A hierarchical model of health service quality: Scale development and investigation of an integrated model

This research developed and empirically validated a multidimensional hierarchical scale for measuring health service quality and investigated the scale's ability to predict important service outcomes, namely, service satisfaction and behavioral intentions. Data were collected from a qualitative study and three different field studies of health care patients in two different health care contexts: oncology clinics and a general medical practice. Service quality was found to conform to the structure of the hierarchical model in all three samples. The research identified nine subdimensions driving four primary dimensions, which in turn were found to drive service quality perceptions. The primary dimensions were interpersonal quality, technical quality, environment quality, and administrative quality. The subdimensions were interaction, relationship, outcome, expertise, atmosphere, tangibles, timeliness, operation, and support. The findings also support the hypothesis that service quality has a significant impact on service satisfaction and behavioral intentions and that service quality mediates the relationship between the dimensions and intentions.