Description
The marketing mix is a business tool used in marketing and by marketing professionals. The marketing mix is often crucial when determining a product or brand's offering, and is often synonymous with the four Ps: price, product, promotion, and place; in service marketing, however, the four Ps have been expanded to the Seven Ps or eight Ps to address the different nature of services.
Case Studies for Analysis on Marketing Mix in Hospitals
Abstract: Hospital marketing is becoming increasingly competitive all over the world and India is no exception. The gradual shift from the selling to marketing vis-a-vis the customer orientation is quiet evident in present day hospital services. Hospitals become consumer centered and are expecting high medical care and demanding quality services at reasonable prices. Under these circumstances, age-old methods may not give us long run results. The application of modern marketing principles would pave avenues for rationalizing and standardizing the services. Thus marketing has become a new 'mantra' for the service providers in a hospital setting. Article evaluates the innovative marketing strategies adopted by corporate hospitals to sell their services and tries to explore the Marketing process explained with the help of 7P's i.e. Product, Price, Place, Promotion, People, Physical evidence and Process in sample hospitals which run under different corporate managements. For this purpose it is proposed to elicit the perceptions from the doctors, nursing staff and administrative staff on marketing mix of hospitals. The data was analyzed by applying different statistical tools to know whether the perceptions of respondents are indistinguishable or not. Keywords: Hospital marketing; Product, Price, Place, Promotion, People, Physical Evidence and Process
International Journal of Advanced Research in Management and Social Sciences
INTRODUCTION
The health care market has become consumer centered and expecting high quality care at a reasonable price. The mushroomed development of corporate hospitals in India, competition is also bringing massive changes in industry structure. In this context, hospital services marketing is slowly and surely coming of age and is being woven into the fabric of hospitals planning and public relations programmes. Earlier, there was an in built tendency that services will be sold out automatically; hospitals will overflow if a doctor has a degree. But now many of the corporate hospitals over the last two decades, have developed marketing culture in their set - up which has enabled them to scale new heights in their ventures. As we are moving to service economy, the customers are more critical and keen towards quality services and high standards. As every one of us know patient is the important person in this changed environment, the hospitals must strive for maximum patient satisfaction. In deriving patient satisfaction, hospital marketing is playing crucial role. The marketing process involves marketing planning, marketing decision making and
formulation of marketing mix strategies. All these can be conventionally classified into seven major strategies namely product/service, price, place promotion, people, physical evidence and process. The product element of the hospitals includes diagnosis, treatment provided, the education training provided to nursing and medical students and research. Services like facilities for attendants, ambulance, and pharmacy services etc., augment the core service. The pricing of services should take into consideration the operational costs and the paying ability of the patient, apart from the value provide to the customer. People play a very important role in marketing of hospital services. Processes add value to customer and also improve the efficiency of the operations of the hospitals. Physical evidence can be provided using a good layout and maintain hygiene. Supplementary services also help in providing physical evidence to customers. The future healthcare environment is likely to be characterized by more competition; tighter margins; more diverse, better informed, and more demanding consumers; demands for accountability; and growing labor shortages. Marketing may not be a panacea for this laundry list of challenges, but the judicial use of marketing resources can certainly contribute to their amelioration.
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OBJECTIVES OF THE STUDY
Specific objectives of this research are to analyze and compare the Marketing process (Product, Price, Place, Promotion, People, Physical Evidence and Process) in two selected corporate hospitals and to study and compare the perceptions of Administrative staff, Doctors and Nursing staff towards marketing process. This study also makes an attempt to suggest suitable measures for effective marketing of hospital Services in general and the selected hospitals in particular.
HYPOTHESES
1. The marketing processes of two select hospitals are indistinguishable. 2. The perceptions of the Doctors, Nursing and Administrative Personnel in both the hospitals are indistinguishable with respect to the (Product/Service, Price, Place, Promotion, People, Physical Evidence and Process) marketing of their services.
METHODOLOGY FOR DATA COLLECTION AND ANALYSIS
The researchers have selected two corporate hospitals in Hyderabad, Andhra Pradesh. They are APOLLO Hospital, Jubleehills and CARE Hospital, Banjarahills which are having similar and almost identical facilities. The select two hospitals under study are providing tertiary care and they are high-tech hospitals. The two hospitals have almost similar physical area, comprehensive equipment, skilled medical specialists and nursing staff with common set of policies and proposals. Two hospitals run on modern scientific and high tech lines, under the control of private management. Following table shows the population of two selected
super specialty hospitals and sample size of selected hospitals. Table 1: Population and Sample size in Selected Hospitals Particulars Doctors Nursing Staff Administrative Personnel APOLLO CARE Total Population Sample Population Sample Population Sample 156 75 127 75 283 150 340 150 320 150 660 300 45 35 40 35 85 70
For collection of data efforts were made to elicit the opinions through personal interviews and by distributing questionnaires. The instrument was tested for its reliability and validity. A five degree scale (Summated Scale) was used. It contains the columns of strongly agree, agree, can't say, disagree and strongly disagree of the respondents with the given IJARMSS | 189
International Journal of Advanced Research in Management and Social Sciences statement. In this aspect researchers have taken help from the different eminent people in the concern area. Observation method is also used while collecting the data. The data is analyzed with statistical tools like percentages, Mean, Standard Deviation, ANOVA to know whether the perceptions of respondents are indistinguishable or not with reference to Marketing Process of sample hospitals.
REVIEW OF RELATED LITERATURE
An article by Smith(2007)[1] argues that a panoramic, or holistic, approach to new service development and a high level of precision at the micro level, will combine to provide a more successful service design and new service development process. Michael R. Bowers
(1987)[2] proposes that hospitals should facilitate market-driven service development. G.M. Naidu et.al (1993)[3] and Burger(1991)[4] examines the result of the study on product-line management (PLM) as management tool on health care industry. Farley (1990)[5] opine
that Hospitals may be able to reduce their costs by limiting the breadth of services they provide. Ronald (1993)[6] discussed relationship between quality and profitability. The authors studied each hospital to determine the relationship between quality and profit levels on one hand and price, occupancy levels, and costs per patient on the other. Stanton (1982)[7] applied a two stage methodology for identifying healthcare market segments. The paper by Richard (2005)[8] examines the role of Internet atmospherics cues on the behavior of pre-purchase and purchase intentions. Berry(2007)[9] explains the services branding model by showing how one organization has created, extended, and protected a powerful brand through an unwavering commitment to the well being of its customers. Kyung et. al. (2007)[10] identifies factors that influence the creation of Brand equity through successful customer relationships. Menon et.al. (2006)[11] has designed a methodology to measure advertising content. Tudor and Kanth(1994)[12] discuss the perceptions of consumers concerning hospital advertising. Altan and Walker (2006)[13] explain the importance of Internet in building physician-patient relationship. Lee and Chung (2007)[14] explain the application of neural network in classifying consumer behavior in choosing hospitals. Christopher et.al. (2001)[15] said that the Patients are becoming increasingly involved in making healthcare choices. Weng(2006)[16] presents a study that investigates the behavior and a patient's choice of hospitals. Chen(2004)[17] proposes value attributes perceived by customers.
Akinic
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et.al.(2004)[18] examines the factors affecting hospital choice decisions of 869 patients in
three public and one private hospital policlinics in Turkey. Study findings highlight the importance of accessibility of hospital services to consumers in hospital choice as well as the role of hospitals image its physical appearance, and technological capabilities in informing such choices. Laing et. al. (2000)[19] examines the organizational solutions adopted by selfgoverning hospitals in managing the marketing function. Sreenivas (2002)[20] discussed the factors influence the satisfaction of the patients in Government owned, semi-Government owned and tertiary care hospitals. The next part of the paper examines how the select hospitals are implementing the marketing programme and it is discussed under the heading of 7Ps. They include - product, price, place, promotion, people, physical evidence and process.
