The Importance-Performance Analysis (IPA) of the Quality of Services Provided for Patients in Hospitals affiliated to Ahvaz Jundishapur University of Medical Science
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Abstract
Background: Quality is a key factor in the distinction of services, and it is a potential source of sustainable competitive advantage to increase productiveness and patient satisfaction. The identification of strengths and weaknesses in quality of provided services can help to recognize priorities and develop improvement strategies.
Objectives: Using importance-performance analysis (IPA) method, this study aimed to evaluate the quality of services provided in hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, Iran.
Methods: Using stratified random sampling, this descriptive-analytical and cross-sectional study included 307 patients admitted to five Educational Hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences in 2016. Data collection tool was a standard questionnaire proposed by Tomes & Chee Peng Ng (1995), which included demographic information and questions regarding the quality of services provided in seven factors. In addition to IPA, data were analyzed using descriptive statistics, analysis of variance (ANOVA), Pearson’s correlation, and chi squared test in SPSS software version 21.
Results: Total scores of quality factors were estimated as “important” in our research. In quality performance, “food”, “physical environment” and “dignity” factors were estimated as “relatively inappropriate” by mean scores of 2.50 ± 0.95, 2.90 ± 0.97 and 2.94 ± 1.05, respectively. These three factors were located in the second region of the IPA matrix. While the other four factors, including “empathy”, “relationship of mutual respect”, “understanding of illness” and “religious needs,” with mean scores higher than 3 were estimated as “appropriate” and located in the first region of this matrix. In all quality factors, scores of performance were lower than importance, and the gap between importance and performance in these seven factors ranged from 0.82 to 1.52. There was a significant relationship between age and education of respondents with the quality of services.
Conclusions: Given that the largest gap was related to the tangible dimensions of quality (including food and physical environment) and in order to improve the quality of services and competitive position, hospital managers must consider tangible dimension as a priority.
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2-Mohammadi A, Shoghli AR. Survey on Quality of Primary Health Cares in Zanjan District Health Centers. Research Journal of Zanjan University of Medical Sciences 2009; 16(65):59-100.[ Persian]
3-Esteki R, Attafar A. Quality of nursing services (contemporary level of reality and level of expectation) from nurses' viewpoint on the basis of SERVQUAL Model in Al-Zahra Hospital in Isfahan. Modern Care Quartterly Scientific of Birjand Nursing and Mid wifery Faculty 2012; 9 (2): 72-79. [Persian]
4- Sharifirad Gh.R, Shamsi M, Pirzadeh A, Daneshvar Farzanega P, Quality gap in primary health care services in Esfahan women's perspective. Health system Research Journal 2011; 6 (1):95-105.[ Persian]
5-Sabahi bidgoli M,mosavi ghA , Kebriyayi A,sayadi H,shahri S, atharizadeh M. Assessing the Quality of Services Provided For bedridden Patients in Educational Hospitals affiliated with kashan University of Medical Science. Research Journal of fayz 2012;15(2):146-152.[ Persian]
6-Bahadori Mk,Zaboli R, ghanbari A.Assessing the Quality of Services Provided branch of the armed forces from the perspective of veterans in medical services hamedan. Iranian Journal of War and Public Health 2013;6(21) :45-50.[ Persian]
7-Gholami A, Noori A, Khojastepoor M, Asgari M, Sajadi H. Gaps in the quality of primary health care services provided by health centers ‐ Care Nishabur city. Scientific Journal of Shahed University 2011;18 (92) :1‐11. [Persian]
8-Ebrahimnia M, Ameriyoon A, Azizabadi Farahani M, Khoddami Vishte H. Satisfaction rate of hospitalized patients in military hospitals from presented services. Iranian Journal of Military Medicine2010;12(2):101-105.[ Persian]
9- Ko HH, Zhang H, Telford JJ, Enns R. Factors influencing patient satisfaction when undergoing endoscopic procedures. Gastrointest Endosc. 2009;69(4):883-91
10-Agha mollaei T, Zare SH, Pudat A, Kebriaei A. Expectations and Perception recipients perceived quality of primary health care services in health centers Bndrabas. Journal Medical of Hormozgan 2007; 11(3): 173-9.[ Persian]
11-Nooshirvani Y, Salarzehi H, Kord B.The study relationship between health service quality dimenations and patients satisfaction and loyalty. Research Journal of Zabol University of Medical Sciences2012;4(4): 62-69.[ Persian]
12-Jena abadi H, Abili Kh, Nastizayi N, Yaghubi N [Between patients' perceptions and expectations of service quality in Zahedan’s centers with SERVQUAL model] payesh Journal 2011;10(4): 449‐457.[ Persian]
13-Arab M, Eskandari z, Rahim A, Pourreza A, Dargahi H .Reasons for patient's readmission in Tehran University of Medical Sciences . Hospital Journal 2010;12(34):43-55.[ Persian]
14-Zarei A, Arab M, Froushani AR, Rashidian A, Ghazi Tabatabaei SM. Service quality of private hospitals: the Iranian patients' perspective. BMC Health Serv Res 2012;5(4):66-76.[ Persian]
15-Farzandipour M, Sheikhtaheri A, Sadeqi Jabali M. Rate of Informed Decision-Making for Treatment Refusal in University Hospitals of Kashan, Iran. Health Information Management 2012; 9(5): 654 .[ Persian]
16- Clever SL, Jin L, Levinson W, Meltzer DO. Does doctorpatient communication affect patient satisfaction with hospital care? Results of an analysis with a novel instrumental variable. Health Service Research 2008;43(5):1505-19
17-Esmaeili A, Mobaraki H, Kamali M, Soltani S. Evaluating quality of rehabilitation services using importanceperformance Analysis in selected rehabilitation centers in Tehran. Modern rehabilitation Re search Journal 2014;8(3):45-53.[ Persian]
18- Deng WJ, Pei W.Fuzzy neural based importance-performance analysis for determining critical service attributes.Expert Syst Appl 2009; 36(2): 3774-84.
19- Tomes A, Chee Peng Ng S.Service quality in hospital care: the development of an in-patient questionnaire.International Journal of Health Care Quality Assurance,1995;8 (3):25-33.
20- Zhao SH, Akkadechanunt T, Xue XL. Quality nursing care as perceived by nurses and patients in a Chinese hospital. J Clin Nurs 2009; 18(12): 1722-8.
21- Gebraeily M, Rahmani B, Khodayari R, Golifarhoodi G, Mohammadi A. Assessment of inpatient satisfaction from services quality in medical and educational centers of Uromia University of Medical Science by SERVQUAL model .Quarterly Scientific and Research Journal of Iranian health Information Management Association(IHMA) 2013;7(2):19-24. [Persian]
22- Hooshmand A, Joolaee S. Mehrdad , N. Bahrani , N. Nurses information and their view points about patients rights and practical facilitators in clinics. Journal of HAYAT.2006; 12(4):57-66.[ Persian]
23- DengJuin L, YaHsin L, JarYuan P, IngCheau S, Glen R, MingJen C. Chronic kidney-disease screening service quality: questionnaire survey research evidence from Taichung City. Journal of BMC Health Services Research 2009; 9(1): 239.
24- Hashami M,Mohamadi M,Ghaedi H,Ghafariyan H. patients ' satisfaction level of services provided hospitals in the province of Bushehr. Quarterly medicine south2009; (1): 9-53.
25- Salehnia M, Kazemi M, Ahmadi Jazi S. Effect of Physical Environment of Hospital on its Image: Customer Viewpoints. Hakim Research Journal 2013; 15(4): 321- 329.
26- MontazeralFaraj R, Shafiee M, dehghani A, Modarresi M, ZareV. Examine the Relationship Between Service Quality and Responsiveness of the Hospital and its Relationship with Loyal Patients in Governmental Hospitals of Yazd Took Place in 2016. J Tolooebehdasht .2017; 16(4):96-108. [Persian]
27- Razlansari M,Teimouri B,AlipourShirsavar HR, Taleghani M, AshtarianH. Patients' views on perceived services quality using SERVQUAL Model at educational and medical centers of Kermanshah University of Medical Sciences 2013.Journal of Clinical Research in Paramedical Sciences 2012; 1(3): 74-83 . [Persian]
28- Ameryoun A, Dopeykar N, Nasiri T, Meskarpour- Amiri M, Fesharaki M, Karamali M, Heydari S, Shokri M, Shams L. Assessment the Gap between Patients’ Expectations and the Services Provided to them in Selected Hospitals of Tehran. Journal of Police Medicine 2012;1(2):1-10 .[ Persian]
29- Roger AA,Gordon AN, Kwame AD.Managing healthcare quality in Ghana: a necessity of patient satisfaction. International Journal of Health Care Quality Assurance 2011; 1 (24): 548-63.
