Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-616 International Journal of Scientific Research and Management (IJSRM) ||Volume||08||Issue||02||Pages||SH-2020-616-627||2020|| Website: www.ijsrm.in ISSN (e): 2321-3418 DOI: 10.18535/ijsrm/v8i02.sh01 Assessing Service Quality in the Ghanaian Private Healthcare Sector: The Case of Comboni Hospital. Fortune Afi Agbi1, Eric Owusu Asamoah2, Gilbert Atteh Joshua Sewu3 1 Department of Health Policy and Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, PRC

Department of Environmental and Safety Engineering, Jiangsu University, 301 Xuefu Road, Zhenjiang, PRC-212013 3 Department of Management Science and Engineering, Jiangsu University, 301 Xuefu Road, Zhenjiang, PRC-212013 Corresponding author: Fortune Afi Agbi Abstract The healthcare industry has become a paramount concern for most people in Ghana and the quality of services rendered to the patients in the private hospitals cannot be overemphasized. Patients need quality of services most and are willing to seek better services. The government has been the main provider of health care services in Ghana but recently, some Non-Governmental Organization's (NGO's), private individuals and stakeholders also provide health care services which has surged the competitiveness in creating more healthcare facilities in Ghana. This study seeks to explore patients' choice of selecting quality healthcare services and the factors that affect patient satisfaction in private hospitals using the case of Comboni Hospital in Sogakope, Ghana. The study therefore used the quantitative research method to collect the data and SPSS version 22 was used to analyze the data on high-quality healthcare. The SERVQUAL model was used as the measurement scale. Multiple regression analysis was used to reveal the effect of the independent variables (reliability, responsiveness, empathy, assurance, and tangibility) on the dependent variable (patient satisfaction). A detailed description in the analysis and the data processing identified the main factors affecting the general perceptions and patient preferences about their healthcare in the private hospital. The study revealed that there exist a positive result and perception for quality healthcare services without a negative expectation of the patient healthcare being compromised. The study recommends that both the government and the private agencies should consider the important aspects of the hospital's healthcare management and also the policy and decision makers should have an efficient and effective standard that impact the quality of healthcare assessment in Ghana. Keywords: Service Quality, Patient Satisfaction, Healthcare, Servqual Measurement, Comboni Hospital 1. Introduction In today's highly competitive environment coupled with the implementation of the National Health Insurance Plan (NHIS), competition among the medical institutions are very delicate as well as advocates for the provision of quality healthcare services (Medhekar, 2014). The concept of patient satisfaction is old and patients are one of the main stakeholders in the ever-changing medical world. According to (Munusamy et al., 2010), formulating health business goals requires patient satisfaction, as this is a principal determinant of performance. Patients' satisfaction are related to their own health and safety issues that must be identified and addressed appropriately. Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-617 Healthcare is one of the largest and fastest growing industries in the world creating jobs and boosting the economies of most countries. Health workers respond to patients needs daily, such as disease treatment, diagnosis, and patient care (Papanikolaou & Zygiaris, 2014). The health care system consists of a variety of medical facilities across the country and provides universal health care for patients in hospitals. Emergency services, diagnostic medicine, surgery, and general care are some of the services provided by medical institutions (Organization, 2014). The aim of this study is to assess the quality of service dimensions that affect quality services and the choice of patients in Ghana's private hospitals using the Comboni hospital. This research discusses the quality of healthcare received by patients in private hospitals in Ghana which provides keen insight into patient satisfaction. Also, this research identifies the gaps in health services that will help Ghana's health services to review their plans and focus on the cost-effectiveness of managing their limited resources to improve service quality. The study therefore provides beliefs about the patient's understanding and degree of expectations as well as the quality of service dimensions, which are essential for effective healthcare systems. 