Mine

ACKNOWLEDGEMENT
I would like to thanks Dr. Preeti Singh for her continuous guidance and support
throughout the project report. I’m deeply indebted to all people who have guided,
inspired and helped me in the successful completion of this project. I owe a debt of
gratitude to all of them, who were so generous with their time and expertise.
Last but not the least, I thank everybody, who helped directly or indirectly in completing
the project that will go a long way in my career, the project is really knowledgeable &
memorable one.
EXECUTIVE SUMMARY
The modern age can be called as the “Age of Consumers”. In today’s cut-throat
competition the consumer is considered as the king. Many policies of various
organizations are aimed at keeping the consumer happy and satisfied. As competition is
increasing, the hospitals are making their best efforts to provide quality health care
services to its customers. They have begun practicing a patient satisfaction strategy
comprising consumer-oriented plans, policies and practices to genuinely meet the needs
of customers. Also, with increased awareness and high expectations of the customers’
hospitals have to provide them better facilities. Patients have begun to demand high
quality of services i.e. a consumer oriented approach.
This study presents the description on BLK hospital is required to focus on customer
satisfaction:- Rendering acceptable, quality health services to patients at affordable price
within reasonable price, within in a reasonable time; Applying zero errors to all patients
services; maintaining a continuous error prevention program; Training employees in
medical care on such aspects as error prevention, reducing delay time and providing
prompt reasonable to patients needs; management system have always improvement in
such systems to realize the true nature of the quality of healthcare and to be motivated
towards improving this quality.
The Data was collected from both primary and secondary sources. Primary data was
collected through questionnaire surveys from patients of BLK hospital. The last part of
this study is to report the findings and analyze the results of survey. Responsiveness,
empathy, tangibility, reliability and assurance are the contributing variables in the process
of shaping the loyalty. The basic objective in this project is to come up with different
recommendations for BLK hospital for improvement in their customer service and
satisfaction.
TABLE OF CONTENTS
CHAPTER PAGE NO.
INTRODUCTION 1–2
COMPANY PROFILE 3 – 11
CONCEPTUAL DISCUSSION 12 – 33
RESEARCH METHODOLOGY 34 – 36
a) Research Objectives
b) Research Design
c) Data Sources
DATA ANALYSIS AND INTERPRETATION 37 – 50
FINDINGS & RECOMMENDATIONS 51 – 58
ANNEXURE- QUESTIONNAIRE 59-60
BIBLIOGRAPHY
LIST OF FIGURES
Figure Title Page NO.

1.1 Stage Model of the buying process 13
1.2 Consumer Behaviour 14
1.3 Factor influencing behaviour 17
1.4 Model of Buyer Behaviour 18
1.5 Process 31
1.6 Data Analysis and Interpretation-Q.1 37
3.0 Satisfaction Score 52
LIST OF TABLES
Table Title Page No.

1.1 Data Analysis and Interpretation-Q.1 (Listened carefully to them) 37
(Explained things in a way they could understand)

(Showed respect for what they had to say)

(Spent enough time with them)

(Got treatment as soon as they wanted when they were sick)

(Got an appointment they wanted for regular health care)

(Waited only 15 minutes past their appoint time to see)

(How many time doctor visit a patient)

(How often doctors talk both patient and its close persons)
(Friendliness of people caring for the patience)

2.1 Data Analysis and Interpretation-Q.13 (Emergency department) 49
CHAPTER 1: 1NTRODUCTION
It is very important for each and every organization to keep its consumers satisfied in
order to maintain its competitiveness in the market. Not only does this help the
organization to maintain the size of its share in the market, it might even help it to
increase the size of its share. It might also be instrumental in increasing the overall
market size. This helps in increasing the overall profitability of the organization. It also
helps the long-term survival prospects of the organization. Consumers when viewed on
the macro level exhibit similar traits. However when we take a closer look and come
down to the micro level, we find that the consumers vary as compared to one another on
one aspect or the other based on a variety of attributes.
In the present business scenario of cutthroat competition, customer satisfaction

has become the prime concern of each and every kind of industry. Companies are
increasingly becoming customer focused. Companies can win customers and surge ahead
of competitors by meeting and satisfying the needs of the customers. World over
businesses have realized that marketing is not the only factor in attracting and retaining
customers. Other major factors responsible for the same are satisfaction through service
quality and value. Even the best marketing companies in the world fail to sell products
and services that fail to satisfy the customers’ needs. So customer satisfaction is the
keyword in today’s fiercely competitive business environment.
The link between customer satisfaction and customer loyalty is not proportional. Suppose
customer satisfaction is rated on a scale from one to five. At a very low level of customer
satisfaction (level one), customers are likely to abandon the company and even bad
mouth it. At levels two to four customers are fairly satisfied but still find it easy to switch
when a better offer comes along. At level five, the customer is very likely to repurchase
and even spread good word out of mouth about the company. High satisfaction creates an
emotional bond with the brand or company, not just a rational preference.
Customer satisfaction is a feeling of pleasure or disappointment on the offers perceived

performance in relation to buyers’ expectations. Expectation is defined as what the
customer wants/requires from the product/service and perceived performance is the
perception of the customer about the product/service i.e. evaluation of the product/service
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after using it. So perception is what the customer actually receives/gets from the
product/service. The evaluation is done by comparing the expectations with the perceived
performance of the product/service. Therefore customer satisfaction is a function of
perceived performance and customer expectations. Customers who are just satisfied find
it easy to switch over when a better offer comes than those who are highly satisfied. For
customer focused companies satisfaction is both a goal as well as a marketing tool. What
a consumer thinks about the product or services offered by a firm can have a marked
effect on the purchase of its products or services. So one of the tasks before the
management is to know what the consumer expect and what they are getting in return.
Satisfaction is a judgment that a product or service feature, or the product or service

itself, provided (or is providing) a pleasurable level of consumption-related fulfillment,
including levels of under- or over fulfillment. The expectations-disconfirmation paradigm
provides the most popular explanation of consumer satisfaction. However, and as is
occasionally noted, if a customer experiences disconfirmation after consuming a product,
future expectations regarding the product should be revised toward the performance
perceived by the customer. If expectations do not change in the face of disconfirmation,
the implication would be that the customer did not learn from their consumption
experience.
These days patients have become more aware about their rights so they want they
should be better facilities like responding to their queries promptly, friendly environment,
understanding their problems, availability of specialized doctors, maintaining cleanliness,
regular repots etc. i.e. providing them every type of essential facilities. So, if the hospitals
want that their customers must be satisfied, they have to provide not only better treatment
but other facilities also. The current study is focused on examining the various factors
related to patient satisfaction with the following specific objectives:
1. To study the customer expectations from BLK hospital.
2. To study the customer perception of hospital services.
3. To study the degree of satisfaction of customers from hospital services.
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CHAPTER 2: COMPANY PROFILE
Dr. B L Kapur, an eminent Obstetrician and Gynaecologist, set up a Charitable Hospital
in 1930 at Lahore. In 1947, he moved to post-partition India and set up a Maternity
Hospital at Ludhiana. In 1956 on the invitation of the then Prime Minister, Dr. B L Kapur
initiated the project for setting up a 200 bed hospital in Delhi. The hospital was
inaugurated by the Prime Minister, Pt. Jawahar Lal Nehru on 2nd January, 1959.
By 1984, when the hospital celebrated its Silver Jubilee, it was an expanding hospital
well on its way to becoming Delhi’s premier multispecialty institute. Services offered
included General Surgery, Ophthalmology, ENT, Dentistry, Pulmonology, Intensive Care
and Orthopedics, apart from mother & child care.
A factor of much importance to the hospital was the health of the community.
Enthusiastic doctors held camps and public health talks to improve the status of
community health in the area.
In the late 1990s, the Trustees of the hospital felt the need to upgrade it to a tertiary care
hospital and tied up with Radiant Life Care Private Limited to re-develop and manage the
facility. Today, a modern state-of-the-art tertiary care hospital has come up in place of the
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old hospital. It is one of the biggest stand alone private Hospitals in the National Capital
Region today.
 cataract surgery in India
 Dr. B. L. Kapur with Prime Minister Pt. Jawahar Lal Nehru
 best eye hospital in Delhi
Sitting Left to Right – Sister Manchanda, Dr. Mrs. A. Kidwai Asst. M.O., Dr. Mrs.
Mehra, Anesthetist, Col. Amir Chand Government Lahore Hospital Society, Dr. Miss
Patel Asstt., M. O., Dr. B. L. Kapur Hony. Medical Sptd., Sister MCregor Nursing Sptd.,
Mrs. B. L. Kapur.
Standing Left to Right – Mirza Ashraf Beg, Abdul Majid Bazaz, Bashir Ahmed Mintoo,
Noor-ud-Din Shah, Mohd. Yousuf Mantoo, G. Habib-Ullah, Tassaduq Hussain Khan,
Mohd. Yaseen Kawaja.
Vision:
To create a patient-centric, tertiary healthcare organization focused on non-intrusive

