Author/Authors :
Mehrabian, Fardin Department of Health Education and Promotion - Health and Environment Research Center - School of Health - Guilan University of Medical Sciences - Rasht, Iran , Hemmati No'doust Gilani, Mahnaz Department of Public Administration - School of Management - Payame Noor University - Tehran, Iran , Almaee, Alireza Graduate - public administration - Payame Noor University of Iran - Rasht, Iran
Abstract :
Service quality is a distinguishing and most powerful competitive factor. By
improving the quality of service delivery, it is possible to increase productivity, reduce costs,
and, as a result, increase patient satisfaction.
Objective: The present study aims to determine the level of patient satisfaction with the
quality of health services provided by public hospitals based on the SERQUAL-KANO model.
Materials and Methods: This is an analytical study with cross-sectional design. The study
population consists of all patients admitted to the emergency department, and male &
female medical wards of public hospitals in Rasht, Iran. This, 250 patients were selected
by a two-stage stratified sampling method. Data collection tools were two questionnaires
of SERVQUAL and Kano with acceptable reliability (α=0.77 and 0.72). Kolmogorov-Smirnov
and Wilcoxon tests were used to analyze data.
Results: The majority of patients were male (53%) with a bachelor’s degree (32%) aged
40-59 years (38%). In all hospitals, according to the Wilcoxon test results, the highest and
lowest mean quality scores were related to assurance and tangibility dimensions (P<0.05).
The highest level of patient satisfaction was reported in Hospital no. 2 with a quality gap of
+0.41, while the lowest level was related to Hospital no. 5 with a gap of -0.23. According to
Importance-Performance Analysis matrix, tangibility was in the “Concentrate Here” quadrant;
the dimensions of reliability and responsiveness were in the “Low Priority” quadrant; the
dimension of assurance was in the “Possible Overkill” quadrant; and the dimension of
empathy was in the “Keep Up the Good Work” quadrant. According to the Kano model, 13
attributes were classified as “Attractive”, 11 as “One-dimensional”, and only 1 property as
“Reverse”; no attribute was classified as “Indifferent”.
Conclusion: It seems necessary to make more improvements in facilities and equipment,
appearance of staff, communication tools, and cleanness of hospital environment to increase
patient satisfaction in public hospitals.
