Evaluating Primary Healthcare Quality from Migrants and Refugees' Viewpoint.

Background: The likelihood of poor health outcomes for refugees is increased due to a variety of complicated causes. Lack of access to high-quality care during resettlement is frequently cited by migrants. Therefore, this study was carried out to assess the quality of primary care services from the perspective of refugees and migrants. Methods: This cross-sectional study was conducted in three health networks affiliated with Iran University of Medical Sciences in 2021. Data were collected by using a self-administrative questionnaire, the validity and reliability of which were checked and confirmed. The questionnaires were randomly completed by 280 migrants and refugees. Data were analyzed by using Kruskal-Wallis, Mann-Whitney U, Spearman correlation, exploratory factor analysis, and Cronbach's α with SPSS 22. Results: According to the results, the overall service quality was 3.86 out of 5. The highest and lowest mean scores were related to efficiency (4.12 ±0.64) and tangibility (3.28 ±0.39). Furthermore, there was a significant relationship between the perception of service quality and gender, education, residence area, and the rate of center visits (P < 0.05). Conclusion: The quality of services was generally rated favorably by the refugees. Managers and decision-makers are recommended to allocate enough funds to equip and upgrade the amenities at health centers to increase the quality of services.

Development and validation of primary health care quality assessment tool.

BACKGROUND: Assessing the quality of health services gives insights to managers about the status of services delivered by them, especially from the client's perspective. Although various tools have been developed to measure the quality of primary health care (PHC), no specific tool was found in this field in Iran. Therefore, the present study was conducted to develop and validate the quality assessment tool of PHC in Iran. METHODS: This methodological study was conducted in 2021. In the first step, based on a literature review, an initial questionnaire was designed, and its face validity, content validity, construct validity, and reliability were evaluated. Descriptive tests, Kolmogorov-Smirnov, exploratory factor analysis, Kaiser-Myer-Olkin (KMO), and Cronbach's alpha were performed by using SPSS 22. RESULTS: The initial questionnaire included 33 items, of which three items were removed due to inconsistency with factorization. The final questionnaire consisted of 30 items and nine dimensions: interaction, efficiency, timeliness, accuracy, consultation, tangibility, safety, accessibility, and environment. The KMO and Cronbach's alpha index values were 0.734 and 0.82, respectively, indicating acceptable reliability and validity. The developed dimensions represented about 73% of the total variance. CONCLUSION: The designed questionnaire has relatively good validity and reliability and can be used to measure the quality of PHC and to identify weaknesses in service delivery. However, researchers should carefully examine it to enhance its applicability as a standard tool for measuring PHC quality.

Assessing the quality of hospital outpatient services in Iran: a systematic review and meta-analysis.

BACKGROUND: Quality healthcare services are considered one of the most effective vehicles for healthcare managers to achieve organizational goals. Therefore, this study aimed to combine the findings of comparable studies to identify consistencies and contradictions in the quality of outpatient services in Iran. METHODS: The current systematic review and meta-analysis study was conducted in 2022 according to PRISMA guideline. All relevant English and Persian studies were searched in databases, including Web of Sciences, PubMed, Scopus, Scientific Information Database, and Magiran. No year restriction was applied. The quality of the studies was assessed by the 22-item Strengthening the Reporting of Observational Studies in Epidemiology checklist. The meta-analysis was conducted by using Open Meta Analyst, and between-study heterogeneity was investigated with I-squared statistic. RESULTS: Of the 106 retrieved articles, seven studies with a total sample size of 2600 were included in the meta-analysis. The pooled estimate of mean for overall perception was 3.95 (95% CI: 3.34- 4.55, P< 0.001, I2= 99.97), while the pooled estimate of the mean for the overall expectation was 4.43 (95% CI: 4.11- 4.75, P< 0.001, I2= 99.93). The highest and lowest perception mean scores were related to tangibility (3.52, Gap= -0.86) and responsiveness (3.30, Gap= -1.04) dimensions. CONCLUSION: Responsiveness was identified as the weakest dimension. Therefore, managers are recommended to design suitable workforce-development programs which focus on the provision of timely and prompt services, polite and courteous interactions with patients, and prioritization of patients' needs. Moreover, training public sector practitioners along with incentives can fill up the existing gaps.

Evaluation of service quality from patients' viewpoint.

BACKGROUND: Measuring patients' perception from health service quality as an important element in the assessment of service quality has attracted much attention in recent years. Therefore, this study was conducted to find out how the patients evaluated service quality of clinics at teaching hospitals affiliated with Tehran University of Medical Sciences in Iran. METHODS: This cross-sectional study was conducted in Tehran in 2017 and 400 patients were randomly selected from four hospitals. Data were collected using a questionnaire, the validity and reliability of which were confirmed in previous study. In order to analyze the data, T-test, ANOVA, and Pearson correlation coefficient were calculated using SPSS 23. RESULTS: The results indicated that among eight dimensions of health service quality, the patients were more satisfied with physician consultation, services costs and admission process. The highest and lowest mean scores were related to physician consultation (Mean = 4.17), and waiting time (Mean = 2.64), in that order. The total mean score of service quality was 3.73 (± 0.51) out of 5. Outpatient services were assessed as good, moderate and weak by 57.5, 40 and 2.5% of the patients, respectively. There was a significant relationship between the positive perception of service quality and reason for admission, source of recommendation, gender, education level, health status, and waiting time in the clinics (p <  0.05). CONCLUSION: The majority of the patients had a positive experience with visiting clinics and perceived service provision as good. In fact, patients' perceptions of physician consultation, provision of information to patients and the environment of delivering services, are the most important determinants of service quality in clinics.