Measuring Customer Satisfaction and Service Quality:

The Case of Croatia

Jelena Legcevic, J. J. Strossmayer University of Osijek, Croatia

ABSTRACT

The conceptualization of service quality and the development of measurement tools and techniques aimed
at assessing service quality and customer satisfaction levels have been a central theme of recent years. The research
has examined the customer expectations and perceptions of service quality in health sector, using the original
version of SERVQUAL instrument.

The research hypothesis is that, between the expected and obtained service, there is a gap regarding
dimensions of reliability, trust, tangibility, complaisance and identification between the service provider and service
user.

The goal of this paper is to measure the customer satisfaction and service quality in Croatia, i.e. in the
Croatian health sector. The research has been carried out in the city of Osijek and its wider surrounding and 434
patients were surveyed regarding the service quality of the general practice doctors. Data were collected using
questionnaires in two parts. The first part is concerned with patient’s perceptions of their health care doctor in
general, while the second part is concerned with health care doctor in particular. The results have emphasized a
negative gap between perception and expectation of given type of service. The biggest negative gaps are noted in
dimensions of reliability and identification, which shows that patients are the least satisfied with promptness of
doctor’s services and trust in the medical staff.

INTRODUCTION

The application of quality-management practices by manufacturers and service providers has become
increasingly widespread. Quality is considered to be one of the management’s crucial competitive priorities and a
prerequisite for the sustenance and growth of firms. The quest for quality improvement has become a highly desired
objective in today´ s intensive competitive markets.

The issue of quality has been increasingly emerging in the literature related to the organizational culture.
The concept of quality has been used to describe the extent to which quality is important and valued in an
organization, i.e. how much organizational culture supports and values the quality (Goodale et al 1997, Kelly and
Moor, 2000, Jebston, 2001, Sureshchandar et al 2002). Firms that are clearly interested in providing outstanding
customer value would be expected to have a culture that reinforces high quality. A culture that supports the quality
is particularly important in service organizations, where simultaneous production and consumption of the service
makes the control of quality rather difficult. Therefore, the measurement and management of service quality is the
fundamental issue for survival and growth of service companies. Knowledge about the content and formation of
perception of service quality enables organizations to deal with the fields that directly influence their competitive
advantage and not to waste too many resources on unimportant fields. If service quality is to become the cornerstone
of marketing strategy, one must have the means to measure it. The most popular measure of service quality is
SERVQUAL, an instrument developed by Parasuraman (see Parasuraman, Zeithaml and Berry, 1985). His research
on this instrument has been often cited in the marketing literature, as well as it has been widely used in the industry
(Brown et al 1993). SERVQUAL is designed to measure service quality as perceived by the customer. Relying on
information from focus group interviews, Parasuraman identified basic dimensions that reflect service attributes
used by consumers in evaluating the quality of service provided by service businesses. Dimensions, for example,
included reliability and responsiveness, while the service businesses included hospital services, banking and credit
card companies. Consumers in focus groups discussed service quality in terms of the extent to which service
performance on the dimensions matched the level of performance that consumers thought a service should provide.
A high quality service would perform at a level that matched the level that consumer felt it should be provided. The
level of performance that a high quality service should provide was conditioned by the customer expectations. If
performance was below expectations, consumers judged quality to be low. To illustrate this, if a firm’s
responsiveness was below consumer expectations of the responsiveness that a high quality service organization

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 123
should have, the organization would be evaluated as low in quality of responsiveness. The focus of this paper is the
customer satisfaction and service quality in Croatia. Croatia as a typical Central and Eastern European country has
undergone a complex process of transition from commanded economy and socialistic regime to the market-oriented
economy and democracy. The current structure of the Croatian economy – where 70% of GDP is created in the
service sector – confirms that services play an important role in the (future) economic development while the
competitive pressures stemming from globalization, information and communication technology (ICT) and other
integration processes, particularly potential membership in the European Union (EU), require that the service
increase in the quality. The goal of this paper is to measure the customer satisfaction and service quality in Croatia,
i.e. in the Croatian health sector. The research has been carried out in the city of Osijek and its wider surrounding
and 434 patients were surveyed regarding the service quality of the general practice doctors. The measuring
instrument in this research has been SERVQUAL. The results have emphasized a negative gap between perception
and expectation of given type of service. The biggest negative gaps are noted in dimensions of reliability and
identification, which shows that patients are the least satisfied with promptness of doctor’s services and trust in the
medical staff.

