Health Services Research
Assessing the Service Quality of Physiotherapy Services: A Cross-Sectional Study at Teaching Hospitals in Klang Valley, Malaysia
Last reviewed: March 2026
Key Findings
- Overall patient satisfaction with physiotherapy services at teaching hospitals in the Klang Valley was moderate, indicating room for improvement in service delivery.
- A total of 311 outpatients were surveyed using the SERVQUAL instrument across two teaching hospitals, providing a robust dataset for quality assessment.
- The ‘Caring Services’ dimension was identified as the area requiring the most attention, suggesting that interpersonal aspects of care needed strengthening.
- The study provided one of the earliest systematic assessments of physiotherapy service quality in Malaysian teaching hospital settings.
Background and Context
Physiotherapy services in Malaysia have undergone significant development since the profession’s establishment at Hospital Kuala Lumpur in the 1950s. As a relatively new and emerging field within the Malaysian healthcare system, physiotherapy has expanded to encompass a wide range of specialisations including musculoskeletal rehabilitation, cardiorespiratory therapy, neurological rehabilitation, and paediatric physiotherapy. Teaching hospitals, as centres of clinical excellence and professional training, play a particularly important role in setting standards for physiotherapy service delivery.
Service quality assessment in healthcare is essential for continuous improvement and patient-centred care. The SERVQUAL model, developed by Parasuraman, Zeithaml, and Berry, provides a structured framework for measuring service quality by comparing patient expectations with their perceptions of actual service delivery across multiple dimensions including tangibles, reliability, responsiveness, assurance, and empathy. Despite the growing importance of physiotherapy services in Malaysia, systematic studies of service quality in this field had been notably lacking at the time of this research.
This study by Nasaruddin Mahdzir and colleagues, published in the Malaysian Journal of Public Health Medicine in 2013, addressed this gap by conducting a cross-sectional assessment of patient satisfaction and service quality in physiotherapy clinics at two teaching hospitals in the Klang Valley metropolitan area.
Study Design and Methods
The cross-sectional study was conducted from March to July 2011 among outpatients attending physiotherapy clinics at two teaching hospitals in the Klang Valley, which encompasses the greater Kuala Lumpur metropolitan area. The Klang Valley is home to several major teaching hospitals, including Hospital Kuala Lumpur and UKM Medical Centre (UKMMC), which serve as key training grounds for healthcare professionals and provide tertiary-level services to approximately 600,000 or more people in the surrounding districts.
A total of 311 outpatients participated in the study. Data were collected using a structured questionnaire based on the SERVQUAL instrument, adapted for the physiotherapy setting. The questionnaire assessed patient expectations and perceptions across the standard SERVQUAL dimensions: tangibles (physical facilities, equipment, and appearance of personnel), reliability (ability to perform the promised service dependably and accurately), responsiveness (willingness to help patients and provide prompt service), assurance (knowledge and courtesy of employees and their ability to inspire trust and confidence), and empathy (caring, individualised attention provided to patients).
The gap between expectations and perceptions was calculated for each dimension, with negative gaps indicating areas where service delivery fell short of patient expectations. Descriptive and inferential statistics were used to analyse satisfaction levels and identify contributing factors.
Patient Satisfaction Levels
The results showed that overall patient satisfaction with physiotherapy services at the teaching hospitals was moderate. While patients generally expressed positive views about the technical competence and professionalism of physiotherapists, there were notable gaps in certain dimensions of service quality. The moderate satisfaction level suggested that while the fundamental elements of physiotherapy service delivery were adequate, the overall patient experience had significant room for enhancement.
When satisfaction was analysed across the SERVQUAL dimensions, the ‘Caring Services’ component — encompassing elements of empathy, individualised attention, and interpersonal warmth — emerged as the area with the largest gap between expectations and perceptions. This finding indicated that patients valued not only the clinical effectiveness of their physiotherapy treatment but also the relational and emotional aspects of their care experience.
Factors Influencing Satisfaction
Several sociodemographic and service-related factors were found to influence patient satisfaction levels. Waiting time, frequency of visits, and the perceived attentiveness of physiotherapy staff were among the factors that contributed to variations in satisfaction scores. Patients who had more frequent interactions with physiotherapy services and those who perceived their physiotherapists as attentive and empathetic tended to report higher satisfaction levels.
The physical environment and equipment adequacy of the physiotherapy clinics — captured in the tangibles dimension — also influenced patient perceptions. Teaching hospitals, while generally well-equipped, sometimes faced space constraints and equipment limitations that could affect the patient experience during physiotherapy sessions, which typically lasted between 30 and 90 minutes.
Implications for Physiotherapy Practice
The identification of ‘Caring Services’ as the dimension requiring the greatest improvement carried important practical implications. Enhancing the interpersonal skills of physiotherapists, fostering a culture of patient-centred communication, and ensuring that patients feel valued and heard during their treatment sessions could substantially improve satisfaction levels. Training programmes that incorporate communication skills, empathy development, and cultural competency alongside clinical skills could help address this gap.
For teaching hospitals specifically, the findings highlighted the importance of integrating service quality awareness into the training of physiotherapy students. As these institutions shape the professional attitudes and practices of future physiotherapists, embedding patient-centred care principles in the educational curriculum could have lasting positive effects on service quality across the Malaysian physiotherapy profession.
Limitations
The study was limited to outpatients at two teaching hospitals in the Klang Valley, and findings may not be generalisable to other healthcare settings, including district hospitals, community clinics, or private physiotherapy practices. The use of a convenience sampling approach may have introduced selection bias. Patient satisfaction is inherently subjective and may be influenced by factors beyond the physiotherapy service itself, including general hospital experience and individual expectations shaped by prior healthcare encounters. The cross-sectional design captured satisfaction at a single point in time and did not track changes over time or in response to service improvements.
Significance for Malaysian Healthcare
This study was significant as one of the first systematic assessments of physiotherapy service quality in Malaysian teaching hospitals. The findings provided baseline evidence for quality improvement initiatives and contributed to the growing body of literature on patient satisfaction in Malaysian healthcare. As physiotherapy services continue to expand and evolve in Malaysia, regular quality assessment and patient feedback will be essential for ensuring that services meet the expectations and needs of an increasingly informed and quality-conscious patient population.
Nasaruddin Mahdzir M, Aniza I, Faridah A, Sulha A. Assessing the service quality of physiotherapy services: a cross-sectional study at teaching hospitals in Klang Valley, Malaysia. Malaysian Journal of Public Health Medicine. 2013;13(2):27–37.