Develop a Quality Indicator System for Evaluating the Internet Plus Home Care Nursing Services Based on SERVQUAL Model：a Delphi-Analytic Hierarchy Process Study (Preprint)

Abstract

BACKGROUND In the context of global population aging and the rapid development of information technology, the demand for Internet Plus Home Care Nursing (Internet + HCN) services have been on the rise, especially in China. The Internet + HCN services have the potential to maximize existing human resources to counter the shortage of medical healthcare services. However, at present, the Internet + HCN services can hardly spread for the lack of standardized service quality governance. Quality indicators for service evaluation of the Internet + HCN services are under-defined. OBJECTIVE To develop a quality indicator system for evaluating the Internet + HCN services, and to shed some theoretical light on assessing mHealth service quality from a user experience perspective. METHODS An initial quality indicator system was established adopting the SERVQUAL model, based on scenarios related to the Internet + HCN services. Then, the Delphi Method was applied to modify the indicators according to experts’ opinions. And the Analytic Hierarchy Process (AHP) was applied to calculate the indicator weight. Finally, a quality indicator system for evaluating the Internet + HCN services was developed based on the SERVQUAL Model. RESULTS Altogether, 17 experts from relevant fields such as nursing education, clinical nursing, health management, and health informatics were consulted through email surveys. The response rates in both rounds of Delphi and the AHP were 100%. The average expert authority coefficients were 0.912 and 0.925 respectively in two rounds of Delphi. And the Kendall’s W, indicating variation coefficients, ranged from 0.262 to 0.265. Finally, a quality indicator system for evaluating the Internet + HCN services, comprising 5 primary indicators and 15 secondary indicators, was developed. Primary indicators and their AHP generated weights were listed as follows: assurance (0.245), reliability (0.240), tangibles (0.192), responsiveness (0.190), and empathy (0.132). CONCLUSIONS By measuring the services quality gap between user expectations and perceptions, the proposed SERVQUAL Model based quality indicator system has the potential in improving the quality of Internet + HCN services through the perspective of user experiences.