Tareen Rahman :
Despite recent developments in the Bangladesh healthcare sector, there is still a great concern about the quality of healthcare services in the country.
But, hospitals in the neighbouring countries, particularly India, the overall quality of service is better compared to that in the private hospitals in Bangladesh in all factors, even the ‘perceived cost’ factor.
This comparative study was done by this correspondent after conducting a survey among the Bangladeshi patients undergoing treatment in several private and public hospitals in Dhaka city and some prominent hospitals in India.
Birla Heary & Research Centre, Calcutta Medical and Woodbine Diabetics Health and Wellness Centre are the Indian medical institutions where the survey was conducted on Bangladeshi patients.
The study was conducted with a view to comparing the health services between the local and foreign hospitals over the last one year, from the perspective of Bangladeshi patients to identify the relevant areas here for development.
About 50 exit patients were interviewed using a structured questionnaire that addressed the probable factors of the quality of healthcare services. The results gave an overview of the perspectives of Bangladeshi patients on the quality of services in the local as well as foreign hospitals. The quality of service in private hospitals scored higher than that in public hospitals for nursing care and tangible hospital matters, such as cleanliness, supply of utilities, and availability of drugs.
General cleanliness of toilets, cabins and water supply, among others, are much better in the foreign hospitals compared to the private hospitals in the country. Tangibility — the amenities of care — is the factor that scored the highest service gap between these two types of hospitals.
The findings also showed that Bangladeshi patients found physicians in the foreign hospitals more available, competent, and empathetic compared to those in the private hospitals in Bangladesh. Regarding physician-relevant matters, i.e. assurance, competence, availability and empathy of physicians, there are substantial differences between the local and foreign hospitals.
While the nurses in the foreign hospitals attained a better service rating in general, the service-quality gap in the responsiveness was higher than that of the empathy factor compared to the nurses of the Bangladeshi private hospitals. The patients found the services of foreign hospitals in availability of drugs and timely administration to patients to be much better than that of the private hospitals in Bangladesh.
Regarding the cost factors, such as consultation of physician, operation, diagnostics, etc., were found to be unreasonable in the private hospitals of Bangladesh compared to the foreign hospitals. In this study, 50 percent private hospital patients and foreign hospital patients (mostly Indian hospital patients) belonged to the middle-class people.
Though the patients have to pay higher costs in foreign hospitals than the private hospitals in Bangladesh, the patients perceived foreign healthcare services to be more reasonably priced.
Tangibility means hospital is visually appealing, hospital premises are neat and clean, there is enough waiting room/space, healthcare centres have modern equipment, cabin/ward’s bedding and floors are clean, cabin/ward’s waste bins are regularly cleaned, hospital has regular water supply, hospital has regular electricity, hospital has adequate security, and toilets and bathrooms are cleaned.
The World Health Organization (WHO) had identified that about 50 percent of the medical equipment in developing countries is unusable .The importance of tangibility matters in the Bangladesh healthcare sector has also been discussed. It has been shown that improvement in tangibility matters enables better service-delivery and results in improved use of healthcare facilities.
The recent establishments in the Bangladesh private healthcare sector, that is, Apollo and Shikder hospitals, are some of the initiatives in this regard. From the initial stage, service providers should emphasis maintenance of such standards of tangibility on a long-term basis. The scope of the private sector’s cooperation in improving the tangibility matters of the existing public hospitals could be worth exploring.
In Bangladesh, perceived cost of private healthcare services came out to be more unreasonable than that of foreign healthcare services. This result could indicate the existence of price and quality imbalance in the Bangladeshi healthcare sector.
It is to be noted that the present study could reveal such unusual findings regarding ‘perceived cost’, as respondents were asked about the cost of the whole process — cost of service providers, accommodation and travelling. Hence, there is an apparent need for private hospitals to maintain higher service quality throughout the process chain — service of physicians, service of nurses, management of drugs and tangibility.
