify significant dimensions of doctor’s service quality. The theoretical model developed with these dimensions, wellness perceptions, and patient satisfaction was estimated using partial least square-based structural equation modeling approach to test hypotheses about linkages among these constructs.

Results: The dimension structure of doctor’s service quality contained constructs such as “price affordability of medicines,†“quality of diagnosis,†“interaction quality of doctor,†“appropriateness of tests prescribed,†and “quality of usage prescriptions.†These service quality dimensions of doctor significantly develop wellness perceptions and satisfaction among patients. Wellness perceptions act as a mediator in satisfaction development.

Conclusions: Patient satisfaction and wellness perceptions are of primary importance in improving service quality in health care and to remain competitive. The health-care firms should train their professionals to interact with the patients more efficiently by adhering to the philosophy of patient centeredness in their service process.

Keywords: Price affordability of medicines, Quality of diagnosis, Interaction quality of doctor, Appropriateness of tests prescribed, Quality of usage prescriptions, Patient centeredness.

Author Biographies

Rejikumar G, Department of Management, Amrita Vishwa Vidyapeetham, Kochi Campus, Kochi, Kerala.

Associate Professor

Department of Management


Archana Ks, Department of Management, Amrita Vishwa Vidyapeetham, Kochi Campus, Kochi, Kerala.


