Xem mẫu
- International Journal of Management (IJM)
Volume 8, Issue 6, Nov–Dec 2017, pp. 33–43, Article ID: IJM_08_06_004
Available online at
http://www.iaeme.com/ijm/issues.asp?JType=IJM&VType=8&IType=6
Journal Impact Factor (2016): 8.1920 (Calculated by GISI) www.jifactor.com
ISSN Print: 0976-6502 and ISSN Online: 0976-6510
© IAEME Publication
CRITICAL ANALYSIS ON INCLUSION OF
HEALTHCARE QUALITY DIMENSIONS
Varsha Agarwal
Assistant Professor, Jain University, Centre for Management Studies, Bangalore
PhD Research Scholar, Christ University, Bangalore
Dr. Ganesh. L
Associate Professor & HOD (General Management),
Institute of Management, Christ University, Bangalore
ABSTRACT
(Starr, 1982) defined Social Transformation of American Medicine and found that
medicine has disappeared from a supreme profession to a massive industry. For
decades, quality was taken for granted and Institute of Medicine (IOM), 2000 report
showed, up to 98,000 deaths happened per year due to inevitable medical errors. The
Institute of Medicine’s “Crossing the Quality Chasm” report recommended six aims
for upgrading healthcare quality.” Those aims were safety, equity, patient-
centeredness, timeliness, effectiveness, and efficiency. According to India’s 12th Five
Year Plan at present, India’s health care system consists of private sector providers.
Inspite of private providers the Indian healthcare system suffers from many
weaknesses such as quality of health care. This study focuses on the healthcare quality
based on Institute of Medicine’s six aims to assess their relevance with healthcare
quality. This research study was designed as descriptive research study. The closed
ended questionnaire was given to outpatients, inpatients or to the accompanying
persons of 4 hospitals chosen for the study. Location of study was Karnataka. In this
study multistage sampling was used for data collection. Sample size taken was 290. 5
point Likert’s scale was used to collect responses for statement questions. While
taking the IOM reports under consideration, this study has focused on health care
quality aims and analyzed relationship among them in context of private hospitals in
India. Findings of the study revealed that among all healthcare quality dimensions
patient centeredness followed by safety showed highest correlation with healthcare
quality. Hence these were the most important healthcare dimensions where healthcare
providers can focus for healthcare quality improvement.
Key words: Healthcare, Healthcare Quality, Patients, Private Hospitals.
Cite this Article: Varsha Agarwal and Dr. Ganesh. L Critical Analysis on Inclusion
of Healthcare Quality Dimensions. International Journal of Management, 8 (6), 2017,
pp. 33–43. http://www.iaeme.com/IJM/issues.asp?JType=IJM&VType=8&IType=6
http://www.iaeme.com/IJM/index.asp 33 editor@iaeme.com
- Varsha Agarwal and Dr. Ganesh. L
1. INTRODUCTION
Health care is the diagnosis, treatment, and prevention of illness, injury, disease and other
types of physical and mental loss in human beings. Healthcare refers to services provided in
primary, secondary, tertiary and public healthcare. In present world, all governments,
healthcare service providers, insurers and patients are involved in a continuous tug of war in
balancing priorities: meeting increased demand of healthcare services, cost reduction of
services and improvement in healthcare quality. (Starr, 1982) defined Social Transformation
of American Medicine and found that medicine has disappeared from a supreme profession to
a massive industry.
From decades there is no clear definition available for quality and it was taken for granted.
It was first revealed by (Institiue of Medicine, 2000), in their report titled “To Err is Human”
and it opened the entire reality of the best healthcare provided by the world. This report
highlighted that 98,000 deaths happened every year was the result of inevitable or preventable
errors. Suddenly quality as well as safety of care provided became a question for everyone.
The main promise of medicine was at risk. To solve this issue of healthcare quality IOM
improved the definition of healthcare quality in context with 21st century‟s healthcare system
and suggested six dimensions of healthcare quality. These dimensions were safety, timeliness,
patient centeredness efficiency, effectiveness, and equitability.
According to (Planning Commission Government of India, 2013) at present, India‟s health
care system consists of private sector providers of health services. Quality of health care
services varies considerably in private sector. Many practitioners in the private sector are
actually not qualified doctors. Private healthcare sector covers entire range from doctors to
clinics, general hospitals, multi-speciality hospitals and super specialty hospitals. But the
system suffers from weakness such as quality of care provided.