30- Javadi M, Yaghoobi M, Raiesi A, Mandegar H, Ayoobian A. A Study of Non-Medical Aspects of Health Services Provided to Patients in Selected Hospitals of Isfahan: Responsiveness. Health Information Management 2011; 8(5): -709717. [Persian]
31- Havasbeigi F, Yasbalaghisharahi B, Mohamadi E2, Mohamadi A. Measuring the Quality of Services Provided For Outpatients In Public Hospitals In Ilam and Kermanshah Cities Based on The SERVQUAL Instrument. Scientific Journal of Ilam University of Medical Sciences 2013;21:207-214.[ Persian]
32- Gorji A, Tabatabaei M ,Akbari A ,Sarkhosh S , Khorasani S. Using the Service Quality Gap's Model (SERVQUAL) in Imam Khomeini Teaching Hospital. Research Journal of Tehran University of Medical Sciences 2012;16(51):7-18.[ Persian]
33- Noorossana R,Rezaei S,Saghaei A, karimzadeh Y, Moradi S. evaluation Quality health care in a hospital emergency department, Based on patients' rights. Journal of Medical Ethics 2013;7(23):162-184.[ Persian]
34- Tabibi SJ, Govhari MR, Shahri S,Aghababa S. Quality of services provided in outpatient clinics at hospitals in Tehran based on SERVQUAL Model. Payavard Salamat 2011; 5:49-56. [Persian]
35- SHakernia I. relationship of the physician – patient, and its role in the satisfaction patients of treatment process. Journal of morality and medical history 2009 ; 2(3):9-16.[ Persian]
36- Jahanpour F, Rasti R. Viewpoints of Nurses and Patients on Paying Respect to the Privacy of Patients in Care. Journal of Mazandaran university medical Science 2013; 24(1): 34-42 .[ Persian]
37- Yildiz S.M. An importance-performance analysis of fitness center service quality: Empirical results from fitness centers in Turkey. African Journal of Business Management 2011; 5(16): 7031-7041.
38- Tzeng, G.-H., & Chang, H.-F. (2011). Applying Importance-Performance Analysis as a Service Quality Measure in Food Service Industry. Journal of Technology Management &Amp; Innovation, 6(3), 106–115. https://doi.org/10.4067/S0718-27242011000300008.
2-Mohammadi A, Shoghli AR. Survey on Quality of Primary Health Cares in Zanjan District Health Centers. Research Journal of Zanjan University of Medical Sciences 2009; 16(65):59-100.[ Persian]
3-Esteki R, Attafar A. Quality of nursing services (contemporary level of reality and level of expectation) from nurses' viewpoint on the basis of SERVQUAL Model in Al-Zahra Hospital in Isfahan. Modern Care Quartterly Scientific of Birjand Nursing and Mid wifery Faculty 2012; 9 (2): 72-79. [Persian]
4- Sharifirad Gh.R, Shamsi M, Pirzadeh A, Daneshvar Farzanega P, Quality gap in primary health care services in Esfahan women's perspective. Health system Research Journal 2011; 6 (1):95-105.[ Persian]
5-Sabahi bidgoli M,mosavi ghA , Kebriyayi A,sayadi H,shahri S, atharizadeh M. Assessing the Quality of Services Provided For bedridden Patients in Educational Hospitals affiliated with kashan University of Medical Science. Research Journal of fayz 2012;15(2):146-152.[ Persian]
6-Bahadori Mk,Zaboli R, ghanbari A.Assessing the Quality of Services Provided branch of the armed forces from the perspective of veterans in medical services hamedan. Iranian Journal of War and Public Health 2013;6(21) :45-50.[ Persian]
7-Gholami A, Noori A, Khojastepoor M, Asgari M, Sajadi H. Gaps in the quality of primary health care services provided by health centers ‐ Care Nishabur city. Scientific Journal of Shahed University 2011;18 (92) :1‐11. [Persian]
