ts of philosophy, economics, operations, management, and marketing. Each of these ares of interest is applicable to the development and maintenance of output quality within the hospital environment; however, as service providers, the development and maintenance of hospital output quality must place an especially heavy emphasis on the marketing factor. This research involved a cross-cultural assessment of nursing service quality in hospital settings in Brazil and the United States.
The standards of health care are generally high throughout the United States. Within a newly industrialized country such as Brazil, however, health care standards tend to be uneven across geographical sectors, within the urban-rural dichotomy, and in relation to personal income levels. The health care needs and the desires of patients for caring and high-quality care tend to be similar, however, regardless of the extend of industrialization and regardless of internal divisions with a specific country.Quality, however, is a highly personalized concept and perception when applied to health care services. Differences in expectations lead to differences in the perceived level of quality in health care services delivered even in a country such as the United States where the overall level of health care is acknowledged to be generally high. Thus, what care provider might consider to represent high quality care may not be viewed similarly by a patient.
Differences in perceptions of health care quality are significant in both industrial and newly industrialized economies because such differences affect both public confidence in and the functioning of health care systems. Cross cultural comparisons of such differences in perceptions are important because such comparisons provide insights into strategies that may be employed across cultures to improve health care quality, and because such comparisons identify strengths in one culture that may be applicable ...