Patient Satisfaction With the Quality of Health Services Provided by Public Hospitals in Rasht, Iran

Abstract

Introduction: 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.