One of the Millennium Growth Aims pinnacle goals is the development of the health sector (MDGs). Bangla-deshs administration, like that of all other UN states, has taken the required steps to achieve the MDGs. Following in the footsteps of the government, a variety of local, national, and international NGOs are striving to implement the MDGs and improve peoples health. The healthcare business in Bangladesh is essential to the countrys long-term socioeconomic development. Health is seen as a highly prized condition (World Health Organization, 2003). Patients satisfaction is one of the expected outcomes of healthcare, and it is closely connected to healthcare usage. Patient happi-ness is measured in a variety of ways, including patient perceptions of healthcare, detecting problems in heal-th-care, and evaluating healthcare (Andaleeb, 2000). The health-care landscape is rapidly shifting across the world (Verma and Sarma, 2000). Patient satisfaction is one of the accepted yardsticks for determining the success of hospital services (Sreenivas and Prasad, 2003). During the Health and Population Sector Pro-gram (HPSP) reforms from 1998 to 2003, widespread discontent with government health services did not improve (Andaleeb, 2007). Uneven demand and per-ceptions of low quality afflict Bangladeshs public health sector. Underutilization of available facilities is a major problem across the nation. The shortage of doctors, nurses, and staff, as well as their unfavorable attitudes and actions, are key barriers to public hospital usage. Patients unfavorable views and unhappiness related to the health care service providers, health care itself, can be shaped by such failures (Dey et al., 2021). 

The goal of public hospitals is to offer health service to individuals from all walks of life. However, due to fast population growth and rising health awareness, pro-viding adequate health care to everybody has become impossible. The fact is that public hospitals in Bangla-desh are unable to offer patients high-quality health care. In Bangladesh, public hospitals are similarly in supply shortage. Despite the high prices and lengthy processes required in getting visas, collecting foreign exchange, organizing transportation, housing, and identifying night providers of service in Bangladesh, a substantial number of Bangladeshi patients who can afford it are seeking treatment in international insti-tutions. Clearly, the benefits they see exceed the dis-advantages. It is for this reason that private hospitals have sprouted up in Bangladesh. This has also opened up the possibility of establishment of private hospitals in Rangpur. Unluckily, worries are present that service quality is also being neglected here. Disregard for conventional treatment methods, a shortage of com-petent nurses, and needless diagnostic tests are only a few of its major flaws (World Bank, 2003). People who are health-conscious are unhappy with their current treatment and want better health care (Uddin, 2012). Therefore, the residents of the Rangpur metro-politan area have grown. However, the hospitals that are obliged to provide health services to them are grossly inadequate under these conditions. 

For a variety of reasons, people from various socio-economic strata in Bangladesh seek treatment from a range of health providers, including governmental, private, and NGO-based institutions. Economic con-ditions, health knowledge, socio-demographic factors, and cultural habits may all influence who people choose (Ahmed et al., 2005). It is essential to analyze patient satisfaction in order to evaluate the health care services provided by health care institutes and to quantify patient outcomes. "The patients perspective is increasingly being recognized as a relevant indication of health care quality, and may, in fact, represent the most important perspective." Its all about perceptions when it comes to customer service. There is no way to test a service before selling it; it cant be stored away, returned, or swapped (Rust and Zahorik, 1996). For all of these reasons, the most essential factor is the custo-mers perspective and interpretation of their experience (Gronroos, 2001). Patient satisfaction is a complex construct involving a large number of factors, inclu-ding the perspective of providers, the physicians knowledge, clinical and communication skills, per-sonal attributes, accessibility, convenience of location and surrounding area, and patients socio-demographic characteristics, expectations, needs, or desires (Krow-inski and Steiber, 1996).

Aim, Objectives and Research question

This study aims to assess the satisfaction of patients with private medical college hospitals in Rangpur, city of Bangladesh. The aim can be broken into three specific objectives:

Ro 1: To investigate the variables of service quality and patients satisfaction with private medical college hospitals.

Ro 2: To recognize whether patients satisfaction is dependent on the five elements of service quality or not.

Ro 3: To identify the degree of patients satisfaction, focusing on Rangpurs private medical college hospitals.

The aim and objectives can be shaped to form three research questions:

Rq 1: How does the tangibility and reliability of private medical college hospitals contribute to patients satisfaction?

Rq 2: How do the responsiveness, assurance, and empathy of private medical college hospitals contribute to patients satisfaction?

