Antecedents and Consequences of Patient Satisfaction in the Context of
Private Hospitalization Services
AHMAD AZMI M. ARIFFIN
NORZALITA A. AZIZ
Graduate School of Business
Universiti Kebangsaan Malaysia
43600 UKM Bangi, Selangor
MALAYSIA
NORHAYATI M. ZAIN
BAMA V.V. MENON
KPJ Healthcare University College
71800 Nilai, Negeri Sembilan
MALAYSIA
Abstract: - This study aims to investigate the impacts of perceived quality and perceived value on patient
satisfaction as well as the influence of patient satisfaction on hospital’s brand image, patient loyalty and word-
of-mouth intention in the context of private hospitalization services. With regards to the conceptualization of
perceived quality, this study also attempts to uncover the underlying dimensions of hospitalization quality in
the specific context of private hospital. This study surveyed 254 patients who were admitted for at least three
days at private hospital in Malaysia, revealing that patient satisfaction with hospitalization services could be
explained directly or indirectly by five hospitalization quality domains namely outcome quality, rights and
privacy, medical quality, service quality, and servicescape. The findings of this study also show that patient
satisfaction has significant impacts on all the three consequences variables – brand image, patient loyalty and
WoM intention. The two major contributions of this study include the conceptualization of hospitalization
quality domains and the newly developed measurement of perceived value in the context of profit-oriented
healthcare institutions.
Key-Words: - Hospitalization quality, Patient satisfaction, Perceived value, Brand image, Patient Loyalty,
Word-of-mouth intention
Received: June 13, 2021. Revised: November 25, 2021. Accepted: January 12, 2022. Published: January 14, 2022.
1 Introduction
As the healthcare industry is experiencing a swift
transformation to meet evolving expectations,
patient satisfaction is widely emphasized as the key
indicator of healthcare quality [1]. However, health
professionals are claimed to have scant
understanding of patients’ experiences and
perceptions of satisfaction [2].
Review of previous literature indicates that most
scholarly works on patient satisfaction focus on
outpatient services, whereas studies on inpatient
services mostly pertained to a specific illness rather
than the admission experiences at large. Minimal
systematic empirical evidence is currently available
on the antecedents and consequences of patient
satisfaction in the context of hospitalization
experiences in privately owned hospital settings.
The hospitalization services of exceptional quality
also have crucial influence in promoting a hospital
in the marketplace of medical tourism, which is a
strategic aim of most private hospitals in the
contemporary global healthcare industry [3].
In general, the public generally hold diverse
levels of perception and expectation on the overall
services offered by public versus private hospitals
[4]. Given the different nature of the service
provisions, studies focusing on inpatient experiences
in private setting require a distinct set of quality
measures that differ from those on publicly funded
hospitals. This study attempts to address these gaps,
proposing new measures of hospitalization quality
in the private hospital setting. To the best
knowledge of the authors, this study is also the first
reference on the relationships between the domains
of hospitalization quality and patient satisfaction as
well as perceived value.
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2 Literature Review
Patient satisfaction is a multidimensional construct
pertaining to patient perceptions and attitudes that
are developed regarding the overall healthcare
experience[1]. Past studies have provided
compelling evidence of the direct relationship
between perceived service quality and patient
satisfaction [5,6,7]. However, most of these studies
examined outpatient service settings. This present
study aims to fill this void by focusing on
hospitalization quality. It is important to note that
quality is always linked to institutional effectiveness
[8].
As previously described, most existing studies
on patient satisfaction employed a widely used
marketing instrument called the Servqual [9,10] or
modified versions, such as the Privhealthqual scale
[11] or Servperf [11]. Such prespecified instruments
are insufficient for measuring the holistic
perspective of perceived quality in hospital settings
[13]as patient and customer are fundamentally
dissimilar concepts [2].