quality care utilizing leading edge technology with a human touch.
Mission:
 Achieve Professional Excellence in delivering Quality care.
 Ensure care with Integrity and Ethics.
4
Infrastructure & Facility
BLK Super Speciality Hospital has a unique combination of the best in class technology,
put to use by the best names in the professional circles to ensure world-class health care
to all patients. Spread on five acres of land, with a capacity of 650 beds, BLK Super
Speciality Hospital is one of the largest tertiary care private hospitals in the country, BLK
has consistently ranked amongst the Top 10 Multi Super Specialty Hospitals in Delhi
NCR. The outpatient services are spread on two floors with 60 consultation rooms. All
ambulatory services have been designed with intent to create dedicated aides for all
specialities, with their interventional services in close vicinity. Therefore, whether it is the
proximity of diagnostic services and blood bank to the emergency or one of the best
Endoscopy suites to ensure timely and efficient services, the infrastructure speaks
volumes about BLK's commitment to 'PASSION FOR HEALING'.
The hospital has 17 state-of-the-art well equipped modular operation theatres with three
stage air filtration and gas scavenging system to ensure patient safety. All the Operation
Theatres are fitted with best in class pendants, operating lights, anesthesia work stations
and advanced information management system.
The Hospital has one of the biggest critical care programmes in the region with 125 beds
in different intensive care units viz Medical, Surgical, Cardiac, Paediatrics, Neonatology,
Neurosciences and Organ Transplant. All critical care beds are in the close vicinity of the
Operation Theatre complex for easy accessibility and continuity of care. Each Critical
care unit is equipped with high end patient monitoring devices, ventilators and dedicated
isolation rooms. Facilities for haemodialysis, CRRT, SLED, endoscopy and
bronchoscopy are available 24X7 by the bedside.
Liver and Renal Transplant Centres have been equipped with dedicated ICUs with
individual hepafilters, specialized instruments and equipments, Veno-venous bypass
system and dedicated anaesthesia equipment.
The Hospital has specialized birthing suites with telemetric foetal monitors to follow the
progression of labor, and also the facility for the family to stay with the patient during the
labor. A dedicated operation theatre adjacent to the labour room helps in shortening the
response time in case there is a need to conduct the delivery through surgical means.
5
The Hospital's advanced Building Management System provides for multi-tiered access
control, electronic security systems with integrated CCTVs spanning across the facility
and advanced fire management system amongst other utilities. The Hospital is the first in
NCR to install and start using automatic pneumatic chute system to enhance the
efficiency and efficacy of health care delivery.
The whole campus is Wi-Fi enabled, with the vision of the Hospital becoming the first
truly paper-less healthcare facility in the country. BLK has top of the line Hospital
Information System (HIS) system which is seemingly connected across outpatient,
inpatient and diagnostic areas. The system has facility for contemporary electronic
medical records (EMR) with remote-accessibility enabling ongoing consultation to
patients from distance as well.
STATE-OF-THE-ART-EQUIPMENT:
Cyberknife VSI– BLK recently became the proud home to Cyberknife VSI, Asia
Pacific's first whole body robotic radio-surgery system for treatment of hitherto
inoperable tumors.
PET CT Scan– BLK has installed the latest generation PET CT Scan machine to aid
accurate diagnosis and treatment of a plethora of diseases. This makes BLK the first
hospital in Delhi to offer coupled services of PET CT and Cyberknife.
Neuro Vascular Biplane Cath Lab– BLK Super Speciality Hospital is the first Centre in
New Delhi to have Neuro Vascular Biplane Cath Lab, which is capable of providing
many complex features like road map, 3D rotation capabilities and many more. This
enables us to do many challenging cases and we call them neurosurgery in cath lab.
A TriologyTx Linear Accelerator with cone beam CT for Radiation Oncology– Image
guided radiotherapy (IGRT), Intensity ModulatedRadiotherapy (IMRT) and Gated
Radiotherapy.
MRI– The hospital is equipped with 1.5 Tesla volume MRI. The special feature of the 1.5
Tesla MRI is its ability to generate 3D images, which cuts the acquisition time by half
and increase the comfort and convenience for the patients.
CT Scan– 128 Slice volume CT Scan capable of generating high quality 3D images.
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Cath Lab– Flat panel combo Cath. Lab with 3D reconstruction, DSA and
Electrophysiological studies.
Nuclear medicine– The hospital has a first of its kind dual head Spect CT, with variable
angle gamma camera. This enables the doctors to trace physiological pathways early in
the disease process, in a non-invasive manner.
Blood Bank– A state-of-the-art blood bank meeting all standards has been set up with
facilities like Aphaeresis, blood component separation and stem cell harvesting. The
Blood Bank is equipped with the NAT(Nucleic Acid Testing) System for the screening of
Blood to ensure the safest possible blood for all its patients. In addition, a Blood
Irradiator- another First of its Kind in any corporate hospital for specially treated blood
for cancer and other subgroup of patients, shall be installed in the current year.
Laboratories– The hospital has one of the most well equipped labs in the NCR for entire
gamut of diagnostic services in Haematology, Biochemistry, Microbiology, Molecular
Biology and Histopathology.
Ultrasound– Ultrasound machines with 3D and 4D imaging and whole body Doppler.
Mammography– Low radiation digital imaging and stereotactic (3D) biopsy system.
X - Ray with high frequency low radiation digital radiography.
Bone Mineral Density– Whole body mineral density scan capable of giving instant
reports.
Dental Facilities– BLK has fully integrated and automatic dental chairs complemented
by low radiation and high precision digital X-Ray.
Endoscopy Suites– The hospital has dedicate endoscopy suite for endoscopic ultrasound
and other advanced endoscopic procedures like ERCP, Stenting, UGIE, Colonoscopy etc.
Ambulance Services– The hospital has a fleet of fully equipped Advanced Life Support
System (ACLS) ambulances for all kinds of emergencies.
Bronchoscopy Suite with most modern equipments in safest and convenient environment.
Push frontiers of care through Research and Education.
Adhere to National and Global Standards in Healthcare.
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Provide Quality healthcare to all Sections of Society.
A passion for healing...
At BLK, we are passionate about delivering the highest standard of healthcare. Be it the
finest Doctors, cutting-edge medicine, state-of-the-art infrastructure or nursing with a
smile. When you are passionate about healing the lives that have been entrusted to us,
nothing is too big or small to ignore.
Accreditation & Quality
Drive towards continuous improvement
With the collective belief that the most simple is often the most effective, the BLK
leadership team follows the quality cycle of planning, designing, checking and applying
the learning to continuously improve the services. Quality indicators have been defined
for every significant process, and are monitored to ensure continuous quality
improvement, to achieve international benchmarks.
More importantly, extensive interactions take place between the management and the
staff so that the organization's passion of constant learning and improving cascades down
to the last rank.
Quality Policy
 Realization of hospital’s vision and mission.
 Meeting changing needs and expectations of the patients.
 Introduce quality in all its services and ensure continuous improvement of quality
through national and international accreditations.
 Quality Objectives
 Engage credentialed professionals in all disciplines and services.
 Continuously update the knowledge of the professionals through in-house or external

training, participation in academic activities such as CMEs, seminars, symposia,
conferences and by providing access to internet and journals and books in the hospital
library.
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 Promote research.
 Provide state-of-the-art health care with compassion and dignity to all.
 Introduce established newer technologies in clinical services without delay.
 Provide reliable and updated diagnostic services.
 Monitor all critical processes to ensure continuance of quality.
 Create health awareness across the sections of the population of Delhi.
 Introduce postgraduate courses and fellowships in different clinical disciplines.
 Start training programmes for paramedical staff.
 Extend health consciousness in the community.
 Provide free health care to indigent patients.
 Ensure safety of patients, attendants, employees and all stakeholders.
 Practice environmental management systems.
 Continuously enhance customer satisfaction.
 Promote staff development and increase employee satisfaction.
 Establish an efficient Hospital Information System to have paperless and permanent

access to patient records and easy analysis of outcomes.
Establish quality assurance system to minimize pre analytical, analytical and post
analytical errors with laboratories.
Quality Parameters
The hospital has been designed for maximum safety and comfort of the patients and
healthcare providers. It complies with national and international standards for hospital
accreditation.
 Clinical governance is an integral part of our practice.
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 Robust quality and infection control practices are in place.
 Best in class modular OT’s and ICU’s with HEPA filters, laminar air flow and 20
complete air changes per hour and access control minimize the risk of infection.
 Isolation rooms have been earmarked in the ICU to treat critically ill infectious
patients thus preventing threat to other patients.
 Stringent “Biomedical Waste Management” practices for segregation, storage,