Rq 3: How does the cost and communication of private medical college hospitals contribute to patients satisfaction?

Hypothesis Development

The following hypotheses can be refined from the research questions. In the present study, the dependent variable is "patient satisfaction". To discover the de-pendency of this variable, 7 (seven) independent fac-tors were chosen. They are tangibility, reliability, res-ponsiveness, assurance, empathy, communication, and cost of services. Tangibility: Tangibility means repre-senting the service physically. The presence of hos-pitals and decoration, hardware, technology, staff and correspondence materials are classified as effects (Hasan et al., 2012). The tangibility of services has a close connection with consumer satisfaction. The above propositions lead to forming the first hypothesis.

H1: There is a clear link between Tangibility and patient satisfaction with private medical college hospital services. Reliability: Reliability is the main determinant of the impression of service quality. Reli-ability is also known as dependability. Reliability means the ability to carry out the promised service in a conditional and precise manner (Hasan et al., 2012). Service reliability is connected to client satisfaction. The above propositions lead to forming the second hypothesis.

H2: There is a substantial link between hospital ser-vice reliability and patient satisfaction.

Responsiveness: Responsiveness means being willing to help. The skill and willingness to assist clients to provide brief assistance is referred to as responsive-ness. This measurement emphasizes mindfulness and promptness in dealing with client requests, inquiries, protests, and problems (Hasan et al., 2012). Respon-siveness has a close connection with the client satis-faction. The above propositions lead to forming the third hypothesis.

H3: There is a close link between responsiveness and patients satisfaction with medical services.

Assurance: Assurance of the service always helps to inspire trust and confidence in the minds of consumers. Works expertise, information, and graciousness, as well as the firms and its members ability to transfer confidence and certainty, are all characteristics of affirmation (Hasan et al., 2012). Assurance of the ser-vice is highly connected to client satisfaction. The above propositions lead to forming the fourth hypo-thesis.

H4: There is a clear link between patients satisfaction with hospital services and assurance.

Empathy: Empathy means treating the client as an individual. Empathy is characterized as the caring, mindful, individualized consideration the bank gives its clients (Hasan et al., 2012). Service Empathy has a connection with client satisfaction. These propositions lead to the fifth hypothesis.

H5: There is a beneficial impact between empathy and patient satisfaction with health care services.

Cost: Customer Costs In addition to service aspects, customer costs include not just perceived treatment costs, such as consultation fees, laboratory test fees, travel, medications, and lodging, but also physical costs. Psychic and sensory costs are two types of ex-penses (Hasan et al., 2012). These propositions lead to the sixth hypothesis.

H6: The higher the level of patient satisfaction in terms of quality, the lower the perceived overall cost of health care services. 

Communication: Communication and the process Patient care is facilitated by process characteristics such as updated patient records and uniform patient release processes. Patients awareness is raised and they are better sensitized to predict results when the nature of the treatment is properly described (Hasan et al., 2012). These propositions lead to the seventh hypothesis.

H7: The patients perception of the quality of process communication has a favorable impact on perceived service quality.

Rationality of the Study

The current research is being conducted on Rangpurs private medical college hospitals. Rangpur is a tiny yet developed region in Bangladesh when it comes to socioeconomic importance. In this city, health care is provided by one state medical institution, two private medical colleges, and 104 private hospitals. In Bangla-desh, and notably in Rangpur, measuring hospital service quality using existing models is a little-studied topic. The research region of Rangpur city and the current study were performed from the aforementioned vantage point. We believe that the outcomes of this study will aid in the planning and closing of the gap in health care services provided by private medical college hospitals in this city and across the country. This would also help to improve the health-care con-ditions in Rangpur City, Bangladesh, the profitability of private medical facilities. Finally, the study will aid the public in comprehending the health service faci-lities and circumstances in this location, as well as enriching the literature on this subject. Due to the scope of this study, we excluded public hospitals, private clinics, and community clinics.

