ارائه مدل ارزیابی کیفیت خدمات درمانی از نگاه مشتریان با استفاده از ابزار تصمیم‌گیری چند معیاره فازی ترکیبی (مطالعه موردی: مراکز درمانی شهرستان شاهرود)
محورهای موضوعی : -مدارک پزشکینورا امیری 1 , علی اکبر حسنی 2
1 - کارشناسی‌ارشد مدیریت صنعتی، دانشگاه صنعتی شاهرود، شاهرود، ایران
2 - دانشیار، گروه مهندسی صنایع، دانشگاه صنعتی شاهرود، شاهرود، ایران
کلید واژه: تصمیم‌گیری چندمعیاره, ارزیابی کیفیت, عدم قطعیت, آزمون‌های آماری, خدمات درمانی,
چکیده مقاله :
مقدمه: آگاهی از رضایت‌مندی بیمار از کیفیت خدمات جهت پیشبرد استراتژی‌های بهبود عملکرد حیاتی است. هدف اصلی ارزیابی کیفیت خدمات در سیستم سلامت و درمان، اندازه‌گیری عملکرد خدمات، تشخیص مشکلات، ارتقای کارایی و در نهایت ارائه خدمات مطلوب برای جامعه وسیع مشتریان است. روش پژوهش: در این پژوهش ابتدا با مطالعه ادبیات موضوع و نظرخواهی از خبرگان، هفت بعد کلیدی جهت ارزیابی کیفیت خدمات درمانی تعیین و با استفاده از روش توسعه‌یافته بهترین - بدترین فازی وزن دهی شده‌اند. در ادامه با استفاده از پرسش‌‌نامه محقق ساخته، نظرات مراجعه‌کنندگان به بخش‌های مختلف مراکز درمانی منتخب به‌عنوان نمونه آماری در مورد کیفیت خدمات بررسی شده است. درنهایت مجموعه مراکز درمانی و بخش‌های بستری و ابعاد کیفیت با استفاده از روش تصمیم‌گیری چندمعیاره ویکور فازی و آزمون‌های آماری مرتبط تحلیل و رتبه‌بندی شده‌اند. یافته‌ها: توسعه مدل ارزیابی رضایت‌مندی جامع توانسته است گستره مطلوبی از معیارهای اثرگذار بر رضایت‌مندی مراجعه‌کنندگان به مراکز درمانی را در برگیرد. علاوه بر آن، استفاده از تصمیم‌گیری چندمعیاره ترکیبی توسعه داده‌شده فازی توانسته است عدم قطعیت فرایند ارزیابی معیارهای کیفی مدنظر ارزیابی‌شوندگان را لحاظ نماید. یافته‌های کلیدی تحقیق حاکی از آن است که اوزان نهایی به ترتیب اولویت عبارت‌اند از ابعاد بیمارمحوری (0/198)، زمان (0/188)، اثربخشی (0/178)، پاسخگوی (0/123)، تضمین (0/112)، مالی (0/108) و ارتباطات سلامت (0/09). نتیجه‌گیری: مراکز درمانی با تمرکز برنامه‌های بهبود عملکرد مبتنی بر اولویت‌های حاصل می‌توانند به سطح مطلوب‌تری از کیفیت خدمات و در نهایت رضایت‌مندی مراجعه‌کنندگان دست یابند. ازاین‌رو خواهند توانست به مزیت رقابتی پایدار نیز دست یابند.
Introduction: Awareness of patient satisfaction from service quality is vital to advance performance improvement strategies. The main goals to evaluate the quality of services in the health and treatment system are service performance, service identification, service performance improvement evaluation and finally providing favorable service to customers. Methods: In this research, seven key aspects were identified to assess the quality of health care system. Then, they weighted by the best-worst fuzzy developed method. In the following by using a researcher-made questionnaire, the openions of referrals to selected departments of the treatment center have been reviewed as a statistical sample of service quality. Finally, the complex of treatment centers, hospital departments, and quality dimensions were analyzed and ranked by Fuzzy Vikor Method, Friedman statistical tests and Analysis of variance. Results: Development of comprehensive satisfaction assessment model could include desirable range of criteria affecting the satisfaction of the referrers to health centers. In addition, using developed multi-criteria fuzzy hybrid decision making has been able to consider the uncertainty of the assessment process for the qualitative criteria considered by the evaluators. Key findings of the research suggest that the final weights in order of priority are: pivotal patient (0.198), time (0.188), effectiveness (0.178), responsiveness (0.123), warranty (0.112), financial (0.108), and health communication (0.9). Conclusion: Health centers by focusing on priority-based performance improvement programs can offer a better level of service quality and can achieve higher customer satisfaction. Therefore, they will be able to achieve a sustainable competitive advantage.
1- Taşkin H, Kahraman Ü A, Kubat, C. Evaluation of the hospital service in Turkey using fuzzy decision making approach. Journal of Intelligent Manufacturing, 2015; 10: 1-12.
