کیفیت خدمات پزشکان عمومی طرف قرارداد سازمان بیمه سلامت از دیدگاه بیماران در شهر تهران
محورهای موضوعی : -مدارک پزشکیابراهیم جعفری پویان 1 , اعظم السادات ریوندی 2
1 - دانشیار، گروه مدیریت و اقتصاد بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران
2 - - کارشناس ارشد مدیریت خدمات بهداشتی ودرمانی، اداره کل بیمه سلامت استان تهران، تهران، ایران
کلید واژه: بیمه سلامت, پزشکان عمومی, شهر تهران, ادراک و انتظار, کیفیت,
چکیده مقاله :
مقدمه: ارتقاء کیفیت خدمات انتظار می‌رود که در بهبود بیماران، ایجاد رضایت در آنان و جلوگیری از مراجعات تکراری به مراکز درمانی و هم‌چنین کاهش هزینه‌‌ها به جامعه بسیار مؤثر است. کیفیت بنابراین می‌تواند برای سازمان‌های خریدار خدمت مثل بیمه‌ها از اهمیت بسیار بالایی برخوردار باشد. هدف این پژوهش بررسی کیفیت خدمات پزشکان عمومی طرف قرارداد سازمان بیمه سلامت از دیدگاه بیماران است. روش پژوهش: در این مطالعه مقطعی دیدگاه‌های 394 نفر از بیماران مراجعه‌کننده به مطب‌ها در مورد کیفیت خدمات با پرسشنامه محقق ساخته مورد سنجش قرار گرفت. روایی و پایایی ابزار بترتیب با استفاده از نظرات خبرگان و آلفای کرونباخ (88/0=α) ارزیابی و تایید گردید. از آزمون‌های آماری توصیفی و استنباطی نرم‌افزار SPSS برای تحلیل و گزارش نتایج استفاده گردید. یافته‌ها: نمره کل مربوط به برداشت مراجعین از کیفیت خدمات مطب‌ها حدود 78 درصد و نمره کل انتظارات آنها 81.8 درصد بود که نشان‌دهنده یک شکاف نسبی معنادار بین ادراک و انتظار آنها از کیفیت خدمات مطب‌ها بود (0/001 <p). میزان این شکاف در ابعاد مختلف کیفیت خدمات پزشکان متفاوت بدست آمد. نتیجه‌گیری: بطور کلی وجود شکاف بین انتظار و ادراک افراد از یک خدمت نیاز به بهبود کیفیت را مطرح می‌نماید. هر چند شکاف محدود نیز می‌تواند برای تصمیم‌گیرندگان نگران‌کننده باشد که باید همزمان با بهبود کیفیت به آموزش و توانمندسازی خدمت گیرندگان نیز توجه نمایند.
Introduction: Quality improvement is expected to enhance patients’ health and satisfaction, avoid recurrent visits and reduce costs. Thus, it is of importance for third party organizations such as health insurances. This study aims to look into GPs’ service quality from the perspective of patients. Method: In present cross-sectional study, perspectives of 394 patients visited health insurance contracted GPs gathered by a researcher-developed questionnaire. Its validity and reliability checked and confirmed respectively by expert panel and Cronbach’s alpha (=α0.88). Descriptive and analytical statistical tests (SPSS) used to analyze and report findings. Results: overall score of patients’ perceptions towards GPs’ service quality was %78 and that of their expectations was %81.8, indicating a significant narrow gap (p=0.001). Conclusion: A need for improvement is felt following any gap between perceptions and expectations of service quality which should be addressed by managers. However, the limited gap can also be of concern for decision-makers.
1- Yesilada F, Direktör E. Health care service quality: A comparison of public and private hospitals. African Journal of business management, 2010; 4(6): 962.
2- Webster M. Online dictionary; 2005.
3- Organization WH. World malaria report 2008: World Health Organization; 2008.
4- Mosadeghrad AM. Factors affecting medical service quality. Iranian journal of public health, 2014; 43(2): 210.
5- Corrigan JM. Crossing the quality chasm. Building a better delivery system, 2005.
6- Chakravarty A. Evaluation of service quality of hospital outpatient department services. Medical Journal Armed Forces India, 2011; 67(3): 221-4.
7- Sheppard C, Franks N, Nolte F, Fantz C. Improving quality of patient care in an emergency department. American journal of clinical pathology, 2008; 130(4): 573-7.
8- Parasuraman A, Zeithaml VA, Berry LL. A conceptual model of service quality and its implications for future research. the Journal of Marketing; 1985: 41-50.