Review of Literature

Recent study has also revealed that services or client satisfaction may greatly improve a patients life quality (Dagger and Sweeney, 2006), allowing service pro-viders to identify particular consumer concerns and solve them (Oja et al., 2006). Other research suggests that unsatisfied health-care customers are more likely to complain to the establishment or seek restitution from it in order to alleviate cognitive dissonance and poor consumption experiences (Nyer, 1999). Further-more, dissatisfaction has serious consequences: pa-tients are less likely to adhere to treatment regimens, are more likely to miss follow-up appointments. However, while the Bangladesh government has begun toadd the health sector into its poverty reduction plan, the public health system is beset by unequal demand and low-quality perceptions (Andaleeb et al., 2007). According to one study, the overall usage rate of public health services is as low as 30% (Ricardo et al., 2004). Another study found that between 1999 and 2003, the rate of usage of public health care services was dropping, (CIET, 2003). The study identified the absenceof doctors and nurses, their negative behaviors, including the lack of medicines, long distance travel and waiting times, as the major factors of dissatis-faction and barriers to use of public hospital services. Information, billing, food services, and staff all impact the healthcare system service quality in hospitals, ac-cording to Sower et al. (2001). Consumers were strongly thoughtful to the price of healthcare services at hospitals, according to Sahn et al. (2002), and this response was stronger for those with lower incomes. Sohail (2003) looked at non-clinical components of service quality in Malaysian hospitals. SERVQUAL was used to determine patients expectations and perceptions of service quality. The findings, which were based on the mean differences between expect-ations and perception, show that, as a result of Mala-ysian hospitals modernization and accreditation, patients perceived value of treatments exceeds expect-ations for all of the variables studied. The World Health Organization, (2003) proposed ways to improve healthcare service quality. Increasing funding, hospital equipment facilities, strengthening management, creat-ing standards, and giving training to health care pro-viders are among the approaches. Patients satisfaction with tangibility and assurance services in South Afri-can public hospitals was assessed by Jager and Plooy, (2007). The hygiene of the facilities and the overall performance of the equipment were discovered to be the most relevant tangibility factors. The most signi-ficant assurance factors have been assessed to be employee politeness and personal safety. Figen and Ebru, (2010) evaluated the service quality of Northern Cyprus public as well as private hospitals, considering the service quality characteristics that effect patient satisfaction. The primary determinants of service qua-lity in those hospitals were found to be reliability, con-fidence, empathy, and tangibility. In all three service quality measures, private hospitals showed lower dis-parities than public hospitals, according to the res-earch. According to Manimaran et al. (2010), there is a discrepancy between patients expectations and percep-tions of service quality. They proposed that, so as to close the gap, hospitals should enhance service quality by concentrating on tangibility, assurance, empathy, responsiveness, and dependability aspects. The service quality gap between patient perceptions and expect-ations was assessed by (Ahmed and Samreen, 2011). It was discovered that there was a significant disparity in characteristics such as the availability of informational pamphlets, waiting times, error-free records, and ser-vice fees. Solayappan et al. (2011) investigated service quality disparities at Chennais top hospitals. They dis-covered that the dependability and assurance aspects had a significant disparity. The lack of interest of hos-pital employees in resolving the situation, commu-nication about services, differences between promised and provided treatments, and lack of personal attention were all factors that negatively impacted patient satisfaction. Patients using public hospitals, according to Irfan et al. (2012), believe that public hospitals are not making apparent efforts to provide higher quality services to patients. It was proposed that public hos-pitals should place a greater emphasis on this aspect of service quality. Ramez (2012) evaluated the service quality of Bahraini healthcare professionals. He discovered that the empathy, concrete, and respon-siveness characteristics had the most impact on hos-pital service quality. In Jordans public and private hospitals, Zamil et al. (2012) studied the influence factors of service quality on patient satisfaction. For determining customer satisfaction with service quality in both the public and commercial sectors, the ‘SER-VPERF method was used to assess service quality in five Indian hospitals. The quality of service in private hospitals was determined to be superior to that in public hospitals. However, out of all the service quality dimensions in the public and private sectors, the responsiveness component of health service quality has the lowest mean. Instead of buying more technology, Jin et al. (2013) proposed that, in order to increase patient happiness in hospitals, more money should be spent on educating the medical staffs professional competence, communication skills, and problem-solving abilities. 

Johnson (2013) looked into many aspects of service quality in Thailand hospitals. The most influential factor was responsiveness, which was followed by em-pathy, tangibles, certainty, and, lastly, reliability. To retain clients, Rahman and Kutubi, (2013) advised that hospitals in Dhaka concentrate on communication, responsiveness, and empathy aspects. Mashhadiabdol et al. (2014) investigated the quality of service in Iranian hospitals and discovered a large difference bet-ween patients and staff opinions. Sharmila and Krish-nan, (2014) studied service quality in Chennai hos-pitals and discovered that tangibility had a higher in-fluence on service quality than cost. Andaleeb, (2000) conducted study compares the quality of services pro-vided by public and private hospitals in Bangladesh. Data analysis techniques were used to check for data entry errors and obtain descriptive statistics. Results suggest that poor patient perceptions are driving many patients to private hospitals. Hussain, (2016) seeks to investigate Bangladeshi patients experiences with public health care services, as well as their self-percep-tions of health and their expectations and demands of government health practitioners and service providers. To obtain the relevant information, the study used a qualitative research approach using different data collection procedures such as interviews, focus group discussions (FGDs), documentation surveys, and so on. 

Mahejabin, (2016) evaluated patient satisfaction with services given in a rural Bangladesh primary health care center. The study participants were chosen using a simple non-probability selection method. A face-to-face interview was performed using a semi-structured, pre-tested questionnaire. According to the findings of this survey, the majority of patients thought the hos-pitals general basic amenities, such as lights, sign-boards, cafeteria services, and bathroom facilities, were acceptable. Patients views of excellent health care are explained by Uddin, (2016). The purpose of this study is to determine patient satisfaction with doctors services in a Bangladeshi government hos-pital. The principal component analysis reveals that the initial solution includes a single factor with Eigen values larger than 1. It was responsible for about 61% of the variance in the original variables. Zubayer, (2017) mentioned that the healthcare service quality depends on some factors as knowledgeable doctor & hygienic nurses, language and cleanliness, degrees & equipment, tests and meals, needs and caring, attract-tive & punctual, examination and skills, doctor and nurses in a private hospital. These factors influence patient choice intension and satisfaction. Ahmed et al. (2017) revealed that private hospitals charge more than public hospital but private hospitals ensuring more quality service than that of public medicals through improved medical system, skilled staff and well-designed service standards. Because of better medical facilities customers are satisfied and loyal to the private hospital. Kalam, (2020) found that lack of proper staff training, monitoring and supervision, drug and supplies poor information provision, long waiting time, poor cleanliness, lack of privacy, and inadequate visiting hours are causes for dissatisfaction of patient. Patient satisfaction is a big issue for private hospital. He also found that most of the patients come to Tairunnessa Memorial Medical College and Hospital- Gazipur from urban areas and above 50% patients are satisfied with various healthcare services. Begum et al. (2021) discussed that taking medical services in Bangladesh from private medical is much higher costly and satisfying than public medical centers. Treatment outcome in private medical has better success rate. Most of the private hospital located in urban areas that are why people of urban areas choose to go to private hospitals. The majority of research studies on service quality were found to be from other cities and coun-tries, but the current study attempts to fill the gap in the literature by evaluating the validity of five SER-VQUAL dimensions in Rangpur private hospitals and identifying the important relevant dimensions in this context.

Research Gap

Concerns regarding the quality of health-care services in Bangladesh have led to a loss of faith in both public and private hospitals, as well as a decrease in the usage of public health facilities and an increase in Bangla-deshi patients seeking treatment in neighboring coun-tries. In these circumstances, assessing the quality of the countrys health-care services has become impor-tant, and patients voices must begin to play a bigger role. The findings of the literature demonstrate that customer satisfaction, repurchase behavior, and recom-mendation behavior are all influenced by an organi-zations perceived service quality. People in our nation receive many types of health care services from private medical hospitals. However, little is known about the current service quality of private medical hospitals based on credible research. The present facilities are insufficient, and how these facilities provide for pati-ents needs is overlooked. Many studies have been conducted on service quality measurement, service satisfaction, the health care situation in Bangladesh, and patient satisfaction with health care services and factors of hospital choice, according to various liter-ature. In Bangladesh, and notably in Rangpur, mea-suring hospital service quality using existing models is a little-studied topic. To our knowledge, no compre-hensive research has been done to assess the service quality of private medical college hospitals in Bangla-desh, particularly in Rangpur. This is a research issue with a distinct gap. The current research is a good start to fulfilling this gap. A greater knowledge of the service quality provided by private medical facilities could aid policymakers and decision-makers in adopting and implementing effective strategies to enhance health care in the country.

Conceptual Development

The theoretical framework is mainly based on the literature review. According to previous work, the constructs are integrated into a theoretical framework. The framework guides the development of research hypotheses, which examine the interrelationships among research constructs. 