2. Literature Review 2.1 Service Quality The meaning of service varies depending on the environment in which it is used. Edvardsson et al. defined service as an in-depth understanding of customer's needs so as to satisfy them (Edvardsson & Strandvik, 2000; Sangiorgi & Eun, 2014). Clark et al. visualized the concept of service as a kind of psychological picture. The need to minimize the gap between expectations and actual service delivery is by creating a service concept that is understood and shared by all stakeholders, employees, and customers (Lemke et al., 2011) . According to (Hu et al., 2011), customer satisfaction and perceived value are affected by quality service and (Ahmad et al., 2013; Solomon & Dodor, 2014) found that service quality has been a top priority in the service industry in recent years. In this study, the quality of service is defined as the gap between patients' perception and the actual services they receive (Asubonteng et al., 1996; El Saghier & Nathan, 2013). A closer look at the existing literature on the quality of health care services revealed that past researches have focused on issues related to internal service quality (Kang & James, 2004). Saravanan & Rao, (2007) found in their research that, from the patient's perspective, healthcare organizations are fully focused on defining quality of service as this illustrates the planning of good customer strategies (Negi, 2009; Wicks & Roethlein, 2009). Seth et al., (2005) believed that quality services in health care services can technical or functional. The technical quality of health care includes the technical accuracy of diagnostics and procedures while the functional quality is related to the way health care is provided. According to (Bopp, 1990), data on technical quality are not available to the public and remain within the purview of healthcare professionals and managers. Functional quality is often the fundamental determinant of a patient's perception of quality as patients are unable to measure the technical quality of medical services (Nandan, 2010). (Nandan, 2010; Parasuraman & Zeithaml, 8 C.E.) in their study reported that the perception of quality is the "most important variable influencing the opinion of patients on value and this influences their intention to buy a service." However, whether the patient has information or not, technical and functional qualities should control the overall quality of healthcare services. 2.2 Perception of Service Quality and Patient Satisfaction in Healthcare The difference between a patient's perception of the services provided by a particular medical institution and their expectations of the medical institution providing these services can be defined as the quality of service in healthcare (Aagja & Garg, 2010). Patient satisfaction is positively rewarding, such as spreading positive rumors or recommending word of mouth to others, which will save medical institutions a lot of advertising costs (Swensen et al., 2013; V. A. Zeithaml & Mary, n.d.). The opposite is true in this statement because dissatisfied patients inevitably lead to disappointment (Zarei et al., 2012). Customer satisfaction can encourage loyalty among customers, although this varies across businesses (Imran et al., 2013). Andaleeb, 2001; Nkrumah et al., 2015; Purcărea et al., (2013) clearly defined the relationship between five factors of service quality and patient satisfaction. They found that the bonus factor had the lowest outcome Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-618 while "tangible" and "assurance" had the greatest impact on patient satisfaction. The SERVQUAL instrument was used to quantify patient referrals in Turkey by engaging 472 patients which revealed that the perception scores of patients were higher than their expected scores for standard hospitals and for first-class hospitals, the expected values were lower (Muhammad Butt & Cyril de Run, 2010). The "responsiveness" and "reliability" tests recorded the least expected scores of all the measures. Owusu-Frimpong et al., (2010) also assessed patient satisfaction with access to public and private health facilities. Their study found that public patients unlike their private colleagues were not satisfied with the delivery of services. Relatively, it has been revealed in the studies of Irfan & Ijaz, (2011) that Pakistani public hospitals provide fewer services in terms of quality as compared to the private hospitals. It was concluded that various studies and researches have been conducted in this areas where various techniques and methods have been used in different places, producing a mass of different results. Even though these differences in results shows the patient's overall satisfaction, some specific service dimensions need improvement. 2.3 Patient Satisfaction: A measurement of the quality of health care service Patients often receive different treatments from health professionals who conclude based on the type of quality treatment provided to them (Choi et al., 2004). A study in the emergency department of a hospital to determine the level of patient satisfaction with medical assistance, waiting time, nurses, etc. through a theory of the main provider was undertaken by (Aragon & Gesell, 2003). They concluded that overall patient satisfaction was closely related to two indicators; patient's recommendations made by medical staff and satisfaction with services. Besides, they pointed out that patient satisfaction varies from patient to patient, depending on the type of experience the patient has received, the general patient satisfaction, and their perception of the treatment. 