(Tandon, Murray, Lauer, & Evans, n.d.) found that France is on number one position in
World Health Organization Ranking of the World‟s Health Systems among total 191
countries of the world and India ranks 112 in world for its health systems. Other countries like
USA, UK, Japan and Bangladesh are ahead of India in this ranking.
Healthcare quality is an important issue. (Institiue of Medicine, 2000) report revealed
44,000 to 98,000 deaths happened because of preventable errors and approximately
1,000,0000 additional injuries each year in U.S. hospitals. Another report (Institute of
Medicine, 2001) found that medication errors were the most common error and harmed 1.5
million patients each year.
A report by (Agency for Healthcare Research and Quality , 2002) found that every year
7,000 patients die because of medication errors and it was 16% more than the predicted
number. Medical errors harm one in ten patients across the world.
(Numbeo, 2015) Presented Health Care Index for 105 Countries where Health Care Index
represents an estimation of the overall quality of the health care system, health care
professionals, equipment, staff, doctors, cost, etc. For survey purpose a scale of 0-100 was
used and according to their findings Japan secured highest score in this health care index with
87.07, whereas other countries‟ scores are as follows: Sri Lanka 74.29, United Kingdom
73.88, United States 67.75 and India 66.86.
(Sinha, Times of India, 2013) found that India records 5.2 million injuries every year
because of preventable errors and other adverse events. Across the world almost 43 billion
http://www.iaeme.com/IJM/index.asp 34 editor@iaeme.com
- Critical Analysis on Inclusion of Healthcare Quality Dimensions
people were injured sue to insecure medical care. For each 100 hospitalizations 14.2 adverse
events occurred in developed countries and 12.7 in developing and under developed countries.
Above statistics clearly represents the scenario of healthcare quality at global and Indian
level and arises the need to focus on healthcare quality improvement. In review of literature
section all healthcare quality dimensions and their relevance with healthcare quality has been
presented.
2. REVIEW OF LITERATURE
(Institute of Medicine, 1990) provided the most widely accepted definition for healthcare
quality as the degree to which health services for persons or populations increase the
occurrence of chosen health results and are reliable with the existing professional knowledge.
According to “Crossing the Quality Chasm” report published by (Institute of Medicine,
2001) six health care quality dimensions were given. These are dimensions were safety,
patient centeredness, efficiency, timeliness effectiveness and equitability. These dimensions
are helping in providing directions to policy makers, clinicians and healthcare providers to
adopt change and improving healthcare quality.
(Mitchell, 2008) found Patient safety and its importance in health care service quality.
This study revealed the role of nurses in improving healthcare quality in through providing
patient safety is very important. Findings of the study revealed that Patient safety was the
foundation of healthcare quality. (Aspden & Institute of Medicine (U.S.), 2004) considered
patient safety “indistinguishable from the delivery of quality health care. According to IOM
report “Crossing the quality chasm” safety is the basis upon which quality healthcare could be
built.
(Sower, Duffy, Kilbourne, Kohers, & Jones, 2001) Conducted a study on the dimensions
of the service quality for hospitals revealed that effectiveness was come out as the important
factor to improve the healthcare quality in hospitals. A report published by (Aston Centre for
Health Service Organization Resea, 2003) highlighted role of effectiveness in health care
quality and revealed that effectiveness in working processes contributed to the healthcare
quality improvement.
A discussion paper published by (Healthcare, 2010) investigated patient centered care and
improvement in safety and quality by focusing on care for patients and consumers and found
that Patient-centered care necessitated a change in the way policy makers and regulators think
about the quality of health care.
(Kenagy, Berwick, & Shore, 1999) Conducted a study on service quality in healthcare and
revealed that top health care services are increasing speed as well as efficiency of the
processes. By this way healthcare professionals would be able to interact more with the
patients and do not have to waste time in other complex processes. (HOPE Sub-Committee on
Coordination, 2001) studied about waiting time in healthcare and focused on role of
timeliness in healthcare delivery and association with quality could make it more effective.
