Questionnaire for Service Quality of Hospitals – Download

Questionnaire for Service Quality of Hospitals

Following questionnaire was proposed by Asghar Zarei et al. in 2012 on their study “Service quality of private hospitals: The Iranian Patients’ perspective”. Authors derived the questionnaire from famous SERQUAL Questionnaire of Parasuraman et al.

The questionnaire composed of 2 parts:

The first part includes 8 questions relating to the socio-demographic data of the patient.

The second part includes three dimensions of the service quality as follows:
Reliability/Responsiveness
Empathy
Tangibles

Download in Word format

Download in PDF format 

Questionnaire for Service Quality of Hospitals

Socio-demographic Variables

Gender:          Male               Female

Age:               ≤ 30                 31-40               41-50               51-60               ≥ 61

Education level:         Illiterate          Primary and secondary school             Academic Degree

Residence:      Urban                         Rural

Hospital ward:           Internal            Surgery            Obstetrics and Gynaecology               Other

Health condition:                   Excellent         Good               Average           Bad

Service Quality Dimensions and items

Service Quality Dimensions and items Strongly Disagree

(1)

Disagree

(2)

Neither Agree Nor Disagree

(3)

Agree

(4)

Strongly Agree

(5)

Reliability/Responsiveness
1. Sincere interest of personnel in solving patients’ problems
2. Carrying out of the services right at the first time
3. Providing services at appointed time
4. Error-free and fast retrieval of documents
5. Telling when services will be performed
6. Prompt performance of medical and non-medical services
7. Willingness of personnel to help patients
8. Attending of personnel whenever called
9. Instilling confidence in patients
10. Feeling safety and security in interaction with personnel
Empathy
11. Polite and friendly dealing of personnel with patients
12. Knowledgeable personnel to answer patients’ questions
13. Individual attention to patients
14. Availability of 24-hour services
15. Attention to the patient’s beliefs and emotions
16. Having patients’ best interest at heart
17. Understanding specific needs of patients
Tangibles
18. Neat and well-dressed personnel
19. Clean and comfortable environment of the hospital
20. Modern and up-to-date equipment
21. Visually appeal of physical facilities

Reference

Zarei, A., Arab, M., Froushani, A. R., Rashidian, A., & Tabatabaei, S. M. G. (2012). Service quality of private hospitals: The Iranian Patients’ perspective. BMC health services research12(1), 31.

Leave a Reply

Your email address will not be published. Required fields are marked *