Measuring patient's expectation and the perception of quality in LASIK services.
BACKGROUND
LASIK is the use of excimer lasers to treat therapeutic and refractive visual disorders, ranging from superficial scars to nearsightedness (myopia), and from astigmatism to farsightedness (hyperopia). The purposes of this study are to checking the applicability and psychometric properties of the SERVQUAL on Lasik surgery population. Second, use SEM methods to investigate the loyalty, perceptions and expectations relationship on LASIK surgery.


METHODS
The method with which this study was conducted was questionnaire development. A total of 463 consecutive patients, attending LASIK surgery affiliated with Chung Shan Medical University Eye Center, enrolled in this study. All participants were asked to complete revised SERVQUAL questionnaires. Student t test, correlation test, and ANOVA and factor analyses were used to identify the characters and factors of service quality. Paired t test were used to test the gap between expectation and perception scores and structural equation modeling was used to examine relationships among satisfaction components.


RESULTS
The effective response rate was 97.3%. Validity was verified by several methods and internal reliability Cronbach's alpha was > 0.958. The results from patient's scores were very high with an overall score of 6.41(0.66), expectations at 6.68(0.47), and perceptions at 6.51(0.57). The gap between expectations and perceptions was significant, however, (t = 6.08). Furthermore, there were significant differences in the expectation scores among the different jobs. Also, the results showed that the higher the education of the patient, the lower their perception score (r = -0.10). The factor loading results of factor analysis showed 5 factors of the 22 items of the SERVQUAL model. The 5 factors of perception explained 72.94% of the total variance there; and on expectations it explained 77.12% of the total variance of satisfaction scores.The goodness-of-fit summary, of structure equation modeling, showed trends in concept on expectations, perceptions, and loyalty.


CONCLUSIONS
The results of this research appear to show that the SERVQUAL instrument is a useful measurement tool in assessing and monitoring service quality in LASIK service, and enabling staff to identify where improvements are needed, from the patients' perspective. There were service quality gaps in the reliability, assurance, and empathy. This study suggested that physicians should increase their discussions with patients; which has, of course, already been proven to be an effective way to increase patient's satisfaction with medical care, regardless of the procedure received.
Lin
Deng-Juin
DJ
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. tccldj@tcmail.doh.gov.tw
Sheu
Ing-Cheau
IC
Pai
Jar-Yuan
JY
Bair
Alex
A
Hung
Che-Yu
CY
Yeh
Yuan-Hung
YH
Chou
Ming-Jen
MJ
D000293:Adolescent; D000328:Adult; D005260:Female; D006302:Health Services Research; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000523:psychology / Q000592:standards*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011594:Psychometrics / Q000379:methods; D011787:Quality of Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult