نوع مقاله : مقاله پژوهشی
نویسندگان
1 کارشناس ارشد، مدیریت خدمات بهداشتی درمانی، گروه مدیریت خدمات بهداشتی درمانی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران
2 استادیار، مرکز تحقیقات سیاستگذاری اقتصاد سلامت و گروه مدیریت خدمات بهداشتی درمانی، دانشکده بهداشت، واحد علوم پزشکی تهران، دانشگاه آزاد اسلامی، تهران، ایران
چکیده
مقدمه: یکی از کارکردهای اصلی نظام سلامت، ارایه خدمات باکیفیت میباشد. رضایت مشتری در قلب هر سازمانی وجود دارد و هدف نهایی هر استراتژی سازمانی به شمار میرود. رضایتمندی بیمار، مفهومی است که امروزه اهمیت بسیار ویژهای در مراقبتهای پزشکی یافته است و در فرایند مراقبت بهداشتی- درمانی نقش مهمی را ایفا میکند. سنجش کیفیت خدمات، پیششرط اساسی برای بهبود کیفیت میباشد. پژوهش حاضر با هدف سنجش کیفیت خدمات با بهره گرفتن از تحلیل اهمیت- عملکرد در مراکز خدمات جامع سلامت انجام شد.روش بررسی: این مطالعه از نوع توصیفی- پیمایشی و جامعه آماری آن شامل کلیه افراد مبتلا به پرفشاری خون تحت پوشش مراکز خدمات جامع سلامت شهرستان پاکدشت (تحت پوشش دانشگاه علوم پزشکی شهید بهشتی) بود. 320 نفر با سن 30 سال و بالاتر مبتلا به پرفشاری خون، به روش نمونهگیری خوشهای دو مرحلهای سیستماتیک کلاسیک انتخاب شدند. به منظور مقایسه اختلاف میانگین عملکرد و اهمیت، از آزمون t با سطح معنیداری 95 درصد استفاده گردید.یافتهها: بین اهمیت و عملکرد در کلیه ابعاد اختلاف معنیداری وجود داشت (050/0 > P). ابعاد احترام (89/2)، استمرار خدمت (68/2)، میزان دسترسی و اعتماد (57/2)، بالاترین میزان اهمیت و ابعاد اختیار (72/2)، میزان دسترسی و اعتماد (33/2) و ایمنی و پیشگیری (19/2) بالاترین میزان عملکرد را به خود اختصاص دادند. میانگین اهمیت خدمات مورد تقاضا به افراد مبتلا به پرفشاری خون، 70 درصد و میانگین عملکرد خدمات دریافت شده به آنان نیز 59 درصد گزارش شد. در مجموع، کیفیت مراقبتهای ارایه شده به افراد دارای پرفشاری خون، پایین بود.نتیجهگیری: بین انتظارات و توقعات بیماران مبتلا به پرفشاری خون از خدمات و ادراک آنها از خدمات دریافت شده (عملکرد)، فاصله زیادی وجود دارد. تمام ابعاد کیفیت نشان میدهد که ارتقای کیفیت در همه ابعاد لازم و ضروری میباشد. نتایج به دست آمده میتواند به منظور بهبود کیفیت ارایه خدمات، در سیاستگذاریهای سلامت مفید باشد.
کلیدواژهها
عنوان مقاله [English]
An Investigation into the Quality of the Healthcare Services to the Patients with Hypertension in Pakdasht, Iran
نویسندگان [English]
- Mostafa Mohammadi 1
- Abaset Mirzaei 2
1 MSc, Health Services Management, Department of Health Services Management, South Tehran Branch, Islamic Azad University, Tehran, Iran
2 Assistant Professor, Health Economics Policy Research Center AND Health Services Management, Department of Health Services Management, School of Health, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
چکیده [English]
Introduction: One of the main functions of the health system is to provide quality services. Customer satisfaction is at the heart of any organization, and is the ultimate goal of any organizational strategy. Patient satisfaction is a concept that has become very important in medical care today, and plays an important role in the health care process. Measuring the quality of services is a basic precondition for improving quality. The aim of this study was to evaluate the quality of services, using the analysis of the importance of performance in comprehensive health service centers.Methods: This study was a descriptive survey, and its statistical population included all people with hypertension under the auspices of Pakdasht Comprehensive Health Service Centers (under the auspices of Shahid Beheshti University of Medical Sciences), Tehran, Iran. 320 people aged 30 years and older with hypertension were selected using classical systematic two-stage cluster sampling method. To compare the difference between mean performance and importance, t-test with a significance level of 95% was used.Results: There was a significant difference between importance and performance in all dimensions. (P < 0.050). Dimensions of respect (2.89%), continuation of service (2.68%), access and trust (2.57%), importance and proportions of authority (2.72%), access and trust (2.33%), and safety and prevention (2.19%) had the highest level of performance. The average importance of the requested services to people with hypertension was 70%, and the average performance of the received services was 59%. Overall, the quality of care provided to people with hypertension was low.Conclusion: It seems that there is a large gap between the expectations of patients with hypertension from services and their perceptions of services received (i.e., performance). All dimensions of quality show that quality improvement in all dimensions is necessary. The results of this study can be useful in health policies to promote the quality of service delivery.