Based on an extensive review of literature in
healthcare, [13] proposed the dimensionality of
hospital service quality called the 6-Q framework:
technical quality, infrastructural quality,
interactional quality, procedural quality, personnel
quality, and social support quality. However, the
authors clearly noted that the framework is
applicable only to tertiary healthcare establishments
that focus on advanced investigation and specialized
treatment. While a lot of studies have investigated
the determinants and consequences of patient
satisfaction, the results remain inconclusive and, in
some cases, contradictory [14].
[15] Strongly argued that any customer
satisfaction index should measure both satisfaction
and its determinants, consequences, and the
relationships among these variables in a single
model based on a specific service context.
Referencing this principle, patient satisfaction is
conceptualized in this study based on the well-
established national Customer Satisfaction Index
Model that represents a cumulative evaluation of
hospitals’ service offering (hospitalization), as
opposed to patients’ evaluation of a specific
transaction [16]. Despite its rigor and utility, no
scholarly study has been found employing the
national satisfaction index model to investigate
hospitalization experience in the context of private
hospitals.
The first national customer satisfaction index
was the Swedish Customer Satisfaction Barometer
developed by [17]. The American Customer
Satisfaction Index (ACSI) was launched in 1994
[16], followed by the Swiss Index of Customer
Satisfaction in 1997, and then the European
Customer Satisfaction Index in 1999. The widely
used ACSI model links customer satisfaction to its
antecedents, namely, perceived quality, customer
expectations, and perceived value, as well as
consequences, identified as customer loyalty and
customer complaints. The results of all these
customer satisfaction indices cannot be directly
compared, as the structure and indicators used
differ.
The Malaysian Customer Satisfaction Index Model
(MCSI) was proposed by [18], representing
customers’ evaluation of the quality of the service
provided by organizations in Malaysia. The MCSI
incorporates product/service image as a
consequence variable of satisfaction in place of the
ACSI’s customer complaint variable.
3 Patient Satisfaction
Based on the ACSI as well as MCSI, Patient
satisfaction is posited to be determined by two
antecedents namely:
1. Hospitalization quality: Patient’s evaluation of
their hospitalization experience starting from
admission until discharged [3].
2. Perceived value: Overall perceived benefits
obtained by the patient relative to the costs
incurred, length of stay as well as perceived
ulterior motive [19].
As previously noted, the impact of perceived
quality on patient satisfaction is unquestionably
critical. According to [20], private healthcare
institutions have been accused of being overly
concerned with generating profit objectives instead
of offering quality medical services at reasonable
prices. Thus, the construct of perceived value in this
study is operationalized partly based on the effect of
perceived ulterior motive.
Because of the intense competition in the private
healthcare industry, unlike nonprofit-oriented
healthcare institutions, private hospitals must
cultivate a stronger base of loyal patients to ensure
long-term survival [19]. Loyalty is undeniably a
vital business success factor that can only be
developed and sustained through the provision of
excellent service quality and continuous
improvement in satisfaction levels [4]. The
proposed model also considers the effect of
hospitals’ brand image as it is considered as one of
the most powerful factors considered by patients
when selecting a hospital for medical treatment [21].
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Apart from loyalty and brand image, [22] contended
that word-of-mouth (WoM) also acts as the most
vital acquisition channel in the profit-based
healthcare industry particularly through social-
media platforms. However, there remains a dearth
of knowledge available regarding the determinants
of WoM in the healthcare industry. The extant of
literature indicates that none of the existing related
models appears to have simultaneously addressed all
the following three outcome variables for predicting
patient satisfaction in a single model:
1. Hospital’s brand image - The set of associations
attached to the hospital as a brand in patient
memory [23,24].
2. Patient loyalty - The tendency of a patient to
recognize and repeatedly choose the same
medical service provider or hospital [3].
3. Word-of-mouth intention - The patient attitude
towards giving favourable word-of-mouth
referrals to others [25].