2.4 The SERVQUAL Model The Servqual model has become one of the main tools for testing service quality. Literary studies indicate that customer satisfaction should be the primary goal of every organization. Effective implementation of service quality can ensure the improvement of the organization's goals in terms of time, guarantee, value, trust, etc. When using the SERVQUAL questionnaire to measure service quality, it involves the difference between the expected level of quality and the level of perception associated with the above statement (Azmi et al., 2017). Below are the service quality dimensions. Tangibility: This relates to the physical environment and appearance of the health facility. This condition includes physical dimensions, appearances, clothing, equipment and tools used by medical staff to provide better medical quality and cleanliness (Grönroos, 2000). Reliability: It refers to the ability to perform expected duties independently and reliably (Parasuraman & Zeithaml, 8 C.E.). Often, health professionals must carry out their activities correctly on their first visit without any errors in treating the patient and this can greatly increase patient satisfaction. Responsiveness: Responsiveness refers to the readiness and willingness of healthcare professionals to provide services to patients. In achieving this condition, time is of the essence (Ghaye & Lillyman, 2014). Assurance: Assurance refers to the skills and courtesy of medical professionals to influence a patient's trust and confidence in the patient (Nkrumah et al., 2015). Empathy: It refers to the paramedics who care most about the patient's interests. Thus, the ability to be compassionate and the ability to show care to the needs of patients (Parasuraman & Zeithaml, 8 C.E.). 2.5 Quality Service Gaps Five service quality gaps occurred in service industries (B. Zeithaml & Bitner, 2013). The gaps include the following; Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-619  Gap 1Listening gap: points to the differences between patient expectations and management's understanding of expectations regarding service delivery (V. A. Zeithaml et al., 1990).  Gap 2Service scheme and the Standard gap: represent the difference between management's compassion in patient expectations and the development of patient-led policies and values (Huang & Li, 2010).  Gap 3-Performance Gap: explains the difference between the growth of patient-driven service standards and actual service performance (B. Zeithaml & Bitner, 2013).  Gap 4External Communications gap: was built on management's responsiveness and ensures full positive interaction with patients (B. Zeithaml & Bitner, 2013).  Gap 5The Expected Service-perceived service gap: is the difference between patients' perceptions and expectations of quality services(P. Pai & T. Chary, 2013). Most businesses used the SERVQUAL to measure service quality. That's because it assesses the prospects of customers with the five service dimensions and what they think of the services they receive. McCabe et al in their research believes that SERVQUAL is not only a "measurement model", but also a good management model (Nkrumah et al., 2015; Regber et al., 2013). Among the tools for measuring patient satisfaction, the SERVQUAL tool is the ideal tool. Numerous studies have proven that the SERVQUAL model has been used in various medical centers to measure patient perceptions of service quality (Irfan & Ijaz, 2011; Zarei et al., 2012). Other studies have identified either fewer dimensions or additional dimensions and have confirmed the five standard quality variations of SERVQUAL tools. However, despite its limitations, SERVQUAL is still the standard tool for measuring patient satisfaction today. 3. Methodology 3.1 Data Collection This study uses a quantitative approach. This research was conducted at Sogakope in the Volta region, Ghana. It shares borders to the West with the Republic of Togo and to the east of Lake Volta. Sogakope homes the Comboni Hospital. There are multiple ethnic and linguistic groups in the area, such as ewe, Guan and Akan. The Sogakope district is mainly a rural area with a nearby 87.1% majority and only 12.9% living in urban areas. Sogakope was chosen because it reveals signs of a densely populated and fast-growing urban center and brings patient-related difficulties. Fig 1: Conceptual Framework Source: Adopted from Wilson Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-620 The researchers selected 150 respondents for this study using a convenient sampling technique. In this study, the questionnaire was a suitable tool for collecting data so the questionnaire was delivered to the selected patients and completed at Comboni Hospital. The questionnaire was structured according to the SERVQUAL dimensions. The research questionnaire consisted of two parts; the first part assessed demographic characteristics of patients, such as gender and age. In the second part, regarding the quality of service, the questionnaire consists of 26 questions divided into five dimensions, including reliability, responsiveness, assurance, empathy, and tangibles. For