DEFINITION AND MEASUREMENT OF SERVICE QUALITY (SQ)

Service quality has been a challenging issue for many scholars, including the pioneers in the field such as
W. Edwards Deming, Joseph M. Juran and Kaoru Ishikawa (Hofman, Worsfold, 1997). Early quality models have
been concentrating on goods, but the (recent) development in the economy, i.e. shift from the manufacturing
economy to service economy, increasingly drew the attention to services and their quality. Service quality is a
concept that has raised considerable interest and debate in the research literature because of the difficulties in
defining and measuring it whereby the consensus on both issues is still missing (Lewis and Mitchell, 1990, Dotchin
and Oakland, 1994, Gaster, 1995, Asunbonteng et al 1996). It has been generally acknowledged that the service
quality is more difficult to model than the quality of goods due to the intangible nature of services themselves
(Bergman and Klefsjo, 1994). There is no universal definition on the service quality. The simplest definition of the
notion states that the service quality is a product of the effort that every member of the organization invests in
satisfying customers. In the broadest sense, service quality is defined as superiority or excellence as perceived by
customer (Peters and Austin, 1985). Zeithamal and Bitner (1996) define the notion as the delivery of excellent or
superior service relative to customer expectations. According to Harvey (1995) quality is behavior – an attitude –
that says you will never settle for anything less that the best in service for your stakeholders, whether they are
customers, the community, your stockholders or colleagues with whom you work every day. Boomsma (1991) says
that when we want to be effective – delivering good quality to the customer – we must produce services that meet
˝as much as possible˝ the needs of the customer while Lewis (1989) considers quality as providing a better service
than the customer expect (Lewis, 1989). Juran (1988) suggests that quality should be seen as ˝fitness for use˝.
Another short definition views quality as ˝conformance to requirements˝ rather THAN ˝goodness, or luxury, or
shininess, or weight˝ (Crosby, 1979). One that is commonly used defines service quality as the extent to which a
service meets customers´ needs or expectations (Wisniewski, 2001). Today there are two popular models of service
quality in use - GRÖNROOS´ SERVICE QUALITY MODEL and Parasuraman’s gap model. The brief description
of each is following.

GRÖNROOS´ SERVICE QUALITY MODEL

The model created by Grönroos attempts to illustrate how the quality of a given service is perceived by
customers. It divides customer’s perception of any particular service into two dimensions:
Technical quality – what the customer receives, the technical outcome of a process. This dimension is called outcome quality by
Parasuraman, 1988 and physical quality by Lehtinen and Lehtinen (1991).
Functional quality – how the customer receives the technical outcome, what Grönroos´ calls the ˝expressive performance of a service˝.
This dimension is called process quality by Parasuraman and interactive quality by Lehtinen and Lehtinen (1991).

˝How˝ the service is delivered is evaluated during delivery (Schwartz and Brown, 1989). Grönroos suggests
that, in the context of services, functional quality is generally perceived to be more important than technical quality,
assuming that the service is provided at a technically satisfactory level. He also points out that the functional quality
dimensions could be perceived in very subjective manner.

