Service quality of private hospitals: the Iranian patients' perspective.

BACKGROUND: Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. METHODS: A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. RESULTS: The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p < 0.001). There was a significant difference between the expectations scores based on gender, education level, and previous hospitalization in that same hospital. Also, there was a significant difference between the perception scores based on insurance coverage, average length of stay, and patients' health conditions on discharge. CONCLUSION: The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.

A comparative study of the effects of temperature, time and factor VIII assay type on factor VIII activity in cryoprecipitate in Iran.

BACKGROUND: In Iran, cryoprecipitate is an important plasma product to provide coagulation factors such as factor VIII (FVIII) in patients with factor VIII deficiency. FVIII is one of the labile coagulation factors and as such is also used as a quality marker of fresh-frozen plasma and cryoprecipitate. It is, therefore, important to optimise plasma production in order to prevent a reduction of FVIII activity. In this study we assessed the effect of temperature, time and FVIII assay type on FVIII activity in cryoprecipitate produced in Iran. METHODS: Ninety-six whole blood units were kept at two different temperatures (48 units kept at 1-6 °C and 48 kept at 20-24 °C) for periods of 4, 6, 8 or 10 hours before plasma freezing. FVIII activity was then measured by both chromogenic and one-stage clotting assays. RESULTS: At both temperatures, FVIII activity in plasma prepared after 8 and 10 hours was lower than that in plasma prepared after 4 and 6 hours. A significant decrease of FVIII activity was not seen in samples kept for 4 and 6 hours. Compared to storage between 1-6 °C, storage at 20-24 °C appears to cause a reduction in FVIII activity. There was a significant difference in apparent FVIII activity measured by the one-stage clot-based and chromogenic assays. CONCLUSION: In Iran, to improve cryoprecipitate quality, freezing should begin within 6 hours after donation and whole blood should be kept at 1-6 °C until the plasma can be frozen. In this study although a good correlation was seen between the results of the one-stage clot-based and chromogenic assays for measuring FVIII activity in cryoprecipitate, the absolute values were significantly different.