8-Ebrahimnia M, Ameriyoon A, Azizabadi Farahani M, Khoddami Vishte H. Satisfaction rate of hospitalized patients in military hospitals from presented services. Iranian Journal of Military Medicine2010;12(2):101-105.[ Persian]
9- Ko HH, Zhang H, Telford JJ, Enns R. Factors influencing patient satisfaction when undergoing endoscopic procedures. Gastrointest Endosc. 2009;69(4):883-91
10-Agha mollaei T, Zare SH, Pudat A, Kebriaei A. Expectations and Perception recipients perceived quality of primary health care services in health centers Bndrabas. Journal Medical of Hormozgan 2007; 11(3): 173-9.[ Persian]
11-Nooshirvani Y, Salarzehi H, Kord B.The study relationship between health service quality dimenations and patients satisfaction and loyalty. Research Journal of Zabol University of Medical Sciences2012;4(4): 62-69.[ Persian]
12-Jena abadi H, Abili Kh, Nastizayi N, Yaghubi N [Between patients' perceptions and expectations of service quality in Zahedan’s centers with SERVQUAL model] payesh Journal 2011;10(4): 449‐457.[ Persian]
13-Arab M, Eskandari z, Rahim A, Pourreza A, Dargahi H .Reasons for patient's readmission in Tehran University of Medical Sciences . Hospital Journal 2010;12(34):43-55.[ Persian]
14-Zarei A, Arab M, Froushani AR, Rashidian A, Ghazi Tabatabaei SM. Service quality of private hospitals: the Iranian patients' perspective. BMC Health Serv Res 2012;5(4):66-76.[ Persian]
15-Farzandipour M, Sheikhtaheri A, Sadeqi Jabali M. Rate of Informed Decision-Making for Treatment Refusal in University Hospitals of Kashan, Iran. Health Information Management 2012; 9(5): 654 .[ Persian]
16- Clever SL, Jin L, Levinson W, Meltzer DO. Does doctorpatient communication affect patient satisfaction with hospital care? Results of an analysis with a novel instrumental variable. Health Service Research 2008;43(5):1505-19
17-Esmaeili A, Mobaraki H, Kamali M, Soltani S. Evaluating quality of rehabilitation services using importanceperformance Analysis in selected rehabilitation centers in Tehran. Modern rehabilitation Re search Journal 2014;8(3):45-53.[ Persian]
18- Deng WJ, Pei W.Fuzzy neural based importance-performance analysis for determining critical service attributes.Expert Syst Appl 2009; 36(2): 3774-84.
19- Tomes A, Chee Peng Ng S.Service quality in hospital care: the development of an in-patient questionnaire.International Journal of Health Care Quality Assurance,1995;8 (3):25-33.
20- Zhao SH, Akkadechanunt T, Xue XL. Quality nursing care as perceived by nurses and patients in a Chinese hospital. J Clin Nurs 2009; 18(12): 1722-8.
21- Gebraeily M, Rahmani B, Khodayari R, Golifarhoodi G, Mohammadi A. Assessment of inpatient satisfaction from services quality in medical and educational centers of Uromia University of Medical Science by SERVQUAL model .Quarterly Scientific and Research Journal of Iranian health Information Management Association(IHMA) 2013;7(2):19-24. [Persian]
22- Hooshmand A, Joolaee S. Mehrdad , N. Bahrani , N. Nurses information and their view points about patients rights and practical facilitators in clinics. Journal of HAYAT.2006; 12(4):57-66.[ Persian]
23- DengJuin L, YaHsin L, JarYuan P, IngCheau S, Glen R, MingJen C. Chronic kidney-disease screening service quality: questionnaire survey research evidence from Taichung City. Journal of BMC Health Services Research 2009; 9(1): 239.
24- Hashami M,Mohamadi M,Ghaedi H,Ghafariyan H. patients ' satisfaction level of services provided hospitals in the province of Bushehr. Quarterly medicine south2009; (1): 9-53.