transport and disposal of hospital waste are in place.
 Green building: The hospital is designed to allow sunlight in most of the ICUs and
patient rooms as it minimizes stress on the patients and gives them proper orientation
of time.
 The hospital has one of the most advanced “Building Management Systems” which
help in patient and employee safety and reduce the excessive burden on the
infrastructure and environment.
 Delhi’s first automated pneumatic chute system for immediate transfer of samples,
medicines and documents minimizing delays & ensuring safe and hygienic transfer.
 The “Hospital Information System” used is most advanced and user friendly and
helps to reduce medical errors as well as contributes to faster and better patient
management.
Hospital Management
The BLK Super Speciality Hospital is now being managed by Radiant Life Care Private
Limited. Prior to taking over management of the Hospital, Radiant Life Care was
responsible for financing and re-developing the erstwhile general hospital known
primarily for mother & child care services and establishing in its place a ultra-modern
and one of India's most comprehensive tertiary care Hospitals.
In order to manage the day to day operations of BLK Super Speciality Hospital, Radiant
Life Care has deputed the entire leadership team including the Executive Director,
Director - Operations & Planning, Head of Human Resources, Head of Marketing and
Administration. In addition, Radiant Life Care has been effective in putting in place
processes and global best practices encompassing both clinical and managerial facets of
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Hospital operations. Attainment of NABH & NABL accreditation in the very first year of
operations is testimony to the hospital’s commitment for patient safety and quality.
Radiant Life Care continues to facilitate the pursuit of excellence by assisting in
procuring of not only the best clinical and non clinical talent but also state of the art
equipment and technology enabling delivery of the highest standards of services to the
patients.
Journey So Far:
The hospital has gone from strength to strength over the last few years. Today, BLK
Super Speciality Hospital offers one of the most comprehensive bouquet of services for
tertiary & quaternary care, at par with country’s most renowned institutes like AIIMS and
Tata Memorial in Mumbai. We have India’s largest Bone Marrow Transplant centre
which is amongst the biggest in Asia as well. BLK Cancer Centre is amongst the regions’
most comprehensive cancer centers of its kind, with over 100 beds dedicated for
oncology services. Our Bariatric program is the largest in the Region. BLK was the
youngest Hospital to have achieved NABH and NABL accreditations.
Besides the domestic patients, Hospital's international patient base has grown
significantly over the last 12 months, owing to it being one of the most advanced
healthcare facilities in the region.
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CHAPTER 3: CONCEPTUAL DISCUSSION
CONSUMERISM AND THE MARKETING CONCEPT
A word about consumerism and the way in which the Marketing Concept can respond to
it would complete this chapter, Consumerism is a relatively recent phenomenon, starting
in the sixties in the affluent societies like the USA. We now see it emerging in India as
well. It is an organized movement of the consumers – a movement that seeks to protect
the consumers from unfair practices of the producers and marketers, and to enhance the
rights of the consumers in relation to producers and marketers. In many cases, the
governments of the societies concerned are also on the side of the concerned are also on
the side of the consumers in this raging battle. We will have an occasion to discuss some
of the aspects of consumerism elsewhere in the text. Here we shall just highlight how the
Marketing Concept can provide the right answer to consumerism.
We have seen that concern for the consumer is the essence of the Marketing Concept. As
such, when a firm practices the Marketing Concept, it automatically takes full care of the
interests of the consumer and there is no need or scope for the consumers to get organized
in their defence. In fact, when a firm practices the Marketing Concept, the attempts if
any, by interest groups to fight the firm and its product will fizzle out quickly, since
consumers at large would reject any accusations against the firm and its products. Only
because several firms functioned against the tenets of the Marketing concept,
consumerism gained ground. That is why Drucker said that `consumerism is the shame of
marketing’. If marketing is practiced as per the Marketing Concept, the very motive of
consumerism will disappear. A firm practicing the Marketing Concept would not only be
sensitive to consumer attitudes, but would also anticipate these attitudes and adjust its
marketing accordingly; and it would proceed on the assumption that what is good for the
consumer is good for the firm. Such an approach would evidently remove the very
raisond’etre of consumerism.
Consumer Behaviour
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Definition: The official definition of consumer behaviour is given by the American
Marketing Association as: the dynamic interaction of the affect and cognition, the
behaviour and environment through which people carry out transactions in their life.
Consumer behaviour reflects consumers’ decisions with respect to:
 the acquisition, consumption, and disposition
 of goods and services, time, and ideas
 By (human) decision making (over time).
Consumer receives stimuli which affect on his consuming behaviour. This stimuli comes
from:
 The financial environment (favourable or ominous financial conditions).
 The political environment (smoothly or foggy political setting).
 The technological environment (technological progress or recession).
 The company’s marketing mix as for the product, the price, the place and the
promotion. (E.g. a television advertising spot or a handing-over in the price of
product).
Five-Stage Model of the buying process:
Figure 1.1
This model implies that consumers pass through all five stages in buying a product. This
may be the case in high-involving purchases. In low-involvement purchases, consumers
may skip or reverse some of these stages. This model shows the full range of
considerations that arise when a consumer face a highly involving new purchase.
Through the studying of consumer behaviour some fundamental questions comes abroad
such as:
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 Why does consumer buy a product?
 How does consumer buy the product?
 How does consumes or use the product?
 How does consumer develop a product after buying it?
 How consumer exempted from the product (or his packing) after its usage?
Figure 1.2
Those questions find answers through the study of the factors that influences consumer’s
behaviour. Those factors are separated in four categories: social, cultural, demographical
and psychological. Those factors and its categories are the following:
CULTURAL FACTORS
Culture: Culture (or civilization) is the highest entity of personal identification with the
society. These entities were in the past the nations and could be in the future the
civilizations (Western, Muslim, Hindi, Chinese). Humane behaviour is largely learned.
The growing child acquires a set of values, perceptions, preferences and behaviours
through a process of socialization involving the family and other education institutions.
Subculture: Each culture consists of smaller subcultures that provide more specific
identification and socialization for its members. We can distinguish several subcultures in
the different countries. We can distinguish:
 National groups (immigrants, Europeans and non-Europeans)
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 Religious groups (Catholics, Protestants, Orthodox, Muslims, and Jews)
 Geographical areas (Regions, regional identity)
SOCIAL FACTORS:
Social class: “Social classes are relatively homogeneous and enduring divisions in a
society, which are hierarchically ordered and whose members share similar values
interests and behaviour” Social classes show distinct product and brand
preferences in such areas as clothing, home furnishing, leisure activities,
automobiles, and food and beverages.
Social roles and statuses: A person participates in many groups throughout life such as
family, clubs, and organizations. The person’s position in each group can be defined in
terms of role and status. A role consists of the activities that a person is expected to
perform according to the persons around him or her. Each role carries a status reflecting
the esteem accorded to it by society. Roles and statuses are at the same time dynamic and
static phenomena:
o they change with the economic and social progress (land owner, entrepreneur)
o People with higher status like to remain their position.
People choose products that communicate their role and status in society. But status
symbols vary for social classes and also geographically.
Reference group: “A person’s reference groups consist of all social groups that have a
direct (face to face) or indirect influence on the person’s attitudes or behaviour”. We
distinguish different reference groups:
o Membership groups are the groups to which the person belongs.
o Non-membership groups are the groups to which a person not belongs, but which
influence the attitudes and behaviour of the person.
o Aspiration groups are groups to which a person would like to belong.
o Dissociate groups are groups whose values or behaviour are rejected.
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Opinion leaders: Individuals which constitute source of information for specific products
and brands, and they influence consumer decisions (opinion follower).
PSYCHOLOGICAL FACTORS
Personality: The total internal characteristics of an individual that determines the way
how he reacts. (E.g. self-monitoring, self-concept, sociability, etc).
Self-concept: The picture or the perception that each individual has for his exterior
appearance, his mental faculties, his character and generally speaking what concerns the
individual as a social being.
Lifestyle: It expresses the values that an individual has in their life. It constitutes
important variable of market segmentation.
Perception: The process, with which an individual selects, organises and it interprets
incomes of information with an aim to create a reasonable picture for the world.
Beliefs and attitudes: The total knowledge from advertises or other promotion energies,
but also personal experiences, that the individual - consumer acquires and maintains in
his memory. Configuration of specific beliefs and attitudes for specific products, specific
brands, specific retailers, even though for specific production countries.
PERSONAL FACTORS
Age and life-cycle stage: People buy different goods and services over their lifetime.
They eat baby food in the early years, most foods in the growing and maturing years, and
special diets in the later years.
Lifestyle: People coming from the same subculture, social class, occupation but may lead
different lifestyles. A person’s lifestyle in the person’s pattern of living in the world as
expressed in the persons activities, interests, and opinions. Lifestyle portrays the “whole
person” interacting with his or her environment.
Occupation: A person’s consumption pattern is also influenced by his or her occupation.