ANALYSIS ON MARKETING MIX IN SAMPLE HOSPITALS
Product: The product mix in hospitals in terms of its length consists of three product lines Inpatient services, Ambulatory services, and Health promotion. Each product line will have certain width - the patient services include medical/ surgical, pediatric, obstetric and cardiac intensive care and each product item will have certain depth - for example, a hospital may contain fifteen pediatric beds. Various services in service mix are different in their relative contribution to the organization. Some constitute the core service of the hospital and others are ancillary services. The core product answers the questions like what for consumer's really looking? What service is really satisfying? The core service stands at the center of the total service. At second level the product consists of the features, quality, styling of the core service. The third level of service include augmented product. If the hospital offers additional services or benefits beyond the tangible service is an augmented service. In both the selected hospitals services are divided into core, tangible, augmented services. The product - mix in APOLLO include medical and surgical services, ICU services, pain relief services, emergency services, supporting services and special services like health check up services, diagnostic services etc. APOLLO corporate services and blood bank services are the augmented services. On the other hand the product - mix in CARE include medical, surgical, laboratory, online, blood bank, and emergency services. When researches look into the services of both the hospitals it is observed that APOLLO is concentrating on generating the core and tangible services, and the CARE is concentrating on core and IJARMSS | 191
International Journal of Advanced Research in Management and Social Sciences augmented services. After observing the length, width and depth of both the hospitals it can be concluded that both the hospitals are striving for quality health care. Pricing: Pricing is the most often used to describe the actual charge made by an
organization. Pricing in hospital services is generally done by keeping in view the cost of running the hospital, the overheads, salaries of the doctors, nursing staff and administrative staff, cost of infrastructure, bed occupancy, quality of service etc. In APOLLO hospital the pricing is described in three heads: 1.Fees 2.Inpatient charges 3.Third party reimbursement. These three heads are based on the costs of producing different services. In addition in APOLLO the prices includes subsidiary elements, and the price may be greater or smaller, depending up on the discounts. The discounts are offering to the special groups such as employer groups and senior citizens etc. While fixing the prices of the services, the management of APOLLO considering the actual charges made by the hospital. While finalizing pricing it is observed that in APOLLO hospital, there are heavy fixed costs. APOLLO is providing different categories of rooms for patients depending up on their paying capacity. On the other hand, Pricing in CARE hospital largely based on costs, which are broadly divided in to direct and indirect costs. Before finalizing pricing for services CARE hospital is trying to know the cost for providing those services. Before fixing prices, CARE hospital is considering all the related components for calculating total cost of service. It is taking fixed and variable costs to determine final price. Place or Distribution Channels: Place is one of the key elements for hospital. Hospital should be easily accessible to the patients and it should be adequately protected from pollution. Every hospital will try to make services available and accessible to its target consumers. Thus hospitals in general will have three major distribution decisions. They include physical access (channels, location, and facilities), time access and promotional access. APOLLO and CARE hospitals are having place convenience as they are located at central location it is accessible with different transportation systems. It is observed that outpatient department timings are not convenient in CARE and patients are feeling comfortable with the OP timings of APOLLO. In conclusion it may be stated that the two hospitals are enjoying satisfactory distribution network of their services. Sales Promotion activities: Promotion is the hot topic in marketing of hospital services. In broader sense, five tools of the marketing mix - service, price, place, promotion, and people IJARMSS | 192
International Journal of Advanced Research in Management and Social Sciences are communication tools. Promotion function of any service organization involves the transmission of message to past, present, and potential customers. Customers need to be made aware of the existence of the service provided. Promotion includes advertising, sales promotion, personal and publicity. Hospitals do not normally undertake aggressive promotion; they rely a lot on a favorable word of mouth. To increase the cliental, the sample hospitals are continuously introducing different health services a like the acupressure clinic, master health programmes, and diabetic health checkups apart from annual health checkups. Two hospitals are conducting camps in rural areas to give medical checkups at a reasonable price. They are sponsoring frequent visits to the spastic society, old age homes etc. These hospitals are advertising in health and fitness magazines. The promotional activities of APOLLO are gaining attention of the patients. CARE is also giving different campaigns like heart checkups, dental checkups at concessional rates. CARE is using audio visual aids for advertising. On the whole one can say that APOLLO is paying attention towards the services at concessional rates and CARE is advertising through Media. People Mix: Being knowledge based industry, people play key role in hospitals. Here the people include patients and the staff. In order to provide quality treatment many hospitals running their own medical and nursing schools to train the staff according to their requirements. Patients also play a key role in hospital service delivery. Apart from maintaining quality staff hospitals also conducting Customer Education Programmes to enable patients and attendants to appreciate the value and quality of services, to build a patient oriented, service minded workforce. The hospital must hire the right people, develop service quality, provide the needed support systems. The people mix of APOLLO consists of Doctors, nursing staff, paramedical staff, supporting staff and front office executives. APOLLO is managing personnel, by developing and enhancing a systematic service culture. Hospital is having a human resource department with eminent people in the concern field. This department is attending different functions like man power planning, training, and motivation, evaluating, and rewarding etc, for building competent personnel. In order to get the right people, APOLLO is following traditional recruitment methods like advertising for posts, calling applications and other recruitment methods such as conducting campus interviews at reputed institutions. The people in CARE hospital classified as high contact people and low contact people. High contact service people include doctors and IJARMSS | 193
International Journal of Advanced Research in Management and Social Sciences nursing staff who are engaged in providing the services to the patients round the clock. The administrative people, supportive service people come under low contact service people. CARE hospital is trying to attract and retain doctors with knowledge and skills. CARE is giving importance to the attitude of the employees. In this regard CARE hospital has adopted certain strategies to retain the competent people for the organization. CARE hospital is maintaining a team of Cardiologists and Cardiac Surgeons, neurologists, critical care specialists etc, Physical Evidence: Physical evidence is the environment in which the service is delivered with physical or tangible commodities and where the firm and the customer interact. Modern hospitals need to create good ambience. Write from the reception ambience plays very important role because when a patient walks into the hospital he forms an opinion about the hospital. It is considered to be important as the patients and their relatives will already in depressed or traumatized state. It is observed that in two sample hospitals from reception onwards they are maintain right ambience that is creating a positive feeling in the minds of patients and attendants. The interior decoration in APOLLO is better compare to the CARE. Ventilation, drinking water and sewerage facilities are good in both select hospitals. For uninterrupted power supply, sample hospitals are maintaining latest power generators and maintenance is good. APOLLO and CARE hospitals are rightly placing the awards and certificates won by the doctors and hospitals for building confidence in the minds of the patients. Process: 'Process' is termed as 'Interactive Marketing' in services marketing. It is one of the important seven components of services marketing. Interactive marketing may be defined as the 'managerial process through which a series of interactions between service provider and consumer are organized to facilitate efficient participation in service production and consumption that satisfies the needs and wants of the consumers and create positive perceived quality'. Process is an essential ingredient in the production and delivery of service. Since the inseparable nature of services does not allow any differences in the production and delivery of a service, process becomes an all-inclusive 'P' for service marketers. Hospitals must pay as much attention to proper planning, designing, organizing and functioning of the various departments (specialties). The patient is examined and given treatment in the out-patient department up to the time he/she is hospitalized. He/she is then admitted and treated as an inpatient until he/she is discharged and the patient gets IJARMSS | 194
International Journal of Advanced Research in Management and Social Sciences treated again in the out-patient department. Besides these the other services like
investigative procedures and counseling services are to be done in the out-patient department. Two sample hospitals are not creating any complications when the patient is discharging on emergency situations. Further it is observed that the patients are waiting more time at service counters in CARE hospital. In the case of patient waiting time at doctors, APOLLO is better than the CARE hospital. The process for discharging the patient is feeling comfortable at APOLLO than CARE hospital. In emergency conditions patients are feeling difficult for their procedure in CARE hospital. But in CARE majority of respondents are not satisfied with the number of service counters. In APOLLO patients and their relatives feeling comfortable for the procedure to discharge the patients in emergency situations. But in normal conditions the process to discharge the patients is good in the two hospitals. It is observed that two hospitals having simple bill payment procedures. On overall two hospitals are having good process element. So far the researchers tried to give blue print about the working of 7Ps in practice. Now, it is proposed to relate above observations with the data given by hospital staff through their perceptions on marketing process. Following tables indicating the Grand Mean and S.D of perceptions of Doctors, Nursing staff and Administrative Personnel on marketing mix of sample hospitals. Table: 2 Perceptions of Doctors, Nursing staff and Administrators on the Marketing Process of Sample Hospitals (Grand Mean and S.D)
Doctors (N=75) Stateme APOLLO nt Mea Mean Product Price Place Promotio 2.66 n People Physical Evidence Process 2.50 0.36 2.61 0.47 2.66 0.61 2.67 0.36 2.34 0.59 2.42 0.37 2.24 2.25 0.33 0.37 2.13 2.12 0.25 0.26 2.17 2.26 0.41 0.47 2.02 2.06 0.36 0.39 2.06 2.03 0.40 0.45 1.87 1.81 0.30 0.33 0.61 2.73 0.48 2.39 0.54 2.25 0.46 1.92 0.42 1.88 0.44 2.34 3.10 2.79 S.D 0.28 0.42 0.48 Mean 2.42 3.32 3.01 S.D 0.20 0.31 0.34 Mean 2.13 3.08 2.76 S.D n 0.33 0.51 0.47 1.94 3.02 2.76 0.21 0.48 0.32 S.D n 1.94 2.19 2.55 0.29 0.59 0.38 Mea S.D n 2.01 2.73 2.52 0.28 0.53 0.36 Mea S.D CARE APOLLO CARE APOLLO CARE Nursing staff (N=150) Administrative staff (N=35)
5 Point Scale: 1-strongly agree??.5-strongly disagree
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International Journal of Advanced Research in Management and Social Sciences Table 10 shows the perceptions of doctors on marketing process, are positively opinioned in two sample hospitals. The mean scores are in the range of 2.34 to 3.10 and 2.12 to 3.01 in APOLLO and CARE hospitals respectively; on a 5 point scale indicating marketing mix of the sample hospitals is agreeable to the respondents. The perceptions of nursing staff on marketing process, are positively opinioned in two sample hospitals. The mean scores are in the range of 2.13 to 3.08 and 1.94 to 3.02 in APOLLO and CARE hospitals respectively. The perceptions of administrative personnel on marketing process, are positively opinioned in two sample hospitals. The mean scores are in the range of 1.92 to 2.55 and 1.81 to 2.73 in APOLLO and CARE hospitals respectively Following tables present the statistical analysis of data collected from doctors, nursing staff, administrative personnel of APOLLO and CARE hospitals. Table 3: Mean Values of Doctors, Nursing staff, Administrative staff Opinions on 7P's in APOLLO Hospital
7P's? Questions Doctors Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 1.9733 2.2000 2.6000 2.2000 2.4666 2.3333 2.4000 2.7333 2.4000 2.7333 3.2666 2.9200 3.1466 3.6000 3.0000 2.6266 3.3733 2.6666 2.8000 2.5600 2.7866 2.7866 Nursing staff Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 1.9333 2.4666 2.3466 1.6066 2.4000 1.9933 1.8666 2.2666 2.7333 3.4666 3.4666 3.6666 2.5266 2.6600 2.3333 3.6666 2.2000 4.4533 2.2000 2.2666 2.2666 2.7333 2.2666 2.2000 2.2000 2.5266 2.4600 2.6066 2.5266 2.2666 2.7333 1.6200 1.6600 2.3266 2.1933 2.2000 2.2666 1.9933 2.1933 2.5933 2.3333 2.2666 2.1400 4.0666 2.4600 1.8000 3.6666 1.9933 1.9333 2.5333 2.8266 2.9466 2.9466 2.5333 2.2000 1.6000 2.1866 2.4000 3.1466 1.9333 2.2666 2.5600 2.2266 1.9466 2.2666 2.0000 2.6666 1.9200 2.3333 1.7066 2.4666 2.6933 2.0133 3.8000 2.0800 2.2666 2.8533 1.8666 2.2000 Product Price Place Promotion People PhysicalEvidence Process
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Q9 1.6800 1.6800 1.9933 -
Administrative staff Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 2.08571 2.8285 2.6285 2.0571 2.3714 1.8000 1.6857 1.8857 1.9428 2.4000 2.2285 2.3714 2.4000 1.7714 2.000 1.8285 4.1714 1.7714 4.5142 1.9428 1.8285 1.8285 2.0857 1.8000 1.9142 1.9142 1.9428 1.8857 2.1142 2.0857 2.2285 2.2571 1.5714 1.5714 1.9714 2.2285 2.5714 1.6857 1.7142 2.1428 2.1714 2.1142 2.0285 2.1714 2.2000 2.0857 3.4571 2.1142 1.6285 2.2000 2.1428 2.5714 -
In order to find whether the perceptions of the doctors, Nursing staff and Administrators are indistinguishable the null hypothesis is framed as"The perceptions of the doctors, Nursing staff and Administrators are indistinguishable with respect to the P's of APOLLO hospital" Table 4: ANOVA of Doctors, Nursing staff, Administrative staff opinion on Ps in APOLLO Hospital
Groups Sum of df Squares Doctors Between Within Total 4.615 8.179 12.794 6 57 63 Nursing Staff Between Within Total 6.228 15.863 22.090 6 57 63 1.038 .278 3.730 .003 .769 .143 5.360 .000 Square Mean F Sig.