(Gounaris, 2001) Conducted a study healthcare quality in Greece and studied efficiency
and effectiveness in context of NHS Secondary Health Care Units. Study suggested a model
for hospital operation based on efficiency measurement and responsiveness. (Sower, Duffy,
Kilbourne, Kohers, & Jones, 2001) studied healthcare quality dimensions and included
KQCAH scale for measurement. Findings of the study revealed that efficiency was the
important factor among others for determination of healthcare quality in hospitals.
http://www.iaeme.com/IJM/index.asp 35 editor@iaeme.com
- Varsha Agarwal and Dr. Ganesh. L
(Mahadevan & McGininnis, 2013) Conducted a study on improving health care quality
and equity by building partnerships between providers and community organizations. Apart
from daily basis hurdles patients also face transportation problems, low awareness about
health, food scarcity and partnerships with local organisations can help in meeting their needs.
(Akatwijuka & Propper, 2012) Conducted a study on importance of equity in service quality
in health care. Findings of the study shows that introducing consumer heterogeneity where
agents are motivated makes the case for competition more nuanced, even where there is no
patient selection by providers.
3. NEED FOR THE STUDY
There are numerous significant motives why there is a need for inclusive study on healthcare
quality dimensions and healthcare quality. The key reason for this study is nonexistence of
any study on Institute of Medicine healthcare quality dimensions in relation with healthcare
quality for private hospitals in Indian context. There is a strong need to study for private
hospitals in Indian context with inclusion of healthcare quality dimensions. This study has
followed patient centric approach to understand the relationship among healthcare quality
dimensions. Hence, this study will have greater practical significance. The present study
therefore, aims to fill the gap in the in healthcare literature by reporting understandings gained
in an extensive study.
4. STATEMENT OF THE PROBLEM
Statistics presented above reflected India‟s extremely low rankings in healthcare quality index
and in various other healthcare parameters at global level and increased number of deaths due
to various medical errors has become an important problem. Hence providing quality in
healthcare has become priority. Low quality leads to dissatisfaction among patients. In this
study healthcare quality on the basis of IOM healthcare quality dimensions has been studied.
This study included patients‟ responses regarding healthcare quality dimensions at private
hospitals in Karnataka, India.
5. OBJECTIVES OF THE STUDY
The main objective of this study is to critically analyze inclusion of healthcare quality
dimensions.
Following are objectives of the study.
To analyze the important factors responsible for selection of hospital
To find the relationship among health care quality dimensions (safety, patient centeredness,
timeliness, effectiveness, efficiency and equitability) and healthcare quality.
To provide the suggestions for healthcare providers, policy makers, customers and others to
improve the health care quality in Karnataka, India.
6. HYPOTHESES
Following is the hypotheses for this study:
H1: Health care quality dimensions has a relationship with healthcare quality.
7. RESEARCH METHODOLOGY
This research study is a descriptive research. Primary data was collected from respondents
using structured questionnaire. A closed ended questionnaire was given to outpatients,
inpatients or to the accompanying persons of 4 hospitals chosen for the study on the basis of
highest ranking obtained by them in terms of number of beds. These hospitals were Fortis
http://www.iaeme.com/IJM/index.asp 36 editor@iaeme.com
- Critical Analysis on Inclusion of Healthcare Quality Dimensions
Health care, Apollo Hospitals, Manipal Hospitals and Narayana Health. Secondary data was
collected using websites, journals, books, reports, news etc. Sampling element was the patient
and patient party. Location of study was Karnataka. (V, 2012) found that Karnataka was
performing as better state in the country. Karnataka has surge of funds and therefore can
direct more resources for private healthcare. Findings revealed that Karnataka was leading
state in healthcare system reforms in India. In this study multistage sampling was used for
data collection. For this study sample size taken was 290. From each hospital equal number of
responses were collected randomly to avoid any unrepresentativeness. Primary data was
collected from patients and patient parties. To collect data from patients and patient parties,
questionnaire was administered. In total 300 questionnaire were given for data collection. Out
of which 290 were finally used for data analysis. The Questionnaire contained mainly three
parts. Part one was for capturing demographic details of respondents. Second part of the
questionnaire contained important statements related selection of hospital. In the end third
part was carrying statements related to healthcare quality dimensions (Safety, Patient
Centeredness, Effectiveness, Efficiency, Timeliness and Equitability) and healthcare quality.
5 point Likert‟s scale was used to collect responses for statement questions.
8. STATISTICAL ANALYSIS IN THE STUDY
The statistical tools used for data analysis in the study were: Frequency tables, Factor analysis
and Correlation Analysis. Frequency tables were used to analyse the demographic details of
respondents. Factor analysis was used to extract important factors responsible for selection of
hospitals. Further correlation analysis was used to find relationship among healthcare quality
dimensions and interrelationships among them.