A white-collar worker will buy other clothing and food as a blue-collar worker.
Economic circumstances consist of their:
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o spendable income
o savings and assets
o borrowing power
o Attitude toward spending and saving.
Figure 1.3
To sum up, we can conclude that consumer’s behaviour in interaction with the factors that
influenced it can be attributed concisely with the following diagram:
Figure 1.4
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Customer Satisfaction
Researchers define consumer satisfaction in various ways. Some of the definitions

provided in the consumer satisfaction literature are fundamentally inconsistent with one
another. In other cases, the definitions have overlapping components but are partially
inconsistent. When examined as a whole, three general components can be identified in
extant definitions: 1) consumer satisfaction is a response (emotional or cognitive); 2) the
response pertains to a particular focus (expectations, product, consumption experience,
etc.); and 3) the response occurs at a particular time (after consumption, after choice,
based on accumulated experience, etc)., these three general categories capture the essence
of all the definitions presented. As expected, existing definitions are inconsistent in the
specifics associated with the type, focus and timing of the satisfaction response.
Customer satisfaction has three stages:
1. The pre-sales stage where there are the expectations for the product, the profits, the
price and the availability of product.
2. The sales stage when customer trays the environment, the product, the type of service,
the delivery, the quality and the redress from the market.
3. The after-sales stage when customer expects the support or the advices, the
replacement of product or the return of sum, repairs and processes of charges..
As concluded by the literature review and validated by the group and personal interview
data, there appears to be three essential components of consumer satisfaction:
1. Summary affective response which varies in intensity;
2. Satisfaction focus around product choice, purchase and consumption; and
3. Time of determination which varies by situation, but is generally limited in duration.
So consumer satisfaction is:
A summary affective response of varying intensity. The exact type of affective

response and the level of intensity likely to be experienced must be explicitly defined by
a researcher depending on the context of interest.
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With a time-specific point of determination and limited duration. The researcher
should select the point of determination most relevant for the research questions and
identify the likely duration of the summary response. It is reasonable to expect that
consumers may consciously determine their satisfaction response when asked by a
researcher; therefore, timing is most critical to ascertain the most accurate, well-formed
response. Directed toward focal aspects of product acquisition and/or consumption.
The researcher should identify the focus of interest based on the managerial or research
question they face. This may include a broad or narrow range of acquisition or
consumption activities/issues.
Many studies have been conducted on the customer satisfaction. An attempt has been
made to present in brief, a review of literature on customer satisfaction in general as well
as on the customer satisfaction from hospital services.
Priscilla et al (2007) proposed a cognitive model to assess the dynamic aspect of

consumer satisfaction/ dissatisfaction in consecutive purchase behavior. They found that
satisfaction have a significant role in mediating intentions and actual behavior for five
product classes that were analyzed in the context of a three- stage longitudinal field study.
They found that repurchases of a given brand is affected by lagged intention whereas
switching behavior is more sensitive to dissatisfaction with brand consumption.
Luthans (2011)have extended consumer satisfaction literature by theoretically and

empirically examining the effect of perceived performance using a model first proposed
by Churchill and Surprenant, investigating how attractive conceptualizations of
comparison standards and disconfirmation capture the satisfaction formation process and
exploring possible multiple comparison processes in satisfaction formation. They suggest
that perceived performance exerts direct significant influence on satisfaction in addition
to those influences from expected performance and subjective disconfirmation.
Saha (1988) made an attempt to investigate the interrelationships between job-

satisfaction, life satisfaction, life satisfaction-over-time and health. The relationship
among these four variables and biographical variables were also examined. The study
was conducted over the nurses in Nigeria. The data was collected from the full time
19
employees only because statements about job satisfaction and other variables are different
when supplied by retirees, part-time nurses.
Aurora and Malhotra (2009) had done a comparative analysis of the satisfaction level of
customer of public and private sector banks, in order to help the bank management to
formulate marketing strategies to lure customers towards them and hence increase
customer base.
Grewal (2007) et al had expanded and integrated prior price perceived value models
within the context of price comparison advertising. More specifically, the conceptual
model explicates the effects of advertised selling and reference prices on buyers’ internet
reference prices, perceptions of quality, acquisition value, transaction value, and purchase
and search intentions. Two experimental studies test the conceptual model. The results
across these two studies, both individually and combined, support the hypothesis that
buyers’ internal reference prices are influenced by both advertised selling and reference
price as well as buyers’ perception of product quality. The authors also find that effect of
advertised selling price on buyers’ acquisition value was mediated by their perceptions of
transaction value. In addition, effects of perceived transaction value on buyers, behavioral
intentions were mediated by their acquisition value perceptions.
Sharma and Chahal (1999) had done a study of patient satisfaction in outdoor services of
private health care facilities. They had done a survey to understand the extent of patient
satisfaction with diagnostic services. They have constructed a special instrument for
measuring patient satisfaction. The instrument captures the behaviour of doctors and
medical assistants, quality of administration, and atmospherics. The role of graphic
characters like gender, occupation, education, and income is also considered. Based on
their findings, they also suggested strategic actions for meeting the needs of the patients
of private health care sector more effectively. In their study provided suggestions like
becoming more friendly and understanding to the problems of patients, maintaining
cleanliness in the units, both internally and externally, providing regular report regarding
the patients’ progress without waiting for them to demand, conducting surveys to know
about the attitude of the patients with regard to the employees and adopting patient-
oriented policies and procedures.
20
Sharma and Chahal (2003) stated that due to increased awareness among the people
patient satisfaction had become very important for the hospitals. The authors examined
the factors related to patient satisfaction in government outpatient services in India. They
said that there are four basic components which had impact on the patient satisfaction
namely, behaviour of doctors, behaviour of medical assistants, quality of atmosphere, and
quality of administration. They also provided strategic actions necessary for meeting the
needs of the patients of the government health care sector in developing countries.
Gruca and Rego (2015) strengthen the chain of effects that link customer satisfaction to
shareholder value by establishing the link between satisfaction and two characteristics of
future cash flows that determine the value of the firm to shareholders: growth and
stability. By using the longitudinal American Customer Satisfaction index and
COMPUSTAT data and hierarchical Bayesian estimation they found that satisfaction
creates shareholder value by increasing future cash flow growth and reducing its
variability. They also test the stability of findings across several firm and industry
characteristics and assess the robustness of the results using multi-measure and multi-
method estimation
Thompson (2005) in his study had shown that consumers often misjudge their health
risks owing to a number of well-documented cognitive biases. These studies assume that
consumers have trust in the expert systems that culturally define safe and risky
behaviours. Consequently, this research stream does not address choice situations where
consumers have reflexive doubts toward prevailing expert risk assessments and gravitate
toward alternative model of risk reductions. This study explores how dissident health risk
perceptions are culturally constructed in the natural childbirth community, internalized by
consumers as a compelling structure of feeling, and enacted through choices that
intentionally run counter to orthodox medical risk management norms.
Folkes and Patrick (2003) in their study showed converging evidence of a positivity
effect in customers’ perceptions about service providers. When the customer has little
experience with the service, positive information about a single employee leads to
perception that the firm’s other service providers are positive to a greater extent than
negative information leads to perception that the firm’s other service providers are
similarly negative. Four studies were conducted that varied in the amount of information
21
about the service provider, the firm, and the service. The positivity effect was supported
despite differences across studies in methods as well as measures.
Vernoer (2013) had investigated the different effects of customer relationship perceptions
and relationship marketing instruments on customer retention and customer share
development over time. Customer relationship perceptions are considered evaluations of
relationship strength and a supplier’s offerings, and customer share development is the
change in customer share between two periods. The results show that affective
commitment and loyalty programs that provide economic incentives positively affect
both customer retention and customer share development, whereas direct mailings
influence customer share development. However, the effect of these variables is rather
small. The results also indicate that firms can use the same strategies to affect customer
satisfaction that can have impact on both customer retention and customer share
development.
Reinartz et al (2004) in their study of Customer Relationship Management Process had

stated that it is very important for maintaining healthy relations with the customers in
order to provide them satisfaction. In their study, they (1) conceptualize a construct of the
CRM process and its dimensions, (2) operationalize and validate the construct, and (3)
empirically investigate the organizational performance consequences of implementing the
CRM processes. Their research questions are addressed in two cross-sectional studies
across four different industries and three countries. The key outcome is a theoretically
sound CRM process measure that outlines three key stages: initiation, maintenance, and
termination.
Homburg et al (2005) conducted two experimental studies (a lab experiment and a study
involving a real usage experience over time) which reveal the existence of a strong,
positive impact of customer satisfaction on willingness to pay and they provide support
for a nonlinear, functional structure based on disappointment theory. In addition, the
second examines dynamic aspects of the relationship and provides evidence for the
stronger impact of cumulative satisfaction rather than of transaction-specific satisfaction
on willingness to pay.
Mithas et al (2005) evaluates the effect of customer relationship management (CRM) on
customer knowledge and customer satisfaction. They analyze archival data of a cross-
section of U.S firms which shows that the use of CRM applications is positively
22
associated with improved customer knowledge and improved customer satisfaction. They
also found that gains in customer knowledge are enhanced when firms share their
customer related information with their supply chain partners.
Gustafsson et al (2005) in their study of telecommunications services examine the effect
of customer satisfaction, affective commitment, and calculative commitment on retention
and the potential for situational conditions to moderate the satisfaction-retention
relationship. Their results support consistent effects of customer satisfaction, calculative
commitment and prior-churn on retention.
23
HEALTHCARE AND HOSPITAL INDUSTRY
Healthcare industry is a wide and intensive form of services which are related to well
being of human beings. Health care is the social sector and it is provided at State level
with the help of Central Government. Health care industry covers hospitals, health
insurances, medical software, health equipments and pharmacy in it.
Right from the time of Ramayana and Mahabharata, health care was there but with time,
Health care sector has changed substantially. With improvement in Medical Science and
technology it has gone through considerable change and improved a lot.
The major inputs of health care industries are as listed below:

I. Hospitals
II Medical insurance
III. Medical software
IV. Health equipments
Health care service is the combination of tangible and intangible aspect with the
intangible aspect dominating the intangible aspect. In fact it can be said to be completely
intangible, in that, the services (consultancy) offered by the doctor are completely
intangible. The tangible things could include the bed, the décor, etc. Efforts made by
hospitals to tangiblize the service offering would be discussed in details in the unique
characteristics part of the report.
Different types of health care services available in India

Hospitals
Pathology Clinics
Blood Banks
Meditation Centres
Emergency services like Ambulances, etc.
Online Medical Services
Telemedicine
Naturopathy
24
Yoga Centres
Fitness Centres
Laughter Clubs
Health Spas
In the Constitution of India, health is a state subject. Central govt’s intervention to

assist the state govt is needed in the areas of control and eradication of major
communicable & non- communicable diseases, policy formulation, international health,
medical & para-medical education along with regulatory measures, drug control and
prevention of food adulteration, besides activities concerning the containment of
population growth including safe motherhood, child survival and immunization Program.
The plan outlay for central sector health programme in the Annual Plans 2015-16 is
Rs.1420 crore including a foreign aid component of Rs.680 Crore. A major portion of
outlay is for the control and eradication of diseases like malaria, , blindness being
implemented under Centrally sponsored schemes.
Another major component of the central sector health programme is purely Central
schemes through which financial assistance is given to institutions engaged in various
health related activities. These institutions are responsible for contribution in the field of
control of communicable & non-communicable diseases, medical education, training,
research and parent -care.
In our project our focus has been the hospital sector which is the major component of the
healthcare industry.
Factors Attracting Corporates In the Healthcare Sector
Recognition as an industry: In the mid 80’s, the healthcare sector was recognized as an
industry. Hence it became possible to get long term funding from the Financial
Institutions. The government also reduced the import duty on medical equipment’s and
technology, thus opening up the sector.
Since the National Health Policy (the policy’s main objective was ‘Health For All’ by the
Year 2000) was approved in 1983, little has been done to update or amend the policy
even as the country changes and the new health problems arise from ecological
25
degradation. The focus has been on epidemiological profile of the medical care and not
on comprehensive healthcare.
Socio-Economic Changes: The rise of literacy rate , higher levels of income and
increasing awareness through deep penetration of media channels, contributed to greater
attention being paid to health. With the rise in the system of nuclear families, it became
necessary for regular health check-ups and increase in health expenses for the bread-
earner of the family.
Brand Development: Many family run business houses, have set-up charity hospitals.
By lending their name to the hospital, they develop a good image in the markets which
further improves the brand image of products from their other businesses.
Extension To Related Business: Some pharmaceutical companies like Wockhardt and

Max India, have ventured into this sector as it is a direct extension to their line of
business.
Opening Of The Insurance Sector:
In India, approx. 60% of the total health expenditure comes from self paid category as
against governments contribution of 25-30 %. A majority of private hospitals are
expensive for a normal middle class family.
The opening up of the insurance sector to private players is expected to give a shot in the
arms of the healthcare industry. Health Insurance will make healthcare affordable to a
large number of people.
Currently, in India only 2 million people ( 0.2 % of total population of 1 billion), are
covered under Mediclaim, whereas in developed nations like USA about 75 % of the total
population are covered under some insurance scheme.
General Insurance Company, has never aggressively marketed health insurance.

Moreover, GIC takes up to 6 months to process a claim and reimburses customers after
they have paid for treatment out of their own pockets. This will give a great advantage to
private players like Cigna which is planning to launch Smart Cards that can be used in
hospitals, patient guidance facilities, travel insurance, etc.
26
The Consultants, Financiers and Insurance Agencies are to benefit from this boom. The
insurers will use PPOs, that will grow into HMOs, to assume insurance risks on clients
behalf. Medical Equipments, Medical Software and Hospitals will see the biggest boom.
27
7PS OF MARKETING FOR HOSPITALS
Product:
The service product is an offering of commercial intent having features of both intangible
and tangible, seeking to satisfy the new wants and demands of the consumer. Hospital
industry is action oriented and there is a lot of interaction with the customers (patients).
The service product of the hospitals normally have the following features:
 Quality Level: When we talk about marketing hospitals, it is natural that we are
very particular about managing our services in the right fashion. Supportive
services play an important role in improving the quality of Medicare. These
services which include laboratory, blood-banks, catering, radiology and laundry,
in a true sense determine the quality of services made available by medical and
para-medical personnel. They get a strong base for treatment since the diagnostic
aspect determines a direction. To get the best result from OT, it is natural that
equipments are properly sterilized. In addition, the dresses and clothes are also
required to be made bacteria free. The patients are required to wear disinfected
linen which should be made available. The radiology department should have hi-
tech facilities keeping in view the pressure of work. Of late, we find sophisticated
equipments and unless hospitals make the same services available the same, the
quality of services cannot be improved.
 Accessories: This is a very good way of segmenting customers. Many hospitals