کلیدواژهها [English]
- Blood Pressure
- Patients
- Quality of Health Care
- Iran
- Kousha A, Najmi M, Mahdavi-Hazaveh AR, Moghisi AR, Ganbari-Motlag A, Yarahmadi S, et al. Essential non-communicable diseases interventions in primary health care system (IAPS). Tehran, Iran: Mojasameh Publications; 2017. [In Persian].
- Tabrizi Sadegh J, Wilson A, Gholipour K. Comparing technical quality assessment methods for measuring quality of healthcare: Systematic review. Journal of Clinical Research & Governance 2012; 1(1): 3-10. [In Persian].
- Shokohyar S, Kaviani H, Mahmoodi FS. Health quality assessment by applying Fuzzy approach: A case study of a military hospital. Ebnesina 2015; 17(3): 37-45. [In Persian].
- Ghamari Zare A, Anousheh M, Vanaki Z, Hajizadeh E. Quality of nurse's performance and patients' satisfaction in cardiac care units. Zahedan J Res Med Sci 2008; 10(1): 27-36. [In Persian].
- Joolaee S, Hajibabaee F, Jafar Jalal E, Bahrani N. Assessment of Patient Satisfaction from Nursing Care in Hospitals of Iran University of Medical Sciences. Hayat 2011; 17(1): 35-44. [In Persian].
- Nabili A, Bastani F. Evaluate quality of nursing care from the viewpoint of elderly patients under hemodialysis in selected medical education centers of Iran University of Medical Sciences. Iran J Nurs Res 2020; 15(3): 10-21. [In Persian].
- Tabrizi J, Gholipour K, Alipour R, Farahbakhsh M, Asghari-Jafarabadi M, Haghaei M. Service Quality of maternity care from the perspective of pregnant women in Tabriz Health Centers and Health Posts - 2010-2011. Hospital 2014; 12(4): 9-14. [In Persian].
- Tabrizi Sadegh J, Gholipour K, Asghari Jafarabadi M, Farahbakhsh M, Mohammadzedeh M. Customer quality and maternity care in Tabriz urban health centers and health posts. Journal of Clinical Research & Governance 2012; 1(1): 11-5.
- Hashemi F, Avaznejad N, Mehdipour M, Karami Robati F. Evaluation of the quality of hospital services from patients' perspective based on SERVQUAL model in a selected teaching hospital in Kerman: A case study. Journal of Health Based Research 2018; 4(2): 147-57. [In Persian].
- Ameryoun A, Dopeykar N, Nasiri T, Meskarpour Amiri M, GholamiFesharaki M, Karamali M. Assessment the gap between patientsexpectations and the services provided to them in selected hospitals of Tehran in 2012. Journal of Police Medicine 2013; 2(1): 1-10. [In Persian].
- Alidoust S, Tabrizi JS, Mohammadi F, Soumi MH, Asghari Jafarabadi M, Gharibi F. Evaluation of service quality in the care provided to patients with bowel inflammation from the perspective of service recipients. Depiction of Health 2013; 4(4): 6-14. [In Persian].
- Papanikolaou V, Zygiaris S. Service quality perceptions in primary health care centres in Greece. Health Expect 2014; 17(2): 197-207.
- Stenner KL, Courtenay M, Carey N. Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views. Int J Nurs Stud 2011; 48(1): 37-46.
- Kazemnezhad L, Ghasemzade M, Mohebi S. the quality of maternal and child health care services with SERVQUAL model. Journal of Health and Care 2016; 18(2): 111-9. [In Persian].
- Karimi S, Gholipour K, Mottaghi P, Yarmohammadian MH, Shokri A. Assessment of quality of delivered care to patients with rheumatoid arthritis based on a model of comprehensive quality measurement. Health Inf Manage 2015; 12(3): 356-66. [In Persian].
- Sharma JK, Narang R. Quality of healthcare services in rural India: The user perspective. Vikalpa 2011; 36(1): 51-60.
- Miranda JJ, Rosales-Mayor E, Quistberg DA, Paca-Palao A, Gianella C, Perel P, et al. Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: A cross-sectional, active surveillance study. F1000Res 2013; 2: 167.
- Walsh JM, McDonald KM, Shojania KG, Sundaram V, Nayak S, Lewis R, et al. Quality improvement strategies for hypertension management: A systematic review. Med Care 2006; 44(7): 646-57.