Quality Evaluation of Health Services Using the Kano Model in Two Hospitals in Peru.

Public-private partnerships (PPP) represent an alternative model of health management focused on improving the quality of health services, particularly in emerging countries. To date, a systematic method to improve the perceived quality of health services by healthcare users in Peru has not been established. The purpose of this study was to evaluate the quality of health services in two PPP hospitals in Peru using the Kano model. A prospective cross-sectional descriptive observational study was carried out through a health service satisfaction survey using the Kano model methodology, measuring six categories of attributes. A total of 250 users of the health services were surveyed in the two PPP hospitals, located in Lima and Callao, using non-probability convenience sampling. Of the 31 attributes evaluated by the patients, 27 (81%) were classified as having a one-dimensional-type attribute, 3 (10%) were reported as mandatory, and 1 (3%) was considered as inverse. These results suggest that the presence of most of the attributes evaluated was relevant to maintaining the level of user satisfaction and that the absence of these attributes generated dissatisfaction in the users. The results showed that the users' evaluation of health services was multidimensional-namely, their evaluation was focused not only on the interaction space between the patient and medical personnel but also addressed other interaction services.

Patient Satisfaction in the Peruvian Health Services: Validation and Application of the HEALTHQUAL Scale.

During recent years, public-private partnerships (PPPs) in the health sector have been an attractive alternative for improving healthcare services in developing countries such as Peru. Therefore, it is fundamental to consider a comprehensive set of healthcare qualities, like the HEALTHQUAL scale, when we measure dimensions of healthcare service quality. Currently, no studies have applied HEALTHQUAL in Peruvian hospitals. The purposes of this study were to (1) validate and evaluate the application of the HEALTHQUAL scale to measure user satisfaction in outpatient services at two PPP hospitals in Peru; and (2) test the relationship between user satisfaction, efficiency, and loyalty. A descriptive, cross-sectional study based on the HEALTHQUAL scale was carried out at the end of 2018. The measurement items were satisfaction with healthcare personnel, satisfaction with nonhealthcare personnel, satisfaction with facilities and equipment, perception of efficiency, and trust. The scale was administered to a nonprobability sample of 250 users who attended one of two PPP hospitals-Barton and Kaelin. The application of partial least squares path modeling significantly impacted on the perceived efficiency in the items of healthcare personnel, nonhealthcare personnel, and facilities and equipment. The HEALTQUAL scale demonstrated sufficient validity and thus can be applied for measuring user satisfaction in PPP hospitals.