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 124
 THE GAP MODEL BY PARASURAMAN

The service quality model by Parasuraman indicates that consumers’ perceptions of quality are influenced
by four gaps occurring in the internal process of service delivery:
Gap 1: Not knowing what customers expect – the difference between consumer expectations and management’s perception of these
expectations.
Gap 2: Not selecting the right service design – the difference between management perceptions of customer expectations and the
service quality specifications.
Gap 3: Not delivering to service standards – the difference between service specifications and actual service delivery.
Gap 4: Not matching performance to promises – the difference between the service delivery and what is communicated about the
service to consumers.
Gap 5: Perceived service quality – the difference between consumer expectations and consumer perceptions (1).

SERVQUAL

In the following section the SERVQUAL method will be described also by shortly reviewing the wider
discussion on the method and its limitations. Since the development of SERVQUAL it has been extensively applied
(Buttle, 1996) leading Robinson to state that would seem to be little doubt that SERVQUAL is the most favored
instrument for measuring service quality.

SERVQUAL scale
SERVQUAL is designed to measure service quality in a variety of different business – or better business
models. Parasuraman measured service quality in the following set of organizations: retail banks, a long-distance
telephone company, a securities broker, an appliance repair and maintenance firm, and credit card companies. From
the results of a set of about 100 questions Parasuraman concluded that consumers perceive service quality by
comparing expectations to performance and evaluate the quality of the service in different dimensions. The first set
comprised ten dimensions. Factor analysis was used to provide a means of determining which questions are
measuring dimension number one, which questions are measuring dimension number two and so on, as well as
which questions do not distinguish between dimensions and the number of dimensions in the data. Questions that
were not clearly related to a dimension were discarded. A revised scale was used in a second sample, questions were
tested and the result was 22-question (item) scale measuring five basic dimensions: Reliability: The ability to
perform a promised service dependently and accurately; Responsiveness: A willingness to help customers and to
provide support services; Assurance: The knowledge and courtesy of employees and their ability to inspire trust and
confidence; Empathy: The caring, individualized attention firm provides its customers; Tangibles: The physical
facilities, equipment and appearance of personnel.

The recipients of the questionnaires were later asked to allocate 100 points among these five dimensions in
order to be able to rank the importance of the respected dimension. During their research Parasuraman identified that
reliability was the most important dimension used by customers in evaluating service quality, responsiveness was
the next and the tangibles had the lowest influence on overall service quality. Based on these quality dimensions
Parasuraman developed the series of standard questionnaires to measure the stated gaps and to what extend they
exist respectively in a given organization. The standard questionnaires firstly measure the respondent’s expectation
of a service then the actual perception of the service delivered by the organization. Since both expectations and
perceptions are measured using 22 parallel questions, a total of 44 questions is inquired. The answers are measured
on a seven-point Likert scale with 7 indicating ˝strongly agree and 1 ˝strongly disagree˝. Quality is measured as the
performance minus expectations for each pair of questions and the summary score across all questions was the
measure of quality. Parasuraman also tested their SERVQUAL scale for reliability and validity. The major test of
reliability is coefficient alpha of Cronbach´s Alpha. The coefficient α is best conceptualized with the average of all
possible split half reliabilities for a set of items. Split half reliability is the reliability between two parts of a test or
instrument where those two parts are halves of the total instrument. The coefficient α measures the extent of internal
consistency between or correlation among the set of questions that are making each of the five dimensions (e.g. five
questions on reliability). The suggested cut-off point for coefficient alpha values is 0.70 indicating that the scale
exhibits desirable levels of internal consistency. High reliabilities, such as 0.90 or above, are favorable.