Administrative Staff Between Within Total 2.356 14.554 16.910 6 57 63 .393 .255 1.538 .183 -
Table representing ANOVA of opinions of Doctors and Nursing staff on 7P's in APOLLO hospital showing the level of significance or risk probability is less than .05 so in these two IJARMSS | 197
International Journal of Advanced Research in Management and Social Sciences cases, hypothesis is rejected. Therefore it can be said that, the perception of doctors and nursing staff are distinguishable i.e. the perception of the doctors are differ from one another. But in case of opinions of administrative personnel on 7P's is showing the level of significance or risk probability is greater than the .05 so the hypothesis is accepted. Therefore it can be said that, the perceptions of administrative personnel are indistinguishable i.e. the perceptions of the administrative personnel are not differing much one another in the 7P's. Table 5: Mean Values of Doctors, Nursing staff, Administrative staff Opinions on 7P's in CARE Hospital
7P's? Questions Doctors Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 1.6666 2.5333 3.2000 2.3333 3.0000 2.4000 2.4133 2.3866 2.3600 3.0000 3.2266 2.8000 3.5333 3.7333 3.6666 3.1333 2.8666 2.2666 4.3866 2.6000 2.9333 2.9333 Nursing staff Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 1.6600 2.0666 2.1333 1.6600 2.3266 1.6800 1.8600 2.2000 2.2666 2.6000 3.7333 3.0000 3.6000 2.4733 2.7200 1.9933 3.9866 2.3266 4.8000 1.6133 2.3400 2.3400 2.1933 2.2666 2.3333 2.3333 2.5933 1.8133 2.1266 2.0666 2.4800 2.4333 1.6200 1.5466 2.0000 2.2600 1.6733 2.2600 2.2666 1.9933 1.9333 1.9266 2.3266 2.0666 2.1333 1.6800 4.0000 2.5333 1.8666 3.4666 2.2000 2.0000 2.7333 2.5333 2.9333 2.9333 2.8666 2.4000 2.0000 2.0000 2.2666 2.9066 1.7733 1.9466 2.5600 2.0000 1.8666 2.2666 2.1333 2.4666 1.7333 1.5200 1.6000 2.0000 2.9333 2.1333 3.6666 2.0666 2.4000 3.2133 2.0000 2.3333 Product Price Place Promotion People PhysicalEvidence Process
Administrative staff Q1 Q2 Q3 2.0000 1.4285 2.4857 1.8571 3.9142 2.3428 2.0000 4.0000 1.9142 1.7714 1.8000 1.8285 2.7142 1.6857 2.0000 2.0000 1.8571 1.7428 4.1142 1.9714 1.7142
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Q4 Q5 Q6 Q7 Q8 Q9 2.7142 2.1428 1.7714 2.6285 1.9428 2.7142 4.1142 2.0857 2.1142 4.2571 1.7428 1.8857 1.8857 1.8285 2.1714 1.9428 2.0857 1.5428 1.5142 1.8571 1.8857 1.6571 1.6857 1.6857 1.9142 1.7428 2.0857 1.5428 2.7428 2.1142 1.8857 -
In order to find whether the perceptions of the doctors, Nursing staff, Administrators are indistinguishable, the null hypothesis is framed as"The perceptions of the doctors, Nursing staff and Administrators are indistinguishable with respect to the P's of CARE hospital" Table 6: ANOVA of Doctors, Nursing staff, Administrative staff opinion on Ps in CARE Hospital
Groups Sum of df Squares Doctors Between Within Total 8.922 11.413 20.335 6 57 63 Nursing Staff Between Within Total 8.923 16.913 25.836 6 57 63 Administrative Staff Between Within Total 5.932 20.266 26.198 6 57 63 .989 .356 2.781 .019 1.487 .297 5.012 .000 1.487 .200 7.426 .000 Square Mean F Sig.
Table representing ANOVA of opinions of Doctors and Nursing staff and Administrative staff on 7P's in CARE hospital showing the level of significance or risk probability is less than .05 so in these two cases, hypothesis is rejected. Therefore it can be said that, the perception of doctors, nursing staff and Administrative staff are distinguishable i.e. the perception of the doctors are differ from one another.
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International Journal of Advanced Research in Management and Social Sciences Table 7: Consolidated Statistical Result
APOLLO Category? * Nursing 7P's? Product Price Place Promotion People Physical 2.2599 (2) evidence Process 2.5110 (4) 2.6533 (5) 2.3523(6) 2.6133 (4) 2.6777 (5) 2.4237 (5) 2.2646 (3) 2.0399(3) 2.1253 (1) 2.0706 (3) 1.8171 (1) Doctors(1) staff(2) 2.3479 (3) 3.1110 (7) 2.7999 (6) 2.6644 (5) 2.2518 (1) 2.1366 (1) 3.0866 (7) 2.7694 (6) 2.3977 (4) 2.1792 (2) 1.9871(2) 2.1952(5) 2.5550(7) 1.9237(1) 2.0666(4) 2.4286 (3) 3.3266 (7) 3.0171 (6) 2.7333 (5) 2.1466 (2) Personnel (3) Doctors(4) (5) 1.9493 (1) 3.0211 (7) 2.7714 (6) 2.2555 (4) 2.0229 (2) Personnel (6) 2.0228 (4) 2.7380 (7) 2.5265 (6) 1.8904 (3) 1.8729 (2) * Administrative * Nursing staff Administrative CARE * *
* The ANOVA gave significant difference between the means of the 7P's.
In the above table the 7P's differ significantly among themselves with respect to the average scores of the responses provided by the staff. The ANOVA gave significant difference between the means of the 7P's (Product, Price, Place, Promotion, People, Physical Evidence and Process). The figures in the brackets parenthesis indicate the rank of the corresponding mean in the ascending order. The column with no-star represents, the average respondents of administrative personnel in APOLLO hospital are not differing much in the 7P's i.e. the respondents have rated them as equally strong with out much distinction of one from the remaining. As none of them is more than 3, there is no evidence of any disagreement. At the same time no neutrality also. The average P (People) with rank 1 is strongly agreeable from the respondents point of view namely doctors of the APOLLO hospital followed by rank 2,3,4,5,6 and 7 respectively. The average P (product) with rank 1 is strongly agreeable from the respondents point of view namely nursing staff of the APOLLO hospital followed by rank 2,3,4,5,6 and 7 respectively.
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International Journal of Advanced Research in Management and Social Sciences The average P (physical evidence) with rank 1 is strongly agreeable from the respondents point of view namely doctors of the CARE hospital followed by rank 2,3,4,5,6 and 7 respectively. The average P (product) with rank 1 is strongly agreeable from the respondents point of view namely nursing staff of the CARE hospital followed by rank 2,3,4,5,6 and 7 respectively. The average P (physical evidence) with rank 1 is strongly agreeable from the respondents' point of view namely administrative personnel followed by rank 2, 3,4,5,6 and 7 respectively.
DISCUSSION:
Product, Price, Place, Promotion, People, Physical Evidence, Process (7P's) The perceptions of doctors on the process, the 7P's entire are positively opinioned by the respondents in two sample hospitals. The mean scores are in the range of 2.34 to 3.10 and 2.12 to 3.01 in APOLLO and CARE hospitals respectively; on a 5 point scale indicating marketing mix (7P's) of the sample hospitals is agreeable to the respondents. The perceptions of nursing staff on marketing mix, the 7P's entire are positively opinioned by the respondents in two sample hospitals. The mean scores are in the range of 2.13 to 3.08 and 1.94 to 3.02 in APOLLO and CARE hospitals respectively; on a 5 point scale indicating marketing mix (7P's) of the sample hospitals is agreeable to the respondents. The perceptions of administrative personnel on marketing mix, the 7P's entire are positively opinioned by the respondents in two sample hospitals. The mean scores are in the range of 1.92 to 2.55 and 1.81 to 2.73 in APOLLO and Care hospitals respectively; on a 5 point scale indicating marketing mix (7P's) of the sample hospitals is agreeable to the respondents. The statistical analysis (ANOVA) and the conclusions revealed that the 7P's from the hospitals people side, the responses have given a relative rating of the 7P's in five out of six cases leading to a particular 'P' being strongly agreeable, a particular 'P' is just agreeable. Therefore respondents with a long term attachment with an organization can better distinguish the organization aspects than those who just stay for short while and leave. Inference: The statistical analysis and the conclusions revealed that the 7P's from the hospitals people side, the responses have given a relative rating of the 7P's in five out of six cases leading to a particular 'P' being strongly agreeable, a particular 'P' is just agreeable. IJARMSS | 201
International Journal of Advanced Research in Management and Social Sciences Therefore respondents with a long term attachment with an organization can better distinguish the organization aspects than those who just stay for short while and leave.
