The effect of service quality on patient satisfaction in medical tourism: The case of Izmir province

Purpose: In today's world, rapidly changing conditions and innovative approaches have become important factors for every sector. In this process, it is necessary to understand and accept that constant change is an inevitable reality. Within the framework of this general change, the health tourism sector has also had to adapt to changing demands and expectations. In this area, meeting the needs and expectations of service recipients - patients - is of fundamental importance for institutions in terms of the quality of the services provided. In the provision of health services, the contribution of experts such as doctors and related health personnel is obviously of great importance. However, patients' perceptions and expectations regarding the services also play a decisive role in the evaluation of service quality. Dealing with these perceptions and expectations correctly can significantly increase the competitiveness of health institutions in the sector and increase customer satisfaction. Therefore, great importance should be given to service quality in order to differentiate from other health institutions and become a preferred institution. In this context, patient satisfaction emerges as a subject that health institutions should primarily focus on. The purpose of this study is to analyze in detail the effect of the quality of services provided by health institutions operating in the field of health tourism in Izmir on the satisfaction levels of patients. For this purpose, detailed information about personal information, service quality and satisfaction levels were obtained with the data collected from the participants. Materials and Methods: In order to determine the conceptual framework before the research, a literature study was conducted and studies on patient satisfaction were examined. In the study conducted in Izmir province, data were collected by applying a survey technique to patients who came to a private hospital with a health tourism authorization certificate to receive medical health services. The survey applied to the participants consists of 2 parts. The first part includes demographic information (age, gender, marital status, education level, nationality) and information about the health service they received (whether they have received service from the same institution before, whether a consultant is assigned to them in the health institution). The second part consists of 7 sub-dimensions that try to determine service quality satisfaction (hospitalization and consultancy services, room and food services, floor and cleaning services, health personnel services, pricing services, physical structure and management services, thoughts about the hospital). The survey form was specially designed to obtain research data. The data obtained as a result of the research were analyzed to test the accuracy of the previously determined hypotheses. Various statistical analyzes were made on the data collected with the study. The descriptive statistics obtained in the study (number, mean, standard deviation, minimum, maximum and median) are given. The reliability of the scales used in the study was tested. As the first step of the statistical analysis, the normality assumption was checked with the Shapiro Wilk test and the variance homogeneity with the Levene test. In cases where the normality assumption was met, the Independent Samples T test was used to examine the difference between the means of two independent groups; and in cases where the normality assumption was not met, the Mann Whitney U test was used. ANOVA was used to compare the means of three or more independent groups with normal distribution, and the Kruskal Wallis test was used when there was no normal distribution. Post Hoc Bonferroni analyses were used to determine the group or groups that created the difference. Spearman correlation was used to measure the relationship between continuous variables that did not conform to normal distribution. The analyses were conducted using the IBM SPSS 25 program. Findings of the Study: As a result of the analysis of the data collected within the scope of the study, it was found that the parameters of marital status and education level from demographic data and the status of having received service from the same institution before from information about the health service they received had no effect on satisfaction; It was determined that the parameters of gender, age and consultant assignment had a partial effect. As a result of the examination of the service quality satisfaction scale in the second section; it was determined that the seven sub-dimensions mentioned had a significant effect on general satisfaction.Findings of the Research: As a result of the analysis of the data collected within the scope of the research, by examining the demographic data; It was determined that the parameters of marital status, education level and previous service from the same institution did not have any effect on satisfaction, while the parameters of gender, age and consultant assignment status had a partial effect. As a result of examining the service quality satisfaction scale in the second section; It was determined that the seven sub-dimensions mentioned had a significant effect on general satisfaction. Conclusion: This study aims to investigate the direct effects of service quality on patient satisfaction in the health tourism sector. The obtained data show that there are significant interactions between the seven dimensions that determine service quality. These findings provide valuable information in the service development and customer-oriented strategy creation processes of health enterprises. Keywords: Health Tourism, Medical Tourism, Patient Satisfaction, Service of Quality.