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ISSN: 2471-268X

Health Economics & Outcome Research: Open Access
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Research Article

The Relationships between Hospital Service Quality and Operational Efficiency: an Alternative Model

Rafael Hod1* , Oded Maimon1 and Eyal Zimlichman2  

1Department of Industrial Engineering, The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Israel

2Deputy General Director and Chief Quality Officer, Sheba Medical Centre, Tel Aviv University, Tel Hashomer, Israel

*Corresponding Author:
Rafael Hod
Department of Industrial Engineering,
The Iby and Aladar Fleischman Faculty of Engineering,
Tel Aviv University, Ramat Aviv, 6997801,
E-mail: [email protected]

Received date: June 28, 2016; Accepted date: August 10, 2016; Published date: August 17, 2016

Citation: Hod R, Maimon O, Zimlichman E (2016) The Relationships between Hospital Service Quality and Operational Efficiency: an Alternative Model. Health Econ Outcome Res Open Access 2:119.doi: 10.4172/2471-268x/1000119

Copyright: © 2016 Hod R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Over the last two centuries, the business world has changed from an industrial world to a servicebased organizations world. Thus, the main concern of efficiency researchers shifted toward service providers, such as healthcare organizations. Until recently, most studies measuring the performance and efficiency of healthcare organizations, such as hospitals, have considered operational attributes, but did not refer to service quality factors, obtained via patient satisfaction surveys.

Objective: To investigate how quality of service, along with some other environmental variables such as teaching status, are associated with hospitals’ operational efficiency.

Methods: The study included three phases: Establishing service quality attributes, using net promoter score; reducing their dimensionality, using principal component analysis; and evaluating hospital efficiency and testing the relationships between research variables, using a two-stage procedure. The data were collected publicly from the databases of the American Hospital Association; Hospital Consumer Assessment of Healthcare Providers; Systems Patient Satisfaction Survey results and the Centers for Medicare and Medicaid Services.

Results: Using data from New Jersey hospitals, we found significant relationships (p value <0.05) between their operational efficiency and global quality of service. Regression analyses reveal that the correlation among teaching hospitals is positive, whilst among non-teaching hospitals, it is negative.

Conclusions: Amongst teaching hospitals, the higher the overall likelihood of their perceived level of global service quality index, the higher the efficiency estimate. This suggests that better managed hospitals also achieve higher patient satisfaction ratings. However, amongst non-teaching hospitals, the negative correlation implies a trade-off between service quality and efficiency.


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