MBA programme


1. Srinivasan V, Chandwani R. HRM innovations in rapid growth contexts: The healthcare sector in India. Int J Hum Res Manage 2014;25:1505-25.
2. Joumard I, Kumar A. Improving Health Outcomes and Health Care in India. Vol. 1184. OECD Economic Department Working Papers; 2015. p. 1-29.
3. Berkowitz EN. Essentials of Health Care Marketing. Sudbury, MA: Jones and Bartlett Publishers; 2016.
4. Asadi-Lari M, Tamburini M, Gray D. Patients’ needs, satisfaction, and health related quality of life: Towards a comprehensive model. Health Qual Life Outcomes 2004;2:1-15.
5. Guldvog BJ. Can patient satisfaction improve health among patients with angina pectoris. Int J Qual Health Care 1999;11:233-40.
6. Donabedian A. Quality and cost: Choices and responsibilities. Inquiry 1988;25:90-9.
7. Marquis MS, Davies AR, Ware JE Jr. Patient satisfaction and change in medical care provider: A longitudinal study. Med Care 1983;21:821-9.
8. Aharony L, Strasser S. Patient satisfaction: What we know about and what we still need to explore. Med Care Rev 1993;50:49-79.
9. Fottler MD, Ford RC, Roberts V, Ford EW. Creating a healing environment: The Importance of the service setting in the new consumer-oriented healthcare system. J Health Care Manage 2000;45:91-106.
10. Jensen HI, Ammentorp J, Kofoed PE. User satisfaction is influenced by the interval between a health care service and the assessment of the service. Soc Sci Med 2010;70:1882-7.
11. Mayer TA, Cates RJ, Mastorovich MJ, Royalty DL. Emergency department patient satisfaction: Customer service training improves patient satisfaction and ratings of physician and nurse skill/practitioner response. J Health Care Manag 1998;43:427-40.
12. Lesko LJ. Personalized medicine: Elusive dream or imminent reality. Clin Pharmacol Ther 2007;81:807-16.
13. Adams T, Bezne, J, Garner L, Woodruff S. Construct validation of the perceived wellness survey. Am J Health Stud 1988;14:212-8.
14. Hatfield E, Cacioppo JT, Rapson RL. Emotional contagion. Curr Dir Psychol Sci 1993;2:96-9.
15. Bringsén Å, Andersson HI, Ejlertsson G. Development and quality analysis of the Salutogenic Health Indicator Scale (SHIS). Scand J Public Health 2009;19:13-9.
16. Watt D, Verma S, Flynn L. Wellness programs: A review of the evidence. Can Med Assoc J 1998;158:224-30.
17. Reicherter EA, Greene R. Wellness and health promotion: Educational applications for older adults in the community. Top Geriatr Rehabil 2005;21:295-303.
18. Wicks AM, Roethlein CJ. A satisfaction-based definition of quality. J Bus Econ Stud 2009;15:82-97.
19. Riskind P, Fossey L, Brill K. Why measure patient satisfaction. J Med Pract Manage 2011;26:217-20.
20. Elliott MN, Cohea CW, Lehrman WG, Goldstein EH, Cleary PD, Giordano LA, et al. Accelerating improvement and narrowing gaps: Trends in patients’ experiences with hospital care reflected in HCAHPS public reporting. Health Serv Res 2015;50:1850-67.
21. Kahn SA, Iannuzzi JC, Stassen NA, Bankey PE, Gestring M. Measuring satisfaction: Factors that drive hospital consumer assessment of healthcare providers and systems survey responses in a trauma and acute care surgery population. Am Surg 2015;81:537-43.
22. Schmocker RK, Stafford LM, Siy AB, Leverson GE, Winslow ER. Understanding the determinants of patient satisfaction with surgical care using the consumer assessment of healthcare providers and systems surgical care survey (S-CAHPS). Surgery 2015;158:1724-33.
23. Kupfer JM, Bond EU. Patient satisfaction and patient-centered care: Necessary but not equal. JAMA 2012;308:139-40.
24. Schneider B, Bowen DE. Understanding customer delight and outrage. Sloan Manage Rev 1999;41:35-46.
25. Strasser S, Aharony L, Greenberger D. The patient satisfaction process: Moving towards a comprehensive model. Med Care Rev 1993;50:219-48.
26. Cronin JJ, Brady MK, Hult GT. Assessing the effects of quality, value, and customer satisfaction on consumer behavioral intentions in service environments. J Retail 2000;76:193-218.
27. Saraswati MS, Kristina SA, Zulkarnain AK. Perceived service quality and patient satisfaction at pharmacy department in Yogyakarta, Indonesia. Int J Pharm Pharm Sci 2017;10:42-5.
28. Javadi MH, Gol R. Service quality evaluation in general department of health insurance of Fars Province using a SERVQUAL model (case study: Shiraz). Interdis J Contem Res Bus 2011;3:118-25.
29. Johansson P, Oleni M, Fridlund B. Patient satisfaction with nursing care in the context of health care: A literature study. Scand J Car Sci 2002;16:337-44.
30. Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet 2004;363:312-9.
31. Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med 2001;52:609-20.
32. Gadalean I, Cheptea M, Constantin I. Evaluation of patient satisfaction. Appl Med Inform 2011;29:41-7.
33. Lee SJ, Back AL, Block SD, Stewart SK. Enhancing physician-patient communication. ASH Educ Program Book 2002;2002:464-83.