Theoretically, the indicators of hospitalization
quality as well as perceived value as the
determinants of patient satisfaction in the context of
private hospitals should differ from those of
outpatient services and public hospitals. The attempt
to address this notable methodological gap is
another main contribution of this study. Thus, the
main objectives of this study are twofold:
1. To examine the relative explanatory power of
hospitalization quality as well as perceived value
on patient satisfaction in the context of private
hospitals.
2. To determine the impacts patient satisfaction on
patient loyalty, hospitals’ brand image, and
WoM intention.
4 Methodology
The unit of analysis of this study is individual
patient of private hospital in Malaysia who are at
least 18 years old and experienced hospitalization
for at least three days in the year 2020. Formal
permission and ethical clearance were obtained to
get the required information from the database of
patient’s basic profiles maintained by the related
health authority. Based on purposive sampling, a
total of 411 ex-patients qualified as respondents. Of
these 411 ex-patients, only 254 agreed to
participate.
A structured questionnaire was used as the main
instrument, and because of the pandemic, the most
suitable method for distribution was web-based.
With close follow-up, all 254 respondents returned
the questionnaires. From these 254 respondents,
only 242 were found to be appropriate for further
analyses; the remainder were discarded mainly due
to issues of extensively missing values and outlier
status. Considering the difficulty of obtaining a
large sample size in healthcare-related studies and
the pandemic outbreak situation, 242 is regarded as
satisfactorily sufficient. A recent related study by
[26] also employed less than 200 patients as their
respondents.
Based on [27], the hospitalization quality
domains were treated as formative measurements as
their indicators are assumed to cause the respective
constructs. The measures for hospitalization quality
were developed based on various sources, including
the CAHPS Adult Hospital Survey, Picker’s eight
domains of Person-Centered Care, MSQH and JCI
accreditation standards. [28] strongly advocated that
the measures of hospitalization quality be developed
using a mixed method of quantitative and qualitative
inquiry. The qualitative technique requires patients
to openly describe their admission experiences
through in-depth interviews. The interviews with 14
respondents combined with a review of literature
managed to generate a total of 47 measurement
items.
Three subject matter experts were appointed to
assess the content validity of the measurements. A
total of 15 items were removed, leaving 32 items for
further analysis. The thematic analysis of the
remaining 32 items produced five distinct
hospitalization quality domains labelled as:
1. Medical quality: “What” the patient actually
receives from the healthcare services to solve
their illness [29].
2. Service quality: “How” the healthcare service is
delivered to the patients [29].
3. Outcome quality: Overall subjective evaluation
of the outcome of the treatments and recovery
status [30].
4. Servicescape: Physical environment including
tangible elements of the hospital [31].
5. Right and privacy: Protection of patient’s privacy
and right including the involvement in the
decision-making process [32].
Hospitalization requires patients to stay longer
in the hospital setting and involves more
interactions with hospital staff compared to
outpatient services. It requires the provisions of
accommodation and meals, in addition to extended
clinical treatments. Thus, the domain of the physical
environment of the hospital (servicescape) and,
patients’ rights and privacy should be singled out as
separate domains. These two domains are also
particularly distinctive to the context of private
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hospital as the patients culturally expect a hospitals’
physical environment to be a hotel-like setting and
are granted more rights or freedom in determining
the manner in which their stay and treatments
should be rendered.
Assessment of the properties of the formative
measurement model indicated that no collinearity
issue was detected, as the VIF for each relationship
among the five domains was less than 10 (Hair et
al., 2021). To further purify the quality domains, an
indicator is to be retained only if its outer loading is
above 0.5. Based on this procedure, the finalized
scale consists of 20 items.
Perceived value was measured using one item
borrowed from [16] and two newly developed items
generated from in-depth interviews. The perceived
value of private hospitalization services should also
be partly reflected in the ratings of the benefits
given the required length of hospital stay, as well as
the perception of whether ulterior profit motive is
involved in service provision. These additional
measurement items reflect the contextual
phenomenon of a private healthcare business model,
thus offering a more inclusive measure of perceived
value as the key methodological contributions of
this study.
