بررسی شکاف کیفیت خدمات از دیدگاه بیماران بستری در بیمارستان‌های دانشگاه آزاد اسلامی واحد علوم پزشکی تهران
محورهای موضوعی : -مدارک پزشکیفرهاد ادهمی مقدم 1 , محمد صاحب الزمانی 2 , معصومه روح افزا 3
1 - دانشیار متخصص چشم، واحد علوم پزشکی تهران، دانشگاه آزاد اسلامی، تهران، ایران
2 - دانشیار، گروه مدیریت آموزشی، واحد علوم پزشکی تهران، دانشگاه آزاد اسلامی، تهران، ایران
3 - کارشناس‌ارشد آموزش پرستاری، واحد علوم پزشکی تهران، دانشگاه آزاد اسلامی، تهران، ایران
کلید واژه: کیفیت خدمات, شکاف, ادراکات, انتظارات, سروکوال,
چکیده مقاله :
مقدمه: توسعه روز افزون کیفیت‌گرایی و مشتری‌محوری در خدمات بهداشتی، از طریق بازخورد مداوم انتظارات بیماران و بهبود مستمر نحوه ارائه خدمات میسر می‌شود. ارزیابی کیفیت خدمات بیمارستانی از دیدگاه بیمار یک شاخص و راهنمای عینی ارزشمند در اختیار مدیران و برنامه‌ریزان امر مراقبت و درمان قرار می‌دهد. روش پژوهش: این پژوهش، توصیفی - همبستگی برروی 405 نفر از بیماران بستری در سه بیمارستان وابسته به دانشگاه آزاد اسلامی واحد علوم پزشکی تهران که به روش نمونه‌گیری در دسترس انتخاب شده بودند، انجام شد. ابزار گردآوری اطلاعات پرسش‌نامه‌ای مشتمل بر دو بخش مشخصات دموگرافیک و سوالات سنجش کیفیت خدمات (سروکوال) بود. یافته‌ها: بیشترین میانگین کیفیت خدمات بیمارستانی در قسمت ادراکات، مربوط به بعد اطمینان با میانگین 17/5 و کمترین درصد مربوط به بعد ملموس بودن با میانگین 12/84 بود. بیشترین میانگین کیفیت خدمات بیمارستانی در قسمت انتظارات، مربوط به بعد همدلی با میانگین 21/12 و کمترین درصد مربوط به بعد ملموس بودن با میانگین 17/23 بود. شکاف بین ادراکات و انتظارات بیماران در بیمارستان‌های وابسته به دانشگاه آزاد اسلامی واحد علوم پزشکی تهران برابر با 19/19- واحد بود. کمترین شکاف با 52/2- واحد مربوط به بُعد تضمین خدمات و بیشترین شکاف با 4/6- واحد مربوط به بُعد انتظار همدلی بود. نتیجه‌گیری: برای ارتقای کیفیت خدمات بهداشتی درمانی برقراری توازن بین انتظارات بیماران و ارائه‌دهندگان این خدمات ضروری است .کنترل مناسب کیفیت راهی برای کاستن از شکاف کیفیت می‌باشد.
Introduction: Ever-increasing development of quality-oriented and customer orientation in health services, through continuous feedback of patients expectations and continual recovery of service presentation, is possible. Patient satisfaction can impact on compliance with suggested treatment and therefore impact on health outcomes. Methods: this correlation-descriptive study of 405 bedridden patients was done at 3 hospitals that are depending to Tehran medical sciences Islamic Azad University that were selected according to the available sampling. Information collecting tools was a questionnaire including of two parts demographic and questions measuring service quality (SERVQUAL). Results: The highest quality of hospital service in the perceptions of the reliability dimension was with 17.5 averages and the lowest percentage was related to tangibility dimension with the average of 12.84. The highest average of hospital services quality in the expectation part was related to Empathy dimension with the average of 21.12 and the lowest percentage was related to tangibility dimension with the average of 17.23. The gap between patients’ perceptions and expectations at hospitals depending to Tehran medical sciences Islamic Azad University equal to -19.9 units. The lowest gap with -2.52 unit related to service Assurance dimension and the most gap with -4.6 units related to Empathy expectations. Conclusion: For promotion of treatment health service quality, it’s necessary to establish a balance between services presenting and patient expectations. Suitable quality control is was to decrease of quality gap.
