THE RELATIONSHIP BETWEEN HEALTH CARE SERVICE QUALITY AND PATIENT SATISFACTION: A COMPARATIVE ANALYSIS BETWEEN PUBLIC AND PRIVATE HEALTH FACILITIES IN NAROK COUNTY, KENYA

Abstract

The economic and social developments of a country are relevant because they result in a healthy population as demonstrated by a robust healthcare system. Policymakers in Kenya have put special emphasis on the relevance of patient-centred care and the confidence people have in the public hospitals in Kenya is low. In this paper, discussion is centered in connection of the five dimensions of service quality reliability, the physical facilities, assurance, the degree of care and responsiveness on patient satisfaction in both the public and the private hospitals in Narok county. The study used a cross-sectional survey design and stratified random sample used with 1,203 patients in the maternity , casualty and outpatient departments in two public hospitals and two private hospitals used as the sample subjects in the research group. Pretesting of the questionnaire confirmed its reliability and validity, with Cronbach’s alpha values exceeding 0.7 for all constructs. The validated questionnaires gathered the data, which was then processed using SPSS Version 27 using the assistance of descriptive statistics and a one-way ANOVA. The results revealed that the differences in all the service quality dimensions between the two hospital systems (the private and the public) were very high. It was also found that the mean score of the physical facilities in the private hospitals (4.136) was higher as compared to the mean score in the public hospitals (3.680) and the results of the ANOVA test indicated that there was a significant difference between the two (F = 41.375, p < 0.05). Customer satisfaction in relation to service reliability was also notable, as in the case of private hospitals, the average ANOVA (4.002) was higher than in public hospitals (3.753) and ANOVA has confirmed it (F = 34.561, p < 0.05). The level of responsiveness was found to have a better impact on satisfaction among the private hospitals (mean = 4.115) when compared to the public hospitals (mean = 3.849) however the F-value of such factor was significant at (p = 0.05) 44.720. The degrees of assurance were considerably different as observed in the instance of private and public hospitals (mean = 4.002 and mean = 3.753 respectively), based on the result of ANOVA (F = 34.551, p < 0.05). The level of care rating was also found to be much more at the privately operating hospitals (mean = 4.305) compared to the public hospitals (mean = 4.079) and the results of the ANOVA indicated a significant difference (F = 41.106, p < 0.05). The study draws the conclusion that the quality of services provided by the private hospitals is better and leads to high customer satisfaction in comparison to the public hospitals. However, both sectors must enhance service reliability, responsiveness, assurance, and physical facilities to improve patient experiences. The study advises public hospitals to enhance infrastructure, staffing, and appointment systems to improve responsiveness and public trust. It urges private hospitals to maintain service quality through advanced technologies, emergency care optimization, and digital health solutions. Both sectors should invest in staff development and personalized care. Future research should compare patient expectations with service delivery and expand analysis across counties to guide national healthcare reforms. Keywords: Service quality, patient satisfaction, physical facilities, public hospitals, private hospitals, healthcare delivery