Three measures of patient satisfaction with
hospitalization experience were also based on the
work of [16] representing overall satisfaction,
disconfirmation of expectation and ideal experience.
Patient loyalty was operationalized using two items
adapted from [33]. Three items adapted from [34]
were used to measure the hospital’s brand image,
reflecting the hospital’s reputation, image, and
sincerity. Finally, two items were borrowed from
[35] to operationalize WoM intention, gauging the
extent to which patients would recommend the
hospital. The PLS-SEM using the Smart-PLS
software was utilized for assessment of the
measurement and structural model.
5 Findings
5.1 Measurement Model of PLS-SEM
The measurement model possess high internal
reliability as the values of Cronbach alpha and
composite reliability for the constructs were all
greater than the recommended value of 0.7 [36].
Convergent validity was also achieved as the values
of all outer loadings and AVE were above 0.5 [36].
The Fornell-Larker criterion employed indicated
that there was sufficient discriminant validity as the
square roots of AVE were higher than the
correlations for all constructs.
Table 1. Reliability and Convergent Validity
Variables
Outer
Loading
Cronbach
Alpha
AVE
Perceived Value
0.729
0.674
Price-benefits
0.822
Benefits-length of
stay
0.808
Perceived ulterior
motive
0.834
Patient
Satisfaction
0.740
0.659
Overall satisfaction
0.871
Fulfilled
expectations
0.846
Ideals
0.78
Patient Loyalty
0.844
0.878
Return to the same
hospital
0.934
Choose the same
hospital
0.940
Word of mouth
0.820
0.858
Recommend the
hospital
0.916
Talk positively of
services
0.936
Brand Image
0.868
0.805
Reputation
0.871
Positive image
0.911
Sincerity
0.909
5.2 Structural Model of PLS-SEM
The R2 represents the quantity of variance in the
endogenous constructs, which is explained by all of
the exogenous constructs. The values of 0.75, 0.50
and 0.25 represent substantial, moderate and weak
effect size respectively [27]. The results presented in
Table 2 showed the values represented mostly
moderate effect sizes with exception of patient
satisfaction.
The results revealed that 78 percent of the
observed variation can be explained by the five
hospitalization quality domains together with
perceived value. The F2 is utilized to examine the
relative impact of a predictor construct on an
endogenous construct [37]. The values of 0.35, 0.15,
and 0.02 represent large, medium, and small effect
sizes respectively. Table 2 indicated that most of the
effects were in the medium range. The results also
showed that predictive relevance had been attained
for all variables as the Q2 value were greater than
zero [36].
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Table 2. Structural Properties
Endogenous
Variables
Predictive
Constructs
R2
F2
Q2
Perceived
Value
Outcome
quality
0.68
0.152
0.468
Rights and
Privacy
0.007
Medical Quality
0.168
Service Quality
0.173
Servicescape
0.150
Patient
Satisfaction
Outcome
Quality
0.78
0.283
0.628
Rights and
Privacy
0.271
Medical Quality
0.246
Service Quality
0.187
Servicescape
0.007
Perceived Value
0.266
Patient
Loyalty
Brand Image
0.60
0.068
0.524
Patient
Satisfaction
0.389
WoM
Intention
Brand Image
0.66
0.299
0.572
Patient
Satisfaction
0.242
Brand Image
Patient
Satisfaction
0.54
0.381
0.437
5.3 Path Analysis
The results of path analysis summarized in Table 3
showed that with the exception of servicescape, all
the hospitalization quality domains including
perceived value have strong significant impacts on
patient satisfaction. Unsurprisingly, outcome quality
appeared to have the greatest influence on patient
satisfaction followed by right and privacy, perceived
value, medical quality and service quality. In the
case of the prediction of perceived value, all
hospitalization quality domains with exception of
right and privacy were found to be significantly
related. The results showed that service quality had
the greatest effect on perceived value followed by
medical quality, outcome quality and servicescape.