9. ANALYSIS AND INTERPRETATION
9.1. Demographic Profile of Respondents
Table 1 gives information about gender, marital status, age, education, occupation and income
of respondents. Out of total 290 respondents majority 62.06% respondents are male followed
by 37.93% female. Most of the respondents 55.17% were single. Among all respondents
majority 20.68% respondents were 61 years above. 34.48% respondents were graduate in
total. Table 1 represents that most of the patients going for private hospitals were above 61
years old, educated and belonged to high income group. Hence private hospitals are the
preference for almost all kind of treatments and also related to patients‟ affordability. Private
hospitals have the opportunity to target all age groups and different income groups which will
help them to increase their market share and service more number of patients. They can adopt
specific pricing strategies to attract more number of patients for different types of treatments.
Table 1 Demographic Details of Respondents
Gender Frequency Percent
Male 180 62
Female 110 38
Total 290 100
Marital Status Frequency Percent
Single 160 55.2
Married 120 41.4
Divorced 5 1.7
Widow 2 0.7
Separated 3 1.0
Total 290 100
Age in years Frequency Percent
Below 20 30 10.4
http://www.iaeme.com/IJM/index.asp 37 editor@iaeme.com
- Varsha Agarwal and Dr. Ganesh. L
20-30 50 17.2
31-40 50 17.2
41-50 50 17.2
51-60 50 17.2
61 and above 60 20.8
Total 290 100
Educational Qualifications Frequency Percent
Below Under Graduate 60 20.7
Graduate 100 34.5
Post Graduate 80 27.6
Above Post Graduate 50 17.2
Total 290 100
Occupation Frequency Percent
IT Professionals 60 20.7
Non-IT Professionals 70 24.2
Government Job 60 20.7
House Wife 20 6.9
Student 30 10.3
Academician 30 10.3
Others 20 6.9
Total 290 100
Monthly Income in Rs. Frequency Percent
Below 30,000 20 6.9
31,000 – 50,000 50 17.3
51,000 – 75,000 70 24.1
75,000 – 1,00,000 80 27.6
Above 1,00,000 70 24.1
Total 290 100
9.1.1. Analysis of Important Factors Responsible For Selection of Hospital
In SPSS version 20, Principal component analysis (PCA) using Varimax rotation was done on
the used 25 item scale. Kaiser Meyer Olkin (KMO) Measure of Sampling adequacy test and
Bartlett Test of Sphericity test was done to check the suitability of factor analysis which is
shown in Table 2. Value of KMO measure of sampling adequacy test was 0.758 which was
above meritorious level. Also Bartlett„s test was significant at .001 level. Table 2 showed both
tests‟ results were acceptable and used scale was suitable for factor analysis. Therefore,
further stages of PCA were conducted.
Table 2 KMO and Bartlett's Test
Kaiser-Meyer-Olkin Measure of Sampling Adequacy. .758
Bartlett's Test of Sphericity Approx. Chi-Square 1092.359
df 300
Sig. .000
Finally, Principal Component Analysis of important factors for utilization of private
hospitals of 25 items revealed a 5-factor structure and is presented in Table 3.
Factor 1 was named as Hospital facilities and was composed of 8 items. It described
30.329% of the total variance in patients‟ responses to hospital utilization. Items in this factor
contained of all of the inquiries involving to the facilities provided by hospital administration.
Factor Hospital facilities contained variables like hospital equipment, infrastructure, canteen,
pharmacy, phone, emergency services, rooms, stretchers, wheelchair, food, lab,
accommodation, 24/7 treatment, doctors and nurses availability.
http://www.iaeme.com/IJM/index.asp 38 editor@iaeme.com
- Critical Analysis on Inclusion of Healthcare Quality Dimensions
Factor 2 was considered as Doctors and Reputation of Hospital and was composed of 7
items. It explained 20.535% of the total variance in patients‟ responses to hospital utilization.
Items in this factor consisted questions connecting to the doctors and reputation of hospital
and included doctors‟ qualification, experience, proper guidance and diagnosis, information
given, time spent with patient, reputation of hospital and hospital recommendation by doctors.
Factor 3 was labeled as Hospital ambience and waiting time and was composed of 4
items. It described 7.294% of the total variance in patients‟ responses to hospital utilization.