1- Tabibi SJ, Gohari MR, SHahri S, Agababa S. Assessment Health Care Services In Outpatient Clinics Based On SERVQUAL Model In Hospitals Of Tehran. Faculty of Tehran University of Medical Sciences, 2012; 5(4): 49-56. [Persian]
2- Ravichandran K, Prabhakaran S, Arun Kumar S. Application of Seroquel Model Measuring Services Quality. A Bayesian Approach. Enterprise Risk Management, (2010); 1(1).
3- Davis BA, Kiesl CK, Mc Farland J, Collard A, Coston K, Keeton A. Evaluating instruments for quality: testing convergent validity of the consumer emergency care satisfaction scale. J Nurs Care Qual, 2005; 20(4): 364-68.
4- Hassan Ismail K. Satisfaction of inpatient in Erbil teaching hospitals. Zanco J. Med, Sci, 2012; 16(2): 98-105.
5- Hekmatpo D, Sorani M, Farazi A, Fallahi Z, Lashgarara B. A survey on the quality of medical services in teaching hospitals of Arak University of Medical Sciences with SERVQUL model in Arak. Arak Medical University Journal (AMUJ), 2012; 15(66): 1-9. [Persian]
6- Abbasian M, Chaman R, Mousavi SA, Amiri M, Gholami Taromsari M, Maleki F, Raei M. Gap Analysis between Students' Perceptions and Expectations of Quality of Educational Services Using Servqual Model. Qom Univ Med Sci J, 2013; 7(1): 2-9. [Persian]
7- Ajam M, Sadeghifar J, Anjomshoa M, Mahmoudi S, Honarvar H, Mousavi SM. Assessing Quality of Healthcare Service by the SERVQUAL Model: A Case Study of a Field Hospital. Journal of Military Medicine, 2014; 15(4): 273-279. [Persian]
8- Abolghasem Gorji H, Tabatabaei SM, Akbari A, Sarkhosh S, Khorasani S. Using the Service Quality Gap's Model (SERVQUAL)in Imam Khomeini Teaching Hospital. Journal of Health Administration, 2013; 16(51): 7-18. [Persian]
9- Rajdeep S. SERVQUAL and model of service quality gaps: S frame work for determining and prioritizing critical factor from faculty perspective in higher education ,International Journal of Engineering science and Technology, 2010; 2(7): 3297-3304.
10- Buchanan J, Dawkins P, LM Lindo J. Satisfaction with nursing care in the emergency department of an urban hospital in the developing world: a pilot study, International Emergency Nursing (2015), http://dx.doi.org/doi:10.1016/j.ienj.2015.01.001
11- Khamis K, Njau B. Patient satisfaction on quality of health care at Mwananyamala hospital in Dar es Salaam, Tanzania. BMC Health Services Research 2014, http://www.biomedcentral.com/1472-6963/14/400
12- Bakar C, Akgün HS, Al Assaf AF. The role of expectations in patients' hospital assessments: a Turkish university hospital example. Int J Health Care QualAssur, 2009; 22(6): 571.
13- Karassavidou E, Niki G, and Papadopoulos Chissoleon T. Health Care Quality in Greek NHS Hospitals: No one knows better than patients. Measuring Business Excellence, 2009; 13(1): 34-46.