2- Lakshmi, B.N, Satish, K.S.N, Meera S.M, Reddy, K T. A Study on Patient Satisfaction through Extemporaneous Responses from Patients in a Tertiary Care Hospital. Indian Journal of Public Health Research & Development, 2014; 5(3): 319-323.
3- Aghamolaei T, et al. Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective. BMC Health Services Research, 2014; 14: 322-332.
4- Shabbir, A., Malik, S. A., and Malik, S. A. Measuring patients’ healthcare service quality perceptions, satisfaction, and loyalty in public and private sector hospitals in Pakistan. International Journal of Quality & Reliability Management, 2016; 33(5): 538-557.
5- Akdag H, Kalayci T , Karag¨oz S, Z¨ulfikar H , Giz D, The. Evaluation of Hospital Service Quality by Fuzzy MCDM. Applied Soft Computing Journal, 2014; 23: 239-248.
6- Giovanis, A Pierrakos, G, Rizomyliotis, I. and Binioris, S. Assessing service quality and customer behavioral responses in hospital outpatient services: A formative measurement approach. International Journal of Quality and Service Sciences, 2018; 10(2): 98-116.
7- Pai YP, Chary ST, Pai RY. Patient-perceived hospital service quality: an empirical assessment. Int J Health Care Qual Assur, 2018; 31(1): 76-91.
8- Shafii M, Rafiei S, Abooee F, Bahrami MA, Nouhi M, Lotfi F, Khanjankhani K. Assessment of Service Quality in Teaching Hospitals of Yazd University of Medical Sciences: Using Multi-criteria Decision Making Techniques. Osong Public Health and Research Perspectives, 2016; 7(4): 239-247.
9- Moffatt-Bruce SD, Ferdinand FD, Fann JI. Patient Safety: Disclosure of Medical Errors and Risk Mitigation, Ann Thorac Surg, 2016; 102(2): 358-62.
10- Ghotbi N, Maddah SB, Dalvandi A, Arsalani N, Farzi M. The effect of education of self-care behaviors based on family-centered empowerment model in type II diabetes. Journal of Nursing and Midwifery Faculty Shahid Beheshti University of Medical Sciences & Health Services, 2014; 23(83): 43-50. [In Persian]
11- Tavalayi R, New Approaches to Organizational Performance Evaluation. Scientific Journal of Police Development Development, 2007; 12: 9-30. [In Persian]
12- Chang SJ, Hsiao HC, Huang LH, Chang H. Taiwan quality indicator project and hospital productivity growth. Omega Elsevier, 2011; 39(1): 14-22.
13- Haddad S, et al.Patient perception of quality following a visit to doctor in a primary care unit. Fam Pract, 2000; 17(1): 21-29.
14- Donabedian A. Quality Assessment and Assurance: Unity of Purpose, Diversity of Means. Inquiry, 1988; 25(1): 173-192.
15- Zivyar F, Ziaee MS, Nargesian J. Investigating the Affective Factors on Customers’ Satisfaction Using Servqual Model. New Marketing Research journal, 2012; 3 (6): 173-186. [In Persian]
16- Ansari H, Ebadi F, Mollasadeghi G. Evaluation of Patients Satisfaction in Hospitals under Iran University of Medical Sciences. Journal of Birjand University of Medical Sciences, 2004; 11(3): 38-46. [In Persian]
17- Kalaja R, Myshketa R, Scalera F. Service quality assessment in health care sector: the case of Durres public hospital. Procedia - Social and Behavioral Sciences, 2016; 235: 557-565.
18- Nemati Doplani F, Mohammad Nezhad S, Tabatabaee A, Ehsani Kuhi R, Sajjadi A, Haji Esmailpour A. satisfaction rate of hospitalized patients in teaching hospitals with presented. Journal of Medical Ethics, 2014; 8(28): 29-50. [In Persian]
19- Arabameri Y, Hasani AA. A Comprehensive Satisfaction Assessment Model for Healthcare Services. Journal of Healthcare Management, 2019; 9(4): 67-77. [In Persian].
20- Opricovic S. Fuzzy VIKOR with an application to water resources planning. Expert Systems with Applications, 2011; 38(10): 12983-12990.
21- Guo S, Zhao H. Fuzzy best-worst multi-criteria decision-making method and its applications. Knowledge-Based Systems, 2017; 121: 23-31.
22- Motaghed Z, Davoudi Monfared E, Mohazab Turabi S, Nemati I, Mousavi A, Eshraghi R, et al . Assessment of Quality of Services in Health Centers from the perspective of Clients by SERVQUAL Method. Hrjbaq, 2017; 2(1): 49-55
23- Tavakoli A, Pouya A, Alavi tabari J. Fuzzy Multi-Criteria Decision Making Fusion Model Design for Facility Layout Selection. Journal of Industrial Management Perspective, 2013; 3(2): 57-84.
_||_1- Taşkin H, Kahraman Ü A, Kubat, C. Evaluation of the hospital service in Turkey using fuzzy decision making approach. Journal of Intelligent Manufacturing, 2015; 10: 1-12.