The SERVQUAL model, established by Parasuraman et al. is one of the most widely used service quality measuring models (1985, 1986, 1988, 1991, 1993, 1994; Zeithaml et al., 1990). Parasuraman et al. (1985,1988) created the SERVQUAL scale to provide a general tool for assessing service quality across a wide variety of service areas. Evaluation of quality for services is more challenging than assessing quality for things due to their intrinsic diversity, inseparability of production and consumption, perishability, and intangibility (Frochot and Hughes, 2000). Service quality is difficult to describe and evaluate because of these unique features. In 1985, Parasuraman et al. (1985) established the SERVQUAL scale, which has proven to be one of the most popular and lasting among academics and practitioners alike. SERVQUAL (Parasuraman et al., 1988) is a commonly utilized research tool in a variety of service sectors (Buttle, 1996; Carman, 1990). Tangibles, responsiveness, assurance, empathy, and dependability are five factors that impact customer perceptions of service quality, according to Parasuraman et al. (1985).

Fig 1: A Theoretical Approach to Measuring Hospital Service Quality.

Research approach - The current research is both exploratory and descriptive in character. 

Sampling technique - The studys population con-sisted of persons who were inpatients at private medical college hospitals in Rangpur City. Because they have substantial and contemporary medical facilities, these private medical college hospitals re-present complete health care services in the private sector in this region. A sample size of 255 patients was chosen from this list using simple random selection. 

Questionnaire design - On the basis of previous research and insights from in-depth qualitative interviews, a preliminary version of the question-naire was produced in English. The measurements were then translated into Bangla and retranslated until a panel of experts, proficient in both English and Bangla, concluded that the two versions were sufficiently similar. In a systematic style, scale items were assessed on five-point Likert scales (Likert, 1932). Each component was anchored at 1 with the verbal remark "very poor" and 5 with the verbal statement "very excellent." For health-care surveys, this format has been proposed (Elbeck 1987; Steiber 1989). To establish adequate measurement chara-cteristics (reliability and validity) of the identified constructs, several items were employed. The ques-tionnaire was pre-testing several times to confirm that the wording, structure, length, question sequen-cing, and scale range (5-point vs. 7-point) were all suitable. Feedback was gathered from around 15 hospital users at each pre-test. This type of input was crucial in improving the measures quality.

Data collection method - This study employed a quantitative research design to look at the link between research components, and the technique of inquiry was a survey. The data was obtained from patients who have visited the private medical college hospitals at least once. The survey was conducted during December, 2020 in the areas of Rangpur. The following are the criteria that looked into: tangibles, dependability, responsiveness, assurance, empathy, communication, and cost; total service quality. This studys hypotheses were developed using the frame-work, and they were designed to see if the cor-relations between variables in the framework were supported or not. The objectives were met using both primary and secondary data. To collect primary data, a structured questionnaire was created. Secon-dary data has been gathered from a variety of sources. 

Data analysis - Data was analyzed using a variety of statistical methods, including descriptive statistics, ANOVA, and principal component analysis. To en-sure the questionnaires reliability, Cronbachs alpha was calculated for each component. Correlation (Pearson product-moment correlation) and multiple regression models were employed to explore the link between service quality factors and patients satis-faction. To analyses and demonstrate the data, statis-tical tools and techniques from SPSS 22 version were used here.

The study deals with the measurement of the degree of satisfaction patients with private medical college hospitals in Rangpur based on several dimensions, including Reliability, Assurance, Tangibility, Em-pathy, and Responsiveness, other clients satisfac-tion dimensions. Findings of the study based on the data collections are -

Table1: Demographic Profile of the respondents.

Table 2: Shows the opinion given to the attributes by the patients.

Table 3: Service quality perception toward the hospital services (N= 255).

Note: The average level of service quality goes from 1 (worst) to 5 (Excellent)

Assessing patients service quality perceptions of Private Medical College Hospitals: Patients were asked to rate the quality of different hospital services on a five-point Likert scale ranging from one to five, with one being extremely poor and five being very ex-cellent. The results are listed in Table 2. Intangibility (M=3.8657) had the highest mean score among the many service dimensions, followed by Responsive-ness (M=3.446) and Reliability (M=3.498), while Service cost (M=3.074) and procedure and communi-cation (M=2.6066) had the lowest mean scores. Attri-butes mean scores below 2.75 are considered bad; scores between 2.75 and 3.25 are considered ordinary; scores 3.25 to 4.00 are considered good; and scores over 4.00 are considered outstanding.