34. Al-Rashed SA, Wright DJ, Roebuck N, Sunter W, Chrystyn H. The value of inpatient pharmaceutical counseling to elderly patients prior to discharge. Br J Clin Pharmacol 2002;54:657-64.
35. Rathert C, May DR, Williams ES. Beyond service quality: The mediating role of patient safety perceptions in the patient experience-satisfaction relationship. Health Care Manage Rev 2011;36:359-68.
36. Kjoenniksen I, Lindbaek M, Granas AG. Patients’ attitudes towards and experiences of generic drug substitution in Norway. Pharm World Sci 2006;28:284-9.
37. Singhal GL, Anita K, Arun N. Jan Aushadhi stores in India and quality of medicines therein. Int J Pharm Pharm Sci 2011;3:204-7.
38. Rao KD, Peters DH, Bandeen-Roche K. Towards patient-centered health services in India-A scale to measure patient perceptions of quality. Int J Qual Health Care 2006;18:414-21.
39. Wen MM, Aref H, Abozaid A, Kandil NH, Elsobky YH. Quality evaluation and survey of the essential need for drug information centers. Int J Pharm Pharm Sci 2016;8:137-43.
40. Edwards JR, Bagozzi RP. On the nature and direction of relationships between constructs and measures. Psychol Methods 2000;5:155-74.
41. Chin WW. The partial least squares approach to structural equation modeling. Mod Method Bus Res 1998;295:295-336.
42. Kock N. Using Warp PLS in e-collaboration studies: What if I have only one group and one condition. Int J e-Collaboration 2013;9:1-12.
43. Bentler PM. Comparative fit indexes in structural models. Psychol Bull 1990;107:238-46.
44. Anderson JC, Gerbing DW. Structural equation modeling in practice: A review and recommended a two-step approach. Psychol Bull 1988;103:411-23.
45. Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate Data Analysis. Upper Saddle River, NJ: Prentice Hall; 1998.
46. Kock N, Gaskins L. Simpson’s paradox, moderation and the emergence of quadratic relationships in path models: An information systems illustration. Int J App Nonlinear Sci 2016;2:200-34.
47. Kock N, Moqbel M. A six-stage framework for evolutionary is research using path models: Conceptual development and a social networking illustration. J Sys Info Tech 2016;18:64-88.
48. Wetzels M, Odekerken-Schröder G, Van Oppen C. Using PLS path modeling for assessing hierarchical construct models: Guidelines and empirical illustration. MIS Quarter 2009;33:177-95.
49. Fornell C, Larcker DF. Structural equation models with unobservable variables and measurement error: Algebra and statistics. J Market Res 1981;18:382-8.
50. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986;51:1173-82.
51. Bitner MJ. Evaluating service encounters: The effects of physical surroundings and employee responses. J Market 1990;1:69-82.
52. Epstein RM. Making communication research matter: What do patients notice, what do patients want, and what do patients need? Patient Educ Couns 2006;60:272-8.
53. Berwick DM. What ‘patient-centered’ should mean: Confessions of an extremist. Health Affairs 2009;28:555-65.
54. Carter RE, Lonial SC, Raju PS. Impact of quality management on hospital performance: An empirical examination. Qual Manage J 2010;17:8-24.
55. Newton PN, Green MD, Fernández FM. Impact of poor-quality medicines in the ‘developing’ World. Trends Pharmacol Sci 2010;31:99-101.
56. Nyanwura EM, Esena RK. Essential medicines availability and affordability: A case study of the top ten registered diseases in Builsa district of Ghana. Int J Sci Tech Res 2013;2:208-19.
57. van Mook WN, van Luijk SJ, O’Sullivan H, Wass V, Zwaveling JH, Schuwirth LW, et al. The concepts of professionalism and professional behavior: Conflicts in both definition and learning outcomes. Eur J Intern Med 2009;20:85-9.
58. Richmond VP, Smith RS Jr., Heisel AD, McCroskey JC. The association of physician socio-communicative style with physician credibility and patient satisfaction. Commun Res Rep 2002;19:207-15.
59. Wrench JS, Booth-Butterfield M. Increasing patient satisfaction, and compliance: An examination of physician humor orientation, compliance-gaining strategies, and perceived credibility. Commun Quarter 2003;51:482-503.
60. Paulsel ML, McCroskey JC, Richmond VP. Perceptions of health care professionals’ credibility as a predictor of patients’ satisfaction with their medical care and physician. Commun Res Rep 2006;23:69-76.
61. Mayun IG, Indrasari M, Kusdhany LS. Relationship between patient’s satisfaction of removable denture wearers and oral health-related quality of life. Int J Appl Pharm 2017;9:150-4.
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How to Cite
G, R., and A. Ks. “PATIENT CENTEREDNESS IN HEALTH CARE: PERSPECTIVES FROM AN EMPIRICAL INVESTIGATION”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 11, no. 8, Aug. 2018, pp. 450-6, doi:10.22159/ajpcr.2018.v11i8.22262.
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