Limitations of the model

Debate concerning the validity and reliability of the SERVQUAL methodology itself has been lively in
recent years (Carman, 1990). Asubonteng et al (1996) summarized the main points of the numerous academic
studies and concluded that there are problems with relying on this method of measurement. SERVQUAL has been

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 125
intensively studied regarding its validity and reliability (Bolton and Drew, 1991). Even though some of these studies
would not support the five dimensions the use of those dimensions was kept based on conceptual and practical
grounds. An important area of criticism of SERVQUAL has been the use of gap scores in the measurement of
service quality. Cronin and Taylor (1992) compare these expectations-perception gaps versus perceptions only,
which they call SERVPERF, and conclude that measurement of service performance (perception) alone is adequate.
In their later refinements, they explicitly asked customers to allocate weighted SERVPERF and found a high
correlation between weighted and outweighed measures. They concluded that outweighed SERVPERF is sufficient.
There are more disagreements with the instrument which involve the issue of whether a scale to measure service
quality can be universally applicable across industries. Another field of disagreements between studies and
researchers has concentrated on the linkage between satisfaction and quality. Although there is no agreement on the
exact linkages, attributes, and dimensions of quality and satisfaction, most researchers agree that service quality
comprises attributes that are both measurable and variable. Carman (1990) noted that it takes more than the simple
adaptation of the SERVQUAL items to address service quality effectively in some situations. Managers are advised
to consider which issues are very important to service quality in their specific environment and to modify the scale
as needed.

DATA AND METHODOLOGY

For the success of health-care organizations, accurate measurement of health-care service quality is as
important as understanding the nature of the service delivery system. Without a valid measure, it would be difficult
to establish and implement appropriate tactics or strategies for service quality management. A survey was conducted
to measure service quality of primary care doctors in Osijek (Croatia). This is a first time where this internationally
recognized SERVQUAL instrument has been used in the Croatia for assessment of service quality of primary care
doctors. The goal of this paper is to measure the customer satisfaction and service quality in Croatia, i.e. in the
Croatian health sector. The research has been carried out in the city of Osijek and its wider surrounding and 434
patients were surveyed regarding the service quality of the general practice doctors. The measuring instrument in
this research has been SERVQUAL. The survey instrument consisted of three sections: (1) items focusing on
patients expectations of service quality, (2) items focusing on received service quality (patient’s perceptions) and (3)
demographic data about the respondents (age, gender, education level, how often they visit their doctor, do they
personally know some doctors). The items in the questionnaire were measured on a 7-point Likert scale ranging
from ˝strongly agree˝ coded as seven to ˝ strongly disagree˝ coded as one. Each question was associated with the
number one to seven and to complete their answers, respondents were asked to circle the number that best matched
their opinion. The items of the scale were pre-tested for wording, layout and comprehension.

Random samples of 434 patients, who fill out the questionnaires, were requested to complete the survey
questionnaire regarding their expectations and perceptions of the service quality of their primary care doctors. Data
collection took place between July and November 2005.

Out of the total number of respondents, 61% were female and 39% were male. The majority of respondents
were between age 25 and 34. Furthermore, 56% of interviewed patients have completed secondary education, while
less than 31% of patients have college or university degree. Finally, 89% of patients usually visit theirs doctor few
times per year and 51% of patients have been personally acquainted with doctors.

The statistical package, SPSS (10.0), was used to summarize and analyze the responses. Data were
analyzed using descriptive statistical analysis. The 22 service quality variables related to their gap scores
(perceptions minus expectations) were factor analyzed to determine the existence of underlying dimensions of
service quality. A principal component analysis with VARIMAX rotation was conducted only on the 22 perception
items measuring the service quality of the primary care doctors. The objective of the analysis was to summaries the
information contained in the original 22 variables into smaller sets of explanatory composite factors, which define
the fundamental constructs assumed to underline the original variables. Factors with an eigenvalue equal to or
greater than 1 were chosen for interpretation. Only variables with factor loading coefficients of 0.45 were
considered; that is, items with less than 0.45 were excluded. A reliability analysis (Cronbach´s alpha) was performed
to test the reliability and internal consistency of each of the perception attributes. Alpha ranges from 0 to 1, and is a
measure of the internal consistency of multi-item scale. The closer that Alpha is to 1, the better. A coefficient alpha
of 0.7 or higher is considered to be adequately reliable for group data purposes.

