Patient perceptions of healthcare service quality in Romania: Public versus private hospitals – Implications for developed and developing healthcare systems

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Objective: Recent increases in per capita income and longevity in Central and Eastern European counties (CEECs), alongside a slow-changing soviet-era public healthcare system, has led to the emergence of private hospitals. This paper investigates the differential patient service quality perceptions for private versus public hospitals, as well as for three types of healthcare services: primary, ambulatory, and inpatient care.Methods: Data from 1,673 patients of private and public hospitals in the capital of Romania were collected in face-to-face interviews. Analysis of covariance and partial-least-squares techniques were used to examine the relationships between perceived service quality, hospital ownership status and the type of health service patients received.Results: Over 70% of women prefer private health facilities to public hospitals (compared to less than 30% of men). While private hospitals rank higher than public hospitals on most attributes, the interaction effect of gender and hospital type reveals that assurance and empathy are the only significant attributes in driving women to private hospitals. (Physical facilities and staff appearance) as well as intangible dimensions of service quality (assurance, responsiveness, reliability, and empathy) have a positive impact on perceived overall service quality of healthcare. Improvements in perceptions of hospital’s tangibles, staff’s responsiveness and empathy have the greatest potential to enhance perceived overall service quality.Conclusions: This paper demonstrates the importance of breaking down health services into various sub-categories both in terms of perceived healthcare attributes and in terms of tangible healthcare facilities, such as public and private hospitals.