literature review about service quality

ORIGINAL RESEARCH article

Service quality and customer satisfaction in the post pandemic world: a study of saudi auto care industry.

• 1 College of Business Administration, Prince Mohammad Bin Fahd University, Khobar, Saudi Arabia
• 2 Department of Management Sciences, University of Baluchistan, Quetta, Pakistan

The aim of this research is to examine the impact of service quality on customer satisfaction in the post pandemic world in auto care industry. The car care vendor in the study made effective use of social media to provide responsive updates to the customers in the post pandemic world; such use of social media provides bases for service quality and customer satisfaction. The study examined the relationship between service quality and customer satisfaction using the SERVQUAL framework. According to the findings, empathy, reliability, assurance, responsiveness, and tangibles have a significant positive relationship with customer satisfaction. Our findings suggest that it is critical for workshops to recognize the service quality factors that contribute to customer satisfaction. Findings also suggest that empathy, assurance, reliability, responsiveness, and tangibles contribute to customer satisfaction. Auto repair industry must regularly provide personal attention, greet customers in a friendly manner, deliver cars after services, notify customers when additional repairs are required, and take the time to clarify problems to customers. Furthermore, workshops must screen and hire courteous staff who can clearly communicate the services required to customers both in-person and online and effectively communicate the risks associated with repairs. Service quality seems to be aided by prompt services.

Introduction

The previous studies on the effect of pandemic have focused on the behavior related to preventative measures to protect the health of the customers; however, less attention has been paid to the influence of pandemic on customer outcomes. To fill this gap, the SERVQUAL framework was employed to examine the changes in customers’ social media behaviors that have occurred since the pandemic was declared ( Mason et al., 2021 ). In the post pandemic world, the parameters for customer satisfaction have changed considerably ( Monmousseau et al., 2020 ; Srivastava and Kumar, 2021 ; Wu et al., 2021 ). Pandemic has made personal interaction more challenging ( Brown, 2020 ). To be less vulnerable to becoming severely ill with the virus, customers prefer touchless digital mediums of communications. For example, Mason et al. (2021) concluded that pandemic has altered customers’ needs, shopping and purchasing behaviors, and post purchase satisfaction levels. Keeping in view the public healthcare concerns, the governmental pandemic mitigation policies also promotes touchless mediums for shopping; therefore, the role of social media as a communication tool stands to increase at a time when social distancing is a common practice; social media provides avenues for buyers to interact with sellers without physical contact. Thus, the use of social media gains critical importance, especially after the pandemic ( Mason et al., 2021 ), and the businesses may find new opportunities to gain competitive advantage through their use of effective social media strategies.

The car care industry uses traditional means of customer communications. The company in this study made use of social media in improving their service quality through effective and safe communication with their customers. The use of social media to provide updates to customers played a significant role in improving service quality and satisfaction ( Ramanathan et al., 2017 ). The company in the study used Snapchat to provide updates on the work, thus minimizing the customers’ need to physically visit the car care facility. This use of social media gave a significant boost to the responsiveness aspect of the service quality.

Service quality and customer satisfaction are important aspects of business since a company’s growth is largely dependent on how well it maintains its customers through service and how well they keep their customers satisfied ( Edward and Sahadev, 2011 ). According to Chang et al. (2017) ; customer satisfaction is expected to result from good service efficiency, which will improve customer engagement and interrelationship. González et al. (2007) asserted that customer satisfaction is linked to high service quality, which makes businesses more competitive in the marketplace. This study uses the SERVQUAL framework to define service quality. This framework uses five dimensions to account for service quality, namely, tangibles, reliability, responsiveness, assurance, and empathy. Identifying issues in service and customer satisfaction can lead to high service quality. Furthermore, service quality can be characterized by analyzing the variations between planned and perceived service. Service quality and customer satisfaction have a positive relationship.

Recognizing and meeting customer expectations through high levels of service quality help distinguish the company’s services from those of its rivals ( Dominic et al., 2010 ). Social media plays a critical role in shaping these service quality-related variables. Specifically, in the context coronavirus disease 2019 (COVID-19), where customers hesitated to visit auto workshops physically, the importance of online platforms such as auto workshops’ social media pages on Instagram and Facebook has increased, where customers try to get information and book appointment. For example, responsiveness is not only physical responsiveness but also digital means of communication. The car care company in this study uses social media as mode of communication with their customers due to physical interaction restriction caused by the pandemic.

Service quality becomes a critical element of success in car care industry because customer contact is one of the most important business processes ( Lambert, 2010 ). Saudi Arabia is one of the Middle East’s largest new vehicle sales and auto part markets. Saudi Arabia’s car repair industry has grown to be a significant market for automakers from all over the world. As a result, the aim of this research was to see how service quality affects customer satisfaction in the Saudi auto repair industry.

This aim of this research was to answer the following research questions:

(i) What is the contribution of individual dimensions of SERVQUAL on customer perceived service quality of car care industry in Saudi Arabia?

(ii) What is the impact of perceived service quality on customer satisfaction in car care industry in Saudi Arabia?

Literature Review

The concept of service has been defined since the 1980s by Churchill and Surprenant (1982) together with Asubonteng et al. (1996) , who popularized the customer satisfaction theory through measuring the firm’s actual service delivery in conformity with the expectations of customers, as defined by the attainment of perceived quality, and that is meeting the customers’ wants and needs beyond their aspirations. With this premise, Armstrong et al. (1997) later expanded the concept of service into the five dimensions of service quality that comprised tangibles, reliability, responsiveness, assurance, and empathy.

Extant literature on service delivery focuses on the traditional emphasis on the contact between the customer and service provider ( Mechinda and Patterson, 2011 ; Han et al., 2021 ). Doucet (2004) explained that the quality in these traditional settings depends on the design of the location and the behavior of the service provider. More recently, the proliferation of the internet has led to the emergence of the online service centers. In these cases, communication both in-person and online plays a critical role in the quality of service rendered. It follows that service quality in hybrid settings depends on quality of communications on social media as well as the behavioral interactions between the customer and the service provider ( Doucet, 2004 ; Palese and Usai, 2018 ). These factors require subjective assessments by the concerned parties, which means that different persons will have varied assessments of the quality of service received.

SERVQUAL Dimensions

Service quality has been described with the help of five quality dimensions, namely, tangibles, reliability, responsiveness, assurance, and empathy. Definitions relating to these variables have been modified by different authors. The relationship between various dimensions of service quality differs based on particular services.

The tangible aspects of a service have a significant influence on perception of service quality. These comprise the external aspects of a service that influence external customer satisfaction. The key aspects of tangibility include price, ranking relative to competitors, marketing communication and actualization, and word-of-mouth effects ( Ismagilova et al., 2019 ), which enhance the perception of service quality of customers ( Santos, 2002 ). These aspects extend beyond SERVQUAL’s definition of quality within the car care industry settings. Thus, we proposed the following hypothesis:

Hypotheses 1a: Tangibles are positively related with perceived service quality.

Reliability

Reliability is attributed to accountability and quality. There are a bunch of precursors that likewise aid basic methodology for shaping clients’ perspectives toward administration quality and reliability in the car care industry in Saudi ( Korda and Snoj, 2010 ; Omar et al., 2015 ). A portion of these predecessors is identified with car repair benefits and includes the convenient accessibility of assets, specialist’s expertise level and productive issue determination, correspondence quality, client care quality, an exhibition of information, client esteem, proficiency of staff, representatives’ capacity to tune in to client inquiries and respond emphatically to their necessities and protests, security, workers’ dependability, more limited holding up time and quickness, actual prompts, cost of administration, accessibility of issue recuperation frameworks, responsibility, guarantees, for example, mistake-free administrations, generally association’s picture and workers’ politeness, and responsiveness. Despite the innovative changes happening in the car care industry and the instructive degree of car administrations suppliers in Saudi Arabia, car care suppliers in the territory are taught about the need to continually refresh their insight into the advancements in the area of vehicle workshops and the components of administration. Thus, we argued that reliability is important to enhance the perception of service quality of customers.

Hypotheses 1b: Reliability is positively linked with perceived service quality.

Responsiveness

Responsiveness refers to the institution’s ability to provide fast and good quality service in the period. It requires minimizing the waiting duration for all interactions between the customer and the service provider ( Nambisan et al., 2016 ). Nambisan et al. (2016) explained that responsiveness is crucial for enhancing the customers’ perception of service quality. Rather, the institution should provide a fast and professional response as to the failure and recommend alternative actions to address the customer’s needs ( Lee et al., 2000 ). In this light, Nambisan summarizes responsiveness to mean four key actions, i.e., giving individual attention to customers, providing prompt service, active willingness to help guests, and employee availability when required. These aspects help companies to enhance the customers’ perception of service quality. Therefore, we proposed the following hypothesis:

Hypotheses 1c: Responsiveness is positively linked with perceived service quality.

Assurance refers to the skills and competencies used in delivering services to the customers. Wu et al. (2015) explains that employee skills and competencies help to inspire trust and confidence in the customer, which in turn stirs feelings of safety and comfort in the process of service delivery. Customers are more likely to make return visits if they feel confident of the employees’ ability to discharge their tasks. Elmadağ et al. (2008) lists the factors that inspire empathy as competence, politeness, positive attitude, and effective communication as the most important factors in assuring customers. Besides, other factors include operational security of the premises as well as the proven quality of the service provided to the customers. Thus, the assurance has significant contribution in the perception of service quality.

Hypotheses 1d: Assurance is positively related with perceived service quality.

Empathy refers to the quality of individualized attention given to the customers. The service providers go an extra mile to make the customer feel special and valued during the interaction ( Bahadur et al., 2018 ). Murray et al. (2019) explains that empathy requires visualizing the needs of the customer by assuming their position. Murray et al. (2019) lists the qualities that foster empathy as including courtesy and friendliness of staff, understanding the specific needs of the client, giving the client special attention, and taking time to explain the practices and procedure to be undertaken in the service delivery process. Therefore, we proposed the following hypothesis:

Hypotheses 1e: Empathy is positively related with perceived service quality.

Perceived Service Quality and Customer Satisfaction

Customer satisfaction refers to the level of fulfillment expressed by the customer after the service delivery process. This is a subjective assessment of the service based on the five dimensions of service quality. Customer satisfaction is important due to its direct impact on customer retention ( Hansemark and Albinsson, 2004 ; Cao et al., 2018 ; Zhou et al., 2019 ), level of spending ( Fornell et al., 2010 ), and long-term competitiveness of the organization ( Suchánek and Králová, 2019 ). Susskind et al. (2003) describes that service quality has a direct impact on customer satisfaction. For this reason, this research considers that five dimensions of service quality are the important antecedents of customer satisfaction.

Service quality refers to the ability of the service to address the needs of the customers ( Atef, 2011 ). Customers have their own perception of quality before interacting with the organization. The expectancy-confirmation paradigm holds that customers compare their perception with the actual experience to determine their level of satisfaction from the interaction ( Teas, 1993 ). These assessments are based on the five independent factors that influence quality. Consequently, this research considers service quality as an independent variable.

This study attempts to quantify perceived service quality though SERVQUAL dimensions. We proposed that customers place a high premium on service quality as a critical determinant of satisfaction. Moreover, it is argued that satisfaction prompts joy and reliability among customers in Saudi Arabia. These discoveries infer that the perception of service quality is significantly related to satisfaction, and quality insight can be applied across different cultures with negligible contrasts in the result. Car care industry in Saudi Arabia has grave quality problems. To rectify this situation, it is essential to apply quality systems as tools for development. The SERVQUAL is one of these system options. It is used to gauge the service quality using five dimensions that have been time-tested since 1982. Thus, the significance of SERVQUAL in car care industry in Saudi Arabia cannot be overemphasized. The study further suggests that the SERVRQUAL dimension increases the perceived service quality, which in turn increases customer satisfaction. Thus, we proposed the following hypothesis:

Hypothesis 2: The perceived service quality of car care customers is positively linked with their satisfaction.

Methods and Procedures

In this study, we employed a cross-sectional research design. Using a paper-pencil survey, data were collected form auto care workshops situated in the Eastern Province of Saudi Arabia. According to the study by Newsted et al. (1998) , the survey method is valuable for assessing opinions and trends by collecting quantitative data. We adapted survey instruments from previous studies. The final survey was presented to a focus group of two Ph.D. marketing scholars who specialized in survey design marketing research. The survey was modified keeping in view the recommendations suggested by focus group members. We contacted the customers who used social media to check the updates and book the appointment for their vehicle’s service and maintenance. We abstained 130 surveys, 13 of which were excluded due to missing information. Therefore, the final sample encompassed 117 (26 female and 91 male) participants across multiple age groups: 10 aged less than 25 years, 46 aged between 26 and 30 years, 28 aged between 31 and 35 years, 21 aged between 36 and 40 years, and 12 aged older than 40 years (for details, refer to Table 1 ). Similarly, the averaged participants were graduates with more than 3 years of auto care service experience.

Table 1. Demographic information.

We measured service quality dimensions using 20 indicators. Customer satisfaction of the restaurant customers was assessed using 4-item scale (for detail, refer to Table 2 ). In this research, the 5-point Likert scale from 1 = strongly disagree to 5 = strongly agree was used.

Table 2. Constructs and items included in the questionnaire.

Control Variables

Following the previous research, customer’s gender and age were controlled to examine the influence of service quality dimensions on customer satisfaction.

Data Analysis and Results

For data analysis and hypotheses testing, we employed the structural equation modeling (SEM) based on the partial least squares (PLS) in Smart-PLS. Smart-PLS 3 is a powerful tool, which is used for the confirmatory factor analysis (CFA) and SEM ( Nachtigall et al., 2003 ). Research suggests that CFA is the best approach to examine the reliability and validity of the constructs. We employed SEM for hypotheses testing because it is a multivariate data analysis technique, which is commonly used in the social sciences ( González et al., 2008 ).

Common Method Bias

To ensure that common method bias (CMB) is not a serious concern for our results, we employed procedural and statistical and procedural remedies. During data collection, each survey in the research contained a covering letter explaining the purpose of the study and guaranteed the full anonymity of the participants. Moreover, it was mentioned in the cover letter that there was no right and wrong questions, and respondents’ answers would neither be related to their personalities nor disclosed to anyone. According to Podsakoff et al. (2003) , the confidentiality of the responses can assist to minimize the possibility of CMB. Furthermore, CMB was verified through the Harman’s single-factor test ( Podsakoff et al., 2003 ). All items in this research framework were categorized into six factors, among which the first factor explained 19.01% of the variance. Thus, our results showed that CMB was not an issue in our research. Moreover, using both tolerance value and the variance inflation factors (VIFs), we assessed the level of multicollinearity among the independent variables. Our results indicate that the tolerance values for all dimensions of service quality were above the recommended threshold point of 0.10 ( Cohen et al., 2003 ), and VIF scores were between 1.4 and 1.8, which suggested the absence of multicollinearity; thus, it is not a serious issue for this study.

Measurement Model

We performed CFA to analyze the reliability and validity of the constructs. The measurement model was assessed by examining the content, convergent, and discriminant validities. To assess the content validity, we reviewed the relevant literature and pilot test the survey. We used item loadings, Cronbach’s alpha, composite reliability (CR), and the average variance extracted (AVE) ( Fornell and Larcker, 1981b ) to assess the convergent validity. The findings of CFA illustrate that all item loadings are greater than 0.70. The acceptable threshold levels for all values were met, as the value of Cronbach’s alpha and CR was greater than 0.70 for all constructs ( Fornell and Larcker, 1981b ), and the AVE for all variables was above 0.50 ( Tabachnick and Fidell, 2007 ; see Table 3 ). Thus, these findings show acceptable convergent validity.

Table 3. Item loadings, Cronbach’s alpha, composite reliability, and average variance extracted.

To analyze the discriminant validity, we evaluated the discriminant validity by matching the association between correlation among variables and the square root of the AVE of the variables ( Fornell and Larcker, 1981a ). The results demonstrate that the square roots of AVE are above the correlation among constructs, hence showing a satisfactory discriminant validity, therefore, indicating an acceptable discriminant validity. Moreover, descriptive statistics and correlations are provided in Table 4 .

Table 4. Descriptive statistics and correlations.

Structural Model and Hypotheses Testing

After establishing the acceptable reliability and validity in the measurement model, we examined the relationship among variables and analyzed the hypotheses based on the examination of standardized paths. The path significance of proposed relations were calculated using the SEM through the bootstrap resampling technique ( Henseler et al., 2009 ), with 2,000 iterations of resampling. The proposed research framework contains five dimensions of service quality (i.e., tangibles of the auto care, reliability of the auto care, responsiveness of the auto care, assurance of the auto care, and empathy of the auto care) and customer satisfaction of auto care. The results show that five dimensions of service quality are significantly related to customer’s perception of service quality of auto care; thus, hypotheses 1a, 1b, 1c, 1d, and 1e were supported. Figure 1 shows that the service quality of auto care is a significant determinant of customer satisfaction of auto care industry (β = 0.85, p < 0.001), supporting hypothesis 2. The result in Figure 1 also shows that 73.8% of the variation exists in customer satisfaction of auto care.

Figure 1. Results of the research model tests. *** p < 0.001.

The main purpose of this research was to assess the relationship between service quality and customer satisfaction in the post pandemic world in Saudi Arabia. This study was designed to examine how satisfaction of auto care customers is influenced by service quality, especially, when pandemic was declared, and due to health concerns, the customers were reluctant to visit workshops physically ( Mason et al., 2021 ). It appears that after the pandemic, customers were increasingly using online platforms for purchasing goods and services. This study reveals how customers of auto repair in Saudi perceive service quality and see how applicable SERVQUAL model across with five dimensions, including tangibles, responsiveness, reliability, assurance, and empathy measure service quality. The findings of this research show that five dimensions of SERVQUAL are positively related to the service quality perception of auto care customers in Saudi Arabia. Moreover, service quality perceptions are positively linked with customer satisfaction. These results indicate that auto care customers view service quality as an important antecedent of their satisfaction. The findings indicate that the customers perceive the service quality as a basic service expectation and will not bear the extra cost for this criterion. In this research, the positive connection between service quality and customer satisfaction is also consistent with previous studies (e.g., González et al., 2007 ; Gallarza-Granizo et al., 2020 ; Cai et al., 2021 ). Thus, service quality plays a key role in satisfying customers. These findings suggest that service organizations, like auto repair industry in Saudi Arabia could enhance satisfaction of their customers through improving service quality. Because of pandemic, people are reluctant to visit auto care workshops, and they try to book appointment through social media; so, by improving the quality of management of their social media pages, the workshops can provide accurate information for monitoring, maintaining, and improving service quality ( Sofyani et al., 2020 ). More specifically, social media, which allows individuals to interact remotely, appears to be gaining significant importance as a tool for identifying customers’ products and service needs. Increasingly, customers are also increasingly engaging with retailers through social media to search and shop for product and services options, evaluate the alternatives, and make purchases.

Furthermore, the research on the customer service quality can be held essential since it acts as a means for the promotion of the competitiveness of an organization. Precisely, the knowledge about the customers’ view concerning service quality can be used by organizations as a tool to improve their customer services. For example, knowledge of the required customer service would help in the facilitation of training programs oriented toward the enlightenment of the overall employees on the practices to improve and offer high-quality customer services. Besides, information concerning customer services would be essential in decision-making process concerning the marketing campaigns of the firm, hence generating competitive advantage of the organization in the marketplace. Findings show that customers demand more from auto repair, so the company must work hard to increase all service quality dimensions to improve customer satisfaction. Thus, organizations ought to venture in customer services initiatives to harness high-quality services.

Managerial Implications

The findings of this research indicate a strong association between SERVQUAL dimensions and perceived service quality. Perception of higher service quality leads to higher level of customer satisfaction among Saudi car care customers. In particular, the results indicate high scores for reliability, empathy, tangibles, and responsiveness. These are clear indications that the immense budgetary allocation has enabled these institutions to develop capacity. Nevertheless, the lack of a strong human resource base remains a key challenge in the car care industry. The effective use of social media plays a critical role in the responsiveness dimension of service quality. Companies need to develop their digital and social media marketing strategies in the post pandemic world to better satisfy their customers.

Saudi Arabia requires a large and well-trained human resource base. This requires intensive investment in training and development. Most of these workers have a limited contract, which reduced their focus on long-term dedication. Consequently, the government should provide longer-term contracts for workers in this critical sector. The contracts should include training on tailored courses to serve the identified needs in effective communication with the customers using digital media. We suggested that the auto car care workshops should provide training to their workers, particularly, on service technicians to enhance their skills that will help to deliver fast and reliable service to their auto customers.

Moreover, the auto car care workshops also provide customer care- or customer handling-related training especially for the service marketing personnel who handles customer directly for them to better understand the customer needs and expectations. This can be done at least once a year. This will help auto care workshops to improve their service quality.

Limitation and Future Research Direction

This research is not without limitations. First, the findings of this study are based on data collected from a single source and at a single point of time, which might be subjected to CMB ( Podsakoff et al., 2003 ). Future research can collect data from different points of time to validate the findings of this research. Second, this research was carried out with data obtained from Saudi auto car care customers; the findings of this research might be different because the research framework was retested in a different cultural context. Therefore, more research is needed to improve the understanding of the principles of service quality and customer satisfaction, as well as how they are evaluated, since these concepts are critical for service organizations’ sustainability and development. A greater sample size should be used in a similar study so that the findings could be applied to a larger population. Research on the effect of inadequate customer service on customer satisfaction, the impact of customer retention strategies on customer satisfaction levels, and the impact of regulatory policies on customer satisfaction is also recommended. Third, because most of the participants participated in this research are men, future studies should obtain data from female participants and provide more insights into the difference between male and female customers’ satisfaction levels. Moreover, due to limitation of time, the sample was collected from the eastern province. Consequently, further research should include a larger and more representative sample of the Saudi population. Because of the non-probability sampling approach used in this research, the results obtained cannot be generalized to a wide range of similar auto repair services situations, even though the methodology used in this study could be extended to these similar situations. Since the sample size considered is not that large, expectations could vary significantly. When compared with the significance of conducting this form of analysis, the limitations mentioned above are minor. Such research should be conducted on a regular basis to track service quality and customer satisfaction levels and, as a result, make appropriate changes to correct any vulnerability that may exist.

Data Availability Statement

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.

Ethics Statement

Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

SZ helped in designing the study. ZH helped in designing and writing the manuscript. MAA helped in data collection and analysis and writing the manuscript. SUR repositioned and fine-tuned the manuscript, wrote the introduction, and provided feedback on the manuscript.

This study was received funding from University Research Fund.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords : auto care, customer satisfaction, service quality, Saudi Arabia, pandemic (COVID-19)

Citation: Zygiaris S, Hameed Z, Ayidh Alsubaie M and Ur Rehman S (2022) Service Quality and Customer Satisfaction in the Post Pandemic World: A Study of Saudi Auto Care Industry. Front. Psychol. 13:842141. doi: 10.3389/fpsyg.2022.842141

Received: 23 December 2021; Accepted: 07 February 2022; Published: 11 March 2022.

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Copyright © 2022 Zygiaris, Hameed, Ayidh Alsubaie and Ur Rehman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Zahid Hameed, [email protected]

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Public Service’s Perceived Quality: A Literature Review

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This study explores the use of perceived service quality concept in the public service. A literature review using a bibliometric approach was conducted in order to identify the trends, characteristics, main topics, and other relevant aspects about the public service’s perceived quality in the academic literature.

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Maceta, P.R.M., Berssaneti, F.T. (2020). Public Service’s Perceived Quality: A Literature Review. In: Leiras, A., González-Calderón, C., de Brito Junior, I., Villa, S., Yoshizaki, H. (eds) Operations Management for Social Good. POMS 2018. Springer Proceedings in Business and Economics. Springer, Cham. https://doi.org/10.1007/978-3-030-23816-2_89

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Dimensions of service quality in healthcare: a systematic review of literature

Affiliations.

• 1 Institute of Quality and Technology Management, University of the Punjab, Lahore, Pakistan.
• 2 Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College and Shaikh Zayed Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, Pakistan.
• 3 Global Health and Development Department, College of Public Health, International Center for Health Information Technology (ICHIT),Taipei Medical University, 250-Wu-xing St. Xinyi District, Taipei, Taiwan.
• PMID: 29901718
• DOI: 10.1093/intqhc/mzy125

Purpose: Various dimensions of healthcare service quality were used and discussed in literature across the globe. This study presents an updated meaningful review of the extensive research that has been conducted on measuring dimensions of healthcare service quality.

Data sources: Systematic review method in current study is based on PRISMA guidelines. We searched for literature using databases such as Google, Google Scholar, PubMed and Social Science, Citation Index.

Study selection: In this study, we screened 1921 identified papers using search terms/phrases. Snowball strategies were adopted to extract published articles from January 1997 till December 2016.

Data extraction: Two-hundred and fourteen papers were identified as relevant for data extraction; completed by two researchers, double checked by the other two to develop agreement in discrepancies. In total, 74 studies fulfilled our pre-defined inclusion and exclusion criteria for data analysis.

Data synthesis: Service quality is mainly measured as technical and functional, incorporating many sub-dimensions. We synthesized the information about dimensions of healthcare service quality with reference to developed and developing countries. 'Tangibility' is found to be the most common contributing factor whereas 'SERVQUAL' as the most commonly used model to measure healthcare service quality.

Conclusion: There are core dimensions of healthcare service quality that are commonly found in all models used in current reviewed studies. We found a little difference in these core dimensions while focusing dimensions in both developed and developing countries, as mostly SERVQUAL is being used as the basic model to either generate a new one or to add further contextual dimensions. The current study ranked the contributing factors based on their frequency in literature. Based on these priorities, if factors are addressed irrespective of any context, may lead to contribute to improve healthcare quality and may provide an important information for evidence-informed decision-making.

Keywords: SERVQUAL, healthcare service quality; dimensions of service quality, quality improvement.

© The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: [email protected].

Publication types

• Systematic Review
• Developed Countries
• Developing Countries
• Quality Assurance, Health Care / methods*
• Quality Improvement
• Quality of Health Care / standards*

Literature review – Measuring service quality – SERVQUAL and SERVPERF

The purpose of this review is to consider both current and past literature concerning the main concept areas associated with the study in question and also to provide some rationale for conducting the study. The literature review will focus on critically analysing tools which have been used in the past to measure service quality such as, SERVQUAL (Parasuraman et al 1988) and SERVPERF (Cronin and Taylor, 1992). By critically analysing these tools through the views of past research, it will provide a better understanding of which tool should be used in the current study.

A service is an act or performance that one party may offer to another that is strictly intangible and does not result in ownership of anything (Kotler, 1991). Fitness centres base their businesses primarily on the provision of services; therefore it is vital the service provided meets customer requirements. Services have four unique characteristics which distinguish them from goods. Services are intangible, perishable, variable and inseparable (Lamb, Hair and McDaniel, 2008). This view on the four characteristics has been criticised by some authors on the basis that the characteristics stated are not applicable to all service sectors (Afthinos et al, 2005). Also, focusing heavily on these characteristics can overlook the consumer role in the delivery of a service (Afthinos et al, 2005). A key feature of the services is inseparability, as it clearly highlights consumer-employee interaction as a vital part of production and consumption of a service (Chelladurai and Chang, 2000). Organisations which deal with tangible goods are able to measure quality by the number of defects produced; organisations such as fitness centres are unable to do this as they need to measure the service they provide. One way of measuring the service provided is to ask customers to give feedback through certain tools.

A variety of past studies have been conducted to assess service quality. Much of the initial work in developing a model to assess service quality came from Parasuraman et al (1985); who noticed that discrepancies existed between organisations and customer perceptions of the service quality delivered. Parasuraman et al (1985) developed the SERVQUAL scale, consisting of 22 expectation and 22 perception questions, which were rated on a seven point likert scale, ranging from strongly agree to strongly disagree. They suggested that when the perceived experience is less than the expected experience, it implies less than satisfactory service quality. After two stages of purification, the SERVQUAL scale was adapted from a model with ten dimensions to five; tangibles, reliability, responsiveness, assurance and empathy (Parasuraman et al, 1988).

Empirical evidence has shown that SERVQUAL has good trait validity and a reliability of between .80 and .93 (Young et al 1994). This shows that the SERVQUAL scale is valid and the results gained from a study are likely to be reliable, however it must be taken into account that the trait validity and the reliability will vary depending on the type of industry that is being evaluated. It was hypothesised by Parasuraman et al (1988) that when there is a negative discrepancy, the performance gap will cause dissatisfaction, whilst a positive discrepancy will cause consumer delight. The positive and negative discrepancies are calculated through subtracting customer perceptions from expectations.

The problem facing a service provider who does not directly deliver a service to the customer, is how to analyse the service quality gap. A solution for this problem was to use the SERVQUAL scale and identify the areas where expected customer service level is not achieved in each of the five dimensions (Gagliano and Hathcote, 1994). The results from the SERVQUAL scale could then indicate where a gap analysis is required. During the late eighties and very early nineties the SERVQUAL scale was advantageous to managers of organisations as it was easy to use, as well as being the first qualitative method to measure service quality. The SERVQUAL scale invented by Parasuraman et al (1988) has been supported by various researchers (Mckay, 1989; Brady and Robertson, 2001).

The scale has also been tested by McKay (1989) in Canadian municipal parks, and he was able to extract the same five dimensions as Parasuraman et al (1988), confirming the reliability of the scale. SERVQUAL has also been tested by Brady and Robertson (2001) who employed the scale to test the quality of service received from travel agencies. They found that it is still a valid and reliable model with which to evaluate service quality provided by travel agencies (Brady and Robertson, 2001).

The SERVQUAL scale focuses on the fifth service quality gap, which is the discrepancy between customer expectations and their perceptions of the service delivered; when customer expectations are greater than perceptions. Parasuraman et al (1988) believed that by using their performance minus expectations theory, they would be able to analyse and close this gap. Managers and employees would know what the customer requirements were and therefore they could establish a plan to close the gap. Once the plan of action had been in place for a certain amount of time they would conduct the study again to see if they were any closer to closing the service quality gap (Parasuraman et al 1988). This was a good plan as it allows an organisation to see how far away they are from closing the service quality gap. If the research is conducted again and the results are more positive then the organisation knows they are heading in the right direction. However, if the results are negative then the organisation knows that the plan they have implemented needs to be altered.

