Kazemi-Karyani Ali, Ramezani-Doroh Vajiheh, Khosravi Farid, Miankali Zhila Seyedi, Soltani Shahin, Soofi Moslem, Khoramrooz Maryam, Matin Behzad Karami
Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Cost Eff Resour Alloc. 2021 Oct 9;19(1):65. doi: 10.1186/s12962-021-00319-y.
Knowing about accurate customer expectations is the most important step in defining and delivering high-quality services. This study aimed to evaluate the preferences of patients referring to two hospitals in Kermanshah, Iran.
Discrete choice experiment (DCE) method used to elicit preferences of 328 patients who were admitted in two hospitals of Kermanshah city in the west of Iran. Literature review and experts opinion were used to identify a candidate list of attributes related to the quality of cares in hospitals. The final study attributes were quality of physician care, quality of nursing care, waiting time for admission, cleaning of wards and toilets, and behavior of staff. Experimental design applied to extract choice sets of hospitals. The data was analyzed by a conditional logit regression.
The regression results showed the most important predictors of hospital selection by respondents was the good quality of physician care (aOR: 3.18, 95% CI 2.61, 3.87), followed by friendly behavior of staffs (aOR: 2.03, 95% CI 1.81, 2.27), cleanness of wards and toilet (aOR: 1.61, 95% CI 1.40, 1.85), and finally quality of nursing cares (aOR: 1.13, 95% CI 0.89, 1.44). However, increasing waiting time made disutility in the study participants (aOR: 0.69, 95% CI 0.60, 0.80).
Our study finding emphasized some potential opportunity of quality augmentation in hospital sector by paying attention to different quality attributes including quality of physician, friendly behavior of staffs, cleanness of hospital environment and finally quality of nursing cares. Considering patients preferences in decision making process could lead to substantial satisfaction improvement.
了解准确的客户期望是定义和提供高质量服务的最重要步骤。本研究旨在评估伊朗克尔曼沙赫两家医院患者的偏好。
采用离散选择实验（DCE）方法，对伊朗西部克尔曼沙赫市两家医院收治的328名患者的偏好进行调查。通过文献综述和专家意见，确定与医院护理质量相关的属性候选清单。最终的研究属性包括医生护理质量、护理质量、入院等待时间、病房和厕所清洁情况以及工作人员行为。应用实验设计提取医院的选择集。数据采用条件logit回归进行分析。
回归结果显示，受访者选择医院的最重要预测因素是医生护理质量好（调整后比值比：3.18，95%置信区间2.61，3.87），其次是工作人员友好行为（调整后比值比：2.03，95%置信区间1.81，2.27）、病房和厕所清洁度（调整后比值比：1.61，95%置信区间1.40，1.85），最后是护理质量（调整后比值比：1.13，95%置信区间0.89，1.44）。然而，等待时间的增加会给研究参与者带来负效用（调整后比值比：0.69，95%置信区间0.60，0.80）。
我们的研究结果强调，通过关注不同的质量属性，包括医生质量、工作人员友好行为、医院环境清洁度以及最后护理质量，医院部门在质量提升方面存在一些潜在机会。在决策过程中考虑患者偏好可以显著提高满意度。