Despite recent developments in the Bangladesh healthcare sector, there is still a great concern about the quality of healthcare services in the country.
But, hospitals in the neighbouring countries, particularly India, the overall quality of service is better compared to that in the private hospitals in Bangladesh in all factors, even the ‘perceived cost’ factor.
This comparative study was done by this correspondent after conducting a survey among the Bangladeshi patients undergoing treatment in several private and public hospitals in Dhaka city and some prominent hospitals in India.
Birla Heary & Research Centre, Calcutta Medical and Woodbine Diabetics Health and Wellness Centre are the Indian medical institutions where the survey was conducted on Bangladeshi patients.
The study was conducted with a view to comparing the health services between the local and foreign hospitals over the last one year, from the perspective of Bangladeshi patients to identify the relevant areas here for development.
About 50 exit patients were interviewed using a structured questionnaire that addressed the probable factors of the quality of healthcare services. The results gave an overview of the perspectives of Bangladeshi patients on the quality of services in the local as well as foreign hospitals. The quality of service in private hospitals scored higher than that in public hospitals for nursing care and tangible hospital matters, such as cleanliness, supply of utilities, and availability of drugs.
General cleanliness of toilets, cabins and water supply, among others, are much better in the foreign hospitals compared to the private hospitals in the country. Tangibility — the amenities of care — is the factor that scored the highest service gap between these two types of hospitals.
The findings also showed that Bangladeshi patients found physicians in the foreign hospitals more available, competent, and empathetic compared to those in the private hospitals in Bangladesh. Regarding physician-relevant matters, i.e. assurance, competence, availability and empathy of physicians, there are substantial differences between the local and foreign hospitals.
While the nurses in the foreign hospitals attained a better service rating in general, the service-quality gap in the responsiveness was higher than that of the empathy factor compared to the nurses of the Bangladeshi private hospitals. The patients found the services of foreign hospitals in availability of drugs and timely administration to patients to be much better than that of the private hospitals in Bangladesh.
Regarding the cost factors, such as consultation of physician, operation, diagnostics, etc., were found to be unreasonable in the private hospitals of Bangladesh compared to the foreign hospitals. In this study, 50 percent private hospital patients and foreign hospital patients (mostly Indian hospital patients) belonged to the middle-class people.
Though the patients have to pay higher costs in foreign hospitals than the private hospitals in Bangladesh, the patients perceived foreign healthcare services to be more reasonably priced.
Tangibility means hospital is visually appealing, hospital premises are neat and clean, there is enough waiting room/space, healthcare centres have modern equipment, cabin/ward’s bedding and floors are clean, cabin/ward’s waste bins are regularly cleaned, hospital has regular water supply, hospital has regular electricity, hospital has adequate security, and toilets and bathrooms are cleaned.
The World Health Organization (WHO) had identified that about 50 percent of the medical equipment in developing countries is unusable .The importance of tangibility matters in the Bangladesh healthcare sector has also been discussed. It has been shown that improvement in tangibility matters enables better service-delivery and results in improved use of healthcare facilities.
The recent establishments in the Bangladesh private healthcare sector, that is, Apollo and Shikder hospitals, are some of the initiatives in this regard. From the initial stage, service providers should emphasis maintenance of such standards of tangibility on a long-term basis. The scope of the private sector’s cooperation in improving the tangibility matters of the existing public hospitals could be worth exploring.
In Bangladesh, perceived cost of private healthcare services came out to be more unreasonable than that of foreign healthcare services. This result could indicate the existence of price and quality imbalance in the Bangladeshi healthcare sector.
It is to be noted that the present study could reveal such unusual findings regarding ‘perceived cost’, as respondents were asked about the cost of the whole process — cost of service providers, accommodation and travelling. Hence, there is an apparent need for private hospitals to maintain higher service quality throughout the process chain — service of physicians, service of nurses, management of drugs and tangibility.
