Assessment of Service Quality and Patient Satisfaction in Primary Health Centres in Madurai District of Tamil Nadu

Abstract

Primary Health Centres (PHCs) constitute an important component of India's public healthcare delivery system and serve as the first point of contact for a large section of the rural and semi-urban population. The quality of services provided at PHCs and patients' satisfaction with those services are important indicators of the effectiveness and responsiveness of primary healthcare delivery. The present study assesses perceived service quality and patient satisfaction among patients visiting Primary Health Centres in Madurai District of Tamil Nadu during the period from June 2023 to December 2023. A quantitative, cross-sectional research design was adopted. A structured questionnaire based primarily on the SERVQUAL framework was administered to 390 patients selected through multistage sampling from PHCs across the district. Service quality was assessed through five dimensions: tangibility, reliability, responsiveness, assurance and empathy. Descriptive statistics, reliability analysis, confirmatory factor analysis, structural equation modelling (SEM), cluster analysis and Chi-square tests were employed. The modelled results indicate that assurance, reliability and empathy were relatively stronger dimensions of perceived service quality, while tangibility and responsiveness showed comparatively greater scope for improvement. SEM indicates that all five service-quality dimensions have a positive and statistically significant influence on patient satisfaction, with reliability emerging as the strongest predictor. Cluster analysis identified three distinct patient groups based on their perception of service quality and satisfaction. Chi-square analysis further indicates significant associations between patient satisfaction and selected socio-demographic characteristics. The study suggests that improving staff responsiveness, waiting-time management, infrastructure, communication and patient-centred care can substantially enhance patient satisfaction at PHCs.