Teshnizi Saeed Hosseini, Aghamolaei Teamur, Kahnouji Kobra, Teshnizi Seyyed Mehrdad Hosseini, Ghani Jalil
Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran.
Social Determinants for Health Promotion Research Center, Hormozgan, University of Medical Sciences, Bandar Abbas, Iran.
Int J Qual Health Care. 2018 Mar 1;30(2):82-89. doi: 10.1093/intqhc/mzx200.
The five-dimension service quality (SERVQUAL) scale is one of the most common tools for evaluating gaps between clients' perceptions and expectations. This study aimed to assess the quality of health services in Iran through a meta-analysis of all Iranian studies which used the SERVQUAL tool.
A systematic literature review has been performed in Web of Science, PubMed, Scopus, Google Scholar, Iran Medex, Magiran and Scientific Information Database.
All relevant English or Persian studies published between January 2009 and April 2016 were have been selected. Papers were considered if they regarded all five dimensions of the SERVQUAL tool for assessing the quality of health care services.
Two reviewer independently extracted mean and standard deviation of five dimensions and characteristics of studies. The quality of studies included in meta-analysis using STROBE checklist.
Of 315 studies initially identified, 12 were included in our meta-analysis. All analyses were performed in Stata MP v. 14. Patients' perceptions were lower than their expectations (gap = -1.64). Responsibility (-1.22) and reliability (-1.15) had the lowest gaps, and tangibility and empathy (-1.03) had the largest gaps. Except gender, other variables had no significant associations with gaps. Patients in the cities of Arak (-3.47) and Shiraz (-3.02) had the largest gaps.
All dimensions of service quality were negative, which implies that the quality of health services in Iran has not been satisfying to patients and needs to be improved.
五维度服务质量（SERVQUAL）量表是评估客户感知与期望之间差距最常用的工具之一。本研究旨在通过对所有使用SERVQUAL工具的伊朗研究进行荟萃分析，评估伊朗的卫生服务质量。
在科学网、PubMed、Scopus、谷歌学术、伊朗医学数据库、Magiran和科学信息数据库中进行了系统的文献综述。
选取了2009年1月至2016年4月期间发表的所有相关英文或波斯文研究。如果论文涉及SERVQUAL工具评估医疗服务质量的所有五个维度，则予以考虑。
两名评审员独立提取五个维度的均值和标准差以及研究特征。使用STROBE清单对纳入荟萃分析的研究质量进行评估。
在最初识别的315项研究中，12项纳入了我们的荟萃分析。所有分析均在Stata MP v. 14中进行。患者的感知低于他们的期望（差距=-1.64）。责任维度（-1.22）和可靠性维度（-1.15）的差距最小，有形性和移情性维度（-1.03）的差距最大。除性别外，其他变量与差距无显著关联。阿拉克市（-3.47）和设拉子市（-3.02）的患者差距最大。
服务质量的所有维度均为负数，这意味着伊朗的卫生服务质量未能令患者满意，需要加以改善。