SUGGESTIONS FOR BETTER MARKETING OF HOSPITAL SERVICES
The following are some of the suggestions made to the marketing managers and policy makers of hospitals. If they are implemented, the present problems in the hospitals may be overcome to a great extent. Marketing Plan: Hospitals should prepare annual Marketing plans to prepare in advance for facing the future. While preparing marketing plan, mission statement of the organization and objectives are to be considered and workable plan is to be prepared. Hospitals have to understand what they want to communicate or what it is or what it is want their target audience to know or remember, or what the hospital stands. This is the most important part of the marketing plan. It provides the necessary directions to marketing efforts and has far reaching consequences. Customer in Hospital is Different: Hospital should realize that there is a big difference in waiting on a customer in a hospital and in any other organization. In the hospital the consumer is a sick person. In unfamiliar surroundings, many of them are in confused, tense, frightened and anxious state. The patient will immediately place his trust in the caring hands of hospital staff and assuredly feel that there is no need to be afraid. If he receives warmth and welcome feeling all the way, the patient will become the hospital's public relation agent. Hospitals should not be out of touch With Society: Hospital managements convert hospitals into consumer-oriented marketing enterprises. Hospitals will have to adopt the marketing concept with a philosophy that all planning is to be done with the patient needs considered first and foremost. Marketing through Public Relations: There are alternate marketing programmes that maintain image and not require advertising while still reaching large number of people. These programmes are a blend of public relations and guest relations activities implemented by well trained, motivated and dedicated staff that provides friendly, courteous service to patients. In almost every area of the hospital where staff comes into direct contact with the patients, the human relations and patient relations are of utmost importance. This is where public relations and marketing work at their best. Depending on IJARMSS | 202
International Journal of Advanced Research in Management and Social Sciences how the staff practices public relations will make or mar the hospital. All other outside marketing activities are secondary, even superfluous and irrelevant. Hospitals have failed to pay attention to this fact which is a key to their success. Service Costs are to be Regulated: Medicine is not mere business. It is an honorable profession with its code of ethics and a statutory body called medical council of India to uphold the dignity of the medical profession. But unfortunately these bodies are inactive and ineffective in curbing irrational practices and malpractices. Somehow, the prevailing high treatment costs are to be brought under control. For this reason, common man is not in a position to go to these corporate hospitals. Some of the strategies to curb the high treatment costs include Establishment of Media Relations Policy: Every hospital, regardless of its size, location must develop and enforce an official policy for dealing with the press and the kinds of information that may be released. The policy should specifically state who should speak for the hospital. All those who are required to make statements to the media should be familiar with the official policy and the procedure lay down therein. Customer Relationship Marketing: Some of the more common goals and objectives for developing and implementing technology-driven customer relationship programs include Improving customer service and satisfaction; Increasing profitability; Reducing the number of negative customer experience; Allocating resources more efficiently' Reducing the cost of managing customer interactions; Attracting and retaining customers and prospects; Staying in front of customers and building stronger relationships over time; and Improving clinical outcomes.
CONCLUSION
Of late, the hospital management has gained prominence the world over. The management of a hospital is found significant to deliver services to the society. For a successful marketing of services, it is essential that the concerned organization is professionally sound. This helps the hospital in many ways, such as an increase in the organizational potentials to show excellence, a strong base for serving the poorer sections and a favorable nexus for making it IJARMSS | 203
International Journal of Advanced Research in Management and Social Sciences an on-going process. The first and foremost task before a marketer is to satisfy the users by making available to them the quality services. We cannot deny the fact that in the Medicare services in addition to the medical aid, a number of other factors also play a significant role. If the doctors and nursing staff are found soft, sympathetic, and decent to the patients, the time-lag for curing a patient is minimized fantastically. Of course the medical aid play a pivotal role but the supportive services also play an incremental role without which the duration of treatment is increased considerably. In the Indian perspective, the core medical personnel lack this dimension. By marketing Medicare services, we engineer a strong foundation for both i.e. the best possible medical aid and a personal touch-in-service. By marketing medical services we mean making available the Medicare services to the users in such a way that they get quality services at the reasonable fee structure. The marketing principles focus on making available the services even to those segments of the society who are not in a position to pay for the services.
REFERENCES
1. M. Smith, Moira Fischbacher, Francis A. Wilson, New Service Development: From Panoramas to Precision, Anne European Management Journal, 2007, Vol. 25, No. 5, pp. 370-383. 2. Michael R. Bowers, MirtMng, Developing New Services For Hospitals: A Suggested Model. June 1987, Vol 7, No. 2, pp.38-48. 3. G.M.Naidu; Klemenhager;Pillari;George.D., Is Product-Line Management Appropriate For Your Health Care Activity, Journal of health care marketing; fall 1993, vol.13.p617,p12. 4. Burger, Pgillip C; Malhotra, Naresh.K, Product Line Management In Hospitals; An Exploratory Study Of Managing Change, Journal of health care marketing; sep-1991. Vol.11. Issue 3. P82. 1/4p. 5. Farley Dean E., Christopher Hogan, Case Mix Specialization in the Market for Hospital Services, Health services research; Vol.25; Dec-1990; p757-783. 6. Ronald.L Zallocco, Is There A Link Between Hospital Profit And Quality?, Journal of health care marketing; winter 1993; Vol.13; Issue.1; p68.
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International Journal of Advanced Research in Management and Social Sciences 7. Stanton. Wilbur W., Jame M. Daley, Identifying Market Segments Within A Health Care Delivery System: A Two Stage Methodology, Journal of Health Care Marketing Vol. 2, No. 3, summer, 1982, p.10. 8. Richard Marie Odile, Modeling the Impact of Internet Atmospherics on Surfer Behavior, Journal of Business Research, 58,2005, pp.1632- 1642. 9. Leonard L. Berry, Kent D. Seltman, Building A Strong Services Brand: Lessons From Mayo Clinic, Business Horizons, 2007, 50, pp.199-209. 10. Kyung Hoon Kim,Kang Sik Kim, Dong Yul Kim, Jong Ho Kim, Suk Hou Kang, Brand Equity In Hospital Marketing, Journal of Business Research, 2007,
doi:10.1016/j.jbusres.2006.05.010. 11. Menon, Mohan K.Goodnight, Janelle M. Wayne, Robin J., Assessing Advertising Content In A Hospital Advertising Campaign: An Application of Puto And Wells Measure Of Informational And Transformational Advertising Content, Journal of Hospital Marketing & Public Relations; 2006, Vol. 17 Issue 1, p27-44. 12. Tudor and Kanth, Hospital Advertising: The Influence of Perceptual and Demographic Factors on Consumer Dispositions, Journal of health care marketing; Winter 1994; Vol.14; Issue.4; p51-51, 1/4p. 13. S. Altan Erdem, L. Jean Harrison-Walker, The Role of the Internet in Physician— Patient Relationships: The Issue of Trust, Business Horizons, 2006, 49, pp.387—393. 14. Wan-I Lee, Bih-Yaw Shih,Yi-Shun Chung, The Exploration Of Consumers' Behavior In Choosing Hospital By The Application Of Neural Network, 2007,
doi:10.1016/j.eswa.2006.10.020. 15. Christopher L. Corbina, Scott W. Kelley, Richard W. Schwartz, Concepts In Service Marketing For Healthcare Professionals, The American Journal of Surgery, 2001, pp.1-7. 16. Weng Hui-Ching, Consumer Empowerment Behavior and Hospital Choice, Health Care Management Review; Jul-Sep2006, Vol. 31 Issue 3, pp197-204. 17. Feng -Chuan Pan Chi-Shan Chen., Enhancing Competitive Advantage Of Hospitals Through Linguistics Evaluation On Customer Perceived Value, Journal of American Academy of Business, Cambridge; Sep. 2004, Vol. 5 Issue 1/2, p481-485.
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International Journal of Advanced Research in Management and Social Sciences 18. Akinic, Fevvzi: Esatoglu,Tangilimagulu,Dilaver,Parsons,Amy, Hospital Choice Factor: A Case Study In Turkey, Health marketing quarterly; 2004, vol.22 issue1, p3-19. 19. Laing, Angus, Mckee, Lorna, Structuring the Marketing Function in Complex Professional Service Organizations, European journal of marketing; 2000; vol.34; issue 5/6; p576, 22p. 20. T.Sreenivas, Management of Hospitals, A.P.H. Publishing Corporation, 2002.
Annexure
Statements used for data collection from DOCTORS/NURSING STAFF/ADMINISTRATIVE PERSONNEL
(1) Strongly agree (2) Agree (3) can't say (4) Disagree (5) strongly disagree
Product: 1 2 3 4 The services are attracting the patients. The package services at your hospital are helpful. Same day surgery services increasing hospital image. Telemedicine services and they are useful for better treatment. 5 Housekeeping department is doing well. 6 7 8 9 Price: 1 2 3 4 5 6 Hospital is offering services at affordable prices. The quality of treatment depends on price. Patients are from higher income level. Hospital follows charges, what the other hospitals follows. Cost of Laboratory tests is reasonable. Hospital follows stable pricing policies. Hospital is having good patient care. Hospital transportation services are satisfactory. Hospital reception services are good. Hospital is more capable in developing and launching new services.
Place: 1 2 Hospital attracting patients from all the places. The hospital still to extend its services to some other areas. 3 Hospital is adequately protected from pollution. 4 5 6 7 You are a visiting or consulting doctor in some other hospital. Hospital is well noted to other hospitals to refer their patients for better treatment. Hospital is having time and place convenience to the patients. Hospital is located at a right place.
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Promotion: 1 2 3 4 5 6 Hospital is able to propagate its services to patients and their relatives. You are a direct promoter of your hospital services. Hospital special promotional campaigns are gaining the attention. There is good response to special campaigns. Talk by doctors in T.V programs is increasing the reputation of hospital. This hospital have strong brand image in the patients.
People: 1 2 3 4 5 6 This hospital is having doctors with Excellent knowledge, Skills, Right attitude. Doctors deal with all the patients alike. Supporting staff play an important role in better recovery. Supporting staff and nursing staff are well qualified. 7 The house keeping personnel are well mannered, gentle. 8 There is value addition to customer awareness programs. 9 The staff are sympathetic towards patient problems .
Physical evidence: 1 2 3 Hospital is making a positive impression on patients and their attendants. The interior decoration in this hospital is very good. Lighting and ventilation in this hospital is good. Especially in patient wards. This hospital is good in the aspects of: 4 5 6 Electricity, Drinking Water, Transportation, 7 Security. 8 Hospital is able to build up confidence in the patients by displaying awards won by doctors and the service certificates won by the hospital. Process: 1 2 3 4 5 6 Treatment the process is very lengthy and time consuming. Bill settlement process is simple. The process to discharge the patient is simple in this hospital. The process for emergency discharge is complicated in this hospital. Service counters provided in this hospital are sufficient. The length of waiting time of patients in this hospital is reasonable.
