Case management service quality
and patient-centered care
Sandun Perera
College of Business, University of Nevada, Reno, Nevada, USA, and
Beverly Waller Dabney
School of Nursing, University of Michigan, Flint, Michigan, USA
Abstract
Purpose – Providing care that is patient-centered is an important objective in the modern healthcare industry.
Despite this objective, hospital inpatient case managers and the services they provide are evaluated routinely
without including patients’ perspectives. Therefore, the purpose of this study is to fill this research gap by
using patient expectations and perceptions to assess the overall quality of and patient satisfaction with hospital
case management services.
Design/methodology/approach – This paper investigates five dimensions of case management services –
reliability, responsiveness, assurance, empathy and tangibles – and how they affect overall quality and patient
satisfaction. Study surveys are based on the SERVQUAL instrument. Survey data from a cross-sectional
sample of 67 inpatients are analyzed using principal component analysis, confirmatory factor analysis, GAP
analysis and a predictive model.
Findings – The preliminary part of the study identifies “tangibles” and “nontangibles”– reliability,
responsiveness, assurance and empathy – as the main components. Among these two components, only
nontangibles have a positive and significant effect on both quality and patient satisfaction according to patient
perspectives. GAP analysis indicates that gaps between patient expectations and perceptions of reliability and
assurance are significant. Finally, the proposed predictive model reveals that gaps in assurance have a
significant impact on both overall quality and satisfaction, while gaps in empathy have a significant impact on
satisfaction, but not overall quality.
Originality/value – Studies on service quality at the case manager level are limited. This study is the first in
this domain to evaluate quality and satisfaction from the patient perspective.
Keywords Case management service quality, Patient-centered care, Customer satisfaction, Empirical (survey)
research
Paper type Research paper
1. Introduction
As healthcare organizations and hospitals become driven mainly by patient-generated
revenues, providing patient-centered services is an operational imperative. Among all types
of patients, inpatients – those who stay in a hospital during treatment – have specific needs
and interact directly with hospital case managers. Despite such interaction, assessing
inpatients’ perceptions of case management services is challenging. In fact, inpatient case
managers and their services are routinely evaluated externally without including the patient
perspective. Therefore, this study assesses case management service quality using actual
patients’ expectations and perceptions of such services. To the best of our knowledge, this is
the first rigorous study integrating patient-centeredness into the assessment of case
management services.
Primary study data were collected in two stages. In the first stage, patients’ expectations for
case manager service quality were obtained from inpatients at one of the largest healthcare
complexes (hospitals) in the United States (US). In the second stage, patient’ perceptions of the
actual service provided by the hospital’s case managers were obtained either online via
Case
management
service quality
551
We thank the editor, Professor Suzanne Robinson, for her precious time, and three anonymous reviewers
for their valuable comments and suggestions. We also gratefully acknowledge the financial support
received from the School of Nursing at the University of Michigan-Flint.
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/1477-7266.htm
Received 9 December 2019
Revised 3 May 2020
Accepted 29 May 2020
Journal of Health Organization and
Management
Vol. 34 No. 5, 2020
pp. 551-568
© Emerald Publishing Limited
1477-7266
DOI 10.1108/JHOM-12-2019-0347