25- Salehnia M, Kazemi M, Ahmadi Jazi S. Effect of Physical Environment of Hospital on its Image: Customer Viewpoints. Hakim Research Journal 2013; 15(4): 321- 329.
26- MontazeralFaraj R, Shafiee M, dehghani A, Modarresi M, ZareV. Examine the Relationship Between Service Quality and Responsiveness of the Hospital and its Relationship with Loyal Patients in Governmental Hospitals of Yazd Took Place in 2016. J Tolooebehdasht .2017; 16(4):96-108. [Persian]
27- Razlansari M,Teimouri B,AlipourShirsavar HR, Taleghani M, AshtarianH. Patients' views on perceived services quality using SERVQUAL Model at educational and medical centers of Kermanshah University of Medical Sciences 2013.Journal of Clinical Research in Paramedical Sciences 2012; 1(3): 74-83 . [Persian]
28- Ameryoun A, Dopeykar N, Nasiri T, Meskarpour- Amiri M, Fesharaki M, Karamali M, Heydari S, Shokri M, Shams L. Assessment the Gap between Patients’ Expectations and the Services Provided to them in Selected Hospitals of Tehran. Journal of Police Medicine 2012;1(2):1-10 .[ Persian]
29- Roger AA,Gordon AN, Kwame AD.Managing healthcare quality in Ghana: a necessity of patient satisfaction. International Journal of Health Care Quality Assurance 2011; 1 (24): 548-63.
30- Javadi M, Yaghoobi M, Raiesi A, Mandegar H, Ayoobian A. A Study of Non-Medical Aspects of Health Services Provided to Patients in Selected Hospitals of Isfahan: Responsiveness. Health Information Management 2011; 8(5): -709717. [Persian]
31- Havasbeigi F, Yasbalaghisharahi B, Mohamadi E2, Mohamadi A. Measuring the Quality of Services Provided For Outpatients In Public Hospitals In Ilam and Kermanshah Cities Based on The SERVQUAL Instrument. Scientific Journal of Ilam University of Medical Sciences 2013;21:207-214.[ Persian]
32- Gorji A, Tabatabaei M ,Akbari A ,Sarkhosh S , Khorasani S. Using the Service Quality Gap's Model (SERVQUAL) in Imam Khomeini Teaching Hospital. Research Journal of Tehran University of Medical Sciences 2012;16(51):7-18.[ Persian]
33- Noorossana R,Rezaei S,Saghaei A, karimzadeh Y, Moradi S. evaluation Quality health care in a hospital emergency department, Based on patients' rights. Journal of Medical Ethics 2013;7(23):162-184.[ Persian]
34- Tabibi SJ, Govhari MR, Shahri S,Aghababa S. Quality of services provided in outpatient clinics at hospitals in Tehran based on SERVQUAL Model. Payavard Salamat 2011; 5:49-56. [Persian]
35- SHakernia I. relationship of the physician – patient, and its role in the satisfaction patients of treatment process. Journal of morality and medical history 2009 ; 2(3):9-16.[ Persian]
36- Jahanpour F, Rasti R. Viewpoints of Nurses and Patients on Paying Respect to the Privacy of Patients in Care. Journal of Mazandaran university medical Science 2013; 24(1): 34-42 .[ Persian]
37- Yildiz S.M. An importance-performance analysis of fitness center service quality: Empirical results from fitness centers in Turkey. African Journal of Business Management 2011; 5(16): 7031-7041.
38- Tzeng, G.-H., & Chang, H.-F. (2011). Applying Importance-Performance Analysis as a Service Quality Measure in Food Service Industry. Journal of Technology Management &Amp; Innovation, 6(3), 106–115. https://doi.org/10.4067/S0718-27242011000300008.
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| Issue | Vol 5, No 1 (2021) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v5i1.7377 | |
| Keywords | ||
| Quality of services Importance- Performance Analysis Hospital Hospital Services | ||
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How to Cite
1.
Ghorbani Z, Faraji-khiavi F, Jahanbani E, Dindamal B. The Importance-Performance Analysis (IPA) of the Quality of Services Provided for Patients in Hospitals affiliated to Ahvaz Jundishapur University of Medical Science. Health Tech Ass Act. 2021;5(1).
