Bridging Service Quality Gaps in Hospital Nutrition Service: An Integrated SERVQUAL and Kano Model Analysis

Authors

  • Hera Laxmi Devi Septiani Universitas Garut
  • Shofia Salsabila Universitas Garut
  • Henry M.P. Siahaan Universitas Garut

DOI:

https://doi.org/10.59784/glosains.v7i3.794

Keywords:

Hospital, Kano Model, Nutrition Service, Patient Satisfaction, SERVQUAL

Abstract

Background: Hospital nutrition services support patient recovery and healthcare quality; however, unmet service attributes still cause dissatisfaction. Although service quality has been widely studied, the integration of SERVQUAL and the Kano Model for evaluating hospital nutrition services remains limited.

Objective: This study aimed to assess patient satisfaction with hospital nutrition services in West Java by applying an integrated SERVQUAL and Kano Model approach to identify service quality gaps and prioritize areas for improvement.

Methods: A cross-sectional quantitative study with a descriptive-analytical design was conducted involving 99 hospitalized patients receiving nutrition services at a hospital in West Java. Participants were selected using purposive sampling and had received nutrition services for at least two days. Data were collected using SERVQUAL and Kano Model questionnaires. SERVQUAL analysis measured the gap between patients' perceptions and expectations across five service quality dimensions, while the Kano Model classified service attributes according to their influence on patient satisfaction.

Results: All SERVQUAL dimensions showed negative gap scores, indicating that patients' expectations exceeded their perceptions of the nutrition service. The largest gaps were observed in the assurance (Gap = −0.90), responsiveness (Gap = −0.88), and empathy (Gap = −0.87) dimensions, suggesting that these areas should be prioritized for service quality improvement. Kano analysis revealed that most service attributes were classified as attractive and one-dimensional, indicating that improvements in menu quality, food presentation, staff friendliness, and service responsiveness have the greatest potential to enhance patient satisfaction.

Conclusion: The integration of SERVQUAL and the Kano Model effectively identifies priority areas for enhancing hospital nutrition services, particularly in the reliability and responsiveness dimensions. This integrated approach provides a systematic framework for improving service quality based on patient expectations and satisfaction determinants.

References

Adebanjo, D., Laosirihongthong, T., & Samaranayake, P. (2016). Prioritizing lean supply chain management initiatives in healthcare service operations: A fuzzy AHP approach. Production Planning & Control, 27(12), 953–966. https://doi.org/10.1080/09537287.2016.1185816

Azwarjaya, F. F., Ulfa, M., Razalli, N. H., Rajikan, R., Akca, N., & Saygili, M. (2025). Evaluation of patient satisfaction with nutrition installation services at PKU Muhammadiyah Gamping Hospital Yogyakarta, Indonesia. Amerta Nutrition, 9(3), 524–532. https://doi.org/10.20473/amnt.v9i3.2025.524-532

Berger, C., Blauth, R., Boger, D., Bolster, C., Burchill, G., DuMouchel, W., Pouliot, F., Richter, R., Rubinoff, A., Shen, D., Timko, M., & Walden, D. (1993). Kano’s methods for understanding customer-defined quality. Center for Quality Management Journal, 2(4), 3–36. https://www.semanticscholar.org/paper/KANO%E2%80%99S-METHODS-FOR-UNDERSTANDING-CUSTOMER-DEFINED-Berger-Blauth/4fe74e5d7220a50662b272330e2f9ffc4e46d3ee

Cronin, J. J., Jr., & Taylor, S. A. (1992). Measuring service quality: A reexamination and extension. Journal of Marketing, 56(3), 55–68. https://doi.org/10.1177/002224299205600304

Dewi, R., & Djokosujono, K. (2022). Hubungan kualitas pelayanan makanan dengan sisa makanan pasien di rumah sakit. Jurnal Gizi Klinik Indonesia, 18(2), 85–92. https://doi.org/10.20884/1.jgipas.2022.6.1.5501

Donabedian, A. (1988). The quality of care: How can it be assessed? JAMA, 260(12), 1743–1748. https://doi.org/10.1001/jama.1988.03410120089033

Ekaterina, G., Stavros, K., Anca, M., & Lambrini, K. (2017). Measurement of patient satisfaction as a quality indicator of hospital health services: The case of outpatient clinics in general hospital. Science Journal of Public Health, 5(2), 128–135. https://doi.org/10.11648/j.sjph.20170502.10.