9- Calnan MW. The patient's perspective. International Journal of Technology Assessment in Health Care, 1998; 14(1): 24-34.
10- Donabedian A. The role of outcomes in quality assessment and assurance. QRB Quality review bulletin, 1992; 18(11): 356-60.
11- Ware Jr JE, Hays RD. Methods for measuring patient satisfaction with specific medical encounters. Medical care, 1988; 26(4): 393-402.
12- Hassanzadeh A. review of the principles of tariff Health Services in Iran. Tamin Ejtemaie; 2006: 25-26.
13- Zarei E. Modeling of structural relationship between the determinants of customer loyality in private hospitals of Tehran using structural equation modeling(persian): Tehran university of Medical Sciences; 2011-2012.
14- Zarei E, Arab M, Rashidian A. The relationship between the quality of provided services and perceived value By hospitalized patients. Mazandaran University of Medical Sciences Magazine, 2012: (98): 105-12.
15- Sokhanvar M. The relationship between organizational culture and service quality in Tehran hospitals. medical University, Tehran 2014.
16- Gorji HA, Tabatabaei S, Akbari A, Sarkhosh S, Khorasan S. Using the service quality gap's model (SERVQUAL) in Imam Khomeini teaching hospital: 2012. Journal of Health Administration (JHA), 2013; 16(51): 7-18.
17- Ramessur V, Hurreeram DK, Maistry K. Service quality framework for clinical laboratories. International journal of health care quality assurance, 2015; 28(4): 367-81.
18- S TSGMS. The quality of services provided in outpatient clinics Based on servequal in hospitals in Tehran (in persian). Payavarde salamat; 1390.
19- Kim Y-K, Cho C-H, Ahn S-K, Goh I-H, Kim H-J. A study on medical services quality and its influence upon value of care and patient satisfaction–Focusing upon outpatients in a large-sized hospital. Total Quality Management, 2008; 19(11): 1155-71.
20- Zarei E, Tabatabai G, Mahmud S, Rahimi Forushani A, Rashidiyan A, Arab M. Hospital Services Quality From Patients' Point Of View: A Cross-Sectional Study In Tehran Private Hospitals. Journal of Payavard Salamat, 2012; 5(4): 66-76.
21- Laroche M, Choi K-S, Lee H, Kim C, Lee S. The service quality dimensions and patient satisfaction relationships in South Korea: comparisons across gender, age and types of service. Journal of Services Marketing, 2005; 19(3): 140-9.
22- Tzeng H-M, Ketefian S, Redman RW. Relationship of nurses’ assessment of organizational culture, job satisfaction, and patient satisfaction with nursing care. International journal of nursing studies, 2002; 39(1): 79-84.
23- Laohasirichaikul B, Chaipoopirutana S, Combs H. Effective customer relationship management of health care: a study of hospitals in Thailand. Journal of Management and Marketing Research, 2011; 6: 1.
24- Choi K-S, Cho W-H, Lee S, Lee H, Kim C. The relationships among quality, value, satisfaction and behavioral intention in health care provider choice: A South Korean study. Journal of Business Research, 2004; 57(8): 913-21.
25- Wu C-C. The impact of hospital brand image on service quality, patient satisfaction and loyalty. African Journal of Business Management, 2011; 5(12): 4873.
26- Mindaye T, Taye B. Patients satisfaction with laboratory services at antiretroviral therapy clinics in public hospitals, Addis Ababa, Ethiopia. BMC research notes, 2012; 5(1): 1.
27- Keimasi M, Karimi O, Rastian Ardestani H. Assessment of service quality of Tehran clinical diagnostic laboratories using the SERVIMPERF model. Journal of School of Public Health and Institute of Public Health Research, 2015; 12(4): 29-42.
28- Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care. 2004; 13(suppl 1): i85-i90.
29- Jen W, Tu R, Lu T. Managing passenger behavioral intention: an integrated framework for service quality, satisfaction, perceived value, and switching barriers. Transportation, 2011; 38(2): 321-42.
30- Organization WH. The world health report 2000: health systems: improving performance: World Health Organization; 2000.
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1- Yesilada F, Direktör E. Health care service quality: A comparison of public and private hospitals. African Journal of business management, 2010; 4(6): 962.
2- Webster M. Online dictionary; 2005.
3- Organization WH. World malaria report 2008: World Health Organization; 2008.
4- Mosadeghrad AM. Factors affecting medical service quality. Iranian journal of public health, 2014; 43(2): 210.
5- Corrigan JM. Crossing the quality chasm. Building a better delivery system, 2005.