2- Lakshmi, B.N, Satish, K.S.N, Meera S.M, Reddy, K T. A Study on Patient Satisfaction through Extemporaneous Responses from Patients in a Tertiary Care Hospital. Indian Journal of Public Health Research & Development, 2014; 5(3): 319-323.
3- Aghamolaei T, et al. Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective. BMC Health Services Research, 2014; 14: 322-332.
4- Shabbir, A., Malik, S. A., and Malik, S. A. Measuring patients’ healthcare service quality perceptions, satisfaction, and loyalty in public and private sector hospitals in Pakistan. International Journal of Quality & Reliability Management, 2016; 33(5): 538-557.
5- Akdag H, Kalayci T , Karag¨oz S, Z¨ulfikar H , Giz D, The. Evaluation of Hospital Service Quality by Fuzzy MCDM. Applied Soft Computing Journal, 2014; 23: 239-248.
6- Giovanis, A Pierrakos, G, Rizomyliotis, I. and Binioris, S. Assessing service quality and customer behavioral responses in hospital outpatient services: A formative measurement approach. International Journal of Quality and Service Sciences, 2018; 10(2): 98-116.
7- Pai YP, Chary ST, Pai RY. Patient-perceived hospital service quality: an empirical assessment. Int J Health Care Qual Assur, 2018; 31(1): 76-91.
8- Shafii M, Rafiei S, Abooee F, Bahrami MA, Nouhi M, Lotfi F, Khanjankhani K. Assessment of Service Quality in Teaching Hospitals of Yazd University of Medical Sciences: Using Multi-criteria Decision Making Techniques. Osong Public Health and Research Perspectives, 2016; 7(4): 239-247.
9- Moffatt-Bruce SD, Ferdinand FD, Fann JI. Patient Safety: Disclosure of Medical Errors and Risk Mitigation, Ann Thorac Surg, 2016; 102(2): 358-62.
10- Ghotbi N, Maddah SB, Dalvandi A, Arsalani N, Farzi M. The effect of education of self-care behaviors based on family-centered empowerment model in type II diabetes. Journal of Nursing and Midwifery Faculty Shahid Beheshti University of Medical Sciences & Health Services, 2014; 23(83): 43-50. [In Persian]
11- Tavalayi R, New Approaches to Organizational Performance Evaluation. Scientific Journal of Police Development Development, 2007; 12: 9-30. [In Persian]
12- Chang SJ, Hsiao HC, Huang LH, Chang H. Taiwan quality indicator project and hospital productivity growth. Omega Elsevier, 2011; 39(1): 14-22.
13- Haddad S, et al.Patient perception of quality following a visit to doctor in a primary care unit. Fam Pract, 2000; 17(1): 21-29.
14- Donabedian A. Quality Assessment and Assurance: Unity of Purpose, Diversity of Means. Inquiry, 1988; 25(1): 173-192.
15- Zivyar F, Ziaee MS, Nargesian J. Investigating the Affective Factors on Customers’ Satisfaction Using Servqual Model. New Marketing Research journal, 2012; 3 (6): 173-186. [In Persian]
16- Ansari H, Ebadi F, Mollasadeghi G. Evaluation of Patients Satisfaction in Hospitals under Iran University of Medical Sciences. Journal of Birjand University of Medical Sciences, 2004; 11(3): 38-46. [In Persian]
17- Kalaja R, Myshketa R, Scalera F. Service quality assessment in health care sector: the case of Durres public hospital. Procedia - Social and Behavioral Sciences, 2016; 235: 557-565.
18- Nemati Doplani F, Mohammad Nezhad S, Tabatabaee A, Ehsani Kuhi R, Sajjadi A, Haji Esmailpour A. satisfaction rate of hospitalized patients in teaching hospitals with presented. Journal of Medical Ethics, 2014; 8(28): 29-50. [In Persian]
19- Arabameri Y, Hasani AA. A Comprehensive Satisfaction Assessment Model for Healthcare Services. Journal of Healthcare Management, 2019; 9(4): 67-77. [In Persian].
20- Opricovic S. Fuzzy VIKOR with an application to water resources planning. Expert Systems with Applications, 2011; 38(10): 12983-12990.
21- Guo S, Zhao H. Fuzzy best-worst multi-criteria decision-making method and its applications. Knowledge-Based Systems, 2017; 121: 23-31.
22- Motaghed Z, Davoudi Monfared E, Mohazab Turabi S, Nemati I, Mousavi A, Eshraghi R, et al . Assessment of Quality of Services in Health Centers from the perspective of Clients by SERVQUAL Method. Hrjbaq, 2017; 2(1): 49-55
23- Tavakoli A, Pouya A, Alavi tabari J. Fuzzy Multi-Criteria Decision Making Fusion Model Design for Facility Layout Selection. Journal of Industrial Management Perspective, 2013; 3(2): 57-84.