Items in this factor consisted of hospital ambience and waiting time and contained hospital
recommendation, good ambience, neat, tidy and moderate visit time.
Factor 4 was labeled consultation. Transportation and appointment and was composed of
3 items. It described 5.541% of the total variance in patients‟ responses.
Factor 5 was labeled as accessibility and affordability and was composed of 3 items. It
described 4.562% of the total variance in patients‟ responses to hospital utilization.
Table 3 List of Factors
S.N. Factor Name Variance Variables Factor
(%) Loading
1 Hospital facilities 30.329 The hospital has facilities (Equipment, Infrastructure .885
etc.)
The hospital gives extra facilities like canteen, .912
pharmacy store and phone is easily available.
The hospital has excellent trauma/ emergency .895
services.
The hospital provides facilities to patients like .857
rooms, stretchers, wheelchair and food.
The hospital gives one stop access facilities (Lab .820
etc.)
The hospital gives food and accommodation to the .753
patients‟ relative.
Treatment is provided 24/7. .759
Availability of doctors, nurses and paramedical staff .778
is good.
2 Doctors and 20.535 Doctors of the hospital are qualified. .574
Reputation of Doctors are experienced. .779
Hospital The doctors give proper guidance and diagnosis. .777
The doctors of the hospital give accurate and true .581
information every time.
Doctors spend sufficient time in attending the .572
patient.
Reputation of the hospital .673
The hospital is recommended by other doctors. .649
3 Hospital ambience 7.294 The hospital is recommended by friends and family. .701
and waiting time The hospital has good ambience. .739
The hospital is neat and tidy. .797
Time duration spent in hospital during each visit is .831
moderate.
4 Consultation 5.541 The hospital offers easy payment system. .731
Transportation facility is good to reach the hospital. .651
Easy to get appointment with the doctor. .598
5 Accessibility and 4.562 The hospital is located in nearby area. .748
affordability My financial status supports me to seek this facility. .591
Insurance Facility is available in this hospital. .714
http://www.iaeme.com/IJM/index.asp 39 editor@iaeme.com
- Varsha Agarwal and Dr. Ganesh. L
9.1.2. Relationship among Theoretical Constructs
The results were studied with correlation analysis and shown in Table 4. The correlation table
in Table 4 displayed that all correlation coefficients were positive and significant at 0.01
level. Among all the correlations, the correlation between safety and efficiency was the
strongest (.767) and correlation between effectiveness and efficiency was the weakest (.259).
Correlation matrix also represents interrelationships among all healthcare quality dimensions.
Table 4 Correlation Matrix for the Theoretical Constructs
CONSTRUCTS SAF PC TIME EFFT EFFY EQUT HCQ
SAF 1
PC .765** 1
TIME .383** .613** 1
EFFT .358* .616** .689** 1
EFFY .767** .674** .334* 0.259 1
EQUI .504** .702** .652** .605** .554** 1
HCQ .713** .732** .404** .385** .517** .420** 1
Table 5 presents relationship among healthcare quality dimensions and related hypotheses
for this study.
Table 5 Results of Hypotheses Testing
S.N. Hypothesis Statement
H1 Health care quality dimensions has a relationship with healthcare quality.
Hypothesis Hypothesis Statement Correlation Hypothesis
Value Status
SAFHCQ Safety has a relationship with healthcare quality. .713 Accepted
PCHCQ Patient Centeredness has a relationship with .732 Accepted
healthcare quality.
TIMEHCQ Timeliness has a relationship with healthcare .404 Accepted
quality.
EFFTHCQ Effectiveness has a relationship with healthcare .385 Accepted
quality.
EFFYHCQ Efficiency has a relationship with healthcare .517 Accepted
quality.
EQUTHCQ Equitability has a relationship with healthcare .420 Accepted
quality.
It is evident that all the hypotheses have been proved using correlation analysis and
reveals that all healthcare quality dimensions (Safety, Patient Centeredness, Timeliness,
Effectiveness, Efficiency and Equitability) are positively related with healthcare quality.
Among all, correlation between patient centeredness and healthcare quality is strongest
(0.732) and correlation between effectiveness and healthcare quality is weakest (0.385).