6- Chakravarty A. Evaluation of service quality of hospital outpatient department services. Medical Journal Armed Forces India, 2011; 67(3): 221-4.
7- Sheppard C, Franks N, Nolte F, Fantz C. Improving quality of patient care in an emergency department. American journal of clinical pathology, 2008; 130(4): 573-7.
8- Parasuraman A, Zeithaml VA, Berry LL. A conceptual model of service quality and its implications for future research. the Journal of Marketing; 1985: 41-50.
9- Calnan MW. The patient's perspective. International Journal of Technology Assessment in Health Care, 1998; 14(1): 24-34.
10- Donabedian A. The role of outcomes in quality assessment and assurance. QRB Quality review bulletin, 1992; 18(11): 356-60.
11- Ware Jr JE, Hays RD. Methods for measuring patient satisfaction with specific medical encounters. Medical care, 1988; 26(4): 393-402.
12- Hassanzadeh A. review of the principles of tariff Health Services in Iran. Tamin Ejtemaie; 2006: 25-26.
13- Zarei E. Modeling of structural relationship between the determinants of customer loyality in private hospitals of Tehran using structural equation modeling(persian): Tehran university of Medical Sciences; 2011-2012.
14- Zarei E, Arab M, Rashidian A. The relationship between the quality of provided services and perceived value By hospitalized patients. Mazandaran University of Medical Sciences Magazine, 2012: (98): 105-12.
15- Sokhanvar M. The relationship between organizational culture and service quality in Tehran hospitals. medical University, Tehran 2014.
16- Gorji HA, Tabatabaei S, Akbari A, Sarkhosh S, Khorasan S. Using the service quality gap's model (SERVQUAL) in Imam Khomeini teaching hospital: 2012. Journal of Health Administration (JHA), 2013; 16(51): 7-18.
17- Ramessur V, Hurreeram DK, Maistry K. Service quality framework for clinical laboratories. International journal of health care quality assurance, 2015; 28(4): 367-81.
18- S TSGMS. The quality of services provided in outpatient clinics Based on servequal in hospitals in Tehran (in persian). Payavarde salamat; 1390.
19- Kim Y-K, Cho C-H, Ahn S-K, Goh I-H, Kim H-J. A study on medical services quality and its influence upon value of care and patient satisfaction–Focusing upon outpatients in a large-sized hospital. Total Quality Management, 2008; 19(11): 1155-71.
20- Zarei E, Tabatabai G, Mahmud S, Rahimi Forushani A, Rashidiyan A, Arab M. Hospital Services Quality From Patients' Point Of View: A Cross-Sectional Study In Tehran Private Hospitals. Journal of Payavard Salamat, 2012; 5(4): 66-76.
21- Laroche M, Choi K-S, Lee H, Kim C, Lee S. The service quality dimensions and patient satisfaction relationships in South Korea: comparisons across gender, age and types of service. Journal of Services Marketing, 2005; 19(3): 140-9.
22- Tzeng H-M, Ketefian S, Redman RW. Relationship of nurses’ assessment of organizational culture, job satisfaction, and patient satisfaction with nursing care. International journal of nursing studies, 2002; 39(1): 79-84.
23- Laohasirichaikul B, Chaipoopirutana S, Combs H. Effective customer relationship management of health care: a study of hospitals in Thailand. Journal of Management and Marketing Research, 2011; 6: 1.
24- Choi K-S, Cho W-H, Lee S, Lee H, Kim C. The relationships among quality, value, satisfaction and behavioral intention in health care provider choice: A South Korean study. Journal of Business Research, 2004; 57(8): 913-21.
25- Wu C-C. The impact of hospital brand image on service quality, patient satisfaction and loyalty. African Journal of Business Management, 2011; 5(12): 4873.
26- Mindaye T, Taye B. Patients satisfaction with laboratory services at antiretroviral therapy clinics in public hospitals, Addis Ababa, Ethiopia. BMC research notes, 2012; 5(1): 1.
27- Keimasi M, Karimi O, Rastian Ardestani H. Assessment of service quality of Tehran clinical diagnostic laboratories using the SERVIMPERF model. Journal of School of Public Health and Institute of Public Health Research, 2015; 12(4): 29-42.
28- Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care. 2004; 13(suppl 1): i85-i90.
29- Jen W, Tu R, Lu T. Managing passenger behavioral intention: an integrated framework for service quality, satisfaction, perceived value, and switching barriers. Transportation, 2011; 38(2): 321-42.
30- Organization WH. The world health report 2000: health systems: improving performance: World Health Organization; 2000.