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doc_391681789.docx
The marketing mix is a business tool used in marketing and by marketing professionals. The marketing mix is often crucial when determining a product or brand's offering, and is often synonymous with the four Ps: price, product, promotion, and place; in service marketing, however, the four Ps have been expanded to the Seven Ps or eight Ps to address the different nature of services.
Case Studies for Analysis on Marketing Mix in Hospitals
Abstract: Hospital marketing is becoming increasingly competitive all over the world and India is no exception. The gradual shift from the selling to marketing vis-a-vis the customer orientation is quiet evident in present day hospital services. Hospitals become consumer centered and are expecting high medical care and demanding quality services at reasonable prices. Under these circumstances, age-old methods may not give us long run results. The application of modern marketing principles would pave avenues for rationalizing and standardizing the services. Thus marketing has become a new 'mantra' for the service providers in a hospital setting. Article evaluates the innovative marketing strategies adopted by corporate hospitals to sell their services and tries to explore the Marketing process explained with the help of 7P's i.e. Product, Price, Place, Promotion, People, Physical evidence and Process in sample hospitals which run under different corporate managements. For this purpose it is proposed to elicit the perceptions from the doctors, nursing staff and administrative staff on marketing mix of hospitals. The data was analyzed by applying different statistical tools to know whether the perceptions of respondents are indistinguishable or not. Keywords: Hospital marketing; Product, Price, Place, Promotion, People, Physical Evidence and Process
International Journal of Advanced Research in Management and Social Sciences
INTRODUCTION
The health care market has become consumer centered and expecting high quality care at a reasonable price. The mushroomed development of corporate hospitals in India, competition is also bringing massive changes in industry structure. In this context, hospital services marketing is slowly and surely coming of age and is being woven into the fabric of hospitals planning and public relations programmes. Earlier, there was an in built tendency that services will be sold out automatically; hospitals will overflow if a doctor has a degree. But now many of the corporate hospitals over the last two decades, have developed marketing culture in their set - up which has enabled them to scale new heights in their ventures. As we are moving to service economy, the customers are more critical and keen towards quality services and high standards. As every one of us know patient is the important person in this changed environment, the hospitals must strive for maximum patient satisfaction. In deriving patient satisfaction, hospital marketing is playing crucial role. The marketing process involves marketing planning, marketing decision making and
formulation of marketing mix strategies. All these can be conventionally classified into seven major strategies namely product/service, price, place promotion, people, physical evidence and process. The product element of the hospitals includes diagnosis, treatment provided, the education training provided to nursing and medical students and research. Services like facilities for attendants, ambulance, and pharmacy services etc., augment the core service. The pricing of services should take into consideration the operational costs and the paying ability of the patient, apart from the value provide to the customer. People play a very important role in marketing of hospital services. Processes add value to customer and also improve the efficiency of the operations of the hospitals. Physical evidence can be provided using a good layout and maintain hygiene. Supplementary services also help in providing physical evidence to customers. The future healthcare environment is likely to be characterized by more competition; tighter margins; more diverse, better informed, and more demanding consumers; demands for accountability; and growing labor shortages. Marketing may not be a panacea for this laundry list of challenges, but the judicial use of marketing resources can certainly contribute to their amelioration.
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OBJECTIVES OF THE STUDY
Specific objectives of this research are to analyze and compare the Marketing process (Product, Price, Place, Promotion, People, Physical Evidence and Process) in two selected corporate hospitals and to study and compare the perceptions of Administrative staff, Doctors and Nursing staff towards marketing process. This study also makes an attempt to suggest suitable measures for effective marketing of hospital Services in general and the selected hospitals in particular.
HYPOTHESES
1. The marketing processes of two select hospitals are indistinguishable. 2. The perceptions of the Doctors, Nursing and Administrative Personnel in both the hospitals are indistinguishable with respect to the (Product/Service, Price, Place, Promotion, People, Physical Evidence and Process) marketing of their services.
METHODOLOGY FOR DATA COLLECTION AND ANALYSIS
The researchers have selected two corporate hospitals in Hyderabad, Andhra Pradesh. They are APOLLO Hospital, Jubleehills and CARE Hospital, Banjarahills which are having similar and almost identical facilities. The select two hospitals under study are providing tertiary care and they are high-tech hospitals. The two hospitals have almost similar physical area, comprehensive equipment, skilled medical specialists and nursing staff with common set of policies and proposals. Two hospitals run on modern scientific and high tech lines, under the control of private management. Following table shows the population of two selected
super specialty hospitals and sample size of selected hospitals. Table 1: Population and Sample size in Selected Hospitals Particulars Doctors Nursing Staff Administrative Personnel APOLLO CARE Total Population Sample Population Sample Population Sample 156 75 127 75 283 150 340 150 320 150 660 300 45 35 40 35 85 70
For collection of data efforts were made to elicit the opinions through personal interviews and by distributing questionnaires. The instrument was tested for its reliability and validity. A five degree scale (Summated Scale) was used. It contains the columns of strongly agree, agree, can't say, disagree and strongly disagree of the respondents with the given IJARMSS | 189
International Journal of Advanced Research in Management and Social Sciences statement. In this aspect researchers have taken help from the different eminent people in the concern area. Observation method is also used while collecting the data. The data is analyzed with statistical tools like percentages, Mean, Standard Deviation, ANOVA to know whether the perceptions of respondents are indistinguishable or not with reference to Marketing Process of sample hospitals.
REVIEW OF RELATED LITERATURE
An article by Smith(2007)[1] argues that a panoramic, or holistic, approach to new service development and a high level of precision at the micro level, will combine to provide a more successful service design and new service development process. Michael R. Bowers
(1987)[2] proposes that hospitals should facilitate market-driven service development. G.M. Naidu et.al (1993)[3] and Burger(1991)[4] examines the result of the study on product-line management (PLM) as management tool on health care industry. Farley (1990)[5] opine
that Hospitals may be able to reduce their costs by limiting the breadth of services they provide. Ronald (1993)[6] discussed relationship between quality and profitability. The authors studied each hospital to determine the relationship between quality and profit levels on one hand and price, occupancy levels, and costs per patient on the other. Stanton (1982)[7] applied a two stage methodology for identifying healthcare market segments. The paper by Richard (2005)[8] examines the role of Internet atmospherics cues on the behavior of pre-purchase and purchase intentions. Berry(2007)[9] explains the services branding model by showing how one organization has created, extended, and protected a powerful brand through an unwavering commitment to the well being of its customers. Kyung et. al. (2007)[10] identifies factors that influence the creation of Brand equity through successful customer relationships. Menon et.al. (2006)[11] has designed a methodology to measure advertising content. Tudor and Kanth(1994)[12] discuss the perceptions of consumers concerning hospital advertising. Altan and Walker (2006)[13] explain the importance of Internet in building physician-patient relationship. Lee and Chung (2007)[14] explain the application of neural network in classifying consumer behavior in choosing hospitals. Christopher et.al. (2001)[15] said that the Patients are becoming increasingly involved in making healthcare choices. Weng(2006)[16] presents a study that investigates the behavior and a patient's choice of hospitals. Chen(2004)[17] proposes value attributes perceived by customers.
Akinic
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et.al.(2004)[18] examines the factors affecting hospital choice decisions of 869 patients in
three public and one private hospital policlinics in Turkey. Study findings highlight the importance of accessibility of hospital services to consumers in hospital choice as well as the role of hospitals image its physical appearance, and technological capabilities in informing such choices. Laing et. al. (2000)[19] examines the organizational solutions adopted by selfgoverning hospitals in managing the marketing function. Sreenivas (2002)[20] discussed the factors influence the satisfaction of the patients in Government owned, semi-Government owned and tertiary care hospitals. The next part of the paper examines how the select hospitals are implementing the marketing programme and it is discussed under the heading of 7Ps. They include - product, price, place, promotion, people, physical evidence and process.
