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
Reliability/Responsiveness
Empathy
Tangibles
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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 research, 12(1), 31.
