Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
PHD candidate of health management, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Ethiop J Health Sci. 2022 Mar;32(2):453-462. doi: 10.4314/ejhs.v32i2.26.
Primary healthcare (PHC) plays an important role in achieving universal health coverage (UHC). The SERVQUAL instrument is the tool for evaluating the quality of services in the health sector. The main purpose of this study is to evaluate the quality of services provided in PHC in Iran using the SERVQUAL instrument.
We searched eight databases from January 2000 to September 2021. We analyzed the mean of various SERVQUAL instrument items using the DerSimonian-Laird approach via a random model with 95% confidence interval. Also, we used I2 to evaluate the heterogeneity of the studies.
Finally, 17 studies were chosen for analysis in the present study. There were 8,767 study participants, out of which 8,237 were female and 530 were male. The mean dimensions of perception were as follows: Tangibles = 3.71, reliability = 4, responsiveness = 3.79, assurance = 3.83, and empathy = 3.86. For the expectation, the mean dimension were: Tangibles = 4.46, reliability = 4.46, responsiveness = 4.36, assurance = 4.36, and empathy = 4.36 respectively. The total gap quality between perception and expectation was -0.53.
All dimensions of quality based on SERVQUAL were negative, and the quality of service in PHC is not satisfactory. Therefore, policymakers must adopt serious and effective programs to improve services in this area. We also recommend that quality management of services in PHC in Iran should move toward comprehensive optimization in all areas, and quality in this area should be a priority.
初级医疗保健（PHC）在实现全民健康覆盖（UHC）方面发挥着重要作用。SERVQUAL 工具是评估卫生部门服务质量的工具。本研究的主要目的是使用 SERVQUAL 工具评估伊朗提供的 PHC 服务质量。
我们从 2000 年 1 月至 2021 年 9 月搜索了 8 个数据库。我们使用随机模型通过 DerSimonian-Laird 方法分析了各种 SERVQUAL 工具项目的平均值，置信区间为 95%。此外，我们还使用 I2 来评估研究的异质性。
最终，本研究选择了 17 项研究进行分析。共有 8767 名研究参与者，其中 8237 名女性，530 名男性。感知的平均维度如下：有形性=3.71，可靠性=4，响应性=3.79，保证性=3.83，同理=3.86。对于期望，平均维度分别为：有形性=4.46，可靠性=4.46，响应性=4.36，保证性=4.36，同理=4.36。感知与期望之间的总质量差距为-0.53。
基于 SERVQUAL 的所有质量维度均为负值，PHC 的服务质量不令人满意。因此，政策制定者必须采取认真有效的计划来改善该领域的服务。我们还建议伊朗初级医疗保健服务的质量管理应朝着所有领域的全面优化方向发展，该领域的质量应成为优先事项。