14- Havasbeigi F, Yasbalaghisharahi B, Mohamadi E, Mohamadi A. Measuring the Quality of Services Provided For Outpatients In Public Hospitals In Ilam and Kermanshah Cities Based on The SERVQUAL Instrument. Scientific Journal of Ilam University of Medical Science, 2013; 21: 207-214. [Persian]
15- Razlansari M , Teimouri B, Alipour Shirsavar H R, Taleghani M, Ashtarian H. Patients’ views on perceived services quality using SERVQUAL Model at educational and medical centers of Kermanshah University of Medical Sciences 2013, Journal of clinical Research in Paramedical Sciences, 2013; 1(3). [Persian]
16- Regaira Martínez E, SolaIriarte M, GoñiViguria R, Del Barrio Linares M, Margall Coscojuela MA, AsiainErro MC. Care quality in intensive care evaluated by the patients using a service quality scale (SERVQUAL) EnfermIntensiva, 2010; 21(1): 3-10.
17- Zarei E, Ghazi Tabatabai M, Rahimi Fourushani A, Rashidiyan A, Arab M. Hospital Services Quality From Patient’ Point Of View: A Cross- Sectional Study In Tehran Private Hospitals. Faculty of Tehran University of Medical Sciences; 2011, 5(4) 66-76. [Persian]
18- Jena abadi H, Abili Kh, Nastizayi N, Yaghubi N [Between patients' perceptions and expectations of service quality in Zahedan’s centers with SERVQUAL model] payesh Journal, 2011; 10(4): 449- 457. [Persian]
19- Jebraeily M, Rahmani B, Khodayari R, Golifarhoodi G, Mohammadi A. Assessment of inpatient satisfaction from services quality in medical and educational centers of Uromia University of Medical Science by SERVQUAL model. Quarterly Scientific and Research Journal of Iranian health Information Management Association (IHMA), 2013; 7(2): 19-24. [Persian]
20- Ranjbar ezzatabadi M, Bahrami M, Zare ahmadabadi H, Nasiri S, Arab M, Hadizade F, Hatami nasab H. The gap between perceptions and expectations of service recipients by using the SERVQUAL approach in Afshar Yazd Hospital, Journal of public Health School, Yazd, 2010; 9(2,3): 75-86. [Persian]
21- tarrahi M J, Hamouzadeh P, Bijanvand M, Lashgarara B. The quality of health care services provided in health care centers of Khorramabad using SERVQUAL model in 2010. Yafte, 2012; 14(1): 13-21. URL: http://yafte.lums.ac.ir/article-1-703-fa.html
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1- Tabibi SJ, Gohari MR, SHahri S, Agababa S. Assessment Health Care Services In Outpatient Clinics Based On SERVQUAL Model In Hospitals Of Tehran. Faculty of Tehran University of Medical Sciences, 2012; 5(4): 49-56. [Persian]
2- Ravichandran K, Prabhakaran S, Arun Kumar S. Application of Seroquel Model Measuring Services Quality. A Bayesian Approach. Enterprise Risk Management, (2010); 1(1).
3- Davis BA, Kiesl CK, Mc Farland J, Collard A, Coston K, Keeton A. Evaluating instruments for quality: testing convergent validity of the consumer emergency care satisfaction scale. J Nurs Care Qual, 2005; 20(4): 364-68.
4- Hassan Ismail K. Satisfaction of inpatient in Erbil teaching hospitals. Zanco J. Med, Sci, 2012; 16(2): 98-105.
5- Hekmatpo D, Sorani M, Farazi A, Fallahi Z, Lashgarara B. A survey on the quality of medical services in teaching hospitals of Arak University of Medical Sciences with SERVQUL model in Arak. Arak Medical University Journal (AMUJ), 2012; 15(66): 1-9. [Persian]
6- Abbasian M, Chaman R, Mousavi SA, Amiri M, Gholami Taromsari M, Maleki F, Raei M. Gap Analysis between Students' Perceptions and Expectations of Quality of Educational Services Using Servqual Model. Qom Univ Med Sci J, 2013; 7(1): 2-9. [Persian]
7- Ajam M, Sadeghifar J, Anjomshoa M, Mahmoudi S, Honarvar H, Mousavi SM. Assessing Quality of Healthcare Service by the SERVQUAL Model: A Case Study of a Field Hospital. Journal of Military Medicine, 2014; 15(4): 273-279. [Persian]
8- Abolghasem Gorji H, Tabatabaei SM, Akbari A, Sarkhosh S, Khorasani S. Using the Service Quality Gap's Model (SERVQUAL)in Imam Khomeini Teaching Hospital. Journal of Health Administration, 2013; 16(51): 7-18. [Persian]
9- Rajdeep S. SERVQUAL and model of service quality gaps: S frame work for determining and prioritizing critical factor from faculty perspective in higher education ,International Journal of Engineering science and Technology, 2010; 2(7): 3297-3304.