Chellaudri et al (1987) were one of the first researchers to evaluate service quality in fitness centres as they developed The Scale of Attributes of Fitness Services (SAFS). The scale consisted of five dimensions and was similar to the SERVQUAL model. Parassuraman et al (1988) criticised the SAFS scale by suggesting that it had a lack of structure, and it was confusing as to what in particular was being measured. Also, the wordings of the dimensions were not clear, which in turn questions the scales validity and reliability. If the wording is not clear to the customers then the investigator may think he is measuring one thing when in fact the customer has interpreted the question in another way. Parasuraman et al (1988) suggested the new and improved SERVQUAL scale was the way forward as it was the superior scale to use when measuring service quality across numerous industries.

However numerous researches and testing have not been supportive of the SERVQUAL scale and it has been heavily criticised. Carman (1990) admitted that the SERVQUAL model has good stability; however the five dimensions stated are not always generic, as the dimensions will alter depending on the organisation being surveyed. The method of collecting customer’s expectations after the service has been delivered has also been questioned; instead it should be collected before the service (Carman 1990). Even when the expectations are taken before a service has been delivered there is still no relationship between one another. One of the major objections against the SERVQUAL scale is in relation to the performance minus expectation gap scores. Many authors have struggled to find a positive fit between the quality measured through the SERVQUAL scale and overall quality measured directly through a single-item scale (Babakus and Mangold 1989, Fin and Lamb 1991). Although the use of the performance minus expectations gap score is naturally appealing and theoretically sensible, the ability of these scores to provide extra information beyond that which is present in the perception component of service quality scale is under doubt (Carmon, 1990).

Churchill, Brown and Peter (1993) further criticise the SERVQUAL scale suggesting that problems of reliability, discriminant validity and variance restrictions are present. These problems exist due to the scores on the SERVQUAL scale being “difference scores”, as the perception scores minus the expectation scores. Churchill, Brown and Peter’s (1993) results displayed that even though the SERVQUAL model had high reliability, a non-difference score rated higher in this aspect. They also found that the distribution of SERVQUAL scores was not normal, and the scale also failed to achieve discriminant validity from its components.

Due to many authors, notably Carman (1990), criticising the SERVQUAL model for not being industry specific, Crompton and McKay (1990) developed the Recreation Quality (REQUAL) scale. The REQUAL scale used the SERVQUAL scale as its basis and it was developed for the evaluation of recreation and leisure services. The scale consisted of the same five dimensions as SERVQUAL. Backman and Veldkamp (1995) tested the REQUAL scale and found that the scale was a valid tool of measurement in the recreational field. They recommended that the scale can serve as a template for other researchers to use in their investigation of recreational service quality. Apart from this study, there has been a real lack of confidence in this scale and it has not been used anywhere near as much as the SERVQUAL scale. It must also be noted that this scale still complies by the rules of the SERVQUAL scale. So the majority of the criticism that SERVQUAL (apart from not being industry specific) receives, is also directed at the REQUAL scale.

Wright et al (1992) also attempted to modify the SERVQUAL model, developing 30 items based on the disconfirmation paradigm between customer’s expectations and perceptions. They found that 28 of the 30 items scored negatively, therefore the perceptions did not meet the customer expectations. They concluded that their modified SERVQUAL instrument could be useful in the public leisure context. Although they state the scale may be useful, it will still cause the fitness centre problems as customer expectations always seem to be higher than their perception. Consumers always want the best; therefore the managers of fitness centres will have difficulty in improving these scores and providing the perfect service for each customer. This is one area where the SERVQUAL scale has received heavy criticism (Cronin and Taylor, 1992; Carmon, 1990)

Many authors have attempted to replicate the SEVQUAL scale and failed. The most intense criticism of the scale has come from Cronin and Taylor (1992), suggesting that the SERVQUAL model is based on very little theoretical and empirical evidence. Cronin and Taylor (1992) developed a performance based model to measure service quality, known as SERVPERF. The SERVPERF scale was developed from earlier work which was conducted by Bolton and Drew (1991), who suggested that a consumer’s perception of service quality is largely based on his/her preconceived attitude regarding the service. It was also noted that a customer’s present attitude is based on their previous experience of service quality and their satisfaction or dissatisfaction of the service (Bolton and Drew 1991). After consumers have experienced a service, their attitudes about the service quality may alter over a certain period of time and can change their future attitudes. For example, just after a person has experienced a holiday they may think it was average or below average but as the person looks back over a period of time then they may feel that it was an enjoyable experience. So the perception of services can interestingly change over a period of time.

