@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2019;11(1):15-21
ISSN: 2008-2630 Iranian Journal of War & Public Health 2019;11(1):15-21
Evaluation of the Quality of Health Care Services of the Injured and Chemical Veterans during the Holy Defense Period since the Time of Injury in Kashan in 2017
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Salarian A. (1*)Mohammadi H.R. (1)
Dargahi H. (1)
(1*) Health Care Administration Department, Management Faculty, Electronic Branch, Islamic Azad University, Tehran, Iran
Correspondence
Article History
Received: May 21, 2018Accepted: October 9, 2018
ePublished: March 16, 2019
ABSTRACT
Aims
Hospitals and health centers are places, where the injured and chemical veterans go to treatment methods. The aim of this study was to determine the difference in expectations and perceptions of the injured and chemical veterans from the quality of health care services.
Instrument & Methods The present study is descriptive cross sectional survey that was carried out in Kashan in 2017. The statistical population consisted of 900 injured and chemical veterans in Kashan by purposive sampling method, of whom 270 were selected based on the sample size of the Cochran; they were evaluated, using the SERVQUAL questionnaire. Investigations were performed on the dimensions of tangibility (Physical facilities, appearance of the hospital, and the staff), reliability (Stability and precision in the work), accountability (Timely delivery, prompt response, and readiness for providing service for patient), assurance (Building trust and security in patients), and empathy (Understanding the needs of the patients and paying attention to them). The dependent t test and SPSS 24 software were used to analyze the data.
Findings There was a significant difference between the perceptions and expectations of the injured and chemical veterans about the five dimensions of service quality (tangibility, reliability, accountability, assurance, and empathy; p=0.0001).
Conclusion Despite the high quality of services, in all aspects of the quality of service, there is a significant difference between patient expectations and existing quality (perception), which requires the authorities to improve the quality in all respects, especially the dimension of tangibility and assurance.
Instrument & Methods The present study is descriptive cross sectional survey that was carried out in Kashan in 2017. The statistical population consisted of 900 injured and chemical veterans in Kashan by purposive sampling method, of whom 270 were selected based on the sample size of the Cochran; they were evaluated, using the SERVQUAL questionnaire. Investigations were performed on the dimensions of tangibility (Physical facilities, appearance of the hospital, and the staff), reliability (Stability and precision in the work), accountability (Timely delivery, prompt response, and readiness for providing service for patient), assurance (Building trust and security in patients), and empathy (Understanding the needs of the patients and paying attention to them). The dependent t test and SPSS 24 software were used to analyze the data.
Findings There was a significant difference between the perceptions and expectations of the injured and chemical veterans about the five dimensions of service quality (tangibility, reliability, accountability, assurance, and empathy; p=0.0001).
Conclusion Despite the high quality of services, in all aspects of the quality of service, there is a significant difference between patient expectations and existing quality (perception), which requires the authorities to improve the quality in all respects, especially the dimension of tangibility and assurance.
CITATION LINKS
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[18]Mohammadi A, Eftekhar Ardebili H, Akbari Haghighi F, Mahmoudi M, Poorreza A. Evaluation of services quality based on the patients' expectations and perceptions in Zanjan hospitals. J Sch Public Health Inst Public Health Res. 2004;2(2):71-84. [Persian]
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[22] Karassavidou E, Glaveli N, Papadopoulos CT. Quality in NHS hospitals: No one knows better than patients. Meas Bus Excell. 2009;13(1):34-46.
[23]Dormohammadi T, Asghari F, Rashidian A. What do patients expect from their physicians?. Iran J Public Health. 2010;39(1):70-7.
[24]Kucukarslan SN, Nadkarni A. Evaluating medication-related services in a hospital setting using the disconfirmation of expectations model of satisfaction. Res Social Adm Pharm. 2008;4(1):12-22.
[25]Dawn AG, Lee PP. Patient expectations for medical and surgical care: A review of the literature and applications to ophthalmology. Surv Ophthalmol. 2004;49(5):513-24.
[26]Parasuraman A, Berry LL, Zeithaml VA. More on improving service quality measurement. J Retail. 1993;69(1):140-7.
[27] Parasuraman A, Zeithaml VA, Berry LL. Alternative scales for measuring service quality: A comparative assessment based on psychometric and diagnostic criteria. J Retail. 1994;70(3):201-30.
[28] Lin HC, Xirasagar S, Laditka JN. Patient perceptions of service quality in group versus solo practice clinics. Int J Qual Health Care. 2004;16(6):437-45.
[29] Lam SSK. Servqual: A tool for measuring patients’ opinions of hospital service quality in Hong Kong. Total Qual Manag. 1997;8(4):145-52.