The results of the path analyses also provide strong
empirical evidences to support the positive impacts
of patient satisfaction on all the three proposed
outcome variables. Patient satisfaction had the
greatest impact on the hospital’s brand image
followed by patient loyalty and word-of-mouth
intention.
Table 3. Path Coefficients
Relationship
B
S.E
P
value
Result
DV: Patient
Satisfaction
Outcome Quality
0.324
0.076
0.000
S
Rights and Privacy
0.280
0.08
0.000
S
Medical Quality
0.221
0.055
0.000
S
Service Quality
0.201
0.042
0.04
S
Servicescape
0.077
0.107
0.171
NS
Perceived Value
0.278
0.056
0.000
S
DV: Perceived
Value
Outcome Quality
0.268
0.056
0.001
S
Rights and Privacy
0.090
0.074
0.131
NS
Medical Quality
0.271
0.053
0.000
S
Service Quality
0.288
0.078
0.000
S
Servicescape
0.133
0.065
0.001
S
IV: Patient
Satisfaction
Brand Image
0.739
0.036
0.000
S
Patient Loyalty
0.572
0.058
0.000
S
WoM Intention
0.413
0.049
0.000
S
S: Supported, NS:Not Supported
6 Discussions and Implications
6.1 Impacts of Hospitalization Quality on
Patient Satisfaction
The outcome quality appears to be the most
influential quality domain affecting the extent to
which patients are satisfied with hospitalization
experiences in the private hospital setting, followed
by rights and privacy, medical quality, and service
quality. Notably, this study reveals servicescape
which is associated with environmental quality to
have an insignificant relationship with patient
satisfaction. Nevertheless, the results indicate that
the servicescape domain may influence patient
satisfaction via perceived value.
Unquestionably, the attainment of desirable
medical outcome quality is the core purpose of an
entire hospitalization experience. It is the result that
patients seek to obtain from the treatment received
throughout their hospital stay. The outcome of
clinical treatment depends on various factors that
are both controllable and uncontrollable. The
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competencies of the medical team, medication
prescribed, nursing care, and clinical facilities are
among the factors. Outcome quality also depends on
the roles the patients and their caregivers play in
maintaining a patient’s health following discharge.
Effective discharge planning can avoid patient
readmission, as well as aiding recovery by ensuring
that medications are prescribed and correctly given.
“Rights and privacy” is the second most
important domain in predicting patient satisfaction.
In the private hospital setting, patients expect to be
actively involved in most of the decisions regarding
their healthcare. However, patients are comfortable
with physicians’ making decisions on their behalf,
as long as the options and implications are clearly
explained [38]. Shared decision-making requires
doctors and patients to discuss the best available
treatment options and patients are assisted in
considering options to determine informed
preferences. In addition to prioritizing the patients’
rights at all times, patients’ privacy must also be
protected in an ethical and professional manner.
Rights and privacy are one of the distinguishing
factors that differentiate private hospitals from
public hospital counterparts.
The third most effective predictor of patient
satisfaction is medical quality. Medical quality
refers to the ability of a hospital to attain high
standards of patient health through clinical
treatments, ultimately generating positive
physiological and physical effects [29]. Medical
quality is a core enabler of outcome quality, but in
many cases, the clinical outcome of a treatment is
not immediately detectable; thus, patients will
normally evaluate it based on available tangible
cues such as the doctors’ expertise and the proper
use of diagnostic equipment. Finally, patient
satisfaction with hospitalization services is also
significantly influenced by the service quality
domain. Unlike medical quality that focuses on
“what,” service quality fundamentally reflects the
“how” of service provision involved. Service quality
domain is highly related to staffs’ communication
and interpersonal skills, including personal manners,
responsiveness, and professionalism. It also
involves the timeliness of treatment and the
efficiency of admission and discharge processes.