Kano, N., Seraku, N., Takahashi, F., & Tsuji, S. (1984). Attractive quality and must-be quality. Journal of the Japanese Society for Quality Control, 14(2), 39–48. https://doi.org/10.20684/quality.14.2_147

Kementerian Kesehatan Republik Indonesia. (2013). Pedoman pelayanan gizi rumah sakit (PGRS). Kementerian Kesehatan Republik Indonesia.

Khikmawati, L. T., & Wardana, A. (2020). Analisis kepuasan pasien berdasarkan model Kano pada pelayanan rumah sakit. Jurnal Manajemen Pelayanan Kesehatan, 23(1), 45–52. https://journal.ugm.ac.id/v3/JMPK

Mardianingsih, D., Rumana, N. A., & Sari, Y. P. (2020). Analisis mutu pelayanan gizi rumah sakit menggunakan metode SERVQUAL. Jurnal Kesehatan, 11(2), 120–128. https://doi.org/10.36082/qjk.v20i1

Matzler, K., & Hinterhuber, H. H. (1998). How to make product development projects more successful by integrating Kano’s model of customer satisfaction into quality function deployment. Technovation, 18(1), 25–38. https://doi.org/10.1016/S0166-4972(97)00072-2

Menyawi, E. A. I., Bader, A. I. H., Jarwan, N. O. M., Gusti, S. W. A., Alkali, E. A. O., & Alsalem, H. A. (2025). The impact of hospital food quality on patient experience and satisfaction. Cultura: International Journal of Philosophy of Culture and Axiology, 22(8s), 240–260. https://culturajournal.com/submissions/index.php/ijpca/article/view/2519

Nofirza, N. (2021). Integrasi metode SERVQUAL dan Kano dalam evaluasi kualitas pelayanan rumah sakit. Jurnal Teknik Industri, 17(1), 55–63. https://doi.org/10.30587/justicb.v2i1.3222

Nofirza, N., & Indrayani, H. (2020). Analisis kepuasan pasien menggunakan model Kano pada pelayanan rumah sakit. Jurnal Optimasi Sistem Industri, 19(2), 101–109. https://www.semanticscholar.org/paper/Aplikasi-Metode-Kano-dalam-Analisis-Indikator-di-Nofirza-Indrayani/74f506d9b8a7550b629af4bdd9a05a2c8bbfb692

Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40. https://www.researchgate.net/publication/200827786_SERVQUAL_A_Multiple-item_Scale_for_Measuring_Consumer_Perceptions_of_Service_Quality

Rollins, C., & Dobak, S. (2018). Creating a great patient experience: Improving care with food and nutrition services. Journal of the Academy of Nutrition and Dietetics, 118(5), 805–808. https://doi.org/10.1016/j.jand.2018.03.002

Semedi, P., Andriani, M., & Briawan, D. (2013). Hubungan kepuasan pelayanan makanan dengan perubahan status gizi pasien rumah sakit. Jurnal Gizi dan Pangan, 8(2), 89–96. https://doi.org/10.14710/jgi.2.1.

Setianto, B., Adriansyah, A. A., Hanik, U., & Bistara, D. N. (2021). The correlation between patient satisfaction regarding nutrition service and hospital length of stay with food waste in COVID-19 patients. Journal of Health Science, 14(2), 147–154. https://doi.org/10.33086/jhs.v14i2.2045

Sumiati, S., Manampiring, A. E., & Wungouw, H. I. S. (2023). Hubungan mutu pelayanan gizi dengan kepuasan pasien rawat inap di rumah sakit. Jurnal Gizi Indonesia, 11(1), 45–53. https://doi.org/10.35790/msj.v5i2.46149

Supangkat, H. K., & Savitri, G. A. M. H. D. (2024). Combining SERVQUAL and Kano: Justification for best action and its selection process. Jurnal Kawistara, 14(2), 165–185. https://doi.org/10.22146/kawistara.88920

Tan, K. C., & Pawitra, T. A. (2001). Integrating SERVQUAL and Kano’s model into QFD for service excellence development. Managing Service Quality, 11(6), 418–430. https://doi.org/10.1108/EUM0000000006520

Tessem, B. (2018). What causes positive customer satisfaction in an ineffectual software development project? A mechanism from a process tracing case study. International Journal of Information Systems and Project Management, 6(4), 83–98. https://doi.org/10.12821/ijispm060405

Williams, P., & Walton, K. (2011). Plate waste in hospitals and strategies for change. E-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 6(6), 235–241. https://doi.org/10.1016/j.eclnm.2011.09.006

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Published

2026-07-13