Analysis of expectations for the quality of medical care in the province of Guayas (Ecuador), through Servqual

This study seeks to determine the most relevant dimensions of service quality expectations contained in the Servqual model, applied to the healthcare sector. It seeks to open a space for open innovation based on users' ex ante needs, with the goal of suggesting strategic management actions to guide the work of service providers. The study was conducted based on 533 interviews with healthcare users in the clinical units where they receive care. Expectations were collected using a seven-point scale. They were analyzed using means analysis and a principal components factorial model, and ratified using the structural equation method to define their internal structure. The results reveal that the expectation dimensions of ''security and assertiveness,'' ''punctuality and professional dedication,'' and ''personalized attention'' shape the quality of service expected by users, structuring a system of significantly related factors that form a coherent construct. The findings of this work suggest a system of service quality dimensions expected by users that managers could adopt, on the one hand, to support some managerial decisions and, on the other, to identify some components of the services provided that could be intervened in order to respond to the ex ante needs of users. We conclude that the model shows that the three latent factors define expectations and reveal potential areas for improvement, as expected by users. Furthermore, it was found that these factors establish mutually influential relationships, where the dimensions of security and assertiveness, as well as timeliness and professional dedication, behave as independent exogenous factors.