This quality domain can be a competitive advantage
for hospitals to compete in the global health tourism
marketplace. While physicians can be hired and
equipment can be procured, personalities and
processes are not easily imitated by the competitors.
Unexpectedly, this study found no empirical
evidence to support a direct relationship between
patient satisfaction and servicescape. Patients
generally do not equate the direct impacts of the
servicescape with the core purpose of
hospitalization, which is centered on health
improvement. The clinical equipment used might
not be the most advanced, and there may not be
luxury furnishings in patients’ rooms, but the
ultimate goal of health recovery may occur. In
addition, compared to all other quality domains
discussed earlier, patients generally already have
some ideas of the hospital servicescape via some
media exposures prior to admission. Although the
servicescape was shown to have no direct impact on
patient satisfaction, it does have a considerable
influence on the service value of the hospitalization
experience and should therefore not be ignored.
6.2 Impacts of Hospitalization Quality on
Perceived Value
The findings of this study reveal that service quality
is the most influential hospitalization quality domain
for explaining perceived value, followed closely by
the medical quality domain. The service quality
domain, centered on how service is rendered, is
closely connected to the perceptions of ulterior
profit motives, whereas the medical quality domain
is linked with both the cost of hospitalization and
duration of stay. Patients do not have adequate
clinical knowledge on the extent the treatments they
received actually affect their recovery or whether
ulterior profit motive is involved. The
trustworthiness of the hospital in providing the best
hospitalization experience at the most ideal cost is
partly assessed by the patients by considering how
they are personally treated by the staffs.
Medical quality is partly judged based on the
treatments received as well as medical team
competencies. Obviously, these elements are closely
related to patients’ cost to enjoy such privileges.
Since not all treatments are covered by employers or
insurance, patients still need to be selective in
deciding the necessary treatments. Thus, hospitals
that offer good (quality) choices of physicians and
treatments (quantity) are regarded as providing
favorable service value and thus manage to attract
more patients. Although the results indicate that
outcome quality is the third most powerful
determinant of perceived value, the coefficient and
corresponding significance level are substantial and
only slightly lower than those of medical quality.
Outcome quality is the direct measure of the desired
health restoration and is indirectly influenced by
perceived medical quality. While outcome quality is
evaluated upon discharge, the notion of perceived
value involves continuous assessment of the entire
service process, starting from admission. This
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disproportion might explain why outcome quality
demonstrates lower prediction power on perceived
value compared with service and medical quality,
despite its fundamental influence on patient
satisfaction.
Despite no relationship being found regarding
patient satisfaction, the servicescape is found to
have a significant impact on perceived value. As
perceived value is evaluated as a continuous
assessment, the more favorable the tangibles aspects
of the hospital, the higher the perceived service
value of the overall hospitalization experience.
Using up-to-date clinical equipment could help
enhance patient perceptions of the service value
although it might not necessarily result in the
expected significant health improvement. The food
served and the entertainment offered obviously have
nothing much to do with the health outcome quality
but might have strong impacts on the perceived
value of the hospitalization service. Interestingly, no
evidence is available to support the influence of
rights and privacy on perceived value. Perceived
value essentially refers to the benefits patients gain
throughout the hospitalization experience. The
rights and privacy domain, referring to the
involvement of patients in decision-making, and the
extent to which patients’ rights and privacy are
protected are fundamentally related to the
performance of a process rather than the resulting
benefits to be attained by patients.
6.3 Impacts of Patient Satisfaction on
Hospital’s Brand Image, Loyalty, and WoM
Intention
This study demonstrated that patient satisfaction has
the strongest impact on hospital image. Hospitals
that managed to satisfactorily fulfill patients’
expectations will be regarded as having a good
reputation or image. Reputation is indeed an
imperative for long-term survival in the healthcare
industry, as the offerings are intangible in nature
and highly dependent on trust. More importantly,
hospitals with a positive brand image are also
preferred and given priority, particularly by new
patients. Interestingly, higher satisfaction will also
lead to the perception that the hospital is sincere in
its efforts to treat patients. This is critical for
managing accusations and perceptions that the
services offered by private hospitals usually involve
ulterior profit motive.