provide additional services such as catering, laundry, yoga sessions, cafeterias,
etc. for the customers (patients)who are willing to pay extra. Hospitals have
different wards - General and Special. Certain hospitals provide services for the
family members of the patients (when they are not from the same city) –
accommodation and catering.
 Packaging: It is the bundling of many services into the core service. Eg: Apollo
hospital offers a full health check-up to the patients. Similarly other hospitals also
offer package deals for health check-ups. For example if a person has to undergo a
bypass surgery, he can pay a lump sum amount during admission, say rupees 1
lakh for all procedures, tests, stay, etc, at once.
28
 Product line: hospitals through their services offer many choices to the patients
and cover a wide range of customer needs. For example: Apollo hospital has
dental department, cardiology department, etc. and within the dental department it
has dental surgery, root canal, etc.
 Brand name: The hospitals, to differentiate themselves, and their services from
others use a brand name. The intangibility factor of the service makes it all the
more important for the hospitals to do so.
Place
Under hospital marketing, distribution of Medicare services plays a crucial role. This
focuses on the instrumentality of almost all who are found involved in making services
available to the ultimate users. In case of hospitals the location of hospital plays a very
important role. The kind of services a hospital is rendering is also very important for
determining the location of the hospital. Eg. Tata memorial hospital specializes in cancer
treatment and is located at a centre place unlike other normal hospitals, which you can
find all over other places.
It can be unambiguously accepted that the medical personnel need a fair blending of two
important properties i.e. – they should be professionally sound and should have in-depth
knowledge at psychology. A particular doctor might be famous for his case handling
records but he may not be made available for all the patients because of the place factor.
Now in this case the service provided, that is the doctor may be a visiting doctor for
different hospitals at different locations to beat the place factors.
Unlike other service industries, under hospital marketing all efforts should be for making
available to the society the best possible medical aid.
In a country like India, which is geographically vast and where majority of the population
lives in the rural areas, place factor for the hospitals play a very crucial role. A typical
small village / town may be having small dispensaries but they will not have super
speciality hospitals. For that they will have to be dependent on the hospitals in the urban
areas.
People
29
Under hospital marketing the marketing mix variable people includes all the different
people involved in the service providing process (internal customers of the hospitals)
which includes doctors, nurses, supporting staff etc. The earliest and the best way of
having control on the quality of people will be by approving professionally sound doctors
and other staff.
Hospital is a place where small activity undertaken can be a matter of life and death, so
the people factor is very important. One of the major classifications of hospitals is –
private and government. In the government hospital the people factor has to be specially
taken care of. In Indian government hospitals except a few almost all the hospitals and
their personnel hardly find the behavioural dimensions significant. It is against this
background that even if the users get the quality medical aid they are found dissatisfied
with the rough and indecent behaviour of the doctors.
Under hospital marketing a right person for the right job has to be appointed and they
should be adaptable and possess versatility. The patients in the hospitals are already
suffering from trauma, which has to be understood by the doctors and other staff. The
people of the hospital should be constantly motivated to give the best of their effort.
Process
Process generally forms the different tasks that are performed by the hospital. The
process factor is mainly dependent on the size of the hospital and kind of service it is
offering. A typical process involved in a medium sized hospital can be as follows.
30
Figure 1.5
Apart from this flow there are other allied activities like record keeping administration at
services etc which fall under the process factor. These stages do not exist separately but
are interlinked. The most important elements are lines of communication within the
setup. The experience of the patient depends on the final interplay of all these factors.
Physical evidence
It does play an important role in health care services, as the core benefit a customer seeks
is proper diagnosis and cure of the problem. For a local small time dispensary or hospital
physical evidence may not be of much help. In recent days some major super speciality
hospitals are using physical evidence for distinguishing itself as something unique.
Physical evidence can be in the form of smart buildings, logos, mascots etc. a smart
building infrastructure indicates that the hospital can take care of all the needs of the
patient.
Examples -
31
1. Lilavati hospital has got a smart building, which helps, in developing in the minds
of the people, the impression that it is the safest option among the different
hospitals available to the people.
2. Fortis and Apollo hospitals have a unique logo, which can be easily identified.
Physical evidence also helps in beating the intangibility factor.
Promotion:
Hospitals for promotion use either advertisement or PR or both after taking into
consideration the target customers, media type, budget and the sales promotion.
Since a few years the prime times in T.V. are reserved for advertising social issues like
family planning, use of different types of contraceptives, care for the girl child and so on.
These commercials use the common man approach for reference group appeal. In case of
health care products and services use for “common man” appeal is widely prevalent. The
use of celebrities is not as effective as that of a common man. An ordinary person thinks
that if it works well for people like him, it will also work equally well for him. The
identification with the common man is easy and quick.
Besides TV, other media of promotion are to be used innovatively. Unlike the urban area,
in rural areas newspapers and magazines do not have the same impact in conveying
messages. In villages, hoardings and wall writings near the markets and recreation centers
attract the attention of villagers. This market consists of 180 million strong middle
income group and a small income group. This group has a large discretionary income.
These discerning consumers are very careful in choosing health care services. The last
decade has witnessed a health, appearance and nutrition conscious population.
The health care field has become very competitive. Although around one-fourth of our
population stays in urban India, three fourths of the total doctors have engaged
themselves in this part. Many of these doctors visit the contiguous rural areas, but they
may operate from the urban area. The patients of upper middle and upper income group
have a wide choice to make from a number of clinics and hospitals. Therefore, many
hospitals have abandoned traditions and adopted marketing strategies to woo more and
more patients to their clinics.
32
Word-of-mouth plays a very important role in promotion of hospitals. A person in need of
a health care service does not know for sure where to search for relevant information. He
consults his family members, relations and friends first. The patients who come to a
hospital generally have the old patients of that hospital as referrals. Word-of-mouth plays
an important role during information acquisition stage of the customers as there are no
objective performance measures to judge the various alternatives available to them.
Therefore, satisfied past patients of a hospital can bring more number of patients to that
hospital than a number of advertisements.
In a competitive market place, the images of the firms swill affect their competitive
standing. One factor that is likely to have a significant impact on the health care scene is
the growth of hospital chains such as Apollo Hospitals, Birla Health Centres ,etc.
Artificial heart transplants and other complex operations although are few in number and
generate a small portion of the total revenue, they help in generating word-of-mouth
which health care providers are actually interested. Many of these companies are
spending a lot in corporate advertising for Image building.
33
CHAPTER 4: RESEARCH METHODOLOGY
RESEARCH OBJECTIVES
 To study consumers’ expectations, perception and their satisfaction level of BLK
hospital
 To examine patients’ expectations from the behaviour of the doctors,
 To study patients’ satisfaction level for the behaviour of the medical assistants.
 To analyze patients’ satisfaction level for the services provided by BLK Hospital
METHODOLOGY
The present chapter describes the research methodology of the study. It includes the
Research Framework, Sample design and selection, Collection of Data, Research vehicle
and Methods for analysis of data. It also points out the limitations of present study.
RESEARCH DESIGN
The present study is based on explorative and descriptive research design with the
objective of measuring the satisfaction level of patients’ of five major private hospitals in
Delhi. The study uses both primary and secondary information. As it is clear from the
objectives of the study, the study was divided into three parts i.e. patients’ expectations,
perceptions from the hospital services and then measuring their satisfaction level from the
hospital services. For both the first and second objective of study i.e. the customers’
expectations and their perceptions of hospital services, primary data was collected
through a structured questionnaire. Then to meet the third objective of the study proper
statistical tools were used on the information collected for the first two objectives of the
study.
DATA SOURCES
Before an attempt was made to collect the information from the sample, the desk research
was conducted to see the literature and other library material available on the subject.
Various studies were reviewed to have a through knowledge before considering how to
collect the information from the respondents. After having the background knowledge a
structured questionnaire was prepared to obtain answer pertinent to the objectives of the
34
study. For the purpose of the study, eighty indoor patients were selected and interviewed
from the five private hospitals.
Secondary data- was also collected from various books, journals, magazines etc.
QUESTIONNAIRE DESIGN
The information was collected through a pre-designed, structured questionnaire.
To study consumers’ expectations, perception and their satisfaction level it was required
to examine the following aspects
(i) Patients’ expectations from the behaviour of the doctors,
(ii) Patients’ expectations from the behaviour of the medical assistants,
(iii) Patients’ expectations from the quality of administration of hospitals,
(iv) Patients’ expectations from the services provided by the hospitals,
(v) Patients’ perceptions for the behaviour of the doctors,
(vi) Patients’ perceptions for the behaviour of the medical assistants,
(vii) Patients’ perceptions for the quality of administration of BLK Hospital,
(viii) Patients’ perceptions for the services provided by the hospitals,
(ix) Patients’ satisfaction level for the behaviour of the doctors,
(x) Patients’ satisfaction level for the behaviour of the medical assistants,
(xi) Patients’ satisfaction level for the quality of administration of hospitals and
(xii) Patients’ satisfaction level for the services provided by BLK Hospital,
SAMPLE DESIGN
Sample Unit
In view of the fact that this was a one person survey to be completed within limited
resources the present study was restricted to only those hospitals which were located in
Delhi. The population of this study comprised of the indoor patients in BLK Hospital.
Sampling Frame : From these hospitals primary data was collected from the
respondents. The respondents were either the patients themselves or their relatives.
Sampling Technique:
35
For sample selection, a multistage sampling procedure was followed. At the first stage,
sample units consisted of total number of general wards and private wards in the hospital.
10% of the general wards and 10% private, wards were selected randomly. Then from
each selected general ward 3 to 5 patients were chosen and from each selected private
ward one patient was chosen.
Sample Size: A sample of 100 respondents selected from these hospitals on the basis of
their convenience for the first objective and the second objective. To suggest solutions to
the problems observed during the survey is done through secondary data.
ANALYSIS OF DATA
The data / information contained in the questionnaire were first transferred to master
table which facilitated tabulation of data in desired form. The collected data was then
grouped into tables and analyzed using various statistical tools like mean scores. Other
statistical tool used includes T-test for measuring whether there is significant difference
between the mean scores of attributes i.e. between expectations and perceptions of a
factor. Reaction of the respondents towards the different factors given was studied using a
structured, non-disguised and well-defined questionnaire designed for the patients or their
attendants. The questionnaire contained rating questions. Each factor was rated over a
scale of 1 to 9 i.e. likert scale was used. The respondents were asked to rate the factors
according to what they expect and what they had perceived from the hospital services.
LIMITATIONS OF THE STUDY

1. As the study was to be completed in a short time, the time factor acted as a
considerable limit on the scope and the extensiveness of the study.
2. The information provided by respondents may not be fully accurate due to
unavoidable biases.
3. The lack of corporation shown by the respondents, because of this optimum
number of responds not collected, so the sample was to be shortened.
36
CHAPTER 5: DATA ANALYSIS AND
INTERPRETATIONS
1. Listened carefully to them
Sometime or never 20
Usually 22
Always 58
Table 1.1
Figure 1.6
Most of the respondents (58%) of the patients said doctors and nurses always listen
them well at BLK Hospital. On the other hand 22 % of the patients said doctors and
nurses sometimes or never listen well and 20% the patients said doctors sometimes or
never listen them well.
37
2. Explained things in a way they could understand
Usually 42
Always 26
Table 1.2
Figure 1.7
42% usually of the patients said that doctors and nurses explained things in a way they
could understand at BLK Hospital. On the other hand 26 % of them said that they
always explained things in a way they could understand.
38
3. Showed respect for what they had to say
Usually 43
Always 38
Table 1.3
Figure 1.8
39
43% of the patients said that the staff of BLK Hospital showed respect for what they
had to say. On the other hand 38 % of them said that they respect for what they had to
say.
40
4. Spent enough time with them
Usually 42
Always 40
Table 1.4
Figure 1.9
From the respondent answer we have found 42% doctors and nurses sometimes or never
spent enough time with patients while 40% said they always spent enough time with
patients.
B. Getting care without long waits:
41
Q5. Got treatment as soon as they wanted when they were sick or injured
Usually 29
Always 52
Table 1.5
Figure 2.0
A random number of 100 patients were asked about are they getting care without long
waits Form the answer we found 19 % of patients sometimes or never got care without
long wits. On the other hand 29 % of the patients usually got care without long wits and
52% the patients got care without long waits.
42
Q6. Got an appointment as soon as they wanted for regular or routine health care
Usually 18
Always 71
Table 1.6
Figure 2.1
got an appointment as soon as they wanted for regular or routine health care. On the
other hand 18 % of the patients always got an appointment as soon as they wanted for
regular or routine health care.
43
Q7. Waited only 15 minutes or less past their appoint time to see
Usually 30
Always 24
Table 1.7
Figure 2.2
Most of the respondents (46%) said that they sometime or never waited only 15
minutes or less past their appoint time to see.
44
Q8. How many time doctor visit a patient?
Times <2 3 to 5 6 to 7 8 to 9 10 or more
% percent 23% 73% 4% 0 0
Table 1.8
Figure 2.3
Hospitals aims to provide unparallel service to the people of NCR by delivering the
highest possible level of care .A random number of 100 patients was surveyed about the
average visit by doctor to patients
45
Q9. How often doctors talk both patients and its close persons?
How often % percent