[30] Shojaei Baghini H, Nakhaee N. Satisfaction of janbazan and azadegan referring health center of janbazan foundation of Kerman city to receive medical services in the year 2003-2004. J Rafsanjan Univ Med Sci. 2005;4(1);41-8. [Persian]
[31]Mohebbifar R, Barikani A, Hasani H. Measuring hospital service quality gap from the viewpoint of inpatients in educational hospitals of Qazvin University of Medical Sciences (2012-13). J Hosp. 2015;14(1):97-104. [Persian]
[32]Ayoubian A, Dopeykar N, Mehdizadeh P, Hoseinpourfard MJ, Izadi M. Surveying the quality of care services in a military health center according to the Servqual model. J Mil Med. 2015;16(4):225-9. [Persian]
[33]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. J Mil Med. 2014;15(4):273-9. [Persian]
[34]Zarei Matin H, Jandaghi Gh, Heydari F, Imani M. The attitude of war handicaped toward the services recieved in terms of their needs. Iran J War Public Health. 2010;2(2):22-31. [Persian]
[35]Lee H, Lee Y, Yoo D. The determinants of perceived service quality and its relationship with satisfaction. J Serv Mark. 2000;14(3):217-31.
[36]Butt MM, De Run EC. Private healthcare quality: Applying a Servqual model. Int J Health Care Qual Assur. 2010;23(7):658-73.
[37]Rouhafza M, Adhami Moghadam F, Sahebalzamani M. Assessment the relationship between patient satisfaction and quality of hospital services based on SERVQUAL Model in the hospitals related to Islamic Azad University, Tehran Medical Sciences Branch in 2015. Medical sciences. 2016;26(3):173-9.
[2]Gaesan K, Raza SK, Vijayaraghavan R. Chemical warfare agents. J Pharm Bioallied Sci. 2010;2(3):166-78.
[3]Safavi M, Mahmoodi M, Akbarnatajbishe K. Assessment of quality of life and its relationship with some of individuals' characteristics in pulmonary complications of sulfur mustard. Daneshvar Med. 2009;16(80):43-52. [Persian]
[4]Khateri Sh, Ghanei M, Keshavarz S, Soroush M, Haines D. Incidence of lung, eye, and skin lesions as late complications in 34000 Iranians with wartime exposure to mustard agent. J Occup Environ Med. 2003;45(11):1136-43.
[5] Bullman T, Kang H. A fifty year mortality follow-up study of veterans exposed to low level chemical warfare agent, mustard gGas. Ann Epidemiol. 2000;10(5):333-8.
[6] Institute of Medicine, Committee on the Survey of the Health Effects of Mustard Gas and Lewisite. Veterans at risk: The health effects of mustard gas and lewisite. Pechura CM, Rall DP, editors. Washington DC: National Academy Press; 1993.
[7]Najafi M, Mohammadi Far MA, Dabiri S, Erfani N, Kamari AA. The comparison of the quality of life in veterans with and without post-traumatic stress disorder. Iran J War Public Health. 2011;3(3):27-35. [Persian]
[8]Emad A, Rezaian GR. The diversity of the effects of sulfur mustard gas inhalation on respiratory system 10 years after a single, heavy exposure: Analysis of 197 cases. Chest. 1997;112(3):734-8.
[9] Mandani B, Fakhri A. Study of health related Quality of Life in Posttraumatic Stress Disorder War Veterans. Iran J War Public Health. 2013;5(2):18-25. [Persian]
[10]Bijani Kh, Moghadamnia AA. Long-term effects of chemical weapons on respiratory tract in Iraq-Iran war victims living in Babol (North of Iran). Ecotoxicol Environ Saf. 2002;53(3):422-4.
[11]Zargar M, Araghizadeh H, Soroush MR, Khaji A. Iranian casualties during the eight years of Iraq-Iran conflict. Revista de Saúde Pública. 2007;41(6):1065-6.
[12]Hartung HP, Matthews V, Ross AP, Pitschnau-Michel D, Thalheim C, Ward-Abel N. Disparities in nursing of multiple sclerosis patients-results of a European nurse survey. Eur Neurol Rev. 2011;6(2):106-9.