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 126
 RESULTS

The study findings are presented in the following order: (1) identification of the original service quality
dimensions, (2) patients expectations, (3) patients perceptions.

Means, mode and standard deviation for patient’s expectations and perceptions by questionnaire items are
listed in Table 1. The paired t-test was used to test the significant mean differences (gap) between patient’s
expectations and perceptions of service quality. The patients in this study have higher expectations according to all
items and dimensions. The total SERVQUAL score is negative (-2.02).

The mean scores in this study ranged from 3.28 (Std. Deviation=2.08) to 7.00, with an overall of 6.84 (Std.
deviation = 0.07 ) for SERVEXP scale and 4.81 (Std. deviation = 1.75) for SERVPERC scale. It is typical in
Croatia, particularly concerning the health sector, to have much higher expectations than perceptions. T-test
confirmed the hypothesis that there is a statistically significant difference between average ratings of expectations
and perceptions by the patients, suggesting that respondents distinguished between SERVQUAL dimensions. Factor
analysis was applied only to 22 items on perceptions of primary care doctor services, with responses on 7-point
Likert scale. There are fewer than two cases, at least one of the variables has zero variance, or there is only one
variable in the analysis. No further statistics will be computed. Scores in the part of expectations wasn’t calculated
in the factor analysis because respondents circled in 86% of questions only 7 and in 14% of questions item 6. These
findings suggest that the expectations scores may not be contributing to the strength of the relationship between
service quality and the intention or overall service quality rating variables (Lam, 1997). In this study, we are
expected that Parasuraman’s factors wouldn’t be asserted, therefore the principal component analysis is applied. To
explore the dimensions of quality in the health sector, a factor analysis was performed and the results were subjected
to Varimax rotation. Factor with eigenvalues greater than one have been extracted. The general pattern of loadings is
shown in Table 2 and explains 54.34% of the total variance in service quality with patients and total cumulative
variance of 60.33% was considered a satisfactory solution and that can be included in a factor when its correlation
degree equals of exceeds 0.5 (Nunnally, 1967). Varimax rotation defined 2 factors on the SERVPERC scale. Factor
analysis results indicate the factor structure with relatively high factor coefficients on the corresponding factors.
Higher factor coefficients indicate correlation of variables with the factors they define communality of each of the
variables is relatively high from 0.50 to 0.70, and this indicates the variance of original values being covered with
factors well. The two-dimensional solution in SERVPERC scale results in the following factors: Factor 1 -
˝reliability of perceived-service quality˝ (N = 17 items, eigenvalue = 11.95, alpha = 0.9580) and Factor 2 -
˝empathy˝ (N = 5 items, eigenvalue = 1.32, alpha = 0.7812). Also, reliability was conducted to measure the inside
consistency of each of the two factors. The results indicate that both factors exceed recommended level of 0.50,
ranking from 0.70 to 0.98. Alpha coefficients for the total SERVPERC scale totals 0.9571.

DISCUSSION

Results suggest, however, that instrument may not easily be generalized to primary care doctors or health-
care service in general. The dimensions identified in this study reflect only partially the hypothesized SERVQUAL
dimensions, and some items had to be reassigned to other factors than originally intended. A number of factors may
have influenced this result.

The results of the current research support Carman’s suggestion that, even though it is necessary to
periodically capture consumer expectations for use as baseline measures in strategic decision making, such measures
are not needed in every data-gathering effort. Thus, managers need not to measure the 22 expectations items
recommended in the SERVQUAL scale in every collection of consumer data. Rather, it appears that managers need
only use the perceptions-of-performance items as a scale of choice. This practice then can be supplemented with the
periodic capture of expectations data. This research leads to the following conclusions. First, almost all expectations
scores measured high on a seven-point Likert scale and had a rather low standard deviation. This suggests that
patients had difficulties in making a trade-off between the different components of the service offering. Patients can
be expected to give these systematically high expectation ratings because of their personal involvement with primary
care services. Second, the wording of the expectation statements should be subjected to closer scrutiny. Two widely
used formulations to measure expectations with a self-administered questionnaire can be distinguished: ˝XYZ
should …˝and ˝I expect that XYZ …˝. Both statements may not be interpreted in the same way by patients or
customers. The uses of the wording ˝I expect …˝ will probably lead to more experience-based expectations scores.
Third, and perhaps the most important, no recursive relationship was found between the service quality and