Overall Patients Perceptions towards the Private Medical College Hospitals - Respondents were also asked about their views on several service aspects in private hospitals. Table 2 shows a summary of the findings. According to the results of the survey, 11. 76% of respondents stated the overall service quality is outstanding, 27.45 percent said well, and 37.25 percent said ordinary. It was also discovered that 17.64% of respondents rated the total service quality as bad, while 5.89 percent rated it as worse. The mean overall per-ceived service quality level of respondents is 3.332, indicating that consumer perceptions of overall service quality are average on a 5-point scale.

Result of Factor Analysis - After analyzing patients perceptions of various services, the authors attempted to categorize them using Factor Analysis in SPSS 22. The first answer was created using the main com-ponents factor technique. The correlation matrix has an overall significance of 0.000, with a Bartlett test of sphericity value of 1796.126 and 378 degrees of free-dom. The statistical probability and test revealed a strong connection between the variables, indicating that factor analysis was necessary. The total Kaiser-Meyer-Olkin index of sample adequacy was 0.758, which was commendable (Hair et al., 1999).The statis-tical probability and test revealed a strong connection between the variables, indicating that factor analysis was necessary. Table 4 shows factor analysis result. The findings of the factor analysis are shown in Table 4. Before the rotation, the Eigen values showed that the seven-factor solution explained 76.805 percent of the overall variation. Each variables communality ranged from 0.415 to 0.857. The Cronbachs alpha was calculated for each component to assess its depend-ability and internal consistency. The alpha coefficients for the seven variables varied from 0.5697 to 0.8185, according to the findings. Because 0.50 is the minimal number for approving the reliability test, the findings were deemed more than dependable (Nunnally, 1967)

Correlation Analysis - A correlation coefficient was used in the study to determine the strength of a linear relationship between the respondents overall impre-ssion of service quality and seven criteria.

Table 4: Shows factor analysis result.

Table 5: Correlation between Overall Service Quality and Factors.

** At the 0.01 level, the correlation is significant (2-tailed) 

The connection between overall quality level and seven variables is positive and significant at the 0.01 level, as shown in Table 5. As a result, the study finds that there is a stronger link between total ser-vice quality and Reliability, Responsiveness, Assurance, and Service Cost than with Tangibility, Process and Communication, and Empathy. These findings backed up premise 1 to 7, indicating that there is a strong link between total service quality and tangibility, depen-dability, responsiveness, assurance, and service cost. H1, H2, H3, H4, and H7 were approved, but, H5, and H6 were denied. 

Analysis of Multiple Regressions - The current study employed regression analysis to evaluate and explain the casual association between variables in order to further provide support for hypothesis 1. The multiple linear regression technique was used because it offered the most accurate interpretation of the independent variables and allowed researchers to determine if the discovered independent factors had a substantial im-pact on overall service quality. The standardized factor scores were used to express the seven independent variables. Based on the beta coefficients, the important variables that remained in the regression equation were ranked in order of importance. The dependent variable, patients total service quality assessment, was assessed using a 5-point Likert-type scale as a proxy indication of patients perceptions of hospital services. The follo-wing specification was used to define the equation for patients total service quality perception: The regres-sion analysis results were shown in Table 7. The mul-tiple correlation coefficients (R), coefficient of deter-mination (R2), and F ratio are used to determine the regression models goodness-of-fit. The R of the independent variables (seven components, X1 to X7) and the dependent variable (patients overall service quality perception) is 0.450, indicating that the patients over-all service quality and the seven aspects of service quality showed positive and moderate rela-tionships. The R2 is 0.233, implying that the seven parameters can explain more than 23% of the variation in total service quality. The F ratio of 6.72 indicates whether the regression models results might have happened by chance. The p value is 0.000, which indi-cates that the result is extremely significant. The re-gression model predicted the variance of patients total service quality in respect to the seven variables with a goodness-of-fit of around 23%, as evaluated by the R, R2, and F ratios described earlier. 

In other words, at least one of the seven variables is critical in determining the total quality of service pro-vided by private hospitals in Rangpur to patients.  Re-gression (Table 6) based on the dimensions, the results of the patients total service quality level (N-255). 