Almost always 7%
Often 26%
Sometimes 60%
Never 7%
Don’t know 0
Refused 0
Total 100%
Table 1.9
Figure 2.4
BLK Hospital is a 150 bed tertiary care hospital. Its vision is that Hospital will become
the location of choice for Delhi & NCR region for quality healthcare and an integrated
centre for clinical services, medical and nursing education and research. According to the
response of patients, we found that 60% of the doctors sometimes talk both patients and a
person they are close to like parents, friends and spouse. Then 26 of the doctors talk both
patients and a person they are close often talk both patients and their close person. 7%
health center almost always and 7 % never talk both patients and a person they are close.
46
Q10. Enough nurse and doctors?
Figure 2.5
A random number of 100 patients were asked about do they think have enough nurse staff
and doctor? According to their answer we have found 85% patients think Hospital have
enough nurse staff and doctor. 10% patients think Hospital don’t have enough nurse staff
and doctor.
47
Q11. Efficiency of receptionists or staff care?
Figure 2.6
Reception staff communicates with patients is important for health care organization.
When asked to rate how helpful they found the receptionists, and how they found they are
usually treated by the receptionists, nearly all respondents (86%) said they were
‘excellent’, ‘very good’ or ‘good’. This reflects the hard work and commitment of the
reception and administration staff that is very important part of the service.
48
Q12. Friendliness of people caring for the patient
Excellent 18
Very good 45
Good 17
Bad 10
Very bad 4
Don’t Know 6
Table 2.0
Figure 2.7
Friendliness of the people caring for the patients is important for health care
organization. When asked to rate how friendly the stuffs and doctors are and how they
usually behave with the patients, nearly all respondents (63%) said they were ‘excellent’,
‘very good’ or ‘good’. This reflects the hard work and commitment of the people caring
for the patients of Hospital.
49
Q13. Effectiveness of emergency department
Very satisfied 42
Satisfied 36
Neutral 10
Dissatisfied 12
Very dissatisfied 0
Table 2.1
Figure 2.8
This Report presents several different indicators that describe how well Hospital
emergency departments perform and whether its patients are satisfied or not. . Emergency
departments (EDs) provide a critical function within the Hospital. Approximately nine
thousand patients pass through Hospital EDs every year. Likewise, this report did
measure the satisfaction of the patients who receive care in EDs. Nearly all respondents
(78%) said they are Very satisfied, somewhat satisfied about Hospital emergency
departments.
50
Q14. Rank overall quality of BLK Hospital
Apollo Hospital is a 300 bed tertiary care hospital. Its vision is that Apollo Hospital will
become the location of choice for Delhi & NCR for quality healthcare and an integrated
centre for clinical services, medical and nursing education and research. The measure of
overall quality helps to identify patient’s impression of the quality of care received. This
indicator has been shown to be closely related to clinical outcomes.
Figure 2.9
A random number of 100 patients were asked to rate the overall satisfaction, nearly all
respondents (83.1%) said they were ‘excellent’, ‘very good’ or ‘good’
CHAPER 6: FINDINGS AND RECOMMENDATIONS
51
Comparison of Results with Other studies
The physical evidence and service environment is poorest in Delhi & NCR health care
industry. We asked about patients about satisfaction with different care of Hospitals in
Delhi. The high satisfaction levels were expressed with Friendliness of the doctors, and
nurses. The service design of Hospital environment creates satisfaction. Good air quality
and ventilation, adequate lighting is linked to patient satisfaction as well as that motive
patients to became fit. For hospital patients, quality of care is strongly linked to the
performance of nursing staff. Over time, Hospital nursing and physical evidence has
increased its appeal to the patients. As a result, BLK Hospital providing quality health
care through
 Providing all patients private rooms
 Providing indoor air quality with well-designed ventilation systems and air filters.
 Made hospitals quieter.
 Providing better lighting and access to natural light to reduce stress and improve
patient safety.
 Created pleasant, comfortable, and informative environments to relieve stress and
Promote satisfaction among patients, their families, and staff.
 Made hospitals easier for patients and their families to navigate
Now if we look at the following table we can easily measure the patient’s satisfaction of
Hospital.
52
Figure 3.0
Moreover the healthcare in BLK Hospital is improving their performance and patients
satisfaction day by day through its doctors, staffs, and owner dedication, hard work, good
communication skills.
MAJOR FINDINGS
53
1. Expectation level is very high and nearly same for almost all the factors i.e. for
behaviour of the doctors, behaviour of medical assistants, quality of
administration and service/facilities provided.
2. Mean score for the expectations from all the four factors is 8.30 which is very
high on the scale 9.
3. Under behaviour of doctors attribute availability and thorough check up has the
highest score 8.98 and empathy and individual consideration have 7.31 and 6.70
respectively.
4. Attribute convenient office hours has lowest expectation score of 6.53 and
behaviour of clerical staff has the highest 8.89 among all the attributes of factor
quality of administration.
5. Bedding arrangements, dust boxes and flies and mosquitoes has score 9 for
expectations for these attributes of factor services provided by the hospitals.
6. Overall mean score for perceptions of patients’ about the four factor is 7.31 which
is considered good on the scale of 9.
7. Empathy with score 5.85 has the minimum score and thorough check up with
score 7.89 has highest score among all the attributes of factor behaviour of
doctors.
8. Perception about the dress of medical assistant is very good with score 9 and
handling of queries is lowest with score 6.1.
9. Fee has the lowest level of perception and behaviour of security staff has the
highest level of perception.
10. Perceptions of patients’ about the attributes of factor services/facilities provided
by the hospitals are almost good.
11. The largest difference between expectations and perceptions is 1.91 for attribute
handling of queries and lowest for individual consideration 0.88 under factor
behaviour of doctors.
12. For behaviour of medical assistants the largest difference is for the attribute
handling of queries and lowest for maintenance of record. Also dress has negative
difference which means perceptions are larger than expectations.
54
13. Attribute convenient office hours of factor quality of administration is negative,
largest difference is for the attribute check up procedure and lowest for behaviour
of security staff.
14. Outer & inner appearance has the lowest difference 0.025 and well equipped units
have the highest 1.24. and attribute staff appearance has the negative difference of
1.11.
55
CONCLUSIONS/FINDINGS
In the present business scenario of cutthroat competition, customer satisfaction has