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 127
satisfaction construct. Identifying this no recursive relationship may help shed light on the continuing mystery about
the causal order of these important constructs. Furthermore, these results suggest that consumers of health services
may not distinguish service quality from satisfaction in their minds when they respond to questions related to the
satisfaction with the service quality in surveys. However, if consumers are able to cognitively distinguish these
constructs, the use of direct measures is seriously questioned by the results of the research. The overall picture of
health care quality in Osijek can be summarized as follows:
1. Patient’s expectations are highest for competent and prompt services. "...give prompt service to patients", "...never be too busy to
respond to patients","...always be willing to help patients" receives the highest expectation scores compared to other items. This
suggests that prompt and competent services are the most important factors patients expect from their physicians. Patients are still
not satisfied with services they expect most, especially in the reliability factor "...provide their services at the time they promise to
do so", "...show a sincere interest in solving a patients problem", "...would carry out services right the first time" with a gap of more
than 2 between the expectations and perceptions. These are the areas physicians can improve in order to achieve better service
quality.
2. The first for items, "...has up-to-date equipment", "...physical facilities are visually appealing", "...materials are visually appealing",
"employees are neat in appearance" show the lowest score among 22 items for expectations. These findings suggest that physical
elements are perceived to be least important and the patients are generally satisfied with this aspect of service quality.
3. Physicians in Osijek do not seem to be good at giving personal attention and caring service to their patients. Although expectations
of these factors were not highest among patients, these are the factors that hospitals should concentrate on in order to improve their
service, so that they not only satisfy the basic needs of their patients but also provide a service which exceeds their expectation.

In this study, we only looked at the service quality construct at the patient level. A more extended model
taking into account the multiplicity of interpersonal contacts between patients and providers and between these
providers and other people belonging to the patients household should be explored in future researches.

CONCLUSIONS

Research of service quality has proven to be a challenging task since the service quality is difficult to
define and measure as well as due to the intangible nature of the service itself. In this paper, service quality and its
model of gaps were reviewed. SERVQUAL methodology as an analytical approach for evaluating the difference
between customer’s expectations and perceptions of quality was also studied.
Table 1: Service quality gap between patient’s perception and expectations in primary care sector
EXPECTATIONS PERCEPTIONS SERVQUAL Paired
Items (SERVEXP scale) (SERVPERC scale) gap samples
Test
Mean Mode Std. Deviation Mean Mode Std. Deviation P-E t-Value
V1 7.00 7 .00 5.79 7 1.38 -1.21 -18.263*
V2 7.00 7 .00 5.38 7 1.66 -1.62 -20.330*
V3 5.51 6 .50 4.45 5 1.92 -1.06 -10.828*
V4 7.00 7 .00 5.04 7 1.73 -1.96 -23.591*
V5 7.00 7 .00 5.18 7 1.74 -1.82 -21.769*
V6 7.00 7 .00 4.57 7 1.84 -2.43 -27.524*
V7 6.49 6 .50 4.58 7 1.90 -1.91 -20.796*
V8 7.00 7 .00 4.21 4 1.80 -2.79 -32.273*
V9 7.00 7 .00 4.91 7 1.90 -2.09 -22.844*
V10 7.00 7 .00 4.52 7 1.93 -2.48 -26.758*
V11 7.00 7 .00 5.17 7 1.79 -1.83 -21.356*
V12 7.00 7 .00 4.15 6 2.02 -2.85 -29.382*
V13 7.00 7 .00 4.88 7 1.78 -2.12 -24.737*
V14 7.00 7 .00 6.12 7 1.31 -0.88 -13.903*
V15 7.00 7 .00 5.60 7 1.56 -1.4 -18.657*
V16 7.00 7 .00 5.04 6 1.61 -1.96 -25.310*
V17 7.00 7 .00 4.78 6 1.77 -2.22 -26.124*
V18 5.55 6 .56 3.53 3 1.80 -2.02 -22.941*
V19 7.00 7 .00 4.29 4 1.71 -2.71 -33.099*
V20 7.00 7 .00 4.92 6 1.69 -2.08 -25.632*
V21 7.00 7 .00 5.56 7 1.67 -1.44 -17.929*
V22 7.00 7 .00 3.28 1 2.06 -3.72 -37.581*
Overall SERVQUAL gap = -2.02