Dependent variable: Overall service quality, indepen-dent variables: seven factors. The beta coefficients may be utilized in regression analysis to explain the relative relevance of each of the seven aspects (in-dependent variables) in contributing to the variation in the overall service quality level of patients (dependent variable). When it comes to the relative relevance of the seven characteristics, Factor 2 (Reliability: beta=-0.277, p=0.001) contributes the most and has the most weight for patients overall service quality, followed by Factor 3 (Responsiveness: beta=0.231, p=0.003). These two elements have a strong link with the total degree of service quality. If all other factors were maintained constant, a one-unit improvement in service quality with the responsiveness factor would result in a 0.277-unit gain in total service quality with private hospital services. To summarize, not all underlying qualities are equally important. As a result, the findings of mul-tiple regression analysis rule out hypotheses 2 and 3, which claim that there is a link between these dimen-sions and total service quality.

Analysis of Variance

Result of Regression Analysis

*Represents p<0.05

The studys findings describe how patients view the service quality of private medical college hospitals in Rangpur, Bangladesh. This study has numerous theo-retical implications that may be added to the expan-ding body of literature on service quality in Bangla-desh, particularly in health care services. In terms of the service quality of private medical college hospitals in the research region, Table 2 shows that the tangible and reliability aspects were scored highly among all SERVQUAL dimensions. The grand mean values for these two dimensions are 3.865 and 3.498, respect-tively. The average mean value for responsiveness, assurance, and empathy was 3.446, 3.444, and 3.39, respectively. Process, communication, and cost, on the other hand, received lower scores than the other cate-gories. In private hospitals, treatment costs are also thought to be excessive, which may be due to the diverse clientele served and their varying socioeco-nomic levels. Those that choose private hospitals are often from the higher income brackets and are in a much better financial position. Even so, they may not all be using the finest hospitals, which contributes to the illusion of low treatment costs. The studys fin-dings indicated that, even if just four of the seven criteria were included, F2 was the most important (reliability), F3 (responsiveness), F4 (assurance), and F7 (cost) all have a role in total service quality. This conclusion may be beneficial to private hospital poli-cymakers in developing measures to preserve or im-prove service quality and competitiveness. In other words, F2 (reliability) and F3 (responsiveness) are more contributing elements to improving total service quality (Table 6). As a result, service firms should provide quality service with dependability, such as doctors following up on patients on a regular basis, an adequate number of doctors and nurses, well-main-tained patient records, accurate and reliable test results, and doctors who are qualified and experi-enced, caring nurses, well-trained and experienced nurses, and modernized machines and equipment. In addition, those involved in the development of the service must contribute more in terms of their create-vity to offer a variety of unique services that can en-sure a high level of customer satisfaction, such as nurses attending sincerely when needed, nurses look-ing after them in a timely manner and doctors listen-ing attentively and willing to answer any questions. Its also worth mentioning that in Bangladesh, health-care providers are sometimes more concerned with the cost of service than with its quality (Mezgebe, 2020). People in Bangladesh, they say, are hesitant to pay more for better service. 

According to this study, cost is not a significant factor in patient satisfaction, particularly in the private sector and for those who utilize international institutions; rather, treatment quality is considerably more impor-tant. As a result, policymakers must understand that a segment of the population chooses high-quality ser-vices over a less expensive but inferior option that might increase future expenses. It could be beneficial to look at health-care delivery from the perspective of market segments, where prices are prioritized for some and services are prioritized for others, but with a proper balance that satisfies basic requirements.

Concerns about the quality of health-care services in Bangladesh have caused people to lose trust in govern-ment institutions. As a result, evaluating the countrys private medical facilities has become critical, with the patients voice playing an increasingly important role. Private medical hospitals are becoming more com-mon. As a result, we must pay greater attention to improving the service quality of private medical faci-lities, and the government must oversee the services offered in private hospitals to ensure that no one is deprived. The physical environment and amenities are not awful, but each hospital should do more to improve the quality of the facilities and atmosphere. The most important thing is that these institutions should charge a reasonable cost so that everyone, not just the rich, may benefit from their services. This will improve the health of people in Rangpur City, Bangla-desh, as well as the profitability of private healthcare facilities. Thus, in order to build a healthy Rangpur city, a focus on improving private medical hospital service quality is a pressing requirement.

At first, all gratefulness goes to the Almighty Allah for keeping us healthy to complete this research paper. Gratitude goes to all the respondents who gave their valuable time for the survey and all others who dire-ctly or indirectly contributed in preparing this study.

The authors declared there are no conflicts of interest to publish the present research study.