become the prime concern of each and every kind of industry. Companies are
increasingly becoming customer focused. Companies can win customers and surge ahead
of competitors by meeting and satisfying the needs of the customers. World over
businesses have realized that marketing is not the only factor in attracting and retaining
customers. Other major factors responsible for the same are satisfaction through service
quality and value. Even the best marketing companies in the world fail to sell products
and services that fail to satisfy the customers’ needs. So customer satisfaction is the
keyword in today’s fiercely competitive business environment.
The measurement of customer satisfaction has become very important for the
health care sector also. The concept of customer satisfaction has encouraged the adoption
of a marketing culture in the health care sector in both developed and developing
countries. As large numbers of hospitals are opening up and the people are becoming
more aware and conscious of health, great competition has emerged in this industry. So to
retain their patients hospitals have to provide better facilities/services to its customers.
Various factors that can affect the patients’ satisfaction include behaviour of doctors,
availability of specialized doctors, behaviour of medical assistants, quality of
administration, quality of atmosphere, availability of modern facilities etc. So, if the
hospitals want that their customers must be satisfied, they have to provide not only better
treatment but other facilities also. The current study is focused on examining the various
factors related to patient satisfaction with the following specific objectives:
1. To study the customer expectations from hospital services.
2. To study the customer perception of hospital services.
3. To study the degree of satisfaction of customers from hospital services.
In order to accomplish the objectives of the study, the primary data was
collected. The population of this study comprised of the indoor patients only. Five major
private hospitals in Ludhiana were selected namely:
Apollo Hospital
Fortis Healthcare
56
Rockland Hospital
Moolchand
Holy Family
From these hospitals primary data was collected from the respondents. The respondents
were either the patients themselves or their relatives. For sample selection, a multistage
sampling procedure was followed. At the first stage, sample units consisted of total
number of general wards and private wards in the hospital. 10% of the general wards and
10% private, wards were selected randomly. Then from each selected general ward 3 to 5
patients were chosen and from each selected private ward one patient was chosen. The
information was collected through a pre-designed, structured questionnaire. A sample of
80 respondents selected from these hospitals on the basis of their convenience for the first
objective and the second objective. To suggest solutions to the problems observed during
the survey is done through secondary data. The collected data was then grouped into
tables and analyzed using various statistical tools like mean scores. Other statistical tool
used includes T-test for measuring whether there is significant difference between the
mean scores of attributes i.e. between mean values of expectations and perceptions of an
attribute.
57
CHAPTER 7: RECOMMENDATIONS
The general perception that large hospitals, with high bed-occupancy rate, are profitable,
is misleading. Global experience shows that hospital with more than 250 beds don’t do
well. Many Indian hospitals are following the US healthcare industry, by decreasing the
average length of stay of patients and increasing patient turnover. US research shows that
80% of the revenues form a patient comes in the first 72 hours post- admission. Hospitals
generate a lot of revenues from General Inspection, because the patient turnover is very
high.
A large percent of revenues come from specialized services like operations and surgeries.
It is because of these reasons that many corporates are planning for a small 100 beds
specialized hospitals, which caters to specific diseases like cardiac, cosmetic surgery,
neurology etc. Research shows that there exist a lot of space for super-specialized
hospitals with 100-150 beds, which generate revenues equivalent to large 500 bed general
hospital. Typically large hospitals with approximately 500 bed capacity takes about 9-10
years to break even whereas super-specialty hospitals with about 100 beds take about 6-7
years to break even. Therefore, going in for super-speciality hospitals seems to be a more
viable option today.
Hospitals could also generate revenues from medicines if they are supplying them in-
house. Some hospitals make it mandatory for the patients to buy medicines from the
hospital’s chemist shop. A margin of 15-20 % can be charged for such medicinal supplies.
Though many hospitals run by Trusts do not earn this way, but new entrants or corporates
for whom private healthcare sector is a direct extension of their line of business ( eg.
Pharma companies), can generate good returns from medicine supply.
Health Plan packages can be provided by hospitals to family and corporate. For example
Family Health Plan Services (FHP), a subsidiary of Apollo Hospitals does health
management of employees of its clients with a wide net work of Hospitals and Healthcare
providers countrywide, and a tie -up with General Insurance Corporation of India, FHP
offers a range of services to employees and dependants, such as Preventive Healthcare,
Corporate Counseling, welfare Programmes, Claims Administration, Patient-care
58
Coordination and so on. So FHP's healthcare packages, optimize the benefits while
keeping the cost under control.
Apart from preventive healthcare, stress management programs could be provided. For
example ‘Effective Stress Management Programme’ offered by Apollo Hospital. This
programme provides a medical perspective of stress and is conducted by a medical
professional. The programme includes a series of one-to-one sessions, with a clinical
Psychologist highlighting the factors responsible for inducing stress, and the
methodologies, which can be adopted to cope with this phenomenon practically.
Hospitals can become integrated healthcare systems i.e. when medicines, food services,
laundry and linen etc will become "purchased" services. These third-party operations will
increase the profit margins.
Mergers could be used for synergy of skills - i.e. to help the merged organisations benefit
from one another's individual strengths by applying them across the board. It also helps
them to make joint investments in branding or information technology and also to react
effectively to the changed market forces.
59
ANNEXURE
DATE :-
NAME :-
CELL NO. :-
AGE :-
QUESTIONNAIRE
A How careful patients in BLK Hospital?
Q1. Listened carefully to them
□Sometime or never □ usually □ Never
Q2. Explained things in a way they could understand
Q3. Showed respect for what they had to say
Q4. Spent enough time with them
B Getting care without long waits:
Q5. Got treatment as soon as they wanted when they were sick or injured.
Q6. Got an appointment as soon as they wanted for regular or routine health care.
Q7. Waited only 15 minutes or less past their appointment time to see
60
Q8. How many time doctor visit a patients?
□< 2 □3 to 5 □6 to 7 □8 to 9 □10 or more
Q9. How often doctors talk both patients & its close person?
□Almost always □Often □Sometimes □Never □Don’t know □Refused
Q10. Enough nurse and doctors?
□ Yes □ No □ Don’t know
Q11. Efficiency of receptionists or staff care?
□ Excellent □ Very good □ Good □ Bad □ very bad □ Don’t Know
Q12. Friendliness of the people caring for the patient:
□ Excellent □ Very good □ Good □ Bad □ very bad □ Don’t Know
Q13. Effectiveness of emergency department
□ Very satisfied □ Satisfied □ Neutral □ Dissatisfied □ Very Dissatisfied
Q14. Do the patients care unit call them patients when they are at home to see how they
are doing?
□ Yes □ No □ Refused
Q15. Rank overall quality of the Hospitals in Delhi and NCR
□ Excellent □ Very good □ Good □ Fair □ Poor
BIBLIOGRAPHY
Luthans, Fred (2011); Organisational behaviour, McGraw Hill International edition.
61
Robbins Stephen, P. (2013) Organisational Behaviour, Prentice-Hall of India Private
Limited, New Delhi.
Anderson E W, Fornell C and Mazvancheryl S K (2014) Customer satisfaction and

shareholder value. J Mktg 68: 172-85.
Gruca T S and Rego L L (2015) Customer satisfaction, cash flow, and shareholder value.
J Mktg 69: 115-130
Gustafsson W, Johnson M D and Roos I (2011) The effects of customer satisfaction,

relationship, commitment, dimensions and triggers ion customer retention. J Mktg
69: 210-215
Sharma R D and Chahal H (1999) A study of patient satisfaction in outdoor services of

private health care facilities. Vikalpa 24: 69-76
Ofir C and Simonson I (2011) In search of negative customer feedback: The effect of
expecting to evaluate on satisfaction evaluations. J Mktg Res 38: 170-182
Vernoer P C (2013) Understanding the effect of customer relationship management

efforts on customer retention and customer share development. J Mktg 67: 30-45
http://www.blkhospital.com/about-us/hospital-management
http://www.dnaindia.com/india/1785953/report-delhi-govt-warns-strict-action-against-
erring-private-hospitals
http://hfhdelhi.org/index.php?option=com_content&view=article&id=119&Itemid=146
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ACKNOWLEDGEMENT

FINDINGS & RECOMMENDATIONS 51 – 58

ANNEXURE- QUESTIONNAIRE 59-60

Figure Title Page NO.

Table Title Page No.

1.2 Data Analysis and Interpretation-Q.2 38

(Explained things in a way they could understand)

(Showed respect for what they had to say)

(Spent enough time with them)

(Got treatment as soon as they wanted when they were sick)

(Got an appointment they wanted for regular health care)

(Waited only 15 minutes past their appoint time to see)

(How many time doctor visit a patient)

(Friendliness of people caring for the patience)

In the present business scenario of cutthroat competition, customer satisfaction

Customer satisfaction is a feeling of pleasure or disappointment on the offers perceived

Satisfaction is a judgment that a product or service feature, or the product or service

1. To study the customer expectations from BLK hospital.

2. To study the customer perception of hospital services.

3. To study the degree of satisfaction of customers from hospital services.

 cataract surgery in India

 Dr. B. L. Kapur with Prime Minister Pt. Jawahar Lal Nehru

 best eye hospital in Delhi

To create a patient-centric, tertiary healthcare organization focused on non-intrusive

 Achieve Professional Excellence in delivering Quality care.

 Ensure care with Integrity and Ethics.

X - Ray with high frequency low radiation digital radiography.

Push frontiers of care through Research and Education.

Adhere to National and Global Standards in Healthcare.

A passion for healing...

Accreditation & Quality

Drive towards continuous improvement

 Realization of hospital’s vision and mission.

 Meeting changing needs and expectations of the patients.

 Engage credentialed professionals in all disciplines and services.

 Continuously update the knowledge of the professionals through in-house or external

 Provide state-of-the-art health care with compassion and dignity to all.

 Introduce established newer technologies in clinical services without delay.

 Provide reliable and updated diagnostic services.

 Monitor all critical processes to ensure continuance of quality.

 Create health awareness across the sections of the population of Delhi.

 Introduce postgraduate courses and fellowships in different clinical disciplines.

 Start training programmes for paramedical staff.

 Extend health consciousness in the community.

 Provide free health care to indigent patients.

 Ensure safety of patients, attendants, employees and all stakeholders.

 Practice environmental management systems.

 Continuously enhance customer satisfaction.

 Promote staff development and increase employee satisfaction.

 Establish an efficient Hospital Information System to have paperless and permanent

 Clinical governance is an integral part of our practice.

 Stringent “Biomedical Waste Management” practices for segregation, storage,

CONSUMERISM AND THE MARKETING CONCEPT

Consumer behaviour reflects consumers’ decisions with respect to:

 the acquisition, consumption, and disposition

 of goods and services, time, and ideas

 By (human) decision making (over time).

 The financial environment (favourable or ominous financial conditions).

 The political environment (smoothly or foggy political setting).

 The technological environment (technological progress or recession).

Five-Stage Model of the buying process:

 How does consumer buy the product?

 How does consumes or use the product?

 How does consumer develop a product after buying it?