Carlos Aníbal Manosalvas-Vaca, Luis Oswaldo Manosalvas-Vaca, Deysi Valeria Quevedo-Amay y Silvana Nataly
Haro-Acosta
ISSN 2477-9024. Innova Research Journal (Mayo-Agosto, 2022). Vol. N7, No. 2, pp. 194-204
this context, the need to analyze the quality and satisfaction of emergency services is viewable. In
this research, the variables were analyzed based on the paradigm of disconfirmation that
established satisfaction is the result of a process of comparison between expectations and the
service received (Oliver & DeSarbo, 1998). According to Fornell (1995) quality should be
understood as the current perception of the client about the performance of a good service while
satisfaction is based on new and past experiences as well as future predictable experiences of the
client, which come from accumulated experiences in combination with the projection of their
expectations In this study the relationships between these variables will be analyzed in order to
obtain a holistic evaluation of the user's satisfaction of the emergency service in public hospitals.
Literature review
Quality Service and Satisfaction
Satisfaction is defined as the perceived difference between the expectation and
performance of a service or product (Oliver, 1980). It is usually related to the final stage of an
acquisition process when the consumer evaluates the perceived benefits of the service purchased
subjectively (Oliver, 2014). The comparison between expectation and performance is based on the
Theory of Confirmation of Expectations (Hoffman & Bateson, 2011) which establishes that the
client is satisfied when the real performance of a service matches the client’s expectations;
however, if the perceived return is lower or higher than the expectation, a negative or positive
disconfirmation is created respectively.
According to Parasuraman, Zeithaml and Berry (1988), consumer satisfaction is defined
on several perspectives such as quality of service and price, which has led authors to affirm that
quality of service is a precedent for satisfaction since an improvement in the first one produces a
significant increase in the second (Ahrholdt, Gudergan & Ringle, 2017; Manzor et. Al., 2019;
Pandža Bajs, 2015). In the same line of research, Almomani, Al-Ghdabi and Banyhamdan (2020)
demonstrated that there was a statistically significant effect of health service quality dimensions
on patient satisfaction in public hospitals, with a sample of 354 patients. This result is similar to
that obtained by Javed et al. (2019), in their study carried out on a representative sample of patients
from two private hospitals and two public hospitals
However, quality service cannot be evaluated with a single dimension (Kaura, Prasad &
Sharma, 2014) for this reason several authors have defined this concept from several perspectives.
Gronroos (1984) identified three dimensions of quality service: functional, technical and corporate
image. Parasuraman et. al. (1988) reported the existence of five dimensions: reliability, sensitivity,
security, empathy and tangibility. Rust & Oliver (1993) proposed three dimensions: functional,
technical and environmental. Each dimension of quality reflects a set of service attributes that
consumers consider when evaluate the quality of that service dimension and the perception of the
influence of the different service dimensions over satisfaction (Ahrholdt et. al., 2017) which is
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Revista de la Universidad Internacional del Ecuador. URL: https://www.uide.edu.ec/
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