10- Buchanan J, Dawkins P, LM Lindo J. Satisfaction with nursing care in the emergency department of an urban hospital in the developing world: a pilot study, International Emergency Nursing (2015), http://dx.doi.org/doi:10.1016/j.ienj.2015.01.001
11- Khamis K, Njau B. Patient satisfaction on quality of health care at Mwananyamala hospital in Dar es Salaam, Tanzania. BMC Health Services Research 2014, http://www.biomedcentral.com/1472-6963/14/400
12- Bakar C, Akgün HS, Al Assaf AF. The role of expectations in patients' hospital assessments: a Turkish university hospital example. Int J Health Care QualAssur, 2009; 22(6): 571.
13- Karassavidou E, Niki G, and Papadopoulos Chissoleon T. Health Care Quality in Greek NHS Hospitals: No one knows better than patients. Measuring Business Excellence, 2009; 13(1): 34-46.
14- Havasbeigi F, Yasbalaghisharahi B, Mohamadi E, Mohamadi A. Measuring the Quality of Services Provided For Outpatients In Public Hospitals In Ilam and Kermanshah Cities Based on The SERVQUAL Instrument. Scientific Journal of Ilam University of Medical Science, 2013; 21: 207-214. [Persian]
15- Razlansari M , Teimouri B, Alipour Shirsavar H R, Taleghani M, Ashtarian H. Patients’ views on perceived services quality using SERVQUAL Model at educational and medical centers of Kermanshah University of Medical Sciences 2013, Journal of clinical Research in Paramedical Sciences, 2013; 1(3). [Persian]
16- Regaira Martínez E, SolaIriarte M, GoñiViguria R, Del Barrio Linares M, Margall Coscojuela MA, AsiainErro MC. Care quality in intensive care evaluated by the patients using a service quality scale (SERVQUAL) EnfermIntensiva, 2010; 21(1): 3-10.
17- Zarei E, Ghazi Tabatabai M, Rahimi Fourushani A, Rashidiyan A, Arab M. Hospital Services Quality From Patient’ Point Of View: A Cross- Sectional Study In Tehran Private Hospitals. Faculty of Tehran University of Medical Sciences; 2011, 5(4) 66-76. [Persian]
18- Jena abadi H, Abili Kh, Nastizayi N, Yaghubi N [Between patients' perceptions and expectations of service quality in Zahedan’s centers with SERVQUAL model] payesh Journal, 2011; 10(4): 449- 457. [Persian]
19- Jebraeily M, Rahmani B, Khodayari R, Golifarhoodi G, Mohammadi A. Assessment of inpatient satisfaction from services quality in medical and educational centers of Uromia University of Medical Science by SERVQUAL model. Quarterly Scientific and Research Journal of Iranian health Information Management Association (IHMA), 2013; 7(2): 19-24. [Persian]
20- Ranjbar ezzatabadi M, Bahrami M, Zare ahmadabadi H, Nasiri S, Arab M, Hadizade F, Hatami nasab H. The gap between perceptions and expectations of service recipients by using the SERVQUAL approach in Afshar Yazd Hospital, Journal of public Health School, Yazd, 2010; 9(2,3): 75-86. [Persian]
21- tarrahi M J, Hamouzadeh P, Bijanvand M, Lashgarara B. The quality of health care services provided in health care centers of Khorramabad using SERVQUAL model in 2010. Yafte, 2012; 14(1): 13-21. URL: http://yafte.lums.ac.ir/article-1-703-fa.html