This research is a novelty in Croatia since the service quality management in Croatia is in its nascent phase
in both academic (e.g. lack of literature) and practical terms (e.g. research studies). Future research should seek to
examine the use of SERVQUAL to close other service quality gaps for different types of organizations. Also, an

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 128
important issue for future research is about the relationship between internal service quality and external customer
satisfaction as well as other constructs, such as employee service orientation, and external service quality.

In conclusion, knowing how customers perceive the service quality and being able to measure service
quality can benefit industry professionals in quantitative and qualitative ways. The measurement of service quality
can provide specific data that can be used in quality management; hence, service organizations would be able to
monitor and maintain quality service. Assessing service quality and better understanding how various dimensions
affect overall service quality would enable organizations to efficiently design the service delivery process. By
identifying strengths and weaknesses pertaining to the dimensions of service quality organizations can better
allocate resources to provide better service and ultimately better service to external customers.
Table 2: Factor analysis and reliability analysis of service quality dimensions (SERVPERC scale)
VARIABLES COMPONENT
1 2
V15 .784
V21 .784
V14 .770
V2 .736
V20 .716 .524
V5 .678
V16 .678 .460
V13 .644 .544
V4 .639 .495
V11 .637
V1 .635
V17 .606 .553
V9 .604
V7 .568 .544
V6 .528 .511
V18 .728
V8 .691
V12 .671
V22 .665
V3 .605
V10 .549 .596
V19 .552 .586
Extraction Method: Principal Component Analysis. / Rotation Method: Varimax with Kaiser Normalization.
a Rotation converged in 3 iteration
Eigenvalues 11.956 1.320
Percent of variation ( overall = 60.344 ) 54.346 5.998
Coefficient Alpha ( overall = 0.9571 ) 0.9580 0.7812
Note: All absolute values less than 0.45 have been suppressed from the purpose of analysis

NOTES:
1. Gap 5 is resulting from the sum of degree and direction of gaps 1 to 4 and is defined as:

REFERENCES
Asubonteng, P., McCleary, K.J., Swan, J.E., (1996), SERVQUAL revisited: A Critical Review of Service Quality, Journal of Services Marketing, Vol 10(6).
Bergman, B. And Klefsjo, B. (1994), Quality: from customer needs to customer satisfaction, london: McGraw-Hill.
Bolton, R.N., Drew, J.H. (1991), A longitudinal analysis of the impact of service changes on customer attitudes, Journal of Marketing, 55, 1-9.
Boomsma, S. (1991), A clear view, managing Service Quality, November, pp. 31-3
Brown, T. J., Churchill, G.A and Peter, J.P. (1993). ˝Research note: Improving the Measurement of Service Quality ˝, Journal of Retailing,
Vol.69, No.1, pp. 126-139.
Buttle, F., (1996), SERVQUAL: review, critique, research agenda, Journal of Marketing, Vol 30(1), pp.8-32
Carman, J.M., (1990), Consumer Perceptions of Service Quality:An Assessment of the SERVQUAL Dimensions, Journal of Retailing, Vol.66(1), pp.33-55.
Cronin, J.J., Taylor.S.A (1992), Measuring Service Quality: A Reexamination and Extension, Journal of Marketing, Vol.56(3), pp.55-68.
Crosby,P.B. (1979), Quality is free: the art of making quality certain. New York: McGraw-Hill
Dotchin, J.A., Oakland, J.S. (1994), ˝Total quality management in services: Part 3 Distinguishing perceptions of service quality˝, International
Journal of Quality and Reliability Management, 11, 4, 6-28.
Gaster, L., (1995), Quality in Public Services, Open University Press, Buckingham
Goodale, J. C.; Koerner, M.; Roney, J.˝Analyzing the Impact of Service Provider Empowerment on Perceptions of Service quality Inside an
organization, Journal of quality Management, Vol.2, No.2, 1997, pp. 191-215.
Gronroos, C. ˝ A Service Quality Model and its Marketing Implications˝, European Journal of Marketing, Vol. 18, issue 4, 1984, pp. 36-44.
Harvey, T. (1995), Service quality: the culprit and the cure, Bank Marketing, June, pp.24-8

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 129
Hofman, P., Worsfold, E. (1997), Selection Criteria for Quality Controlled Information Gateways, Work Package 3 of Telematics for research
project DESIRE (RE 1004).
Jebston, L. R. ˝ Investing in patients by Investing in staff: Developing A Structured Training and Retention Model ˝, Health Care Biller, Vol. 10,
Issue 8, 2001, pp.1-4.
Juran, J.M. (1988), The quality funkcion. In: Jurans quality control handbook, 4th ed. New York: McGraw-Hill, pp. 2.1 – 2.13
Kelly, S. T.; Moore, M. J. ˝Quality Now: Moving Human services Organizations toward a Consumer Orientation to Service Quality˝, Social
Work, Vol.41, Issue 2/3, 2000, pp. 244-271.
Lehtinen, U., Lehtinen, J.R. (1991), Two Approaches to Service Quality Dimensions, Service Industries Journal, Vol. 11, No.3, pp. 287-303.
Lewis, B. (1989), ˝Quality in the service sector: a review˝, International Journal of bank marketing, Vol. 7 No.5, pp. 4-12
Lewis, B.R., Mitchell, V.W. (1990), ˝Defining and measuring the quality of customer service˝, Marketing Intelligence and Planning, 8, 6, 11-17.
Parasuraman, A., Zeithaml,V.A and Berry,L.L., (1988), SERVQUAL: A Multiple Item Scale for Measuring Consumer Perceptions of Service
Quality, Journal of Retailing, Vol.64(1), pp.12-40.
Parasuraman,A., Zeithaml,V.A. and Berry,L.L. (1985), A conceptual model of service quality and its implications for future research, Journal of
Marketing, Vol. 49, Fall, pp. 41-50.
Peters, T. And Austin, N. (1985), Passion for Excellence, Random House, New York, NY
Sureshchandar, G. S.; Rajendran, C.; Anantharamn, R. N. ˝The Relationship between Management´s Perception of Total Quality Service and
Customer Perceptions of Service Quality ˝, Total Quality Management, Vol.13, No.1, 2002, pp. 69-88.
Swartz,T. A., Brown, S.W., (1989), Consumer and provider expectations and experience in evaluating professional service quality, Journal of the
Academy of Marketing Science, 17, 189-95
Wisniewski, M. (2001), Using SERVQUAL to assess customer satisfaction with public sector services, Managing Service Quality, 11, 6, pp.380-88
Zeithaml, V.A. and Bitner, M.J. (1996), Services Marketing, McGraw-Hill, New York, NY

The Journal of American Academy of Business, Cambridge * Vol. 14 * Num. 1 * September 2008 130
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.