[13]Mousavi B, Maftoon F, Sorush MR, Mohammad K, Rahimpoor D, khoubyarian A. Satisfaction with outpatient visits in veterans covered by supplementary health insurance. Payesh. 2017;16(2):142-9. [Persian]
[14]Shokohyar S, Kaviani H, Mahmoodi F. Health quality assessment by applying Fuzzy approach: A case study of a military hospital. Ebnesina J Med. 2015;17(3):37-45. [Persian]
[15]Farsijani H, Zandi O. Explanation and measuring service, quality strategic model. J Strateg Manag Stud. 2010;1(1):69-94. [Persian]
[16]Shahin A, Abolhasani Z. Measuring the difference between quality characteristics and delivery of service in the insurance industry (The case of Iran insurance company in the Isfahan province). Knowl Dev. 2010;18(31):75-96. [Persian]
[17]Mohammadnia M, Delgoshaei B, Tofighi Sh, Riahi L, Omrani A. Survey on nursing service quality by Servqual at Tehran social security organization hospitals. J Hosp. 2010;8(3-4):68-73. [Persian]
[18]Mohammadi A, Eftekhar Ardebili H, Akbari Haghighi F, Mahmoudi M, Poorreza A. Evaluation of services quality based on the patients' expectations and perceptions in Zanjan hospitals. J Sch Public Health Inst Public Health Res. 2004;2(2):71-84. [Persian]
[19]Sharifirad GR, Shamsi M, Pirzadeh A, Daneshvar Farzanegan P. Quality gap in primary health care services in Esfahan women’s perspective. Health Syst Res. 2010;6(1):95-105. [Persian]
[20] Parasuraman A, Zeithaml VA, Berry LL. A conceptual model of service quality and its implications for future research. J Mark. 1985;49(4):41-50.
[21] Joseph Cronin Jr J, Taylor SA. Measuring service quality: A reexamination and extension. J Mark. 1992;56(3):55-68.
[22] Karassavidou E, Glaveli N, Papadopoulos CT. Quality in NHS hospitals: No one knows better than patients. Meas Bus Excell. 2009;13(1):34-46.
[23]Dormohammadi T, Asghari F, Rashidian A. What do patients expect from their physicians?. Iran J Public Health. 2010;39(1):70-7.
[24]Kucukarslan SN, Nadkarni A. Evaluating medication-related services in a hospital setting using the disconfirmation of expectations model of satisfaction. Res Social Adm Pharm. 2008;4(1):12-22.
[25]Dawn AG, Lee PP. Patient expectations for medical and surgical care: A review of the literature and applications to ophthalmology. Surv Ophthalmol. 2004;49(5):513-24.
[26]Parasuraman A, Berry LL, Zeithaml VA. More on improving service quality measurement. J Retail. 1993;69(1):140-7.
[27] Parasuraman A, Zeithaml VA, Berry LL. Alternative scales for measuring service quality: A comparative assessment based on psychometric and diagnostic criteria. J Retail. 1994;70(3):201-30.
[28] Lin HC, Xirasagar S, Laditka JN. Patient perceptions of service quality in group versus solo practice clinics. Int J Qual Health Care. 2004;16(6):437-45.
[29] Lam SSK. Servqual: A tool for measuring patients’ opinions of hospital service quality in Hong Kong. Total Qual Manag. 1997;8(4):145-52.
[30] Shojaei Baghini H, Nakhaee N. Satisfaction of janbazan and azadegan referring health center of janbazan foundation of Kerman city to receive medical services in the year 2003-2004. J Rafsanjan Univ Med Sci. 2005;4(1);41-8. [Persian]
[31]Mohebbifar R, Barikani A, Hasani H. Measuring hospital service quality gap from the viewpoint of inpatients in educational hospitals of Qazvin University of Medical Sciences (2012-13). J Hosp. 2015;14(1):97-104. [Persian]
[32]Ayoubian A, Dopeykar N, Mehdizadeh P, Hoseinpourfard MJ, Izadi M. Surveying the quality of care services in a military health center according to the Servqual model. J Mil Med. 2015;16(4):225-9. [Persian]
[33]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. J Mil Med. 2014;15(4):273-9. [Persian]
[34]Zarei Matin H, Jandaghi Gh, Heydari F, Imani M. The attitude of war handicaped toward the services recieved in terms of their needs. Iran J War Public Health. 2010;2(2):22-31. [Persian]
[35]Lee H, Lee Y, Yoo D. The determinants of perceived service quality and its relationship with satisfaction. J Serv Mark. 2000;14(3):217-31.
[36]Butt MM, De Run EC. Private healthcare quality: Applying a Servqual model. Int J Health Care Qual Assur. 2010;23(7):658-73.
[37]Rouhafza M, Adhami Moghadam F, Sahebalzamani M. Assessment the relationship between patient satisfaction and quality of hospital services based on SERVQUAL Model in the hospitals related to Islamic Azad University, Tehran Medical Sciences Branch in 2015. Medical sciences. 2016;26(3):173-9.