ANALYSIS ON MARKETING MIX IN SAMPLE HOSPITALS
Product: The product mix in hospitals in terms of its length consists of three product lines Inpatient services, Ambulatory services, and Health promotion. Each product line will have certain width - the patient services include medical/ surgical, pediatric, obstetric and cardiac intensive care and each product item will have certain depth - for example, a hospital may contain fifteen pediatric beds. Various services in service mix are different in their relative contribution to the organization. Some constitute the core service of the hospital and others are ancillary services. The core product answers the questions like what for consumer's really looking? What service is really satisfying? The core service stands at the center of the total service. At second level the product consists of the features, quality, styling of the core service. The third level of service include augmented product. If the hospital offers additional services or benefits beyond the tangible service is an augmented service. In both the selected hospitals services are divided into core, tangible, augmented services. The product - mix in APOLLO include medical and surgical services, ICU services, pain relief services, emergency services, supporting services and special services like health check up services, diagnostic services etc. APOLLO corporate services and blood bank services are the augmented services. On the other hand the product - mix in CARE include medical, surgical, laboratory, online, blood bank, and emergency services. When researches look into the services of both the hospitals it is observed that APOLLO is concentrating on generating the core and tangible services, and the CARE is concentrating on core and IJARMSS | 191
International Journal of Advanced Research in Management and Social Sciences augmented services. After observing the length, width and depth of both the hospitals it can be concluded that both the hospitals are striving for quality health care. Pricing: Pricing is the most often used to describe the actual charge made by an
organization. Pricing in hospital services is generally done by keeping in view the cost of running the hospital, the overheads, salaries of the doctors, nursing staff and administrative staff, cost of infrastructure, bed occupancy, quality of service etc. In APOLLO hospital the pricing is described in three heads: 1.Fees 2.Inpatient charges 3.Third party reimbursement. These three heads are based on the costs of producing different services. In addition in APOLLO the prices includes subsidiary elements, and the price may be greater or smaller, depending up on the discounts. The discounts are offering to the special groups such as employer groups and senior citizens etc. While fixing the prices of the services, the management of APOLLO considering the actual charges made by the hospital. While finalizing pricing it is observed that in APOLLO hospital, there are heavy fixed costs. APOLLO is providing different categories of rooms for patients depending up on their paying capacity. On the other hand, Pricing in CARE hospital largely based on costs, which are broadly divided in to direct and indirect costs. Before finalizing pricing for services CARE hospital is trying to know the cost for providing those services. Before fixing prices, CARE hospital is considering all the related components for calculating total cost of service. It is taking fixed and variable costs to determine final price. Place or Distribution Channels: Place is one of the key elements for hospital. Hospital should be easily accessible to the patients and it should be adequately protected from pollution. Every hospital will try to make services available and accessible to its target consumers. Thus hospitals in general will have three major distribution decisions. They include physical access (channels, location, and facilities), time access and promotional access. APOLLO and CARE hospitals are having place convenience as they are located at central location it is accessible with different transportation systems. It is observed that outpatient department timings are not convenient in CARE and patients are feeling comfortable with the OP timings of APOLLO. In conclusion it may be stated that the two hospitals are enjoying satisfactory distribution network of their services. Sales Promotion activities: Promotion is the hot topic in marketing of hospital services. In broader sense, five tools of the marketing mix - service, price, place, promotion, and people IJARMSS | 192
International Journal of Advanced Research in Management and Social Sciences are communication tools. Promotion function of any service organization involves the transmission of message to past, present, and potential customers. Customers need to be made aware of the existence of the service provided. Promotion includes advertising, sales promotion, personal and publicity. Hospitals do not normally undertake aggressive promotion; they rely a lot on a favorable word of mouth. To increase the cliental, the sample hospitals are continuously introducing different health services a like the acupressure clinic, master health programmes, and diabetic health checkups apart from annual health checkups. Two hospitals are conducting camps in rural areas to give medical checkups at a reasonable price. They are sponsoring frequent visits to the spastic society, old age homes etc. These hospitals are advertising in health and fitness magazines. The promotional activities of APOLLO are gaining attention of the patients. CARE is also giving different campaigns like heart checkups, dental checkups at concessional rates. CARE is using audio visual aids for advertising. On the whole one can say that APOLLO is paying attention towards the services at concessional rates and CARE is advertising through Media. People Mix: Being knowledge based industry, people play key role in hospitals. Here the people include patients and the staff. In order to provide quality treatment many hospitals running their own medical and nursing schools to train the staff according to their requirements. Patients also play a key role in hospital service delivery. Apart from maintaining quality staff hospitals also conducting Customer Education Programmes to enable patients and attendants to appreciate the value and quality of services, to build a patient oriented, service minded workforce. The hospital must hire the right people, develop service quality, provide the needed support systems. The people mix of APOLLO consists of Doctors, nursing staff, paramedical staff, supporting staff and front office executives. APOLLO is managing personnel, by developing and enhancing a systematic service culture. Hospital is having a human resource department with eminent people in the concern field. This department is attending different functions like man power planning, training, and motivation, evaluating, and rewarding etc, for building competent personnel. In order to get the right people, APOLLO is following traditional recruitment methods like advertising for posts, calling applications and other recruitment methods such as conducting campus interviews at reputed institutions. The people in CARE hospital classified as high contact people and low contact people. High contact service people include doctors and IJARMSS | 193
International Journal of Advanced Research in Management and Social Sciences nursing staff who are engaged in providing the services to the patients round the clock. The administrative people, supportive service people come under low contact service people. CARE hospital is trying to attract and retain doctors with knowledge and skills. CARE is giving importance to the attitude of the employees. In this regard CARE hospital has adopted certain strategies to retain the competent people for the organization. CARE hospital is maintaining a team of Cardiologists and Cardiac Surgeons, neurologists, critical care specialists etc, Physical Evidence: Physical evidence is the environment in which the service is delivered with physical or tangible commodities and where the firm and the customer interact. Modern hospitals need to create good ambience. Write from the reception ambience plays very important role because when a patient walks into the hospital he forms an opinion about the hospital. It is considered to be important as the patients and their relatives will already in depressed or traumatized state. It is observed that in two sample hospitals from reception onwards they are maintain right ambience that is creating a positive feeling in the minds of patients and attendants. The interior decoration in APOLLO is better compare to the CARE. Ventilation, drinking water and sewerage facilities are good in both select hospitals. For uninterrupted power supply, sample hospitals are maintaining latest power generators and maintenance is good. APOLLO and CARE hospitals are rightly placing the awards and certificates won by the doctors and hospitals for building confidence in the minds of the patients. Process: 'Process' is termed as 'Interactive Marketing' in services marketing. It is one of the important seven components of services marketing. Interactive marketing may be defined as the 'managerial process through which a series of interactions between service provider and consumer are organized to facilitate efficient participation in service production and consumption that satisfies the needs and wants of the consumers and create positive perceived quality'. Process is an essential ingredient in the production and delivery of service. Since the inseparable nature of services does not allow any differences in the production and delivery of a service, process becomes an all-inclusive 'P' for service marketers. Hospitals must pay as much attention to proper planning, designing, organizing and functioning of the various departments (specialties). The patient is examined and given treatment in the out-patient department up to the time he/she is hospitalized. He/she is then admitted and treated as an inpatient until he/she is discharged and the patient gets IJARMSS | 194
International Journal of Advanced Research in Management and Social Sciences treated again in the out-patient department. Besides these the other services like
investigative procedures and counseling services are to be done in the out-patient department. Two sample hospitals are not creating any complications when the patient is discharging on emergency situations. Further it is observed that the patients are waiting more time at service counters in CARE hospital. In the case of patient waiting time at doctors, APOLLO is better than the CARE hospital. The process for discharging the patient is feeling comfortable at APOLLO than CARE hospital. In emergency conditions patients are feeling difficult for their procedure in CARE hospital. But in CARE majority of respondents are not satisfied with the number of service counters. In APOLLO patients and their relatives feeling comfortable for the procedure to discharge the patients in emergency situations. But in normal conditions the process to discharge the patients is good in the two hospitals. It is observed that two hospitals having simple bill payment procedures. On overall two hospitals are having good process element. So far the researchers tried to give blue print about the working of 7Ps in practice. Now, it is proposed to relate above observations with the data given by hospital staff through their perceptions on marketing process. Following tables indicating the Grand Mean and S.D of perceptions of Doctors, Nursing staff and Administrative Personnel on marketing mix of sample hospitals. Table: 2 Perceptions of Doctors, Nursing staff and Administrators on the Marketing Process of Sample Hospitals (Grand Mean and S.D)
Doctors (N=75) Stateme APOLLO nt Mea Mean Product Price Place Promotio 2.66 n People Physical Evidence Process 2.50 0.36 2.61 0.47 2.66 0.61 2.67 0.36 2.34 0.59 2.42 0.37 2.24 2.25 0.33 0.37 2.13 2.12 0.25 0.26 2.17 2.26 0.41 0.47 2.02 2.06 0.36 0.39 2.06 2.03 0.40 0.45 1.87 1.81 0.30 0.33 0.61 2.73 0.48 2.39 0.54 2.25 0.46 1.92 0.42 1.88 0.44 2.34 3.10 2.79 S.D 0.28 0.42 0.48 Mean 2.42 3.32 3.01 S.D 0.20 0.31 0.34 Mean 2.13 3.08 2.76 S.D n 0.33 0.51 0.47 1.94 3.02 2.76 0.21 0.48 0.32 S.D n 1.94 2.19 2.55 0.29 0.59 0.38 Mea S.D n 2.01 2.73 2.52 0.28 0.53 0.36 Mea S.D CARE APOLLO CARE APOLLO CARE Nursing staff (N=150) Administrative staff (N=35)
5 Point Scale: 1-strongly agree??.5-strongly disagree
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International Journal of Advanced Research in Management and Social Sciences Table 10 shows the perceptions of doctors on marketing process, are positively opinioned in two sample hospitals. The mean scores are in the range of 2.34 to 3.10 and 2.12 to 3.01 in APOLLO and CARE hospitals respectively; on a 5 point scale indicating marketing mix of the sample hospitals is agreeable to the respondents. The perceptions of nursing staff on marketing process, are positively opinioned in two sample hospitals. The mean scores are in the range of 2.13 to 3.08 and 1.94 to 3.02 in APOLLO and CARE hospitals respectively. The perceptions of administrative personnel on marketing process, are positively opinioned in two sample hospitals. The mean scores are in the range of 1.92 to 2.55 and 1.81 to 2.73 in APOLLO and CARE hospitals respectively Following tables present the statistical analysis of data collected from doctors, nursing staff, administrative personnel of APOLLO and CARE hospitals. Table 3: Mean Values of Doctors, Nursing staff, Administrative staff Opinions on 7P's in APOLLO Hospital
7P's? Questions Doctors Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 1.9733 2.2000 2.6000 2.2000 2.4666 2.3333 2.4000 2.7333 2.4000 2.7333 3.2666 2.9200 3.1466 3.6000 3.0000 2.6266 3.3733 2.6666 2.8000 2.5600 2.7866 2.7866 Nursing staff Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 1.9333 2.4666 2.3466 1.6066 2.4000 1.9933 1.8666 2.2666 2.7333 3.4666 3.4666 3.6666 2.5266 2.6600 2.3333 3.6666 2.2000 4.4533 2.2000 2.2666 2.2666 2.7333 2.2666 2.2000 2.2000 2.5266 2.4600 2.6066 2.5266 2.2666 2.7333 1.6200 1.6600 2.3266 2.1933 2.2000 2.2666 1.9933 2.1933 2.5933 2.3333 2.2666 2.1400 4.0666 2.4600 1.8000 3.6666 1.9933 1.9333 2.5333 2.8266 2.9466 2.9466 2.5333 2.2000 1.6000 2.1866 2.4000 3.1466 1.9333 2.2666 2.5600 2.2266 1.9466 2.2666 2.0000 2.6666 1.9200 2.3333 1.7066 2.4666 2.6933 2.0133 3.8000 2.0800 2.2666 2.8533 1.8666 2.2000 Product Price Place Promotion People PhysicalEvidence Process
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Q9 1.6800 1.6800 1.9933 -
Administrative staff Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 2.08571 2.8285 2.6285 2.0571 2.3714 1.8000 1.6857 1.8857 1.9428 2.4000 2.2285 2.3714 2.4000 1.7714 2.000 1.8285 4.1714 1.7714 4.5142 1.9428 1.8285 1.8285 2.0857 1.8000 1.9142 1.9142 1.9428 1.8857 2.1142 2.0857 2.2285 2.2571 1.5714 1.5714 1.9714 2.2285 2.5714 1.6857 1.7142 2.1428 2.1714 2.1142 2.0285 2.1714 2.2000 2.0857 3.4571 2.1142 1.6285 2.2000 2.1428 2.5714 -
In order to find whether the perceptions of the doctors, Nursing staff and Administrators are indistinguishable the null hypothesis is framed as"The perceptions of the doctors, Nursing staff and Administrators are indistinguishable with respect to the P's of APOLLO hospital" Table 4: ANOVA of Doctors, Nursing staff, Administrative staff opinion on Ps in APOLLO Hospital
Groups Sum of df Squares Doctors Between Within Total 4.615 8.179 12.794 6 57 63 Nursing Staff Between Within Total 6.228 15.863 22.090 6 57 63 1.038 .278 3.730 .003 .769 .143 5.360 .000 Square Mean F Sig.
