Quality of Primary Health Service Provision from the Perspective of Visitors to the Health Centers in the City of Esfarayen

Authors
Fatemeh Soltani
Ahmad Sadeghi
Marzieh Mahmoudimanesh
Razieh Pirouzeh
Nasim Pirzadeh
10.61186/ibj.25th-11th-IACRTIMSS
Abstract
Introduction: The World Health Organization has identified the enhancement of healthcare service quality as one of the 10 global goal objectives in its "Health for All" policy. Improving service quality not only reduces costs and increases productivity for healthcare providers but also enhances access to services for patients. This research was conducted to assess the quality of primary health services from the perspective of individuals seeking care at the health centers in the city of Esfarayen.

Methods and Materials: The current descriptive-analytical study was conducted cross-sectionally with 332 participants aged 15 to 65 years who were referred to nine health centers in Esfarayen City, North Khorasan Province, Iran. In this study, non-random sampling was employed based on the population served by each center. The data collection tool consisted of a two-part demographic information questionnaire and the standard SERVQUAL questionnaire, which was psychometrically evaluated before. Following data collection, the information was analyzed using descriptive and analytical statistics tests, including mean and standard deviation, frequency and percentage of frequency, independent t-test, and ANOVA, utilizing SPSS version 22 software.

Results: Most of the participants were women (262; 78.9%) aged between 30 and 40 years (119; 35.8%), with university education (114; 34.3%) and the majority were housewives (196; 59%). The service recipients rated the overall service quality and the scores of all dimensions measured in the SERVQUAL questionnaire as favorable, achieving an average score of 81.97 out of 100. The most favorable and unfavorable quality dimensions were reassurance (21.25 ± 3.04) and empathy (11.25 ± 2.45), respectively. A significant relationship was found between individual’s occupations and their total quality score evaluations (p = 0.05). Also, a significant relationship existed between the confidence dimension with job variables (p = 0.009), as well as monthly income (p = 0.010). However, no significant relationship was observed between the response dimension and demographic variables such as gender (p = 0.48), occupation (p = 0.02), and monthly income (p = 0.014).

Conclusion and Discussion: Our study reveals that the average score for service quality across all five dimensions—reliability, reassurance, empathy, responsiveness, and tangible factors—in the health centers of Esfarayen is favorable. While some dimensions received higher scores than others, the differences between the scores are minimal and closely aligned. This issue suggests that all dimensions hold nearly equal importance and should carefully be considered in health planning.



Keywords
Health services
Iran
Reloiability