The findings of this study also support the
strong relationship between customer satisfaction
and customer loyalty. The more satisfied the
patients with the hospital experience, the more
likely they will return for any future healthcare
treatments needed. Finally, patient satisfaction is
also found to significantly affect WoM marketing.
Those who are impressed by the level of service
offered by a hospital will be more likely to
recommend the hospital to other people. Literature
has demonstrated personal referral to be one of the
most influential promotional strategies for
healthcare services [19]. The importance of WoM
marketing in today’s digital world is increasing, as
patients tend to share their hospitalization
experiences on social media platforms, which are
accessible to people across the globe.
7 Suggestions for Future Research
and Conclusions
Hospital management amid contemporary industry
competition must focus on patient satisfaction with
hospitalization services in an effort to maximize
patient loyalty, hospital’s brand image, and patients’
referral intention. Exceptional hospitalization
experience quality has a crucial influence on
promoting a hospital in the medical tourism
marketplace.
The findings of this study yielded actionable
results that can be used by hospital management to
address areas or service processes demanding
improvement. Except for the servicescape, all the
hospitalization quality domains are found to have
strong direct impacts on patient satisfaction, while
the servicescape was shown to indirectly influence
patient satisfaction via perceived value. The results
also provide strong empirical evidence regarding the
impacts of patient satisfaction on brand image,
loyalty, and WoM intention.
Patients who are extremely dissatisfied with a
hospital service will be more likely to lodge a
complaint [19]; thus, a hospital should have a good
system for handling complaints to minimize the
potentially negative impacts on patient loyalty,
hospital’s image, and WoM intention. Given the
highly competitive healthcare industry, patient
satisfaction should not be treated as the ultimate
aim, as patients can apparently be satisfied with
more than one hospital. Thus, future studies should
also consider investigating the influence of hospital
brand attachment as a mediator between patient
satisfaction and loyalty, as the construct of brand
attachment represents emotional bonding that
deeply connects patients with a particular hospital
[39]. Different types of illnesses require different
hospitalization services and therefore, offer different
experiences to the patients. Finally, it is
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recommended that future studies on hospitalization
should incorporate types of illnesses as one of the
segmentation variables as well as patients from
different types of private hospitals to provide a more
meaningful interpretation of the findings.
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DOI: 10.37394/23207.2022.19.24
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Norhayati M. Zain, Bama V. V. Menon
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Contribution of Individual Authors to the
Creation of a Scientific Article (Ghostwriting
Policy)
Ahmad Azmi M. Ariffin primarily involved in
research instrument development.
Norhayati M.Zain and Bama V.V.Menon were the
key persons for the data collection and
interpretation.
Norzalita A. Aziz was mainly responsible for data
analysis.
WSEAS TRANSACTIONS on BUSINESS and ECONOMICS
DOI: 10.37394/23207.2022.19.24
Ahmad Azmi M. Ariffin, Norzalita A. Aziz,
Norhayati M. Zain, Bama V. V. Menon
E-ISSN: 2224-2899
267
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This study was funded by KPJ Healthcare
Berhad (GSB-2019-012).
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(Attribution 4.0 International, CC BY 4.0)
This article is published under the terms of the
Creative Commons Attribution License 4.0
https://creativecommons.org/licenses/by/4.0/deed.en
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Sources of Funding for Research Presented
in a Scientific Article or Scientific Article
Itself
WSEAS TRANSACTIONS on BUSINESS and ECONOMICS
DOI: 10.37394/23207.2022.19.24
Ahmad Azmi M. Ariffin, Norzalita A. Aziz,
Norhayati M. Zain, Bama V. V. Menon
E-ISSN: 2224-2899
268
Volume 19, 2022