The Quality Gap in the Services Provided by Rural Maternity Units in Southeast of Iran

Tabatabaei, Seyed Mehdi; Pour, Fateme Behmanesh; Mollashahi, Sedighe Share; Moakhar, Zahra Sargazi; Zaboli, Maryam

doi:10.17795/jhealthscope-25344

Cited by 9 publications

(11 citation statements)

References 30 publications

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“…Although it was anticipated that there would be significant differences in perceptions of quality of care between vulnerable and non-vulnerable groups, there were in fact only a limited number of differences reported between women with and without disabilities, and even fewer between Dalit and non-Dalit women. The study found fewer associations between socio-demographic factors and perceived quality of care than studies in other settings [ 46 , 47 ]. However, it is important to note that all groups rated many aspects of care very low and thus the findings in this study reflect overall dissatisfaction with the quality of care.…”

Section: Discussioncontrasting

confidence: 68%

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

Devkota

Clarke²,

Murray

et al. 2017

PLoS ONE

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BackgroundSuboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women’s socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities.MethodsA cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15–49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: ‘Health Facility’, ‘Healthcare Delivery’, ‘Inter-personal’ and ‘Access to Care’ was used to measure women’s perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension.ResultsAll groups, women with disabilities and women without disabilities, Dalit and non-Dalit rated their perceptions and experiences of quality of care lowly in a number of items. While perceived quality of care between women with disabilities and without disabilities in the ‘Health Facility’ dimension and associated items, was found to differ (p<0.05), this difference was linked to disability status, but was not linked to caste differences. For example, differences in mean scores relating to ‘Cleanliness and Facilities’, ‘Open and Friendliness’ and ‘Compassion and Kindness’ were highly significant (p<0.001), with women with disabilities rating these as better than women without disabilities. On the other hand, women without disabilities rated the ‘Availability of cash Incentives’ more highly (p<0.01). No significant differences were found between Dalit and non-Dalit women in perceived quality of care, except in relation to ‘Cleanliness and facilities’, which Dalit women rated lower than non-Dalits (p<0.05).ConclusionsPerceptions about the quality of care differed significantly by disability status but not by caste. All groups rated the quality of healthcare delivery, interpersonal and personal factors as well as access to services ‘low.’ Poor service user experiences and perceptions of quality of care undermine opportunities to translate increased healthcare coverage into improved access and outcomes. Greater attention is required by policy makers, health planners and providers to the improvement of quality of care in health facilities.

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Section: Discussioncontrasting

confidence: 68%

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

Devkota

Clarke²,

Murray

et al. 2017

PLoS ONE

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“…Previous studies found the largest gaps in responsibility (22,23) and reliability (24,25). In contrast, some studies found the smallest gap in responsibility (26) and reliability (27). This dissimilarity can be caused by those different characteristics of patients, different facilities of health organizations, and the diverse nature of services.…”

Section: Discussionmentioning

confidence: 92%

Evaluation of Service Quality From the Patients’ Viewpoint in the Oncology Setting of a University Hospital in Iran

et al. 2020

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Background: Hospitals are one of the most important units in providing healthcare services. The assessment of the quality of provided services is essential in these settings. Patient satisfaction is one of the key indicators of service quality in healthcare organizations. Objectives: This study aimed at investigating the gap between the perceptions and expectations of service recipients in Shohada-e-Tajrish Hospital (Tehran, Iran), using the SERVQUAL model in 2020. Methods: This cross-sectional study was conducted on patients with cancer, who were upon discharge from Shohada-e-Tajrish Hospital. Patients (> 18 years) with a cancer diagnosis, who were being discharged from the oncology ward of the hospital, were included in this study. The sample size was estimated at 118. The required information was collected, using the modified SERVQUAL questionnaire. Statistical analyses were performed in SPSS version 20, using a paired t test and one-sample t-test. Results: The results showed that the quality of the provided services from the patients’ perspective was significantly lower than their expectations. The mean gap between the expectations and perceptions of patients was significantly above zero (P < 0.001). The most influential factor in improving patient satisfaction with the quality of services was assurance, followed by reliability, while the least effective factor was empathy. The correlation coefficient between the general status of provided services from the patients’ point of view and loyalty was 0.740 (P < 0.001). Conclusions: The findings of the present study indicated that patient expectations were higher than their satisfaction. Therefore, hospital authorities should take major steps to improve the quality of services, especially reliability and responsiveness, through proper planning, prioritization of services, and review of processes contributing to patient expectations. The existing gaps can also be addressed by considering the perspectives of patients as the clients of healthcare organizations.

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“…Results of a study conducted in the city of Qazvin in Iran with regard to quality health services in 2014 revealed that, from the perspective of people in Qazvin (Iran), there was a gap in health quality of organizations providing health services in this province; however, there was no study conducted for comparison between public and private sectors in Qazvin Province ( 15 ). Tabatabai’s study also showed a quality gap in health services, and patients’ expectations were not met adequately ( 16 ). Evaluating quality of health services provided to patients and their perception of services as well as identifying factors influencing their perception is among the main criteria of a health system.…”

Section: Introductionmentioning

confidence: 99%

Comparison Quality of Health Services between Public and Private Providers: The Iranian People’s Perspective

Alijanzadeh¹,

Zare²,

Rajaee³

et al. 2016

Electron physician

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IntroductionHealth services quality has been the most important criteria of judging, and its improvement causes people’s satisfaction of health systems. In a health system, public and private sectors provide services and typically have been effective in promoting health services quality of community. The aim of this study was to compare the quality of health services in both public and private sectors from the perspective of residents in Qazvin (Iran).MethodsThis cross-sectional study was conducted in 2014. The study population included all residents of Qazvin Province, and the sample size was estimated to 1002. The research tool was a perceptions of services quality standard questionnaire. Data were collected by trained interviewers visiting homes and were analyzed by IBM-SPSS software version 22 and t-test and linear regression. Cronbach’s alpha coefficient was 0.91 and test–re-test coefficient was 83%.Results741 people (74%) in their last visit to receive services were referred to the public sector. Between the perception of people participating in the study about medical equipment and supplies, welfare facilities, competence and experience of doctor, waiting time, rapid reception, and access to doctor in public and private sectors, significant differences were observed (p < 0.05). In the tangible realm in perception of health services, there was a significant difference in quality between the public and private sectors (p < 0.05). In addition, place of receiving services, waiting time, education, occupation, and type of received services were affecting factors in regards to perceptions of health services from the perspective of Iran’s population (p < 0.05).ConclusionThe results showed the importance of a tangible realm on people’s satisfaction of health services. It seems that the public sector should pay more attention to this issue.

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The Quality Gap in the Services Provided by Rural Maternity Units in Southeast of Iran

Cited by 9 publications

References 30 publications

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

Do experiences and perceptions about quality of care differ among social groups in Nepal? : A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

Evaluation of Service Quality From the Patients’ Viewpoint in the Oncology Setting of a University Hospital in Iran

Comparison Quality of Health Services between Public and Private Providers: The Iranian People’s Perspective

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