Administrative Staff Between Within Total 2.356 14.554 16.910 6 57 63 .393 .255 1.538 .183 -
Table representing ANOVA of opinions of Doctors and Nursing staff on 7P's in APOLLO hospital showing the level of significance or risk probability is less than .05 so in these two IJARMSS | 197
International Journal of Advanced Research in Management and Social Sciences cases, hypothesis is rejected. Therefore it can be said that, the perception of doctors and nursing staff are distinguishable i.e. the perception of the doctors are differ from one another. But in case of opinions of administrative personnel on 7P's is showing the level of significance or risk probability is greater than the .05 so the hypothesis is accepted. Therefore it can be said that, the perceptions of administrative personnel are indistinguishable i.e. the perceptions of the administrative personnel are not differing much one another in the 7P's. Table 5: Mean Values of Doctors, Nursing staff, Administrative staff Opinions on 7P's in CARE Hospital
7P's? Questions Doctors Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 1.6666 2.5333 3.2000 2.3333 3.0000 2.4000 2.4133 2.3866 2.3600 3.0000 3.2266 2.8000 3.5333 3.7333 3.6666 3.1333 2.8666 2.2666 4.3866 2.6000 2.9333 2.9333 Nursing staff Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 1.6600 2.0666 2.1333 1.6600 2.3266 1.6800 1.8600 2.2000 2.2666 2.6000 3.7333 3.0000 3.6000 2.4733 2.7200 1.9933 3.9866 2.3266 4.8000 1.6133 2.3400 2.3400 2.1933 2.2666 2.3333 2.3333 2.5933 1.8133 2.1266 2.0666 2.4800 2.4333 1.6200 1.5466 2.0000 2.2600 1.6733 2.2600 2.2666 1.9933 1.9333 1.9266 2.3266 2.0666 2.1333 1.6800 4.0000 2.5333 1.8666 3.4666 2.2000 2.0000 2.7333 2.5333 2.9333 2.9333 2.8666 2.4000 2.0000 2.0000 2.2666 2.9066 1.7733 1.9466 2.5600 2.0000 1.8666 2.2666 2.1333 2.4666 1.7333 1.5200 1.6000 2.0000 2.9333 2.1333 3.6666 2.0666 2.4000 3.2133 2.0000 2.3333 Product Price Place Promotion People PhysicalEvidence Process
Administrative staff Q1 Q2 Q3 2.0000 1.4285 2.4857 1.8571 3.9142 2.3428 2.0000 4.0000 1.9142 1.7714 1.8000 1.8285 2.7142 1.6857 2.0000 2.0000 1.8571 1.7428 4.1142 1.9714 1.7142
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Q4 Q5 Q6 Q7 Q8 Q9 2.7142 2.1428 1.7714 2.6285 1.9428 2.7142 4.1142 2.0857 2.1142 4.2571 1.7428 1.8857 1.8857 1.8285 2.1714 1.9428 2.0857 1.5428 1.5142 1.8571 1.8857 1.6571 1.6857 1.6857 1.9142 1.7428 2.0857 1.5428 2.7428 2.1142 1.8857 -
In order to find whether the perceptions of the doctors, Nursing staff, Administrators are indistinguishable, the null hypothesis is framed as"The perceptions of the doctors, Nursing staff and Administrators are indistinguishable with respect to the P's of CARE hospital" Table 6: ANOVA of Doctors, Nursing staff, Administrative staff opinion on Ps in CARE Hospital
Groups Sum of df Squares Doctors Between Within Total 8.922 11.413 20.335 6 57 63 Nursing Staff Between Within Total 8.923 16.913 25.836 6 57 63 Administrative Staff Between Within Total 5.932 20.266 26.198 6 57 63 .989 .356 2.781 .019 1.487 .297 5.012 .000 1.487 .200 7.426 .000 Square Mean F Sig.
Table representing ANOVA of opinions of Doctors and Nursing staff and Administrative staff on 7P's in CARE hospital showing the level of significance or risk probability is less than .05 so in these two cases, hypothesis is rejected. Therefore it can be said that, the perception of doctors, nursing staff and Administrative staff are distinguishable i.e. the perception of the doctors are differ from one another.
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International Journal of Advanced Research in Management and Social Sciences Table 7: Consolidated Statistical Result
APOLLO Category? * Nursing 7P's? Product Price Place Promotion People Physical 2.2599 (2) evidence Process 2.5110 (4) 2.6533 (5) 2.3523(6) 2.6133 (4) 2.6777 (5) 2.4237 (5) 2.2646 (3) 2.0399(3) 2.1253 (1) 2.0706 (3) 1.8171 (1) Doctors(1) staff(2) 2.3479 (3) 3.1110 (7) 2.7999 (6) 2.6644 (5) 2.2518 (1) 2.1366 (1) 3.0866 (7) 2.7694 (6) 2.3977 (4) 2.1792 (2) 1.9871(2) 2.1952(5) 2.5550(7) 1.9237(1) 2.0666(4) 2.4286 (3) 3.3266 (7) 3.0171 (6) 2.7333 (5) 2.1466 (2) Personnel (3) Doctors(4) (5) 1.9493 (1) 3.0211 (7) 2.7714 (6) 2.2555 (4) 2.0229 (2) Personnel (6) 2.0228 (4) 2.7380 (7) 2.5265 (6) 1.8904 (3) 1.8729 (2) * Administrative * Nursing staff Administrative CARE * *
* The ANOVA gave significant difference between the means of the 7P's.
In the above table the 7P's differ significantly among themselves with respect to the average scores of the responses provided by the staff. The ANOVA gave significant difference between the means of the 7P's (Product, Price, Place, Promotion, People, Physical Evidence and Process). The figures in the brackets parenthesis indicate the rank of the corresponding mean in the ascending order. The column with no-star represents, the average respondents of administrative personnel in APOLLO hospital are not differing much in the 7P's i.e. the respondents have rated them as equally strong with out much distinction of one from the remaining. As none of them is more than 3, there is no evidence of any disagreement. At the same time no neutrality also. The average P (People) with rank 1 is strongly agreeable from the respondents point of view namely doctors of the APOLLO hospital followed by rank 2,3,4,5,6 and 7 respectively. The average P (product) with rank 1 is strongly agreeable from the respondents point of view namely nursing staff of the APOLLO hospital followed by rank 2,3,4,5,6 and 7 respectively.
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International Journal of Advanced Research in Management and Social Sciences The average P (physical evidence) with rank 1 is strongly agreeable from the respondents point of view namely doctors of the CARE hospital followed by rank 2,3,4,5,6 and 7 respectively. The average P (product) with rank 1 is strongly agreeable from the respondents point of view namely nursing staff of the CARE hospital followed by rank 2,3,4,5,6 and 7 respectively. The average P (physical evidence) with rank 1 is strongly agreeable from the respondents' point of view namely administrative personnel followed by rank 2, 3,4,5,6 and 7 respectively.
DISCUSSION:
Product, Price, Place, Promotion, People, Physical Evidence, Process (7P's) The perceptions of doctors on the process, the 7P's entire are positively opinioned by the respondents in two sample hospitals. The mean scores are in the range of 2.34 to 3.10 and 2.12 to 3.01 in APOLLO and CARE hospitals respectively; on a 5 point scale indicating marketing mix (7P's) of the sample hospitals is agreeable to the respondents. The perceptions of nursing staff on marketing mix, the 7P's entire are positively opinioned by the respondents in two sample hospitals. The mean scores are in the range of 2.13 to 3.08 and 1.94 to 3.02 in APOLLO and CARE hospitals respectively; on a 5 point scale indicating marketing mix (7P's) of the sample hospitals is agreeable to the respondents. The perceptions of administrative personnel on marketing mix, the 7P's entire are positively opinioned by the respondents in two sample hospitals. The mean scores are in the range of 1.92 to 2.55 and 1.81 to 2.73 in APOLLO and Care hospitals respectively; on a 5 point scale indicating marketing mix (7P's) of the sample hospitals is agreeable to the respondents. The statistical analysis (ANOVA) and the conclusions revealed that the 7P's from the hospitals people side, the responses have given a relative rating of the 7P's in five out of six cases leading to a particular 'P' being strongly agreeable, a particular 'P' is just agreeable. Therefore respondents with a long term attachment with an organization can better distinguish the organization aspects than those who just stay for short while and leave. Inference: The statistical analysis and the conclusions revealed that the 7P's from the hospitals people side, the responses have given a relative rating of the 7P's in five out of six cases leading to a particular 'P' being strongly agreeable, a particular 'P' is just agreeable. IJARMSS | 201
International Journal of Advanced Research in Management and Social Sciences Therefore respondents with a long term attachment with an organization can better distinguish the organization aspects than those who just stay for short while and leave.