10. CONCLUSIONS
(Seshadri & Gauvreau, 2015) observed the growth of private healthcare sector in Karnataka
and suggested to assess the quality of care provided here. His research was carried out to
assess the healthcare quality dimensions in context with private hospitals and to see how
patients rate these dimensions. Findings of the study revealed that safety, equity, patient-
centeredness, timeliness, effectiveness, and efficiency had positive relationships with
healthcare quality. Study also identified the important factors responsible for selection of
private hospitals to better understand the requirements of the patients. Five important factors
identified for selection of private hospitals are as follows: Hospital facilities, Doctors and
Reputation of Hospital, Hospital ambience and waiting time, Consultation and Accessibility
http://www.iaeme.com/IJM/index.asp 40 editor@iaeme.com
- Critical Analysis on Inclusion of Healthcare Quality Dimensions
and affordability. Therefore, the study suggested that the private hospitals managers should
suitably consider healthcare quality dimensions which are serious influencer of healthcare
quality.
Correlation matrix clearly indicated the relationship among all healthcare quality
dimensions and healthcare quality. Therefore these healthcare quality dimensions has to be
included to focus and improve healthcare quality. To improve reliability in healthcare
facilities, correct treatment and promised service has to be delivered. If patient is not informed
or involved about his / her health condition and processes, it may have an impact on healing
process. Therefore, there should be improved communication between healthcare providers
and patients. Private healthcare sector supports significantly to country‟s economy, henceforth
it is very significant for them to contain healthcare quality dimensions and concentrating on
their improvements. This will benefit private hospitals to contribute more in country‟s GDP.
Health is important universal index of human development. To achieve sustainable
improvement in health and human development private hospitals should be more quality
focused.
11. SUGGESTIONS AND RECOMMENDATIONS
Healthcare providers should provide correct information on time as quality information
improves patient satisfaction. Hospitals should have adequate number of nurses who can
provide individual attention to their patients and convenient operating hours. Private sector
uses franchising option for expansion of certain products, achieving economies of scale and
providing product quality. Therefore, private sector is suitable for improving healthcare
accessibility and healthcare can be served as packaged product. Government should maintain
standards for hospitals and centres at different levels. It should implement system of
accreditation for healthcare facilities in private sector. The authorisation position of hospitals
should contain numerous features of healthcare quality. Quality improvement process should
include non-clinical and other support services. Patients load should be reduced at higher
level facilities so that doctors and supporting staff can give more attention to the patients. To
improve healthcare quality, infrastructure and human resource at lower level healthcare
facilities should be fortify.
12. SCOPE FOR FURTHER RESEARCH
There is a scope for conducting further research study to understand views of healthcare
providers about service quality and patient satisfaction. So that they can work towards
improving healthcare quality dimensions and patient satisfaction. It will help them in
formulating new strategies. Same study can be conducted at different locations with larger
sample size. Further studies can also include information related to insurance availability,
usage of telemedicine and other latest techniques in healthcare industry.
13. LIMITATIONS OF THE STUDY
The major limitations of this study is the study has only included perception from patient side.
In this study only four hospitals have been chosen with limited sample size. Therefore this
study may not reflect the overall scenario of healthcare service quality and patient
satisfaction. In this study data were gathered from the patients in four private hospitals in
Karnataka, India. The results might not be generalizable to all the patients in other private
hospitals in India. Further study may include more number of hospitals and also may target
hospitals located in different cities in India and regional areas.
http://www.iaeme.com/IJM/index.asp 41 editor@iaeme.com
- Varsha Agarwal and Dr. Ganesh. L
REFERENCES
[1] Agency for Healthcare Research and Quality . (2002). Medical error explained. Retrieved
from http://everything.explained.today/Medical_error/
[2] Akatwijuka, M. H., & Propper, C. (2012). Competition, Equity and Quality in Healthcare.
The Centre for Market and Public Organization, 12(296).
[3] Aspden, P., & Institute of Medicine (U.S.). (2004). Patient Safety: Achieving a New
Standard for Care. Washington, DC: National Academic Press.
[4] Aston Centre for Health Service Organization Resea. (2003). Team Working and
Effectiveness in Healthcare: Findings from the Healthcare Team Effectiveness Project.
[5] Gounaris, C. C. (2001). Health Services Quality and Management in Greece Efficiency
and Effectiveness of NHS Secondary Healthcare Units.
[6] Healthcare, A. C. (2010). Patient-centered Care: Improving Quality and Safety by
Focusing Care on Patients and Consumers. Biotext, Canberra.
[7] HOPE Sub-Committee on Coordination. (2001). Waiting Lists and Waiting Times in
Healthcare Managing Demand and Supply.
