Investigating and measuring the quality of medical services and its relationship with the overall satisfaction of patients

Dissertation for Master's Degree

Commercial Management Field: Internal

Abstract:

The issue of service quality in today's world has a special place in customer marketing. But this issue is of double importance in relation to patients. Because following the correct tips and principles of providing services to patients can play a significant role in the physical and mental health of patients and even the satisfaction of their families.  In this research, the relationship between service quality and patient satisfaction was investigated based on the SERQUAL model. Porsina Hospital in Rasht was chosen as the study case and 270 patients who came to it for treatment were selected as a sample. The dimensions of service quality were extracted based on the SERVQUAL model, including five components: reliability, tangibles, trust, responsiveness, and empathy. The results of Pearson's correlation test showed that there is a significant positive relationship between service quality and the above dimensions with overall patient satisfaction. Also, the results of measuring patients' satisfaction with the quality of services provided by the W. Kendall test showed that the satisfaction of Porsina Hospital patients is the highest from the dimensions of responsiveness and assurance, respectively, and their satisfaction from the dimension of trust is the lowest.

Key words: service quality, patient satisfaction, reliability, concrete, trust, responsiveness, empathy, hospital

Introduction:

Public sector organizations have found that providing quality services to customers is a strategic and strategic category. the survival of organizations in the coming years; Undoubtedly, in a few years, it will become a "competitive breeze" among the service organizations in our country today. In order to achieve a suitable position in such a competitive "transformation storm", we must provide services that are considered quality by customers.

This will not be possible without a clear definition of quality and awareness of the real needs of customers. Public sector organizations are aware of the importance of quality and the need to measure it, but the problem is that these organizations are not properly aware of the different dimensions and factors affecting service quality. Managers of service departments are always trying to prove the centrality of customers in their organization; On the other hand, due to the limited resources that plague all organizations, the managers of these organizations are forced to first identify the needs and expectations of their customers, and then, by measuring their perceptions of the services received, identify the gap between the expectations and perceptions of their customers, and finally, by using this information, choose and recover the solution that has the most cost-effectiveness in filling the existing gap (Amini and Farjam, 2018). Health also has a special place as a matter of quality, because this department has the important task and mission of preserving health and taking care of the life of the society. Hospitals are the most important element of the health care system. In terms of resources, they account for about 50% of health care expenses because they are the largest and most expensive operating unit of health systems and absorb a large part of capital, financial and human resources and use a large part of educated manpower (Mohammadi et al., 2013).

From an organizational point of view, hospitals dominate the rest of the health system. No health system can function without the participation and support of hospitals. The care they provide is second to none. In fact, hospitals complement and support primary health care. Therefore, any improvement in service provision is considered as an optimal use of resources. Service quality helps the organization to differentiate itself from other organizations and thereby achieve a competitive position. The higher quality of services is the basic determinant of long-term profitability not only of service organizations but also of production organizations (same source, 2012).

In this chapter, a general outline of the research is presented. In this way, first, the main questions raised in the research are raised in the form of problem statements, and then the importance and necessity of the discussion, regarding the research topic, will be examined, and then the objectives, research framework and research assumptions will be fully explained. And at the end, after presenting the conceptual definitions, the operational definitions related to each of the indicators will be presented separately.

1-2) Statement of the problem:

Due to the priority of the formation of industrial organizations and companies, the origin of most of the management theories of industry and factory environment has been, but during the last century, with the transformation of the way of life and the mechanization of industrial production, the majority of the workforce in industrialized countries have joined service organizations (Yousfi and Rezaei, 2000).  These new developments have caused the service sector to expand rapidly. One of the sub-sectors of services is the health services sector [2], which has a special place among different types of services, because, firstly, this sector is related to a wide segment of the society, and more importantly, this sector is responsible for the important task and mission of preserving health and taking care of the life of the society (Maqbul Ba'ar and Mohammadi, 2012). Meanwhile, hospitals, as the center of gravity for providing healthcare and treatment, are considered to be one of the determining factors in the success of the healthcare sector and the equitable expansion of care at all levels (Nasiripour et al., 2018).  So that the patient's satisfaction refers to the satisfaction of his inner needs and desires from the provision of hospital services in reaching the "goal of providing health" (Clifford, 1992). And this, in turn, can increase the brand of the hospital.

The British National Health System (NHS) has defined the service quality as "providing the right services to the right people, at the right time, in a suitable and practical way, within the average capacity of people and with a humane method" (Mohammadi and Zajari, 2017). The patient's satisfaction with the way of medical care is considered as one of the methods of measuring and evaluating the quality of medical services. Service satisfaction is influenced by service quality[3], service delivery quality, and service receivers' level of expectation from service quality. Therefore, satisfaction with services is a suitable indicator for measuring the quality of services and how they are provided from the point of view of service recipients (Farzadi et al., 2013).

The criteria and criteria used to measure the quality of service and the level of satisfaction of patients are various, and there are various tools and techniques for it. Although obstacles such as the immortality of the service, the inseparability of the service from the service provider, and the time and place of its delivery make its measurement more complicated, but the efforts of scientists such as Parasuraman and Zeitamel [4] (1985) in identifying and introducing qualitative dimensions and components paved the way for measuring quality in service organizations (Mirghafouri and Ahmadabadi, 2016). In this research, in order to measure the quality of services, the Serqual model [5] is used. SERVQUAL measurement tool was revised and revised in 1985, 1988 and 1991 by Parasuraman and his colleagues to measure the quality of services provided. The Seroqual scale has been used to measure the quality of services in various departments, including hospitals and healthcare departments. This scale includes five dimensions: tangibles [6], trust [7], accountability [8], assurance [9], and compassion [10], each dimension includes components to measure patients' perceptions and expectations of the services used (Rajabipour et al., 2018). In the continuation of the research, we will describe and follow the dimensions and components of each one.

To sum up, considering that Porsina Rasht Hospital is a government hospital and receives a large number of patients, in this research we seek to investigate and measure the quality of medical services provided in the above hospital and its relationship with the overall satisfaction of patients. Based on this, the main question of the research was formulated as follows:

What is the relationship between the quality of health care services provided and the overall satisfaction of patients in Porsina Hospital in Rasht? As mentioned, in the health services sector, the issue of quality has a special place; Because the important duty and mission of maintaining the health and taking care of the life of the society is the responsibility of this department. Hospitals are the most important element of the health care system, which in terms of resources account for about 50% of health care expenses, and therefore, evaluating the quality of their services seems necessary. In recent years, the government's attention to providing quality services to the people has been shown more than in the past. Due to the fact that Porsina Hospital in Rasht is state-owned, the officials want to provide services that increase the satisfaction of people and citizens in order to gain people's trust and increase social capital. Service quality can be used as a strategic tool for success in competitive situations, and medical centers should strive to obtain and achieve superior quality (Lim & Tang, 2000).