SUGGESTIONS FOR BETTER MARKETING OF HOSPITAL SERVICES
The following are some of the suggestions made to the marketing managers and policy makers of hospitals. If they are implemented, the present problems in the hospitals may be overcome to a great extent. Marketing Plan: Hospitals should prepare annual Marketing plans to prepare in advance for facing the future. While preparing marketing plan, mission statement of the organization and objectives are to be considered and workable plan is to be prepared. Hospitals have to understand what they want to communicate or what it is or what it is want their target audience to know or remember, or what the hospital stands. This is the most important part of the marketing plan. It provides the necessary directions to marketing efforts and has far reaching consequences. Customer in Hospital is Different: Hospital should realize that there is a big difference in waiting on a customer in a hospital and in any other organization. In the hospital the consumer is a sick person. In unfamiliar surroundings, many of them are in confused, tense, frightened and anxious state. The patient will immediately place his trust in the caring hands of hospital staff and assuredly feel that there is no need to be afraid. If he receives warmth and welcome feeling all the way, the patient will become the hospital's public relation agent. Hospitals should not be out of touch With Society: Hospital managements convert hospitals into consumer-oriented marketing enterprises. Hospitals will have to adopt the marketing concept with a philosophy that all planning is to be done with the patient needs considered first and foremost. Marketing through Public Relations: There are alternate marketing programmes that maintain image and not require advertising while still reaching large number of people. These programmes are a blend of public relations and guest relations activities implemented by well trained, motivated and dedicated staff that provides friendly, courteous service to patients. In almost every area of the hospital where staff comes into direct contact with the patients, the human relations and patient relations are of utmost importance. This is where public relations and marketing work at their best. Depending on IJARMSS | 202
International Journal of Advanced Research in Management and Social Sciences how the staff practices public relations will make or mar the hospital. All other outside marketing activities are secondary, even superfluous and irrelevant. Hospitals have failed to pay attention to this fact which is a key to their success. Service Costs are to be Regulated: Medicine is not mere business. It is an honorable profession with its code of ethics and a statutory body called medical council of India to uphold the dignity of the medical profession. But unfortunately these bodies are inactive and ineffective in curbing irrational practices and malpractices. Somehow, the prevailing high treatment costs are to be brought under control. For this reason, common man is not in a position to go to these corporate hospitals. Some of the strategies to curb the high treatment costs include Establishment of Media Relations Policy: Every hospital, regardless of its size, location must develop and enforce an official policy for dealing with the press and the kinds of information that may be released. The policy should specifically state who should speak for the hospital. All those who are required to make statements to the media should be familiar with the official policy and the procedure lay down therein. Customer Relationship Marketing: Some of the more common goals and objectives for developing and implementing technology-driven customer relationship programs include Improving customer service and satisfaction; Increasing profitability; Reducing the number of negative customer experience; Allocating resources more efficiently' Reducing the cost of managing customer interactions; Attracting and retaining customers and prospects; Staying in front of customers and building stronger relationships over time; and Improving clinical outcomes.
CONCLUSION
Of late, the hospital management has gained prominence the world over. The management of a hospital is found significant to deliver services to the society. For a successful marketing of services, it is essential that the concerned organization is professionally sound. This helps the hospital in many ways, such as an increase in the organizational potentials to show excellence, a strong base for serving the poorer sections and a favorable nexus for making it IJARMSS | 203
International Journal of Advanced Research in Management and Social Sciences an on-going process. The first and foremost task before a marketer is to satisfy the users by making available to them the quality services. We cannot deny the fact that in the Medicare services in addition to the medical aid, a number of other factors also play a significant role. If the doctors and nursing staff are found soft, sympathetic, and decent to the patients, the time-lag for curing a patient is minimized fantastically. Of course the medical aid play a pivotal role but the supportive services also play an incremental role without which the duration of treatment is increased considerably. In the Indian perspective, the core medical personnel lack this dimension. By marketing Medicare services, we engineer a strong foundation for both i.e. the best possible medical aid and a personal touch-in-service. By marketing medical services we mean making available the Medicare services to the users in such a way that they get quality services at the reasonable fee structure. The marketing principles focus on making available the services even to those segments of the society who are not in a position to pay for the services.
REFERENCES
1. M. Smith, Moira Fischbacher, Francis A. Wilson, New Service Development: From Panoramas to Precision, Anne European Management Journal, 2007, Vol. 25, No. 5, pp. 370-383. 2. Michael R. Bowers, MirtMng, Developing New Services For Hospitals: A Suggested Model. June 1987, Vol 7, No. 2, pp.38-48. 3. G.M.Naidu; Klemenhager;Pillari;George.D., Is Product-Line Management Appropriate For Your Health Care Activity, Journal of health care marketing; fall 1993, vol.13.p617,p12. 4. Burger, Pgillip C; Malhotra, Naresh.K, Product Line Management In Hospitals; An Exploratory Study Of Managing Change, Journal of health care marketing; sep-1991. Vol.11. Issue 3. P82. 1/4p. 5. Farley Dean E., Christopher Hogan, Case Mix Specialization in the Market for Hospital Services, Health services research; Vol.25; Dec-1990; p757-783. 6. Ronald.L Zallocco, Is There A Link Between Hospital Profit And Quality?, Journal of health care marketing; winter 1993; Vol.13; Issue.1; p68.
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International Journal of Advanced Research in Management and Social Sciences 7. Stanton. Wilbur W., Jame M. Daley, Identifying Market Segments Within A Health Care Delivery System: A Two Stage Methodology, Journal of Health Care Marketing Vol. 2, No. 3, summer, 1982, p.10. 8. Richard Marie Odile, Modeling the Impact of Internet Atmospherics on Surfer Behavior, Journal of Business Research, 58,2005, pp.1632- 1642. 9. Leonard L. Berry, Kent D. Seltman, Building A Strong Services Brand: Lessons From Mayo Clinic, Business Horizons, 2007, 50, pp.199-209. 10. Kyung Hoon Kim,Kang Sik Kim, Dong Yul Kim, Jong Ho Kim, Suk Hou Kang, Brand Equity In Hospital Marketing, Journal of Business Research, 2007,
doi:10.1016/j.jbusres.2006.05.010. 11. Menon, Mohan K.Goodnight, Janelle M. Wayne, Robin J., Assessing Advertising Content In A Hospital Advertising Campaign: An Application of Puto And Wells Measure Of Informational And Transformational Advertising Content, Journal of Hospital Marketing & Public Relations; 2006, Vol. 17 Issue 1, p27-44. 12. Tudor and Kanth, Hospital Advertising: The Influence of Perceptual and Demographic Factors on Consumer Dispositions, Journal of health care marketing; Winter 1994; Vol.14; Issue.4; p51-51, 1/4p. 13. S. Altan Erdem, L. Jean Harrison-Walker, The Role of the Internet in Physician— Patient Relationships: The Issue of Trust, Business Horizons, 2006, 49, pp.387—393. 14. Wan-I Lee, Bih-Yaw Shih,Yi-Shun Chung, The Exploration Of Consumers' Behavior In Choosing Hospital By The Application Of Neural Network, 2007,
doi:10.1016/j.eswa.2006.10.020. 15. Christopher L. Corbina, Scott W. Kelley, Richard W. Schwartz, Concepts In Service Marketing For Healthcare Professionals, The American Journal of Surgery, 2001, pp.1-7. 16. Weng Hui-Ching, Consumer Empowerment Behavior and Hospital Choice, Health Care Management Review; Jul-Sep2006, Vol. 31 Issue 3, pp197-204. 17. Feng -Chuan Pan Chi-Shan Chen., Enhancing Competitive Advantage Of Hospitals Through Linguistics Evaluation On Customer Perceived Value, Journal of American Academy of Business, Cambridge; Sep. 2004, Vol. 5 Issue 1/2, p481-485.
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International Journal of Advanced Research in Management and Social Sciences 18. Akinic, Fevvzi: Esatoglu,Tangilimagulu,Dilaver,Parsons,Amy, Hospital Choice Factor: A Case Study In Turkey, Health marketing quarterly; 2004, vol.22 issue1, p3-19. 19. Laing, Angus, Mckee, Lorna, Structuring the Marketing Function in Complex Professional Service Organizations, European journal of marketing; 2000; vol.34; issue 5/6; p576, 22p. 20. T.Sreenivas, Management of Hospitals, A.P.H. Publishing Corporation, 2002.
Annexure
Statements used for data collection from DOCTORS/NURSING STAFF/ADMINISTRATIVE PERSONNEL
(1) Strongly agree (2) Agree (3) can't say (4) Disagree (5) strongly disagree
Product: 1 2 3 4 The services are attracting the patients. The package services at your hospital are helpful. Same day surgery services increasing hospital image. Telemedicine services and they are useful for better treatment. 5 Housekeeping department is doing well. 6 7 8 9 Price: 1 2 3 4 5 6 Hospital is offering services at affordable prices. The quality of treatment depends on price. Patients are from higher income level. Hospital follows charges, what the other hospitals follows. Cost of Laboratory tests is reasonable. Hospital follows stable pricing policies. Hospital is having good patient care. Hospital transportation services are satisfactory. Hospital reception services are good. Hospital is more capable in developing and launching new services.
Place: 1 2 Hospital attracting patients from all the places. The hospital still to extend its services to some other areas. 3 Hospital is adequately protected from pollution. 4 5 6 7 You are a visiting or consulting doctor in some other hospital. Hospital is well noted to other hospitals to refer their patients for better treatment. Hospital is having time and place convenience to the patients. Hospital is located at a right place.
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Promotion: 1 2 3 4 5 6 Hospital is able to propagate its services to patients and their relatives. You are a direct promoter of your hospital services. Hospital special promotional campaigns are gaining the attention. There is good response to special campaigns. Talk by doctors in T.V programs is increasing the reputation of hospital. This hospital have strong brand image in the patients.
People: 1 2 3 4 5 6 This hospital is having doctors with Excellent knowledge, Skills, Right attitude. Doctors deal with all the patients alike. Supporting staff play an important role in better recovery. Supporting staff and nursing staff are well qualified. 7 The house keeping personnel are well mannered, gentle. 8 There is value addition to customer awareness programs. 9 The staff are sympathetic towards patient problems .
Physical evidence: 1 2 3 Hospital is making a positive impression on patients and their attendants. The interior decoration in this hospital is very good. Lighting and ventilation in this hospital is good. Especially in patient wards. This hospital is good in the aspects of: 4 5 6 Electricity, Drinking Water, Transportation, 7 Security. 8 Hospital is able to build up confidence in the patients by displaying awards won by doctors and the service certificates won by the hospital. Process: 1 2 3 4 5 6 Treatment the process is very lengthy and time consuming. Bill settlement process is simple. The process to discharge the patient is simple in this hospital. The process for emergency discharge is complicated in this hospital. Service counters provided in this hospital are sufficient. The length of waiting time of patients in this hospital is reasonable.
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