descriptive statistics, frequency, percentage and mean were applied. Table 1 provides the descriptive statistics of the respondents of this study. The data was measured on a fivepoint Likert – type scale, where 1 = strongly disagree, 2= disagree, 3=neutral, 4= agree and 5= strongly agree. The analysis was based on the primary data. These patients were permitted to read through and respond to the questionnaires willingly. Out of the 150 questionnaires administered, 135 questionnaires were retrieved for the analysis. The Statistical Package for the Social Sciences software (SPSS) version 22, was used to analyze the data received. Quantitative data analysis methods provide a unified basis for examining data. This makes logical comparisons and distinctions easy. 3.2 Model Estimation and Measurement of Variables When testing the relationship between the service quality dimension and patient satisfaction, patient satisfaction was used as the dependent variable and the service quality dimensions as the independent variables to estimate the multiple regression model. The model is listed as follows: Let: Patient Satisfaction = Y1, Reliability = X1, Responsiveness = X2, Assurance = X3, Empathy = X4, Tangibility = X5, and Error Term = e Y1 = B0 + β1X1 + β2X2 + β3X3 + β4X4 + β5X5 + e (1) Where X1 ... ... ... . X5 are the independent variables, β1 . . . β5 are the coefficients of the independent variables, β0 = intercept, and e = error term. 4. Results 4.1 Demographic characteristics of respondents Out of the 135 patients who completed the questionnaire at Comboni Hospital, 61 were males (45%) and 74 were females (55%). With the age distribution, more than half of the participants (63.0%) were aged between 29-39years, 1828 years denoted (15.6%) and those aged 40-50 years comprised 14.8%. Participants aged 51 and over accounted for 6.6%. From table 1, the marital status distribution shows that 78.5% of the participants were married with 21.5% being single. 23% had primary education. 45.9% of the participants had high school education and those who fell under tertiary education constituted 31.1%. In the distribution regarding occupation, 26.7% of the participants were company workers, 29.6% were teachers,11.1% were farmers and 32.6% of the participants were in other occupations other than the ones listed. In the patronizing the services of Comboni hospital, the first-timers represented 20.0%, those who visit monthly were 24.4% and those who attend on weekly and daily basis were7.4% and 3.7% respectively. Most participants (44.4%) visited the hospital only when they are sick. Table 1: General information Variables Responses Frequency (N) Percentages (%) Gender Male Female 61 74 45 55 Age 18-28 years 29 39years 40 50years 21 85 20 15.6 63.0 14.8 Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-621 Above 51years 9 6.6 Marital Status Married Single 106 29 78.5 21.5 Educational Level Basic School High School Tertiary 31 62 42 23 45.9 31.1 Occupation/Profession Company Employee Teaching Farmers Others 36 40 15 44 26.7 29.6 11.1 32.6 How often do you visit this hospital First time Yearly Monthly Weekly 27 33 10 20.0 24.4 7.4 Daily When sick 5 60 3.7 44.4 Source: Author's guide (2019) 4.2 Gaps The quality of service is calculated as the difference between the perception and expectations of each dimension, called the gap (Parasuraman & Zeithaml, 8 C.E.). Table 2-6 lists the assessment gaps for each dimension. In general, patient expectations tend to be average or slightly higher. It is worth emphasizing that despite the average expectations, patients give a positive evaluation of almost all aspects of service quality, which reflects that the gap in almost all aspects is positive. Reliability is the dimension where patients were satisfied but with a smaller deviation than all the other dimensions, because patients' expectations for this dimension were higher. This happened because patients' expectations were at the maximum, and because the service evaluation average score is 4.49, the evaluation tends to be good. This aspect is considered to be the top priority in terms of whether the hospital is fulfilling its promises. This contributed to Johnson's research that the reliability and performance of health facilities and their employees are critical to patient satisfaction (Sweeney et al., 1997). Table 2: Reliability Factors under Reliability Dimension Expectation (Average) Patient's Perception (Average) Gap Score (Expectation Perception ) REL1 4.09 4.58 0.49 REL2 4.16 4.47 0.31 REL3 4.03 4.24 0.21 REL4 4.08 4.55 0.47 REL5 4.13 4.61 0.48 Average Reliability Gap Score 0.39 Source: Author's calculation Responsiveness is a dimension in which patient satisfaction is higher than other dimensions. With regard to responsiveness, patients' expectations were above average, and their actual perception of service quality was assessed to be slightly higher than this good level of 3.81, with a gap value of 0.54, indicating that patients were indeed satisfied with this dimension. With the results above, it can be concluded that workers responding quickly to patients' request was the highest factor with a relative mean of 3.29. This makes it the most critical factor. This proved that staff willingness to provide better services can improve the quality of care (Grönroos, 2000). Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-622 Table 3: Responsiveness Factors under Responsiveness Dimension Expectation (Average) Patient's Perception (Average) Gap Score (Expectation Perception ) RES1 3.17 3.72 0.55 RES2 3.25 3.74 0. 49 RES3 3.29 4.05 0.76 RES4 3.35 3.72 0.37 Average Responsiveness Gap Score 0.54 Source: Author's calculation Assurance is another dimension where patient outcomes were very satisfied with a gap greater than the other three dimensions and patients' expectations for this dimension were higher. Given that this involves the ability of the doctor to care and diagnose, this is normal and expected. It was also important to emphasize that even real estimates were high with an average of 4.57, resulting in a positive gap of 0.52 which indicates that patients were very satisfied. The results obtained from the participants showed that skilled and knowledgeable staff were rated as the highest element. It comes with a mean factor of 4.25. This means that skillful and knowledgeable was the most important element to patients. (Fitzsimmons et al., 2008) emphasized this factor. They emphasized that "knowledge is the ability of healthcare professionals to convey patient trust and confidence." Table 4: Assurance Factors under Assurance Dimension Expectation (Average) Patient's Perception (Average) Gap Score (Expectation Perception ) ASS1 4.19 4.51 0.32 ASS2 4.10 4.68 0.58 ASS3 3.96 4.71 0.75 ASS4 4.25 4.60 0.35 ASS5 3.76 4.37 0.61 Average Assurance Gap Score 0.52 Source: Author's calculations Empathy is another aspect of positive indicators for improving patient satisfaction, as staff are relatively sensitive, polite and genuinely worry about patients. This happened because the expectations were not at their maximum and also because the service evaluation averaged was 4.31, so it was evaluated and tended very well. Table 5: Empathy Factors under Empathy Dimension Expectation (Average) Patient's Perception (Average) Gap Score (Expectation Perception ) EMP1 3.81 4.44 0.63 EMP2 3.93 4.22 0.29 EMP3 3.89 4.15 0.26 EMP4 3.98 4.43 0.45 Average Empathy Gap Score 0.40 Source: Author's calculation Tangibles are the dimension that shows a positive deviation with a slightly good average deviation of 0.46. This shows that patients were more satisfied despite the obstacles. Estimates of negative gaps in this regard are related to the modernization of equipment and technology used (and much more to be improved) and Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-623 food. Hospital and staff have slightly higher cleanliness levels. However, the average gap is still positive, indicating that patients are at least happy with this dimension. From the results obtained, the system expansion, modern equipment and new equipment scored the highest, with an average of 3.99 and 3.50. This means that these two elements were ranked the most important by patients. (Grönroos, 2000) described in his research that physical facilities such as equipment, employees, and work materials can promote highquality healthcare. This factor is also true for private-sector medical institutions, as they also buy medicines on credit to meet the needs of patients. Table 6: Tangibility Factors under Tangibles Dimension Expectation (Average) Patient's Perception (Average) Gap Score (Expectation Perception ) TAN1 3.17 3.12 -0.05 TAN2 3.99 4.72 0.73 TAN3 3.50 4.18 0.68 TAN4 3.06 3.52 0.46 Average Tangible Gap Score 0.46 Source: Author's calculation Table 7: Regression Analysis Variables β SE t Prob. Constant -1.770 .321 -5.506 .000 REL .033 .016 2.135 .035 RES .727 .055 13.113 .000 ASS .472 .056 8.494 .000 EMP .611 .109 5.606 .000 TAN .527 .069 7.589 .000 R2 .730 F-statistic 71.024 *** ≈ P-value significant at 0.1% (0.001) ** ≈ P-value significant at 1% (0.01) * ≈ P-value significant at 5% (0.05) General Patient Satisfaction Patients that preferred an alternative healthcare rather than Comboni Hospital were 27% while 73% preferred to visit Comboni hospital for treatment representing the highest percentage. 5. Discussions The study aimed at assessing the quality of service choices made by patients in the private medical sector in Ghana. The following five quality of service dimensions were used to assess a patient's choice of a private healthcare system: reliability, responsiveness, assurance, compassion, and the tangibles of the services provided. A multiple regression analysis was performed using data collected from Comboni Hospital and the Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-624 results showed that these service dimensions are important to patient satisfaction. Comboni Hospital represents private healthcare because it has the practical characteristics of a typical private hospital in Ghana. Multiple regression analysis was used to test the relationship between the service quality dimensions and patient satisfaction. Patient satisfaction was used as the dependent variable, and quality of service dimensions were used as independent variables. The results shown in Table 7 indicate