[8] Institute of Medicine. (1990). Medicare: A Strategy for Quality Assurance. Washington,
DC: National Academy Press.
[9] INSTITUTE OF MEDICINE. (2000). To Err Is Human Building a Safer Health System.
Washington, D.C.: National Academy Press.
[10] Institute of Medicine. (2001). Crossing The Quality Chasm: A new health system for the
21st century. Washington, DC.: National Academy Press.
[11] Institute of Medicine. (2006). Preventing Medication Errors. Washinton, DC: The
National Academies.
[12] Kenagy, J. W., Berwick, D. M., & Shore, M. F. (1999). Service Quality in Healthcare.
JAMA, 281(7), 661-665.
[13] Mahadevan, R., & McGininnis, T. (2013). Improving Healthcare Quality and Equity:
Considerations for Building Partnerships between Provider Practices and Community
Organization. Aligning Forces for Quality.
[14] Mitchell, P. H. (2008). Patient Safety and Quality: An Evidence-Based Handbook for
Nurses.
[15] Nielsen, M., Gibson, A., Buelt, L., Grundy, P., & Grumbach, K. (2015). The Patient-
Centered Medical Home's Impact on Cost and Quality. Patient-Centered Primary Care
Collaborative.
[16] Numbeo. (2015). Healthcare Index for country 2015. Retrieved from
http://www.numbeo.com/health-care/rankings_by_country
[17] Planning Commission Government of India. (2013). Twelth Five Year Plan (2012-2017)
Social Sectors Volume III. Sage Publications India Pvt Ltd.
[18] Seshadri, S. R., & Gauvreau, U. R. (2015). Karnataka's Roadmap to Improved Health.
Retrieved from http://azimpremjiuniversity.edu.in/SitePages/pdf/Karnataka-Roadmap-to-
Improved-Health-A-Report.pdf
[19] Sinha, K. (2013). (T. T. India, Producer) Retrieved from Times of India:
http://timesofindia.indiatimes.com/india/India-records-5-2-million-medical-injuries-a-
year/articleshow/22832260.cms
http://www.iaeme.com/IJM/index.asp 42 editor@iaeme.com
- Critical Analysis on Inclusion of Healthcare Quality Dimensions
[20] Sower, V., Duffy, J., Kilbourne, W., Kohers, G., & Jones, P. (2001). The Dimensions of
Service Quality for Hospitals: Development and use of the KQCAH scale. Healthcare
Management Review, 26(2), 47-59.
[21] Starr, P. (1982). The social transformation of American medicine. New York: Basic
Books.
[22] Tandon, A., Murray, C. J., Lauer, J. A., & Evans, D. B. (n.d.). Measuring overall health
system performance for 191 countries. Retrieved from World Health Organization:
http://www.who.int/healthinfo/paper30.pdf
[23] V, F. (2012). Does Efficiency Matter in Getting to Universal Health Coverage? Retrieved
5 8, 2017, from https://www.cgdev.org/blog/does-efficiency-matter-getting-universal-
health-coverage
[24] Sanjeev Pandey and Dr. Sandeep Srivastava. A Study on Determinants of Customer
Purchase Intention in Healthcare Product - A Case of General Medical Equipment in
India. Journal of Management, 4 ( 2), 2017 , pp. 1 9 – 30 .
[25] N. Kamakshi Priya and Dr. M. Kalyana Sundaram, A Study on Relationships Among Job
Satisfaction, Organizational Commitment and Turnover Intention In Kolors Healthcare
India Pvt ltd, Chennai . International Journal of Advanced Research in Management, 7 (1),
2016, pp. 58 – 71 .
[26] Dr. N. Shaik Mohamed and D. Heena Kausar. An Empirical Study on Factors Influencing
the Patients Satisfaction towards Healthcare Services of Selected Multi Specialty
Hospitals in Trichy. International Journal of Management, 7(2), 2016, pp. 516 - 528 .
[27] Dr. Hani J. Irtaimeh, Dr. Zeyad F. Al-Azzam and Dr. Amineh A. Khaddam, Exploring the
Impact of Talent Management Strategies and Service Quality on Beneficiaries Satisfaction
in Jordan Healthcare Sector: Provider Point of View. International Journal of
Management, 7(7), 2016, pp. 23–38.
http://www.iaeme.com/IJM/index.asp 43 editor@iaeme.com
nguon tai.lieu . vn