Cronin and Taylor (1992) suggest that their SERVPERF scale is a better means of measuring an organisation’s service quality than the SERVQUAL scale. Depending on the type of industry surveyed SERPERF’s reliability ranges between .884 and .964 whilst also exhibiting convergent validity (Cronin and Taylor, 1992). Empirical evidence has been shown across a variety of industries to support their performance only scale over the SERVQUAL instrument. According to several authors, the SERVPERF scale is a clear improvement on the SERQUAL instrument (Boulding et al 1993; Carman 1990). Researchers have also found that the single – item performance based scale is able to measure greater variance in the overall service quality than the SERVQUAL scale (Grewal and Brown, 1994; Hartline and Ferrell, 1996). Many authors prefer the SERVPERF scale as it is more efficient than the SEVQUAL scale. This will allow greater feedback as more customers will be willing to answer the questions as there is a reduction in time taken to complete the questionnaires. Another benefit is that the results gained from measuring customer perceptions only are more relevant and meaningful as it is discovered straight away what the customers thought of the service. However, several authors will argue the fact that measuring customers expectations are still important (Parasuraman et al 1988; Gronroos 1984; Bopp 1990)

Teas (1994) has questioned SERVQUAL on a conceptual basis and suggested that it was very confusing in relation to service satisfaction. They agreed with Carman (1990) who suggested that the expectations element of SERVQUAL should be eliminated and instead the performance element alone should be used. They proposed that Cronin and Taylor’s (1992) SERVPERF scale is of better quality and should be used in its place. Although the SERVPERF scale is still trailing the SERVQUAL scale in terms of the amount of researchers who have used the instrument, the number of researchers who are making use of the SERVPERF scale are increasing remarkably. When the two scales have been applied in conjunction with one another, the SERVPERF scale has been shown to outperform the SERVQUAL scale (Cronin and Brand, 2002; Dabholkar et al, 1996).

The debate between the two scales has been continuous. In 1994 Parasuraman et al defended their SERVQUAL model against the numerous amounts of criticism it received. They stated that although Cronin and Taylor (1992) suggest that there is little empirical evidence to support the theory of perceptions minus expectations gap, many researchers have supported this theory (Crompton and Mckay 1987; Gronroos, 1982). Parasuraman et al (1994) also argue that the SERVQUAL model attempts to measure consumers attitude level, whereas SERVPERF tends to focus on the formation of attitudes, therefore according to Parasuraman et al (1994), the two scales are not measuring the same variables. By suggesting that the two models are measuring different variables they are implying that the criticism of the SERVQUAL scale and the preference of the SERVPERF model is irrelevant, however Cronin and Taylor (1994) disagree. It is also noted that research has shown that the SERVQUAL scale has greater convergent and discriminant validity than the SERVPERF model (Parasuraman et al 1994).

The authors do however admit that their perception minus expectations method is less predictive than the SERVPERF scale, but they believe the SERVQUAL scale has better diagnostic value. Cronin and Taylor (1994) responded to the arguments made by Parasuraman et al (1994) and suggest that they are not the only researchers to challenge the SERVQUAL model and many others have found faults in the model (Grewal and Brown, 1994; Hartline and Ferrell, 1996). They go on to say that based on the literature they reviewed, SERVQUAL does not exhibit construct validity. Finally they stress that SERVQUAL has little research that conceptually supports the scale, therefore the question needs to be asked if the SERVPERF scale can validly and reliably measure service quality. Cronin and Taylor (1994) strongly believe that their scale is valid, reliable and very useful in measuring service quality and consumer attitudes. One of the most significant views on the SERVPERF versus SERVQUAL debate comes from one of the founders of the SERVQUAL scale. Zeithamal states that “our results are incompatible with both the one dimensional view of expectations and the gap formation for service quality. Instead, we find that service quality is directly influenced only by perceptions” (Zeithamal, 1993). The findings support the SERVPERF scale as they are in favour of measuring service quality through consumer’s perceptions only. This statement by Zeithamal shows the superiority of the SERVPERF scale, as he was one of the founders of the SERVQUAL scale and is now admitting that his opposing model is superior to his own. Researchers started using the SERVQUAL and the SERVPERF scales as platforms to develop new models with which to measure service quality.

Kim and Kim (1995) developed the Quality of Excellence in Sports Centres (QUESC) instrument, which consisted of 11 dimensions with only sevencorresponding with the SERVQUAL model. The instrument was tested in Korean sports centres and is similar to the SERVQUAL model as it focuses on gaining results from the difference between customers’ expectations and perceptions. After reviewing the literature on service quality, Kim and Kim had the option of creating an instrument to measure customers expectations and perceptions (similar to SERVQUAL) or customers perceptions only (similar to SERVPERF). They decided on the former due to the explosive growth in sports centres over the past few years in the Republic of Korea, which coincided with the emergence of “Sport for All” (Kim and Kim 1995). The fitness centres in Korea at this time were gradually increasing, as demand was increasing. Consequently, the managers of fitness centres wanted to know what customers in this new field required so they could implement it in their fitness centre and gain a competitive advantage over existing and new competitors.

Summary of literature review

A variety of different models and tools have been assessed in the literature review. Although the Parasurman et al’s (1988) SERVQUAL scale has been present for numerous years, praised by several authors and used in many industries, it has been continuously criticised by researchers for a number of reasons. Cronin and Taylor’s (1992) SERVPERF scale has been proven to be more popular than the SERVQUAL scale as the majority of the literature reviewed has been in favour of this model and it has shown greater reliability and validity. The SERVPERF scale has been used more and more as years have passed and it is becoming a strong tool of measurement for service quality. Although other models have been proposed which directly measure service quality in fitness centres they have not received the same support that the SERVPERF scale has. The results gained from this study will be interesting as there has been a lack of use of the SERVPERF scale in the fitness industry.

Hypotheses 1 – There will be no significant difference in service quality between fitness centre A and fitness centre B.

Hypotheses 2 – The empathy dimension will be the highest rated dimension.

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