a positive significant relationship between patient satisfaction and service quality dimensions (F =71.024, p <.05). This means reliability, responsiveness, assurance, empathy, and tangibility define patient satisfaction. An R-squared of .730 shows that the independent variables describe 73% of patient satisfaction. At Comboni Hospital, responsiveness has been found to have the greatest impact on patient satisfaction (β = .727, t = 13.113, p < .001). Followed by assurance (β = .472, t = 8.494, p <.001) indicates that skills that evoke trust and confidence in patients may also affect patient satisfaction. More so, Tangibles was also discovered as a significant determinant of patient satisfaction (β = .527, t = 7.589, p <.001) followed by Empathy with (β = .611, t = 5.606, p <.001) and Reliability in relation to patients in the hospital was the least significant impact on patient satisfaction (β = .033, t = 2.135, p < .005). It is also important to point out that all five dimensions of service quality are important in the analysis of achieving patient satisfaction at Comboni Hospital. Tangibles dimension having negative gap estimates show that there is more room for improvement. Therefore, marketing managers and governments must also invest in technology and equipment as well as employee image. This is logical because most patients try to assess services based on tangible factors such as the environment and the price of the service business. Managers can apply strategies used in ergonomics, such as music, and must take care of their medical environment. Managers must pay careful attention to the recruitment phase of employees and ensure continuous training of employees based on each employee's ability. These trainings will focus on professional qualifications and how to communicate with patients if they want to improve scores of empathy and reliability indicators. Although the analysis showed that patients were highly satisfied with all service dimensions (positive gaps), the average gap was relatively low. One explanation for this result is the low expectation of patients due to the service they had encountered during their hospitalization in previous years. Even if the analyzed dimensions have high scores, if all the dimensions are ranked first, then it is the responsiveness, then the assurance, tangibility, empathy, and reliability. In addition, it is important to emphasize that patients rated high scores for staff skills in defining an accurate diagnosis, the readiness of staff to respond in a friendly and polite manner. This is important information for hospital administrators that, they should go all out to improve equipment and other content conditions to make the hospital more attractive so as to improve quality services and patient satisfaction in the future. Furthermore, it is highly recommended that quality services be evaluated occasionally in different ways to assess the situation through the patient's eyes to develop and improve the competitiveness of Comboni Hospital in the field of health. However, the analysis showed that despite the assessment, the hospital's patients were loyal and they would return to the hospital. This happens mainly because the services provided have improved and because a large percentage of the patients questioned have enough financial resources to operate in private medical institutions. Strengthening health care systems can reduce hospital stays and reduce deaths. Failure to meet the needs of patients in a healthcare facility can lead to finding opportunities and learning from their shortcomings. Conclusion The Comboni hospital (private sector) selected for this study scored higher in all the quality of service dimensions. The analysis of the data received from the Comboni Hospital showed that the hospital has made improvements in recent years in the quality of its services. A comparison between lower patient expectations and higher scores can attest to this fact, as well as from patient statements, especially for first-time hospitalized patients who claim situations have improved. However, the road to higher achievement in highquality services is long and cumbersome. Fortune Afi Agbi, IJSRM Volume 08 Issue 02 February 2020 [www.ijsrm.in] SH-2020-625 In summary, in order to provide high-quality medical services and gain patient preferences, hospital managers should be made aware of these requirements by listening to patients and participating in further improvement projects. The authorities of private hospitals must continue to use the SERVQUAL model proposed by (Parasuraman & Zeithaml, 8 C.E.) to improve their performance in medical institutions, compete with others and enhance the service level for Ghanaians. For health care organizations to survive longer in a changing population, preferences, and lifestyle, it is important to continuously study patients' expectations and perspectives. It is also important to understand healthcare customers in a highly competitive market. References Aagja, J. P., & Garg, R. (2010). Measuring perceived service quality for public hospitals (PubHosQual) in the Indian context. 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