Excellent healthcare services delivered to patients would not necessarily entail an excellent patient service fulfillment, fulfill patient expectations, and attain high satisfaction levels. Hence, patient satisfaction is multifactorial and difficult to measure. Appliance of satisfaction model, service dissatisfaction and satisfaction feedback are able to translate the non-linear attributes for a more accurate service dissatisfaction and satisfaction feedback assessment. Service recipients of experienced Inpatient and Outpatient (IOPs) can be translated into levels of compliments and complaints to describe degrees of patient satisfaction and dissatisfaction, respectively. Compliments and complaints voiced by patients should be taken seriously. As a result, the translation of service satisfaction and service dissatisfaction based on compliments and complaints from patients in the form of satisfaction index SCi and dissatisfaction index SCa introduced a new theoretical concept of concurrent and balance measurement in evaluating customer (VOC) or VOPs feedback. In normal practice, the service improvement is usually based on complaints or dissatisfaction aspect, but the compliments or satisfaction aspect on the same service delivery was always neglected. In this study, the formulation which was based on a non-linear assessment, not only amplified the effectiveness in communicating patients' compliments and complaints in a more receptive manner but also corresponded with Kano model.

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This paper presents an optimization concept of service fulfillment measurement. Service delivery is assumed free from constraint, while service fulfillment is expected to achieve by maximizing the customer preferences. As the constraints are considered, the customer preferences are developed in a form of new model to set the optimum level of variables. The concepts will be further improved for medium and large scale optimization, which capable to evaluate the customer requirement in Kano-QFD integration. The results were also validated based on Kano Model and Quality Function Deployment (QFD) is integrated for patient attribute and service attribute prioritization. The new non-linear Kano-QFD service satisfaction model has been developed, tested and validated with Kano model to facilitate the analysis and decision making for better service delivery improvement.

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