Service Quality in Iranian Hospitals From Patients' Perspectives Based on the SERVQUAL Model: A Systematic Review and Meta-Analysis

Overview

Journal Health Sci Rep

Date 2025 Jan 23

PMID 39846046

Authors

Tara Alizadeh

Marzieh Jahani Sayad Noveiry

Samad Karkhah

Ehsan Kazemnezhad Leyli

Kobra Salami Kohan

Pooyan Ghorbani Vajargah

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to evaluate the service quality in Iranian hospitals from patients' perspectives based on the SERVQUAL model.

Materials And Methods: A thorough exploration of online electronic databases, including Scopus, PubMed, Web of Science, IranMedex, and the Scientific Information Database (SID), was undertaken using keywords extracted from Medical Subject Headings such as "Quality of Health Care," "Hospital," and "Patients" spanning from the earliest available records up to August 11, 2023.

Results: In the context of 25 cross-sectional studies encompassing a collective participant pool of 8021 hospitalized patients in Iranian medical facilities, an assessment of patients' perspectives on the quality of hospital services revealed a mean perception score of 3.54 (SE = 0.08). Concurrently, the mean expectation score for the quality of services was determined to be 4.43 (SE = 0.06). Using the SERVQUAL model, the overall disparity between patients' perceptions and expectations was calculated as -0.89. Subsequent examination of specific dimensions within the SERVQUAL framework revealed gaps between patients' perceptions and expectations in the tangibility dimension (-0.84), reliability dimension (-0.94), responsiveness dimension (-0.91), assurance dimension (-0.89), and empathy dimension (-0.82).

Conclusion: Therefore, healthcare administrators consider the study's findings as a motivating force to initiate measures aimed at improving service quality in Iranian hospitals. Tackling the recognized shortcomings and areas requiring enhancement holds the promise of raising patient satisfaction levels and, consequently, improving overall healthcare outcomes.

References

Donabedian A . Evaluating the quality of medical care. 1966. Milbank Q. 2005; 83(4):691-729. PMC: 2690293. DOI: 10.1111/j.1468-0009.2005.00397.x. View

Butt M, de Run E . Private healthcare quality: applying a SERVQUAL model. Int J Health Care Qual Assur. 2010; 23(7):658-73. DOI: 10.1108/09526861011071580. View

Rezaei S, Karami Matin B, Moradi K, Bijan B, Fallahi M, Shokati B . Measurement of Quality of Educational Hospital Services by the SERVQUAL Model: The Iranian Patients' Perspective. Electron Physician. 2016; 8(3):2101-6. PMC: 4844475. DOI: 10.19082/2101. View

Andaleeb S . Service quality perceptions and patient satisfaction: a study of hospitals in a developing country. Soc Sci Med. 2001; 52(9):1359-70. DOI: 10.1016/s0277-9536(00)00235-5. View

Qolipour M, Torabipour A, Khiavi F, Malehi A . Assessing Medical Tourism Services Quality Using SERVQUAL Model: A Patient's Perspective. Iran J Public Health. 2018; 47(1):103-110. PMC: 5756584. View

Jonkisz A, Karniej P, Krasowska D . SERVQUAL Method as an "Old New" Tool for Improving the Quality of Medical Services: A Literature Review. Int J Environ Res Public Health. 2021; 18(20). PMC: 8535625. DOI: 10.3390/ijerph182010758. View

Nadi A, Shojaee J, Abedi G, Siamian H, Abedini E, Rostami F . Patients' Expectations and Perceptions of Service Quality in the Selected Hospitals. Med Arch. 2016; 70(2):135-9. PMC: 4851526. DOI: 10.5455/medarh.2016.70.135-139. View

Nekoei-Moghadam M, Amiresmaili M . Hospital services quality assessment: hospitals of Kerman University of Medical Sciences, as a tangible example of a developing country. Int J Health Care Qual Assur. 2011; 24(1):57-66. DOI: 10.1108/09526861111098247. View

Downes M, Brennan M, Williams H, Dean R . Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016; 6(12):e011458. PMC: 5168618. DOI: 10.1136/bmjopen-2016-011458. View

10.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Int J Surg. 2021; 88:105906. DOI: 10.1016/j.ijsu.2021.105906. View

11.

Mohammadi-Sardo M, Salehi S . Emergency Department Patient Satisfaction Assessment using Modified Servqual Model; a Cross-sectional Study. Adv J Emerg Med. 2019; 3(1):e3. PMC: 6548076. DOI: 10.22114/AJEM.v0i0.107. View

12.

Ahmad E, Itrat M . Patient Satisfaction With Medical Services Provided at Unani Medicine Hospital, Bengaluru: A Cross-Sectional Study. J Patient Exp. 2021; 7(6):1432-1437. PMC: 7786698. DOI: 10.1177/2374373520969001. View

13.

Rezaei S, Hajizadeh M, Zandian H, Fathi A, Nouri B . Service quality in Iranian hospitals: A systematic review and meta-analysis. Med J Islam Repub Iran. 2018; 32:59. PMC: 6113587. DOI: 10.14196/mjiri.32.59. View

14.

Batbaatar E, Dorjdagva J, Luvsannyam A, Savino M, Amenta P . Determinants of patient satisfaction: a systematic review. Perspect Public Health. 2016; 137(2):89-101. DOI: 10.1177/1757913916634136. View

15.

Teshnizi S, Aghamolaei T, Kahnouji K, Hosseini Teshnizi S, Ghani J . Assessing quality of health services with the SERVQUAL model in Iran. A systematic review and meta-analysis. Int J Qual Health Care. 2018; 30(2):82-89. DOI: 10.1093/intqhc/mzx200. View

16.

Rezaei T, Ghahramanian A, Abdullahzaed F, Sheikhalipour Z, Asghari-Jafarabadi M, Fadaei Z . Service Quality Gaps in the Provision of Care to Surgical Patients: a Cross-Sectional Study in the Northwest of Iran. J Caring Sci. 2018; 7(3):157-162. PMC: 6163155. DOI: 10.15171/jcs.2018.025. View

17.

Aghamolaei T, Eftekhaari T, Rafati S, Kahnouji K, Ahangari S, Shahrzad M . Service quality assessment of a referral hospital in southern Iran with SERVQUAL technique: patients' perspective. BMC Health Serv Res. 2014; 14:322. PMC: 4115484. DOI: 10.1186/1472-6963-14-322. View